NATIONAL HEALTH MAGAZINE JUNE, 1981 $1.25 HOW TO GET A BETTER NIGHT'S SLEEP 'CHILDBIRTH: *JAPANESE STYLE • • • Y -• HELP YOUR PRESCHOOLER TO AVOID DRUG ABUSE MILLIONS OF AMERICANS HAVE HIGH BLOOD **** **** PRESSURE & **** DON'T EVEN KNOW IT YOU may be among the millions of Americans who have high blood pressure—and don't even know it. And that's a shame—because successful treatment of this disease can reduce your chances of having a stroke, heart disease, or kidney disease. Of the estimated 25 to 30 million Americans who have high blood pressure (hypertension), about 29 percent are unaware that they have it. How can you tell if you are one of them? Who are the most likely candidates to be afflicted with this disease? What can you do to prevent it? You'll find the answers to these questions and others in the new special issue of LIFE & HEALTH magazine entitled "Hypertension." Some of the articles included in this issue are "Hypertension: Disease Without Symptoms," "Dentists Join the Fight Against High Blood Pressure," "What You Need to Know About High Blood Pressure," "Children Have High Blood Pressure, Too!" "How Much Salt Is Too Much?" and "Taking the Tension Out of Hypertension." Get the facts straight about high blood pressure. Order your copy of "Hypertension" today. The dollar you spend may help save your life. r Yes, I want to get the facts straight about high blood pressure. Send copy/copies of "Hypertension." I have enclosed In U.S., $1.00 per issue . me Name _ Address City State Zip Mail to: Review and Herald Publishing Association Periodical Dept. 6856 Eastern Ave., NW. Washington, D.C. 20012 Price subject to change without notice. LIFEMIEALTH® NATIONAL HEALTH MAGAZINE JUNE, 1981 Editor JOYCE MC CLINTOCK, M.A. Editorial Secretary CLARA B. BURTNETT Art Director BYRON STEELE BANK Designer ROBERT WRIGHT DEPOSITS ONLY Circulation Manager R. S. SMITH Associate Circulation Manager CHARLES L. FLETCHER ' Marketing/Advertising EDMUND M. PETERSON Advertising Assistant KAREN R. CRADDOCK Consulting Editor LEO VAN DOLSON, Ph.D., M.P.H. Braille Editor RICHARD KAISER Medical Consultant ALBERT S. WHITING, M.D. Dental Health Consultants ELDON E. CARMAN, D.D.S. ELMER KELLN, D.D.S. Special Consultant " RUTH M. WHITE, Dr.P.H. 6 SDA Dietetic Association Nutrition Consultant ALICE G. MARSH, Sc.D., R.D. 97th Year of Publication Volume 96, No. 6 °MOTIVE: LIFE & HEALTH. a family magazine. features significant health information to motivate readers to adopt sound principles of p. healthful living, as well as articles to enhance other facets of the reader's life. MANUSCRIPTS: LIFE & HEALTH gives consideration to unsolicited manuscripts, provided they meet certain requirements. Submissions can be up to seven double-spaced typewritten pages; brevity is encouraged. Articles should be health oriented, properly researched. scientifically documented, and written in an inter, esting style for nonprofessionals. Emphasis is on prevention. Only those articles accompanied by a self-addressed and stamped reply • envelope are returned. CONSUMER SAFETY: An attempt is made to screen those products and services that are felt to be harmful, but the companies who advertise take actual responsibility for their products or services. ADVERTISING: LIFE & HEALTH accepts those advertisements that are compatible with the aims and objectives of the journal. Those wishing to advertise should submit advance data on copy • and product to the Marketing and Advertising Department. BRAILLE: Selections are available in Braille. Write to LIFE & HEALTH, P.O. • Box 6097, Lincoln, Nebraska 68506. CHANGE OF ADDRESS: Please use the change-ofaddress form in the Gazette section of this magazine. SUBSCRIPTION PRICE: U.S. currency: $12.95. one year. Single copy. $1 25 Prices may vary where national currencies differ. Prices subject to change without notice. LIFE & HEALTH (ISSN 0024-3035) is published monthly and copyrighted ©1981 by the • Review and Herald Publishing Association, 6856 Eastern Avenue NW., Washington. D.C. 20012. (202) 723-3700. Second-class postage ▪ paid at Washington, D.C. Vol. 96, No. 6. All rights reserved. Title registered in U.S. Patent Office. The owner is the General Conference of Seventh-day Adventists. ▪ Page 22 Page 24 How to Get a Better Night's Sleep U.S. Public Health Service Childbirth: Japanese Style Karen Michener Warm, sensitive care with technology makes childbirth not a thing of fear, but of joy. A Tribute to Dad Erwin F. Hodde New Hope for Many Cardiac Patients Richard V. Dunning Keep a Healthy Distance From Wild Animals Massachusetts General Hospital GOLDEN YEARS How to Plan for Your Retirement Raymond Schuessler DRUG EDUCATION Help Your Preschooler to Avoid Drug Abuse Kristi Holl EXERCISE The Tortoise vs. the Hare Philosophy Betty Nix Want to exercise, but feel you can't keep up the pace? Often the slow, consistent ones are the winners. TOTAL HEALTH Lifestakes Leo R. Van Dolson, Ph.D., M.P.H. The author gives some good counsel on how to have a longer life. GAZETTE BOOKSHELF Cover Illustration by Jeff Dever 4 7 13 22 24 10 14 16 19 LIFE & HEALTH—JUNE 1981 27 30 3 • , L 86l3N1V-H11V3HV33 11 -17 HOW TO GET A BETTER NIGHT'S SLEEP Knowing the facts about sleep can help you to improve your rest and enhance your health. U.S. Public Health Service oper rest is mandatory for good health. You cannot, however, mandate sleep. The same kind of determination that gets a person to take up exercise and quit smoking is practically useless when you're pursuing those "forty winks." As a rule, the harder you try to fall asleep, the harder it is to nod off. Most age-old cures for sleeplessness, such as a nightcap or strenuous exercise before bed, tend to backfire by waking you up more. Sleeping pills lose their effectiveness when taken nightly over a long period of time, and some medications can even interfere with sleep. Then, too, there's the attending fear that your inability to sleep is a sign that something's wrong with you—a thought that's sure to keep you awake. Occasional sleeplessness is not a cause for alarm, especially when it is linked to some unusual excitement. Many people toss and turn the night before a big event, whether it's a wedding, a job interview, or an appearance in court. A physical ailment or injury also may bring on restless nights because of pain or discomfort. But for too many people, chronic sleeplessness—or insomnia—is a con- Pr JP, This article has been produced under the auspices of Project Sleep: National Program on Insomnia and Sleep Disorders, a physician- and public-education program of the Public Health Service, U.S. Department of Health and Human Services. stant drain on their physical capacities and sense of well-being. In light of estimates that 50 million Americans have trouble sleeping, and some 4 to 6 million take sleeping pills, which can be dangerous to health, the United States Public Health Service has launched Project Sleep to bring the latest information on insomnia and sleep disorders to physicians and the public. The warning is: Be careful about using sleep medications, and find out from your physician how to get at the underlying cause of your problem. Some facts about sleep It helps to know the medical facts about sleep. Most of us have been misled by the old chestnut about needing eight hours or more a night. According to reports released by Project Sleep, which are based on studies conducted by sleep experts, the need for sleep varies from individual to individual. Some people are able to get complete rest on four or five hours each night; others need a regular ten to twelve hours of sleep. Sleep is a very complex activity composed of different states, stages, and cycles. There are two major sleep states: nonrapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. Throughout a normal night's sleep, the two states occur and reoccur in predictable ninety-minute cycles. NREM sleep is divided into four separate stages. Stage one is the threshold stage, the brief juncture between wakefulness and sleep. During the first ten minutes of sleep, the heart slows down, blood pressure drops, and the mind is in reverie. In stage two, sleep becomes deeper. Thoughts sweep freely, and the eyes roll slowly from right to left. In stage three, the mind is pulled into deeper sleep. Heart rate, blood pressure, and body temperature continue to fall, and these diminish even further in stage four. At the end of this cycle the body moves into the next sleep state, REM sleep. During REM sleep, many of the body's activities, including heart rate, body temperature, and blood pressure, function actively, as if the body were awake. In fact, REM sleep gets its name from the rapid darting back and forth of the eyes beneath closed lids that is characteristic of this sleep state. The mind is busy during REM sleep, for 80 percent of all dreams take place in this state. Everyone dreams—and in color. Some people do not recall their dreams, and some, who focus mainly on the dream content, recall their dreams only in black and white. Research has shown that the different states and stages of sleep alter with age. An infant may spend as much as 50 percent of sleeping time in the REM state, while a normal adult's sleep is 20 to 25 percent REM. Children and young adults have considerably more sleep in stages three and four than do elderly people, many of whom seldom or never fall into these last two sleep stages. Each person's own pattern of sleep cycles is regulated by a mechanism within the brain called the "circadian clock." This clock—or 24-hour body rhythm—may be influenced by environment or life style, but for the most part it governs with an iron hand. If you are not sleeping well, you may have fallen out of sync with your circadian cycle. Your sleep needs Sleep experts have devised this rule of thumb: your sleep need is being met if you are not sleepy during the day and are fully alert with a sense of well-being. In other words, the best way to judge your sleep needs is to LIFE HEALTH—JUNE 1981 5 judge the way you feel during your waking hours. You can determine your sleep needs more precisely by experimenting with different lengths of sleeping time. Give each length of time at least a few weeks' trial before changing your bedtime or the time you wake up. If you cut back below the amount of sleep you truly need, you will feel excessively tired during the day. If the sleep length is more than your circadian clock requires, you will lie awake in bed at night. Another good way to get acquainted with your sleep needs is to monitor your sleep for a few weeks. In a journal or notebook, describe each day's activities, including important or stressful occasions. Then write down the number of hours you sleep each night. Note the time that you (1) go to bed, (2) actually fall asleep (estimated time), and (3) wake up. Briefly describe the quality of each night's sleep. This kind of monitoring should provide you with a complete picture of the ways that waking events interact with sleep. You may find that many busy and productive days are followed by nights of deep sleep, and vice versa. When you have to shortchange your normal sleep, you may feel sluggish the next day. If you must work overtime or are faced with extraordinary pressures, you may toss and turn that night, even though you feel exhausted. As you monitor your days and nights, pay special attention to your physical exercise patterns, especially if you play sports regularly. Athletic activity definitely affects sleep and other behavior in a variety of ways. For example, novice joggers and tennis players who begin a weekly regimen often reach a physical plateau after a few weeks: at the same time that they feel more energetic and alert. their eating and sleeping habits change so that they need less food and rest, but they enjoy these more. On the other hand, experienced road runners who begin training for the long-distance marathon usually need more sleep to compensate for the increased exertion. And anyone who engages in unusually rigorous activity—especially late in the day—may have trouble falling asleep that night. 6 LIFE & HEALTH—JUNE 1981 Strenuous exercise just before bedtime definitely is not recommended as conducive to sleep. Of course, the monitoring system does not take several external factors into account—and such factors often are at the root of insomnia. Sleep patterns can be interrupted by any of the following: Drinks containing caffeine, including tea and some light-colored sodas, as well as coffee and cola Heavy meals before bedtime or foods with high sugar content, such as cand) and cookies Going to sleep at irregular times The quality of your sleep is certain to affect the quality of your waking life. The kind of noise stimulation produced by loud television shows and fast music Alcoholic beverages Cigarette smoking Certain prescription drugs, especially diet pills. Very strong evidence exists that these prevent or at least interfere with deep sleep. Even if you can doze all night after drinking a lot of coffee or beer, these substances still will disturb your normal sleep cycles and affect the quality of your rest. Depression can cause insomnia Depression often is associated with persistent insomnia. Symptoms of depression that can correspond with sleep problems include loss of appetite, listlessness, irritability, inability to concentrate, and the "blues." Many depressed people report that they wake up in the early-morning hours and cannot return to sleep. If your insomnia has lasted more than three weeks and/or is accompanied by these feelings during the day, you may wish to talk with a physician or other mental health professional about your symptoms. At any given time, 30 million Americans suffer from some kind of emotional or mental disorder, and another 50 million are faced with a life stress that taxes their ability to cope. A number of therapies and techniques are used successfully to root out depression. A visit to your doctor or local community mental health center is a good first step. Whatever else you use to ward off insomnia, don't rely on long-term use of sleeping pills. Prescription sleeping pills may work when used on an occasional or temporary basis, but these drugs lose their effectiveness when taken nightly over long periods of time, and regular use can lead to psychological and/or physical dependency. Sleeping medications also tend to interfere with the circadian clock and actually impede the cycles and levels of sleep. In fact, researchers have found that some sleeping medications have a "hangover" effect, which means that they can impair coordination for driving a car or performing other manual tasks the next day. If you use a sleeping pill, ask your physician or pharmacist if there are any known side effects. And never mix alcohol and sleeping pills—this could be fatal. The quality of your sleep is certain to affect the quality of your waking life. You can ensure good sleep by learning about and heeding the dictates of your body's own rhythms. Regular, moderate exercise during the day and a quiet, relaxing time before getting to bed may also help. Sensible sleeping habits can be incorporated easily into almost anyone's daily routine. With regular sleep, your daytime functioning probably will improve, and your sense of command over your physical and mental health will be greater than ever. For more information, write Project Sleep, 5600 Fishers Lane, Room 17-60, Rockville, Maryland 20857. BIBLIOGRAPHY Clift, A. D. (ed.). Sleep Disturbance and Hypnotic Drug Dependence. Excerpta Medica, Amsterdam, 1975. Dement, W. C. Some Must Watch While Some Must Sleep. San Francisco: W. H. Freeman, 1974. Hauri, P. The Sleep Disorders. Kalamazoo: The Upjohn Co., 1977. Hoskisson, J. B. What Is This Thing Called Sleep? London: David-Poynter, 1976. Luce, G. G. and J. Segal. Insomnia: The Guide for Troubled Sleepers. New York: Doubleday, 1969. Mendelson, W. M., J. C. Gillin, and R. J. Wyatt. Human Sleep and Its Disorders. New York: Plenum Press, 1977. 4 A 0 0 0 P• 0 CHILDBIRTH • • JAPANESE STYLE Combining warm, sensitive care with technology, the Japanese have an impressively low infant-death rare. by Karen Michener I was visiting the obstetrical unit of a Japanese hospital on the island of Okinawa, when I spotted a young Karen Michener spent some of her growing-up years in Japan and, as an adult, lived for a time on the Japanese island of Okinawa. She has been a high school teacher and is now a Navy wife and the mother of three daughters. She lives in Severn, Maryland. woman who was apparently in early labor. Because I had just recently given birth, I could not refrain from gushing with encouragement. I waited until the look of pained concentration passed from her face and then I cheered, "Gambatte ne!" which translates "Hang in there!" She brightened and I beamed back, feeling contentedly in touch with the universal satisfaction of childbearing. From what I had already learned about childbirth in Japan, I could predict much of what that young woman was likely to experience in the next hours. I knew that she had already been spared the enema ordeal. I could see that no i.v. hung by her bedside. Though her husband stood uneasily beside her, I knew that he would shortly be dismissed. In a land where role expectations often determine behavior, his presence in the delivery room would be inappropriate, if not redundant. The midwife would serve as comforter and companion. She would carefully watch the woman's progress, encouraging her through the difficult moments, breathing with her face to face if she lost control. A doctor might complete the delivery, LIFE & HEALTH—JUNE 1981 7 especially if the mother had complications. If the birth proceeded routinely, she would be spared anesthesia, and possibly the episiotomy with its accompanying stitches. Alert throughout her delivery, she would probably enjoy an emotionally gratifying experience. She would especially benefit from the kind of warm, sensitive care that has been offered by midwives for generations in Japan. This quality of care has not been lost among technological advances in obstetrics. Rather, the woman's personal involvement with her midwife defines the essence of childbirth, just as it did in 1954, when Hana McKay began having her babies. Role of traditional midwife Hana delivered uneventfully in her midwife's home three times. As the bride of an American serviceman, she could have chosen to give birth in a United States Army hospital in Tokyo. She preferred, however, to follow her own cultural patterns of childbirth. Accordingly, when she reached her fourth month of pregnancy, she visited a midwife who lived just a block from her Tokyo apartment. The midwife examined her and predicted a normal birth. The following month, the midwife performed the quaint ritual of binding Hana's womb. Hoping to keep the baby small, she wrapped a wide strap, girdletight, around Hana's abdomen. Later Hana would use the strap to carry the baby on her back. Hana received monthly examinations and followed the midwife's instructions concerning nutrition and exercise. Finally, the day arrived when she began having mild contractions, and she knew it was time to walk to the midwife's home. She settled comfortably there on the tatami-covered floor, reclining on cushions protected with disposable cloth. She received no special preparations, such as enema, pubic shave, or intravenous. The midwife remained with her constantly, encouraging her to relax, rubbing her back, noting her dilation, coaching her breathing patterns, and offering light snacks and hot tea. After nine hours, Hana's strength began to fail, and the midwife told her not to give up. She coaxed her to drink a concoction of raw egg whipped with a little soy sauce, which revived Hana's strength for the expulsion stage. Hana remembers thinking, I start, so I got to finish. 8 LIFE & HEALTH-JUNE 1981 The midwife's hardest physical work then began. She wrapped her thumb in cotton and placed it in her patient',, rectum, exerting continuous, firm counterpressure to the baby's head on the perineum, preventing tearing. She encouraged Hana to push with the contractions or pant to hold back, as she expertly eased the baby's head out. As the nine-pound baby boy emerged, the midwife placed him momentarily underneath Hana's thigh. As Hana felt the warm, slippery body in contact with her own, she felt overwhelmed with her new identity. I've become a mother, she thought. Hana had two more nine-pound children born in a similar manner, one in 1956 and one in 1958, under the same midwife's care, with shorter delivery times. For these pregnancies Hana abandoned the practice of womb-binding. In the third delivery a doctor was consulted by telephone, because Hana's water broke before labor began. He authorized the midwife to administer a labor-inducing drug, the only drug used during any of the three births. No episiotomy was performed for any of the deliveries, and Hana experienced no tearing of the perineum. A casual observer might be deceived into thinking that Japanese obstetrics has changed drastically since 1954. After all, the move from home to hospital has been a thorough revolution, with 98 percent of women now giving birth in a hospital. Of course, modern equipment and procedures are nearly as accessible in technologically advanced Japan as they are in the United States. The number of obstetricians has greatly increased, so that most women have some contact with a doctor throughout pregnancy, especially for nonroutine matters. Also, the lay midwife has been replaced by the certified nurse-midwife, whose credentials include three years of training in nursing and one year in obstetrics/midwifery. Today's nurse-midwife However, even modern nurse-midwives cherish the viability of the natural birth process and distrust excessive reliance on technology. For example, youthful, pixielike midwife Yoshiko Chinen described the simplicity of the preps for low-risk mothers at the Red Cross Hospital in Naha, Okinawa. Enema and i.v. are optional. Half-shaves are required only of first-time mothers. She added, though, that standards can vary. In a hospital a few miles north of Naha, the staff obstetrician, who was trained in the United States, requires that all patients receive a full prep. A more experienced midwife, Mrs. Eiko Kyoda, educational coordinator for Naha Nursing School, believes that avoidance of drugs during labor and delivery is safer for the baby. She says that an analgesic is prescribed sparingly, and anesthesia is reserved for complications and special circumstances. Local anesthesia can be given for an episiot- • , • omy, but episiotomies are the exception painful experience. Unmedicated birth is rather than the rule. Furthermore, Mrs. achievable because the mother has been Kyoda claims that tearing of the peri- trained to work with the contractions of neum rarely occurs for those women who her uterus rather than to resist them. One do not have episiotomies. Rather, expert Japanese study reported that 5 percent of coaching by the midwives and doctors women will experience no pain in allows the woman to control the baby's childbirth regardless of prenatal care or passage into the world by panting or training. For the other 95 percent of blowing when she needs to refrain from women, natural childbirth training pushing. Obstetrical teams encourage would shorten labor time and lessen vaginal delivery for breech birth, avoid- complications. ing Caesarean section unless absolutely Low infant-death rate necessary. The paradoxical fact about natural Mrs. Kyoda also feels that the fetal monitor need not be used routinely, childbirth in Japan is that the safety of the though nurse-midwives are trained in its patient is enhanced by cautious applicause. She thinks that the expert observa- tion of technology. Japan's impressive tions of the midwife are effective and infant mortality statistics confirm the safe. "The personal approach is better," success of the common-sense approach that balances technology and warm, she comments. Without this personal attention, natu- sensitive care. The Population Bulletin ral childbirth could be a frightening and of the United States Population Refer- ence Bureau states that Japan has made "spectacular gains in reducing infant mortality in the past twenty years."' Japan held the position of fourth lowest in the world in 1974, while the U.S. ranked sixteenth. In 1976, Japan climbed to second position. Mrs. Doris Haire, past president of the International Childbirth Education Association, has observed that "the mortality rate figures relate to a difference in cultural attitudes toward birth, and babies die less frequently in countries where midwives form an essential part of obstetrical care both in and out of the hospital; where the physician is only called on when the pregnant woman is ill or the birth is expected to be in some way abnormal; and where mothers are actively encouraged to breastfeed their children."' One Japanese nursing journal attributed the lowering of the infant mortality rate to universally accessible prenatal care. Approximately 28,000 midwives nationwide provide free prenatal and postnatal care to all mothers, under the provision of National Mother and Child Health and Child Welfare Laws. Private medical insurance plans pay for further hospital costs, including any services rendered by midwives. Of course, other factors contribute to the impressive birth-safety record of the Japanese. These may include improved nutrition, uniformity of physique in the population, and selective abortion of high-risk pregnancies. However the individual factors might be weighted, the sum of them equals a formula for childbirth that approaches Dr. Grantly Dick-Read's ideal. He wrote, "I am persuaded from long years of experience among women of many nationalities that good midwifery is essential for the true happiness of motherhood—that good midwifery is the birth of a baby in a manner nearest to the natural law and design—and good midwifery, next to wise and healthy pregnancy, sets the pattern of the newborn infant and its relationship to its mother." ' Good midwifery and wise and healthy pregnancy—these are the strengths of the Japanese way of childbirth. REFERENCES I Leon F. Bouvier and Jean van der Tak, "Infant Mortality—Progress and Problems," Population Bulletin, April, 1976, p. 8. 2 Danae Brook, Naturebirth: You, Your Body, and Your Baby (New York: Pantheon Books, 1976). p. 78. 3 Grantly Dick-Read, Childbirth Without Fear (New York: Harper Brothers, 1959), p. xvii. LIFE & HEALTH—JUNE 1981 9 it " LIFE . HEALTH-JU NE 198 11111.11AIIIA,11.001M115.501 0 FOR YOUR RETIREMENT You should plan for your later years Ion(3 before it is time to retire. by Raymond Schuessler I A t's later than you think! Remember when that was a catch phrase? You may think you're a long way from retiring, but somehow the years roll by very rapidly. One day, sooner than seems possible, zero hour will arrive, and you'll enter a new phase of your life. Will you be ready for it? To have an active, interesting, worthwhile retirement takes planning. That means looking ahead, saving ahead, really getting set to move into your time of leisure. It is never too early to begin cultivating interests to fill your later years with happy and constructive activities. You cannot wait until you are retired to acquire interests and hobbies and friends. You must do it now, before the time comes for retirement. To their dismay, many have found out the truth—that you cannot change the habits of a working lifetime overnight. The man behind the desk or machine who keeps looking forward to the day when he can sleep late in the morning is going to find it harder than he thinks to turn off the habits that have regulated his life for so many years. After a few days of the pleasure of rolling over again and going back to Raymond Schuessler has been a free-lance writer since l995. He lives in Venice. Florida. sleep, he soon is going to roll over and sigh, "Now what can I do today?" When there is no reason for getting up day after day, the pleasure of retirement will begin to fade. Just what are the problems of retirement, and what can you do about them? First of all, don't retire unless you have to. Many companies are giving their employees the option of working longer if they are capable. Think it over. If you do decide to retire, choose a retirement date. By the time you reach middle age, have a retirement cutoff date in mind—a definite month and year when you will make that important change in your life. This will help you prepare psychologically and financially for retirement. You will know just when to leave your present company and how much more money you will need to save during your productive years in order to have adequate golden years security. Second, don't think of retirement as a time of being turned out to pasture. When you stop working, start doing something else. Retirement isn't the end; it is a beginning. Third, recognize the changes now, before you are retired. You are going to have more time on your hands when you retire. What are you going to do with it? Most likely you will have a reduced income. How will you manage? Living arrangements might be different. Will you live where you are, or will you move? Start thinking about these problems early enough so you can make the change while still young enough to adjust and get established more easily in a new way of life. Visit your local library for literature on ways of making the later years worthwhile. Subscribe to the new magazines for senior citizens. A vast and increasing amount of such data is available from which you can get useful ideas to form a bulwark against the hopelessness of inactive retirement. Seek out others who have retired and see what they have done. Adult education classes can supply you with a formal course to prepare for later maturity. By enrolling in such a class you can not only hear experts speak on employment, health, hobbies, emotional adjustment, and other subjects, but also exchange ideas with other students who, like yourself, are thinking about what kind of retirement they might make for themselves. The greatest advantage you will have in old age is to pursue varied interests. No life should focus only on one narrow interest or objective. Nor should one allow the drive for success LIFE & HEALTH—JUNE 1981 11 to lead to neglect of family life, friendships, creative expression, community participation, or just plain fun. Friendships can make life worth living. If you do not have many friends, join clubs or recreation centers for the aged. These clubs, sponsored by churches, social agencies, libraries, or other community groups, provide elderly people with chances for fun, creative activity, crafts, and social intercourse. This doesn't mean you must be a flighty gadabout. Take an interest in some sort of hobby, so that being alone won't mean automatic loneliness and empty time. A real hobby takes root in your personality; it excites and arouses; it enables you to take hold of a challenge and meet it by work and creative effort. It doesn't matter what the hobby is; it can involve birds, clay, stamps, coins, research, letters to editors, painting, gardening, or many other things. Many hobbies can be turned into profitable ventures, too, such as photography, carpentry, and doll making. One couple who dabbled in leathercraft have opened a gift shop and are doing well. A retired lawyer gives advice for a dollar a problem. Think in terms of a second career. One executive who retired from the television production business started a repair shop in a small town and is doing nicely both in business and in making friends. Some of the most successful retired persons have used former vocations or hobbies to start businesses of their own. One enterprising soul who used to visit auction sales has opened his own antique store, as well as a repair shop for broken furniture. His profit is small, but he's having a lot of fun and making many new friends. It isn't always the position that counts; it's the fun you get out of it and the opportunity you have to meet people. Too often the fear of "lowering themselves" prevents many retired people from being active. One socialite became a sightseeing guide in a scenic Florida city. His relatives almost had apoplexy; but he was never so happy, and he outlived them all. If you were to analyze all the successfully retired people you know, you would find two common denominators: they possess an active interest in the life and work around them, and they 12 LIFE 8 HEALTH—JUNE 1981 have a big circle of friends. Nothing is so corrosive to old age as lack of friends—to be limited to only one's relatives and a small circle of childhood friends. The happiest retired people are those who keep on making friends. In this sense they are never retired. Retirement years can be unpleasant if your financial situation is grim. Here are some tips you can put into practice now to help minimize some worries later. 1. Set up an adequate savings program, regularly allotting a certain portion of your funds to savings or investment—preferably toward a home of your own. "Don't spend it all" is a The happiest retired people are those who keep on making friends. good motto whether you're 19 or 49. Adequate insurance is part of this program. 2. Keep your installment buying down as you mature. In a youthful period, installment buying is often welcomed because one cannot pay outright for all the things needed. As you grow older, don't burden your future earnings too heavily, except for your retirement plans. 3. Learn your Social Security benefits. Go over them with your personnel director or other qualified adviser and make sure you understand them perfectly. You can only get the benefits you apply for. If you don't know about all of them, you may miss benefits to which you are entitled, including survivor's old-age and disability benefits. 4. Pension Plans. Consider the advantages of company cooperative retirement plans if they are available to you. They are intended for the very purpose of helping you to retire with a sound financial basis for your older years. Should you work? Figure out, too, whether you will work part time at some sort of job. Sure, jobs are scarcer at your age, but they do exist. Employment experts say jobs most open to you will be in maintenance and service occupations, sales opportunities, and small industries. 'You definitely will have a better chance of breaking into an organization in which hiring is done on a more personal basis. Long before you retire, it is best to develop a special skill to fall back on in your retirement years. Try evening adult courses in which tests are given to discover where your aptitude lies. Where to retire must be considered too. Some think it is a time for drastic moves—from city to farm, from the North to the sunny South, from private home to hotel. The success of your move will depend on how well you plan. Consider all angles. According to one social worker, one of the most tragic aspects of moving from a hometown is the terrible loneliness of those who have left home, friends, and familiar scenes. Of course, sticking to your hometown with in-laws after retirement may be a mistake. It can not only disrupt your children's lives, but actually interfere with your own independence and freedom. Weigh the advantages and disadvantages of every move. If you plan to retire in Florida or California, then go and scout the territory before you do so. Consider the pros and cons of job opportunities, climate, cost of living, and other important aspects of the proposed new location. Most of all, keep alive your sense of curiosity. Most people lose this wonderful desire to learn, to know, to experience, to experiment. It is the key to happiness in your later years. If you plan well, you can enjoy some of the richest, most rewarding, and most satisfying years of your life. BIBLIOGRAPHY Atchley, R. C. The Sociology of Retirement. New York: Halstead Press, 1975. Buckley, J. C. Retirement Handbook: Complete Planning Guide to Your Future. New York: Harper & Row Publishers, Inc., 1962. Hunter, W. W. "Education for Retirement." Michigan Institute of Gerontology, 1978. Margolius, Sidney. Your Personal Guide to Successful Retirement. Westminster, Maryland: Random House, Inc., 1969. Plan Your Retirement Now So You Won't Be Sorry Later. Washington, D.C.: U.S. News & World Report Books, 1978. 4 P TRIBUTE TO DAD The author presents his concept of the qualities that a good father possesses. by Erwin F. Hodde .4 special day is set aside each June in which to honor our fathers. I wish to paint a composite picture of a good father. I hope you find your father in it. A good father is masculine, yet loving and tenderhearted. He may never have built a house, but he is a builder nevertheless. He builds character. He lays a good foundation for his children to build upon. He may be of medium stature or even short, but in moral and spiritual qualities he stands tall. A good father may not have had the privilege of a formal education, but he is a teacher. He teaches his children to be Erwin F. Hodde is a free-lance writer who lives in Glendale, California. honest, industrious, and thrifty. Even though he may have lived in the city all his life, he is like a farmer. He plants seeds of faith, hope, and love in the hearts of his sons and daughters. A good father is a sportsman of sorts. He plays with his toddlers, giving them horsy-back rides. He is an administrator, dispensing justice, but blending it with mercy and love. He may wear big patches on his clothing, as my father did while working on the truck garden, but he labors hard to give his family the necessities of life and the blessings of a God-oriented upbringing. He is like a shepherd out on the mountain on a cold, dark, stormy night looking for his one straying black sheep. He does not give up on his wayward child. He is like a physician, for he heals fractured relationships. A good father is like a priest. He lays his personal, cherished desires and ambitions on the altar of sacrifice for the eternal well-being of his children. If you are blessed with having your father still, express your love and appreciation to him lavishly. Remember the words of the fifth commandment, the first commandment with promise: "Honour thy father and thy mother: that thy days may be long upon the land which the Lord thy God giveth thee." LIFE 8 HEALTH—JUNE 1981 13 DRUG EDUCATION HELP YOUR PRESCHOOLER TO AVOID DRUG ABUSE Are we unintentionally giving our children the concept that everything unpleasant or painful can be made better by raking a pill? by Kristi Hell alking past my 4-year-old daughter's bedroom, I was captivated by the scene I saw. Jenny cradled her baby doll protectively and crooned, "Here's some aspirin, Pinkie. They taste yummy! Soon your headache will be all better." Sneaking away with a smile on my face, I was pleased that she was learning to show love and concern, even in this pretend situation. But later in the day as I reflected on the incident, it bothered me. I wondered whether I hadn't witnessed something more serious and revealing than love and concern in Jenny's conversation with her sniffly doll. Somehow my daughter had formed the idea that at the first sign of discomfort, you reach for aspirin (a drug), and soon everything will be "all better." Adults are enchanted by toddlers' and preschoolers' imitative behavior of adults, usually their parents. Since children learn more from what parents do than from what they say, the importance of setting a good example can't be overestimated. So the question for me became: What in my behavior was Jenny imitating? I carefully reviewed my own drug habits during the past year. Lately—more and more, I realized—I had reached for the aspirin bottle as soon as I walked into the kitchen in the morning. Sometimes my early-morning headaches were caused by dry air when the humidifier ran out of water, or because I had consumed too much caffeine before bed the night before. But instead of remedying the causes, I just reached for the aspirin. W Kristi Hull, a former schoolteacher, is a free-lance writer in Conrad, Iowa. She is the mother of three young children. 14 LIFE & HEALTH—JUNE 1981 I had always prided myself that our three children were healthy and I seldom had to buy medicine. But I kept an abundant supply of baby aspirin and chewable vitamin C tablets on hand, and out they came at the first sign in any of the children of teething or a cold. Was I reaching for them too quickly? Attitudes are contagious Our attitudes about things are as catching in preschoolers as our actions. I looked to aspirin and cold remedies for instant relief and talked about how much better I felt afterward. In coaxing my children to take occasional medicine, I also stressed how much better they would feel if they swallowed it. Did I overemphasize this good feeling derived from taking drugs? I remember, as a child, taking half an adult aspirin, ground up and mixed with water. The bitter taste of the aspirin never tempted me to eat them like candy. But children's medicines, aspirin, and vitamins are very tasty now. How many of us are guilty of inducing a child to take his medicine because it tastes good? Should the purpose of medicine be to taste good? The seeds of adult behavior are planted early in childhood. Many habits we exhibit can be traced back to our preschool conditioning. I believe the seeds of drug abuse can be planted early also. So the time to think about preventing drug abuse is in your child's early, formative years. Several things can be done. Control your child's vitamins and medicine, including aspirin. Emphasize that you are giving her or him one aspirin or one teaspoon of cough syrup, as the doctor has specified. Always dispense the medicine to your young child yourself, and be sure that she or he takes it in your presence. However tempting it is, especially during the night, don't leave the bottle of medicine in your child's room. Do not place undue emphasis on the taste or effect of the drugs. The child should realize that the medicine is necessary, and that the decision was made by a responsible adult. Taking medicine is not supposed to be a delightful experience, and we should not try to make it so. A Other options My next suggestion may at first seem unnecessary or cruel. I believe you should teach your child that there are ways to deal with life's stresses and discomforts without resorting to a drug. Show your child you can stand a certain amount of pain or emotional upset without turning to drugs for quick relief. Young children are adept at spotting hypocrisy, so we must practice what we preach. (Does your preschooler see you run for aspirin, tranquilizers, or alcohol when you get angry or upset?) Try other remedies for yourself and for your child's discomfort—a warm bath, a hot drink, 0 lying down briefly. Remember, too, that medicine is no substitute for tender loving care. Pain and sickness are a part of life—understanding this helps a child learn to handle it. Don't unwittingly give the impression that drugs are "magic" and will make everything unpleasant go it away. Drugs can be a very helpful part of our lives, but they should be treated as a temporary necessity. Form good druguse habits yourself, and help your preschooler to think of drugs as medical • aids, not sources of pleasure. Begin drug-abuse prevention now. p PHOTOGRAPH BYROBERTWRIGHT 4 LIFE & HEALTH-JUNE 1981 15 EXERCISE THE TORTOISE vs. THE HARE PHILOSOPHY Slow and steady may be the solution to the I-hate-ro-exercise problem. by Detty Nix 16 LIFE & HEALTH-JUNE 1981 4 aybe fairy tales still come true! Maybe we need not "tote that barge and lift that bale" or jog five miles every day to remain at the peak of good health. Something less arduous may serve us quite well. After reading a recent report in the New England Journal of Medicine, I felt almost euphoric. My personal philosophy of exercise, which actually sprang from the ashes of a number of failures, may be more effective than I had dared to M 0 4 Betty Nix, a free-lance writer living in Tulsa, Oklahoma, is a former English teacher. hope. The tenacious tortoise on the exercise track may stack up favorably against the hasty hare, even as he did in the ancient fable. I discovered some time ago that exercise, like the weather, is something that everyone is talking about but that few do anything about on a long-term basis. I was one of this myriad for longer than I care to admit. Finally, it dawned on me that I and many of my acquaintances were approaching the matter unrealistically. The exercise history of most of us could be accurately described as a series of spectacular starts and fast ILLUSTRATION BY BOBBI TULL fizzles. Of course, our intentions were good. Most of us have been impressed to some degree by the reams of data that seem to indicate that we will be healthier and happier if we get regular physical exercise. Doctors have been telling us for years that the heart and lungs need exercise if they are to function optimally. More recently, psychiatrists have begun expressing the opinion that exercise helps alleviate anxiety and depression. Our bathroom scales chide us. Our flabby underarms and spreading waistlines tell us that we need a fitness LIFE 8 HEALTH—JUNE 1981 17 program to help us shape up. So what do we do in the face of all this evidence? Frequently we embark on an ambitious exercise program that fails to take into account two important factors: (1) our present level of physical fitness and (2) our degree of dedication to an exercise program. Consequently, we have two strikes against us in the beginning. Like the hare in the fable, we wear ourselves out early in the race, then decide it's time to rest. We would probably derive more benefit from a steady, tortoiselike pace that will not be so likely to induce rapid burnout. A study done at Duke University Medical Center and published in the May 1, 1980, issue of the New England Journal of Medicine* seems to give credence to the theory that even moderate exercise, if engaged in regularly, has the potential to decrease the risk of heart disease and strokes. For this study, the doctors chose 69 adults who had not been exercising regularly. Two weeks before the start of the exercise program, blood pressure cuffs were used to cut off the flow of blood through the veins of the volunteers' arms, thus simulating a blood clot, and specific blood tests were made. The volunteers were then supervised three times a week as they engaged in ten minutes of stretching exercises followed by thirty to forty-five minutes of walking on a treadmill. This moderate exercise program was continued for ten weeks, at the end of which time the blood tests were repeated. Moderate exercise has benefits The doctors concluded that the test results seem to indicate that even moderate regular exercise can release plasminogen activators that are capable of dissolving fibrin, which is the stringy protein that forms the essential portion of blood clots. Needless to say, blood clots in the major vessels are culprits that can cause heart attacks and strokes. The doctors further concluded that "the exercise program produced a distinct aerobic conditioning effect, defined as a reduction in heart rate"; i.e., the heart was doing its job more efficiently at the end of the test period. Their findings were also similar to those of other researchers in that their subjects showed higher blood levels of HDL cholesterol, which has been associated with less heart disease in other experiments. Of course, we are not being promised threescore and ten years in a rose garden 18 LIFE & HEALTH—JUNE 1981 in exchange for working out moderately three times a week. So many variables are involved that it is difficult to prove that there is a direct correlation between exercise and good health. Consequently, the case for exercise is still considered circumstantial by some. Studies such as this one, however, are helping to forge a connecting link and remove the doubts. The results of this study served to reinforce my own commitment to exercise. The Duke study's exercise program was very close to the routine I had finally settled into after my more ambitious plans had ended in failure. A new philosophical approach to the subject marked the turning point for me. I simply acknowledged at the outset that exercise would never be the high point of my day. I had never been able to fool myself for long anyhow. Those for whom exercise is a joy are fortunate, but not all of us are fleet of foot and agile of I simply acknowledged at the outset that exercise would never be the high point of my day. arm. For some of us, exercise is a bore at best and a chore at worst. This does not alter the fact that we need exercise. So with the tortoise as my role model, I said to myself: "You will benefit more from a moderate, long-range exercise program than from a rigorous one that will cause you to become discouraged and quit within a few weeks' time." My doctor agreed with me. From there, it was simply a matter of deciding what kind of exercise I needed most and what I could live with on a day-to-day basis. This part of the program must be decided by each individual. There is general agreement, however, that all of us need some aerobic exercise, such as walking, jogging, swimming, or cycling, to strengthen the heart and lungs and improve blood circulation. I decided that walking or cycling would best fit my needs and capabilities. Three or four days a week I either walk very briskly for about a mile and a half (fifteen average city blocks), or I ride my bicycle about twice that distance. This will not impress someone who jogs this distance or farther, but it's a routine I can live with. It is not oppressive in terms of time or energy. Work on those lazy muscles The other phase of my exercise program consists of sit-ups and bend-andstretch exercises that are designed to improve the elasticity of my lazier muscles. I work at them for about ten minutes at a time, three or four times a week, but I do not necessarily do them in conjunction with the aerobic exercises. In fact, I tend to work on my indoor exercises when it is rainy, windy, cold, or otherwise miserable outdoors. Again, the needs of each person will vary considerably, yet there are problems that are common to most of us. The midsection is a good example. Breathes there one with soul so dead who never to himself has said, I must firm up my abdomen? For toning abdominal muscles, it's hard to beat the old-fashioned sit-ups and leg lifts. But take it easy in the beginning. A half-dozen sit-ups may be enough at first if you're really out of shape. If you make those unused muscles so sore that you groan when you get out of bed the next morning, you're probably setting the stage for premature termination of your fitness program. For most of us, it is probably necessary that we make exercise a ritual. We need to establish a time and a place for it, and then not allow anything else to fill that slot in our lives. There's nothing new about this idea, but it bears repeating. It is also helpful to some persons to enlist a friend as an exercise companion. Neither wants to disappoint the other, so both stick with the routine. The philosophy of exercise that has proved successful for me can be condensed as follows: 1. Decide what kind of exercise you need most. 2. Set realistic goals. 3. Quit before exhaustion and internal rebellion set in. 4. Work regularly but not fanatically at whatever program you decide is best for you. If you recognize yourself to be a "tortoise" on the exercise scene, don't despair. Those of us who exercise moderately but consistently may be the winners in this race. * "Physical Conditioning Augments the Fibrinolytic Response to Venous Occlusion in Healthy Adults," New England Journal of Medicine, vol. 302, No. 18, 1980, pp. 987-991. 4 TOTAL HEALTH 1. 8 0 6 z 0 0 LIFESTAKES Every person receives ar birth a specific amount of 'adaptation energy'" or "vital force.- It's up to each of us ro determine how fasr we use ours up by Leo R. Van Dolson, .,, • • ► et's do some fantasizing. Suppose you are the one in five-and-a-half million persons who wins the grand prize in the current Reader's Digest sweepstakes. Immediately you are confronted with a choice. Will you accept a lump sum of $127,000 all at once or settle for $102,000 now, plus $100 a month for the rest of your life? One thing I'm sure of—you'd like to be able to make that kind of choice. But in one sense you are making a similar choice every day of your life. When you were born you were equipped L Leo R. Van Dolson, in addition to being an associate editor of Adventist Review, is a minister and a health educator. He has had numerous articles and several books published. Dr. Van Dolson is a former editor of LIFE & HEALTH. M.P.H. with a certain amount of what Dr. Hans Selye terms "adaptation energy" and others call "vital force." Some people receive more than others, he tells us, not by chance, as in a sweepstakes, but by inheritance. We might call this our "lifestakes." We receive a given amount of adaptation energy, and that has to last us an entire lifetime. Dr. Selye likens it to a bank account that we can draw on but cannot place any deposits against. If we wish, we can use it up quickly, or we can stretch it out and consequently live longer—but when the account is depleted, that's all there is. Selye informs us: "Your only control over this most precious fortune is the rate at which you make your withdrawals."' Our lifestakes really depends on the way we live. Since we each have only a certain amount of adaptation energy or vital force, we cannot afford to be spendthrifts with it but instead need to conserve our energies and powers and make sure that we use this vital force for truly vital purposes. Those who use their bank account of vital force unwisely are borrowing against future resources, and the time for paying the debt will come before it needs to. Yet we won't find much enjoyment in life, either, if we simply avoid all stress and unnecessarily hoard our allotment of vital energy. There has to be a balance. As with most of that which counts in life, the secret to proper budgeting of our lifestakes is moderation and self-control. A large share of sickness and disease is brought on ourselves by intemperate LIFE & HEALTH--JUNE 1981 19 usage, even of those things that are in themselves good for us. One of the essential laws of life and health, therefore, is that of temperance. In a relevant Bible illustration of this principle the apostle Paul asks, "Do you not know that in a race all the runners compete, but only one receives the prize?" Then he admonishes, "So run that you may obtain it. Every athlete exercises self-control in all things. They do it to receive a perishable wreath, but we an imperishable." ' Every time I read this instruction I am reminded of the two fellows on my high school track team who were discharged by the coach because he caught them smoking. If high school coaches are strict with track team members, how should humans relate to the far more important game of life? We're in a greater race than any athletic contest. Our life and health are at stake. Certainly it is more imperative to exercise temperance and selfcontrol when the stakes are so much higher than when the goal is what Paul calls "a perishable wreath." U.S. News and World Report states: "In Los Angeles County, 25 chapters of Alcoholics Anonymous are composed solely of teen-agers and 75 other chapters in the county have some teen-age members. One young Houston woman, now 18, says she began drinking when she was 9 and quit, as an alcoholic, at age 15." ' Even more insidious, however, is the free use of those drugs and other harmful substances that are not ordinarily recognized as being especially detrimental. For instance, a common drug that is sometimes detrimental to health is one that fifteen million Americans are said to take regularly—aspirin. One in twenty of those admitted to hospitals because of adverse drug reactions are there because of aspirin-related reactions, usually intestinal bleeding.' One definition of temperance is abstinence from that which is harmful and moderation in that which is good. The latter point can be illustrated by one of the most prevalent physical problems in the United States—obesity. Life insur- Physical application In the physical dimension, this law of life can be applied to either lessening or eliminating the various stress factors that Selye identifies as being involved in the needless expenditure of our adaptation energy or vital force. Among these he lists: 1. Mechanical (example: accidents) 2. Psychological (example: worry, fear) 3. Chemical (example: abuse of narcotics) 4. Bacterial (example: disease) 5. Physiological (example: defects) Some of these stress factors cannot be avoided, of course. But many of them, such as drug abuse, are entirely the result of our own course of action or choice. In recent years the American nation has become alarmed at the increasing use of alcohol and marijuana by high school and elementary school youth. The drug problem in schools has shifted away from hard drugs to use of alcohol and marijuana. The Surgeon General's report issued in 1979 estimates that youthful problem drinkers (aged 14 to 17) now number three million, between 20 and 25 percent of the age group. About 10 percent of high school seniors surveyed reported daily use of marijuana.' Misuse of the body shortens the life span by unnecessarily calling on those reserves of vital power that cannot be replaced. 20 LIFE & HEALTH—JUNE 1981 The above article is taken from Dr. Leo Van Dolson's book The Golden Eight. Read the entire volume to learn more principles of good health. Available for only $4.50. postpaid. Send your order to The Golden Eight. Box 4353. Washington. D.C. 20012. Please send check or money order. Price slightly higher in Canada. ante companies are interested in our cutting down on overweight because they recognize that obesity contributes strongly to shortening of the life span, as well as to many degenerative diseases. By shortening the waistline we lengthen the lifeline. Since the primary cause of obesity is "exceeding the feed limit," the best and only really successful way to control overweight is through a well-balanced, but abstemious diet combined with a mild exercise program. With many of us, the "battle of the bulge" must become a lifelong one. Mind control Since this takes willpower (or won't power) the mental aspects of the law of self-control are extremely significant. Selye's thesis is that misuse of the body shortens the life span by unnecessarily calling on those reserves of vital power that cannot be replaced. When we allow ourselves to keep late hours, gratify appetite at the expense of health, and overeat and overdo in a variety of ways, we bring physical problems on ourselves. By underexercising the body and overworking the mind we also can unbalance and weaken the nervous system. Physical habits such as overeating and using alcohol, tobacco, and drugs of all kinds can so interfere with the powers of the mind that they inhibit our ability to think straight and to exercise self-control. This effect is so well known that it doesn't need documentation here. However, one intriguing statement concerning the effects of improper diet probably needs more publicity. The informative book Counsels on Diet and Foods states: "An intemperate man cannot be a patient man. . . . Intemperate eating, eating too frequently, too much, and of rich, unwholesome food, destroys the healthy action of the digestive organs, affects the brain, and perverts the judgment, preventing rational, calm, healthy thinking and acting." "Many spoil their dispositions by eating improperly." 6 Obviously, here is a vicious cycle. In order to control our physical habits we need to exercise mental discipline. But in order to think straight we must refrain from mind-benumbing indulgences. The question needs to be considered, "Where can we best intervene in this cycle in order to gain control of what's happening?" 1.. Various intervention techniques have proved successful. For instance, behaviorists are helping people to overcome obesity through such techniques as rewards, reinforcements, interruption during meals, eating only when sitting, and so forth. But these techniques in and of themselves are not enough. You can't escape the need for self-control and willpower. So motivation, group therapy, reflection (or thinking carefully about what is being done), and techniques that develop psychological distance are being used in addition to behavior-modification methods. Too often, however, even these approaches fail to gain lasting results. Spiritual resources There is one long-proven and truly effective way to achieve self-control. It is successful because it gets right down to the root of the problem—the sinful, selfish nature of man. There is only one possible prescription for this disease that has infected every living individual in the world. It was made available to us by the Creator and was dramatically illustrated at the cross on Calvary. There God accepted the life and death that were rightfully ours and gave us in exchange the victory and overcoming power that were His. When we accept Christ as our Saviour, He makes it possible for us to accomplish that which unaided human willpower cannot possibly achieve. By choosing to bring our will into harmony with His will for us, we find more than human strength in meeting those problems and situations in which, without divine help, we have so often failed. And it works! If you are a Christian, you've undoubtedly seen it work, not only in your own life but in many dramatic cases in the lives of your fellow Christians. When my wife and I served as missionaries in Japan, a young murderer of three people (including two policemen) was converted right in his jail cell by the power of Christ's love. Before he was executed, he not only was baptized as a Christian but also became an effective witness to Christ's power to turn even the most hardened criminal from the habits of sin to the practice of purity. Several of his fellow prisoners, impressed by his example, were also converted. On a less dramatic level, in recent years of conducting health-education programs in communities across America, I have seen many people who could not of themselves overcome smoking or overeating find the help they needed by turning to the divine resources that are freely available to those who seek them. God does not ask us to overcome sin and intemperance without Himself providing the power necessary to accomplish His biddings. Social stakes Let us now consider the social issues involved in the law of temperance and self-control. In a thought-provoking article entitled "It's My Life, Isn't It?" published in the October, 1968, Reader's Digest, Author Each of us is affected and molded to some degree by those we meet, even as we help shape their lives. Evan Hill proposed that one's life isn't entirely one's own. As a college professor he asked one of his students why he took the risk of smoking. The young man thought that it wasn't anyone else's business whether he ruined his health by the use of tobacco. He reasoned that it was his lungs, his health, his life, and that he should be free to do as he wished as long as he didn't harm anyone else. He believed that this philosophy covered all areas of his life. If he wanted to speed down the road at one hundred miles an hour he should be allowed to do so if the road was empty of traffic and he had no passengers. The professor disagreed with that viewpoint, telling the student, "It's such a bleak and lonely view of man. It's as if you felt you had no value." Professor Hill went on to point out that each man's life is intertwined with the lives of others. Each of us is affected and molded to some degree by those we meet, even as we help shape their lives. Although a man may consider his body his own, he does not have the right to abuse it, the professor continued, and then referred to Scripture to substantiate his belief: "Do you not know that your body is a temple of the Holy Spirit within you, which you have from God?" says the New Testament. "You are not your own" (1 Cor. 6:19, R.S.V.). He told of a man he knew who was warned by his friends that his heavy drinking was endangering his health. The man replied that he was harming no one but himself and asked his friends to mind their own business. Ten years later, married, and having difficulty holding his job, he was discovering the impossibility of obtaining insurance because he had cirrhosis of the liver. "During his carefree, unmarried, drinking years, he was steadily damaging a girl he was not to meet for at least five years; he was harming children yet unborn," Professor Hill added. We are not our own, the text tells us. As Christians we belong to God and are closely involved with those about us. In every aspect of life we cannot do just what we please. Instead, we must abide by the selfless commitments we have freely chosen. It is because people are afraid of such commitment to God and others that they often hesitate to turn to Christ for the power and victory He can bring to their lives. Somehow we seem to think that God wants to deprive us of something good, that He's trying to shortchange us. What is the result? We remain enslaved to sin and caught in the stranglehold of self-destroying habits. If God is to save us from ourselves, He must break the pattern of enslavement to self and sin. This He wants to do. Talk about lifestakes! God offers us something far beyond the lifestakes we acquired as a result of being born into this world. He offers eternal life, not just "pie in the sky by and by" but, in a sense, right now. Through His grace we can begin to enjoy a new, healthy, happy, holy pattern of life that brings us peace, confidence, joy, and the pleasure of victory over those life-destroying habits that we find so difficult to overcome. REFERENCES Hans Selye, The Stress of Life (New York: McGraw-Hill Co., 1956), p. 274. 2 1 Cor. 9:24, 25, R.S.V. 3 Healthy People, The Surgeon General's Report on Health Promotion and Disease Prevention (Washington, D.C., U.S. Government Printing Office, 1979), pp. 125, 126. U.S. News and World Report, Nov. 24, 1975, p. 28. 5 U.S. News and World Report, June 16. 1975. p. 61. 6 Ellen G. White. Counsels on Diet and Foods (Takoma Park, Washington, D.C.: Review and Herald Publishing Association, 1938), pp. 50. 126. LIFE & HEALTH—JUNE 1981 21 NEW HOPE FOR MANY CARDIAC PATIENTS A look at coronary bypass surgery by Richard V. Dunning T hings are not always what they seem. You might think that the human heart, which is continually pumping blood, would always have as much as it needed. Actually, the heart is unable to receive nourishment from the blood that it pumps; only blood that is fed through vessels known as the coronary arteries can permeate it in such a way as to nourish all the cells.' Some people's coronary arteries (there are three major arteries) become narrower with the passage of years, as fatty deposits accumulate and restrict the amount of blood that can flow through them. A person with this problem is said to have coronary artery disease. The severity of the disease will be directly related to just how much the blood flow is restricted.' As the disease advances, a person who has this type of restricted blood flow will feel heart pain known as angina whenever his heart is not receiving sufficient blood. This will usually occur during some type of exercise or strong emotion, either of which increases the heart's requirement for blood by increasing the heart rate.' Until recent years there was no permanent cure for a person with this disease. Medication afforded some relief, but Richard V. Dunning, a 1970 graduate of Brigham Young University, has worked with the New Jersey Commission for the Blind and Visually impaired for the past ten years. He is involved with blind and visually impaired children and their teachers in a program that enables the children to attend regular public school classes. His wife, Cassandra, who is a physician, assisted in the writing of this article. 22 LIFE 8 HEALTH—JUNE 1981 patients with more advanced coronary artery disease still found it necessary to restrict their activities, and many were prime candidates for a heart attack. (Heart attacks occur when one or more of the coronary arteries are blocked long enough for part of the heart to die from lack of fresh blood.) In the late 1960s an operation known as coronary artery bypass surgery was developed. This surgery improves the circulation to the heart because new blood vessels are grafted in to circulate blood around blocked or narrow areas. Major surgery of this type is not recommended unless the physician in charge of the case feels that the disease is too far advanced to be controlled by nonsurgical means, including diet, exercise, and medication. One test that lets him know just how much exercise his patient's heart can support is called a stress test. This test is by no means reserved for surgical candidates; it is routinely given to anyone with any complaints of this nature and may even be part of a thorough physical exam for healthy adults.' The actual test involves having the patient walk in place on a treadmill while electrodes on his chest monitor his heart's activity. The electrodes are attached to an electrocardiograph (EKG) machine. The readout of this machine helps to tell the doctor whether a particular level of exercise may be causing his patient's heart to need more blood than it is getting.' A more complicated test, known as a coronary angiography, is used on a patient who is being considered seriously for surgery. This test involves inserting a catheter through an artery in the groin or arm and threading it through the artery until it is at the coronary artery. When it is there, a dye is injected that will be • visible on X-rays. While this dye is going through the arteries feeding the heart, X-ray movies are taken from different angles, showing just how much blockage exists in various arteries and where the blockage occurs. This lets the physician know whether the blockage is serious enough to warrant surgery, and if so, what will be found during the actual surgery.6 ' The procedure also evaluates other aspects of heart function. The bypass operation During the operation the surgeon will remove from one leg a vein that will be cut and grafted in such a way as to form one or more bypass vessels. The removal will not cause permanent damage to the leg, because other veins will permit continued adequate circulation.' The coronary arteries that are not providing sufficient blood flow to the heart are not removed but are bypassed with the replacement vessels, which detour around the artery whose circulation they are supplementing. The operation can involve the bypassing of one, two, three, or more arteries (known as a single, double, triple, et cetera, bypass), depending on the condition of the arteries in question. The recovery period can vary considerably from one patient to another, depending on the particular patient's health and whether or not there are any complications. A typical recovery period for someone who is not having any complications would begin with his sitting up in about two days. He would be taking a few slow, short walks in about four days and would be out of the hospital in ten to fourteen days. A person with an office job might be back at work in six to eight weeks. As with any major operation, healing takes place over a number of months.' The most obvious benefit of this operation is immediately apparent: the absence of anginal pain. This, of course, is very significant, since it may make a difference in whether or not a person can do housework or gardening or even hold a job. Is length of life increased? A number of studies have been done 4 4 46 0 z F 0 z r 0 I a' during the past several years to determine to what extent, if at all, a person's life expectancy is extended by this operation. This is not as easy to decide as it might appear, since data must be obtained on large groups of people over a number of years. Information must be gathered not only on postoperative patients but also on a similar group of persons that did not have the operation, so that a comparison can be made. Because of the size and complexity of these studies, legitimate disagreement may exist among scientists as to the validity of a particular study. One study was done a few years ago in association with Veterans Administration hospitals. It concluded that patients who had blockage in a major vessel known as the left main artery would have a longer life expectancy as a result of this, operation, but that the majority of patients, while being enabled to lead more active lives, would not actually live longer.10 11. 12 A large number of surgeons have disagreed with this study, maintaining that the vast majority of patients have increased life expectancy. As in many areas of science, there appear to be studies supporting both sides, although more recent evidence leans toward the belief that life expectancy is, indeed, increased."-'4• " Regardless of the dispute concerning these figures, there is universal agreement that the quality of many people's lives can be vastly improved. Many thousands of people have been able to resume normal or near-normal activities as a result of coronary artery bypass surgery. Conviction is also growing that patients do better and may even avoid (or slow) blockage of vessels in the future if, after the operation, they change their life style (habits of diet, smoking, exercise, et cetera) so as to reduce further narrowing of arteries. Hope does indeed exist for many cardiac patients. REFERENCES Arthur C. Guyton, M.D., Textbook of Medical Physiology (Philadelphia: W. B. Saunders Co., 1976), p. 320. 2 Stanley L. Robbins, M.D., Pathologic Basis of Disease (Philadelphia: W. B. Saunders Co., 1974), pp. 586, 587. 3 George W. Thom, M.D., Harrison's Principles of Internal Medicine (New York: McGraw-Hill Book Co., 1977), p. 1267. 4 C. Dunning, M.D., personal communication. 5 Ibid. Thom, op. cit., pp. 1266, 1267. C. Dunning, M.D., personal communication. 8 Ibid. 9 Ibid. m Marvin L. Murphy, M.D., "Treatment of Chronic Stable Angina," New England Journal of Medicine, September 22, 1977, p. 621. II Katherine Detre, M.D., DPH, "Veterans Administration Cooperative Study of Surgery for Coronary Arterial Occlusive Disease," American Journal of Cardiology, August, 1977, p. 212. 12 Henry D. McIntoch, M.D., "Will Coronary Vein Bypass Grafting Prolong Life in Patients with Chronic, Stable Angina Pectoris?" in Current Controversies in Cardiovascular Disease, Elliot Rapaport, M.D. (Philadelphia: W. B. Saunders Co., 1980), p. 172. 6 7 13 George J. Reul, Jr., M.D., "Long-Term Survival Following Coronary Artery Bypass," Archives of Surgery, November, 1975, p. 1419. 14 "Coronary Bypass Said to Prolong Angina Patients' Lives," Family Practice News, October 1, 1980. 15 Nicholas T. Kouchoukos, M.D., "Coronary Vein Bypass Graft Surgery Prolongs Life in Patients with Chronic, Stable Angina Pectoris," in Current Controversies in Cardiovascular Disease, Elliot Rapaport, M.D. (Philadelphia: W. B. Saunders Co., 1980), pp. 155-157. LIFE & HEALTH—JUNE 1981 23 KEEP A HEALTHY DISTANCE FROM WILD ANIMALS Animals in the wild are fun to watch, bur they can inflict painful or dangerous bites and may transmit diseases. T he great outdoors is beckoning again, and as millions of city dwellers plan their annual trek to commune with nature, some advice seems in order: Keep a healthy distance from all animals living in the wild. This article is slightly adapted from one that appeared in the June-August, 1979, issue of MGH News, published by the Massachusetts General Hospital. Boston. Massachusetts. 24 LIFE & HEALTH—JUNE 1981 A half-million Americans receive treatment for animal bites each year, and although domestic dogs and cats rank as the principal offenders, untamed creatures pose the greatest threat of inflicting serious diseases. Although since 1968 only fifteen humans are known to have been infected with rabies in the United States, an estimated 30,000 Americans undergo PHOTOGRAPH BY RALPH BLODGETT antirabies inoculations each year. In most instances the injections are purely precautionary, since the animal that inflicts the bite usually escapes and cannot be examined. Rabies is a virus that thrives in the saliva of an infected animal. Conveyed to a human via a bite, the virus enters the central nervous system, first causing headache, fever, and general malaise, then confusion, muscle spasms, and paralysis. Inoculations against rabies usually succeed because the disease has an incubation period of from ten days to a full year. In the past, if an infected person delayed being vaccinated until symptoms of the disease appeared, he was regarded as beyond chance of survival. "This is not necessarily the case today," says Dr. Ann S. Baker. "It's worth an all-out effort to treat the patient with all the cardiopulmonary support that one can provide." Dr. Baker is a physician and member of the Infectious Disease Unit at Massachusetts General Hospital, an assistant professor of medicine at Harvard Medical School, and an epidemiologist at the Massachusetts Eye and Ear Infirmary. She explains that a new antirabies vaccine (Human Diploid Cell Strain Vaccine) is six to ten times more potent than the• duck-embryo vaccine used successfully against the malady since being licensed in 1957. In place of a series of twenty-one or twenty-two painful injections administered over a two-week period, only a half-dozen inoculations of the new vaccine assure full immunization. And the side effects, such as muscle pain and fever, are less severe. Most cities in the United States have been declared rabies-free as the result of Between 6,000 and 7,000 poisonous snakebites are recorded each year in this country. years of compulsory vaccination of domestic pets. In rural areas, however, if the biting animal cannot be caught and examined, two questions must be asked: Was the attack provoked? Has ownership of the offender been established? A negative reply to either question might warrant vaccinating the victim. The Federal Center for Disease Control in Atlanta, Georgia, reports that in 1977, the latest year for which statistics are available, 3,130 animals in this country were found to be rabid. Skunks accounted for 52 percent of the total, followed by bats, 20 percent; raccoons, 8 percent; cattle, 6 percent; PHOTOGRAPHS BY RALPH 8 ARLAN BLODGETT foxes, 4 percent; and dogs, 3 percent. Miscellaneous other domestic or wild creatures completed the list. In Massachusetts during 1977, ten cases of animal rabies were reported, all involving bats, according to the State Laboratory Institute. How to care for bites Dr. Baker says that all animal bites require very careful washing of the wound, but that suspected rabies calls for additional scrubbing of the site with soap and a brush, a careful rinse, then a repeat wash with alcohol to try to remove and kill the virus. Gauze or some such cover may be put on the wound to keep dirt out, but no attempt should be made to sew up the wound, whether rabies is suspected or not, until a medical professional can examine and treat the injury. Tourists and campers are advised to be LIFE & HEALTH-JUNE 1981 25 on the alert for snakes. Between 6,000 and 7,000 poisonous snakebites are recorded each year in this country, the largest proportion in the Southwestern and Gulf States. Even areas like Massachusetts and Rhode Island, however, have rattlesnakes and copperheads. Most commonly treated are snake handlers, entertainers, farmers, and children. The degree of toxicity from the bite depends on the potency of the venom, the amount injected, the size and condition of the snake, and the age, size, and health of the person attacked. "As soon as possible after a limb is bitten, a tourniquet should be placed around the extremity above the wound to prevent the venom from traveling through the blood stream," says Dr. Baker. "However, the tourniquet should be loosened periodically to avoid impairment of the blood supply to the limb. "Parallel cuts can also be made through the fang marks to give the poison a better chance to drain. A suctioning device is also helpful, but there should be no delay in reaching a hospital or clinic to receive an antidote to the poison." Dr. Baker says that emergency rooms in urban medical centers should be prepared to • treat the bite of the most common poisonous snakes. Some years ago a 16-year-old boy was treated successfully at Massachusetts General Hospital after being bitten by a cottonmouth, also called a water moccasin. A collector of reptiles, the youth had the cottonmouth shipped from a snake farm in Florida. In handling the pet, the boy mistakenly thought the snake had been defanged. Spiders have a much worse reputation than they deserve. In the United States, the female black widow, which has an hourglass-shaped red mark on its abdomen, represents the greatest concern. The bite of the aggressive black widow produces at the site a sharp pain that subsides, only to be followed by a cramping pain, mainly in the abdomen. Patients usually do well after evaluation and treatment. Contrary to common belief, death is quite rare. Public health officials caution travelers against handling wild rabbits because of a disease call tularemia, or rabbit fever. Several days after contact with the animal, symptoms of the disease appear in the form of headache, fever, lymph-node swelling, and, at the site of the bite, a skin lesion. The disease may also be contracted by eating poorly 26 LIFE & HEALTH-JUNE 1981 Do not try to play with animals in the wild or to capture them as pets. cooked rabbit meat. Ticks inhabiting the rabbit's fur can also transmit the disease to humans. In Massachusetts most cases of tularemia are caused by these parasitic insects. Ticks transmit another potentially deadly disease—Rocky Mountain spotted fever. Dr. Baker points out that more cases of this malady occur on the Atlantic Coast than in the Rocky Mountains. "In recent years," she says, "we have seen an increasing incidence of the disease in the Cape Cod area." Watch out for insects Guarding against insect bites of all types during this time of year is important. "One percent of our population is allergic to insect stings," Dr. Baker explains. Some persons are subject to a kind of shock (anaphylactic) and can die from such stings. "If a person is stung by a bee, wasp, or hornet and develops an unusually large area of skin redness, inflammation, or , swelling around the bite, he should avail himself of kits containing antiinsect remedies," Dr. Baker says. "Many such kits are available commercially. "Meantime, regardless of the insect, the stinger should be removed by scraping it off with a clean, dull blade, and the wound should be cleaned. Pulling out the stinger with thumb and forefinger could squeeze more venom into the wound. Cold compresses should then be applied. If the victim does experience an allergic reaction, he should seek professional treatment. Among household pets, principally cats, the most common bacterial infection transmitted to humans by means of bites is called Pasteurella multocida. If the organism penetrates deeply, an inflammation of the bone (osteomyelitis) can result. "One would prescribe penicillin if the bite were inflicted by a cat," Dr. Baker says, "because a feline usually possesses longer and sharper teeth than a dog. Also, the organism isn't quite as prevalent in the dog's mouth. In tending to dog bites, it is usually sufficient to clean the wound and leave it open." The second most common concern among cat owners, especially those having kittens, is an ailment called cat scratch disease. The cause is uncertain, but the scratch may lead to a skin lump, fever, lymph-node swelling, and general malaise. The victim eventually recovers without treatment. In general, to avoid infections trans- r mitted by animals, Dr. Baker recommends: • Do not try to play with animals in the wild or to capture them as pets. • If bitten without provocation by an animal whose ownership cannot be established, seek immediate professional care. • When traveling in an area where snakes or insects abound, carry an • appropriate antivenin kit and wear protective clothing. • Do not tease animals, especially if they are caged or tethered. • Make sure pets are properly immunized. • After fondling pets of any kind, be sure to wash your hands. GAZETTE 4 Addiction may be reason smokers can't quit Addiction rather than weak will could be the reason millions of cigarette smokers can't quit, a team of University of Minnesota researchers may prove. Working under a grant from the National Institute on Drug Abuse, the four-member team is studying behavior of smokers and those trying to quit. According to John Hughes, a psychiatrist with the Laboratory of Physiological Hygiene, the four-year project will attempt to show that nicotine can cause addiction similar to alcohol and drug dependency, and, therefore, that smoking is more than a habit. The study will focus on three major questions: Is smoking addictive? What drug in tobacco makes it addictive? How can smokers best be withdrawn from the drug? Although it has long been assumed that nicotine is the ingredient in tobacco that gets smokers hooked, it has never been proved, says psychologist Roy Pickens. However, a series of studies at the university will attempt to show the link. "We're taking a drug-abuse approach toward the problem," says Pickens, an expert in drug problems. "We're trying to capitalize on every- thing we know about drug dependency." Smokers in the study will be given a nicotine-blocking drug while they continue to smoke, to determine if their bodies react as if they had stopped smoking. Another phase of the project will involve administering nicotine to smokers to see if their desire to smoke is satisfied. One indication that smokers develop a physical need for daily levels of nicotine, Pickens says, is that those trying to cut down gradually unconsciously begin to compensate for the decrease. For instance, if a smoker goes from two packs a day to one pack, each cigarette may be smoked longer and the smoke held in longer. "This seems to show that the underlying purpose of the habit is to regulate the daily level of nicotine," Pickens says. The research could change society's attitude toward smokers, Hughes says. "One of the problems of smokers and exsmokers is that people don't understand how much distress they're in—they think it's just a silly habit," he says. "Society used to tell alcoholics and drug addicts to just stop, and say they were weak-willed if they didn't," Hughes points out. "Most people don't understand it's not something you can just do or not do." ILLUSTRATION BY WARREN ROOD One indication that attitudes are changing comes from the Federal Government's shift of smoking research from the National Institutes of Health to the National Institute on Drug Abuse, Hughes says. Once researchers understand what causes the physical problems—irritability, insomnia, increased appetite, and nervousness—associated with giving up cigarettes, they'll be able to develop better treatment for smokers, Pickens says. "If we find it is a physical dependency, we may be able to detoxify patients, get them through the transition period, and keep them from falling back into smoking." "Most people would like to stop," Hughes says, "but they know it's going to hurt. But we don't know how long it hurts and why it hurts longer in some than in others." He says that studies indicate that 95 percent of all smokers would like to quit and 65 percent would if there were an easy way. —News feature, University of Minnesota. CU cereal study hits fortification "The mere addition of a vitamin or a mineral to a food does not ensure that the vitamin or mineral will be used by the body," Consumer Reports, the LIFE 8 HEALTH-JUNE 1981 27 magazine of Consumers Union (CU), notes in a report on 57 breakfast cereals in its February issue. "Cereal companies, well aware of the selling power of 'good nutrition,' have co-opted for their advertising pronouncements both the U.S. RDA figures and the number of vitamins and minerals added as fortification," CU continues. "To judge by the banners and 'screamers' on cereal boxes, you'd think there was a vitamin war in progress. This cereal has seven vitamins, that one eight, the next one nine plus iron. . . "The hoopla helps create a false impression of nutritional completeness. Total, for instance, implies in its very name that it supplies 100 percent of everything you need to eat. What Total really supplies is 100 percent of the U.S. RDA for nine vitamins and iron, smaller amounts of the RDA for a few other minerals, and amounts of protein and carbohydrate typical for a cereal. That's obviously not 'total' nutrition, as the results of our laboratory tests demonstrate." In a replay of its controversial study of the early 1970s, CU fed cereal plus water (not milk) to young rats, then observed how they thrived—or failed to thrive—on various brands. CU argues that rat feeding, with cereal as the sole food, is a fair test of a product's nutritional quality. In the CU test, traditional cereals such as All-Bran, Cheerios, and Grape Nuts drew high ratings, whereas several "100 percent fortified" cereals—including Total, Most, and Product 19—were near the bottom of the scale. "A breakfast cereal masquerading as a vitamin supplement appeals to the mistaken notion that if a little bit of vitamin or mineral is good, more must be better," CU said. "A person eating one of the 'supplement' cereals might think that eating such a breakfast gives license to eat junk food the rest for pilot training have been followed down through the years. Most of the subjects after WW II went on to find different occupations, but they have been contacted annually, and complete medical exams have been performed on them every three years. Dr. Rabkin, who is an associate professor of medicine at the University of British Columbia, found that for men with previous evidence of heart disease, the death rate from sudden cardiac death was pretty much uniform throughout the week. In contrast, men with no prior history of heart trouble suffered a significant number of sudden-death heart attacks on Monday. In fact, 75 percent of such fatal attacks occurring at work were on Mondays. Home was no haven either, with 43 percent of sudden-death heart attacks taking place at home, also on Mondays. While finding a definite cause for the sharp increase of sudden-death heart attacks on Mondays was not part of the study, Dr. Rabkin speculates that it relates to a return to the work environment. "Going back to work on Monday ti after a weekend's rest may be exposing people to a reintroduction to occupational stress, physical activity, or occupational pollutants," said Rabkin. "Of the three possibilities, we tend to favor the stress theory because many of the individuals were not in occupations that exposed them to marked physical activity or occupational pollutions. There were a number of people with sedentary of the day without ill effect. The low ratings . . . demonstrate the futility of '100 percent fortification' with fewer than 50 percent of the nutrients needed to sustain life and growth." The CU report also discusses the role of sugar, fiber, sodium, and artificial colors, flavors, and preservatives in the manufacture and marketing of ready-to-eat cereals. —CNI Weekly Report, Vol. XI, No. 5, published by the Community Nutrition Institute, Washington, D.C. Mondays may be hazardous to your health Mondays have never been popular, because they usually signal the end of leisure time and a return to work. Now evidence is turning up that indicates that those "Blue Mondays" may be producing more than anxiety about going back to the daily grind. Information from a new study shows that more sudden-death heart attacks occur on Monday than on any other day of the week. Even more startling is that the high incidence of sudden-death heart attacks at the beginning of the week is in men with no previous history of heart trouble. While an exact cause is not known, researchers speculate that it relates to a return to occupational stress. The findings, reported by Dr. Simon Rabkin in a recent issue of the Journal of the American Medical Association (224:1357, 1358; 1980), are part of an ongoing study (the Manitoba Study) on cardiovascular problems that began in 1948. A group of nearly 4,000 men found fit r _ ,.. _ _ ,.. _ _, _ _ _ .., _ _ _ _ _ _ - -, - - .1 • I MOVING? I Eight weeks before you go, I let us know I NEW ADDRESS I Name Street or P.O. Box I I 4 ANON WANTED Y NEW YOKK PUBLIM ER Leading subsidy book publisher seeks manuscripts of all types: fiction, non-fiction, poetry, scholarly and juvenile works. etc. New authors welcomed. Send for free, illustrated 52-page brochure 0-65 Vantage Press, 516 W. 34 St.. New York. N.Y. 10001. For faster service, attach your current address label (from magazine cover or wrapper) in the space indicated. Then fill in your new address and mail to LIFE & HEALTH Circulation Department, 6856 Eastern Ave., NW., Washington, D.C. 20012 LE I= MO MIN 28 LIFE & HEALTH—JUNE 1981 City State Zip 4 Attach your address label from current issue here. =I MEI NMI NIB MN MN NM INN I =I ENJ jobs who came in to work on Monday, sat down at their desks, and died." Psychological stress has been related to sudden cardiac death in other studies (W. A. Green, S. Goldstein, A. J. Moss, "Psychosocial Aspects of Sudden Death: A Preliminary Report," Arch. Intern. Med. 129:725-731, 1972), and Rabkin feels that returning to work on Monday may be serving as a stressor. While more study on the subject is needed, it may be that the stress brought on by "Blue Mondays" shouldn't be taken so lightly. It could actually be hazardous to your health. —Thomas C. Lawry, Director of Public Relations, Reid Memorial Hospital, Richmond, Indiana. Energy conservation—a community life style If any community leads the nation in energy conservation, the small university town of Davis, California, has to be a prime candidate. Back in the early 1970s Davis enacted a tough building code requiring pas sive solar features in new homes. Later, an energy conservation retrofit law was passed. Before a house could be sold it had to meet certain insulation and weatherstripping standards and be equipped with low-flow shower heads. The town built some twenty-four miles of bike lanes and now has nearly as many registered bicycles (28,000 to 30,000) as residents (35,000). Energy conservation is a way of life in Davis. There's far less pollution and congestion, and since 1973 electricity consumption per capita has dropped 18 percent and natural gas use is down 35 percent. —The Energy Consumer, January 1981, published by the U.S. Department of Energy. rently rely on insulin produced from the pancreas glands of swine and cattle. Biosynthetic human insulin is identical to insulin produced in the human body, but is made by means of recombinant DNA, using a laboratory strain of common bacteria found in the body. This is believed to be the first long-term application of recombinant DNA technology in the world. Clinical evaluation in diabetics began in December, 1980, at the University of Kansas School of Medicine—Wichita. Other centers in the United States and Canada will begin evaluation of the recombinant DNAproduced medicine in the near future, according to Eli Lilly and Company, manufacturer of the new insulin. Lilly is a pioneer in the development of insulin. The company developed the first commercial production of insulin in 1923 and has continued its efforts to improve the medicine. —News release, Eli Lilly and Company, Indianapolis, Indiana. Bicycle touring—California style or in the Michigan manner Bicycle touring seems to be a growing form of recreation in the United States as more and more people discover the joys of riding out and seeing the countryside, getting close to nature, feeling more fit, and saving on gasoline costs. (For some suggestions about how to become involved in bicycle touring, see LIFE & HEALTH, May, 1981.) Backroads Bicycle Touring Co., based in Berkeley, California, offers weekend, three-day, five-day, and six-day tours, for novice, intermediate, and advanced cyclists. Some of the scenic areas scheduled to be visited this summer and fall are the Big Sur Coast, Grand Tetons-Yellowstone, The Canadian Rockies, Puget Biosynthetic human insulin being Sound, Zion-Bryce-Grand Canyon, and a number of northern California tested Clinical evaluation of biosynthetic sites. For more information, contact Tom human insulin in diabetic patients began in February of this year at Hale or Linda Petty, P.O. Box 5534, medical centers in Detroit, Philadel- Berkeley, California 94705, telephone (415) 652-0786. phia, and Trenton. If you'd prefer Michigan scenery, Thorough evaluation of the new insulin must be conducted prior to Michigan Bicycle Touring offers the application for the Government opportunity to experience the natural approvals required before the prod- splendor of northern Michigan. A variety of tours allows you to make a uct is available for all diabetics. Insulin-dependent diabetics cur- selection based on trip length, cycling distance per day, degree of difficulty, and scenic attractions. Some of the tours include a little canoeing in addition to cycling. For specifics, contact Michael Robold, 162 Golfview Drive, Brooklyn, Michigan 49230, telephone (517) 592-8620. And man created heat The extreme heat waves that swept the country during the summer of 1980 could be a sign of a mancreated process that could destroy the world's ecosystem by the year 2,030, says the chairman of the Chemistry Department at the University of Alabama. According to Dr. William Paudler, soaring temperatures could be part of "tremendous climatic changes, the likes of which man cannot possibly imagine." Paudler says the changes might be caused by the "greenhouse effect." This effect, he notes, deals with the burning of fossil fuels, which results in the burning of carbon dioxide. Plants convert carbon dioxide into oxygen for people to breathe and into carbon compounds," he says. "If there is too much carbon dioxide in the atmosphere, which there is, several things can happen. One, there are not enough plants or algae to convert the carbon dioxide to oxygen and carbon compounds, so we begin to have a decrease in our atmosphere's oxygen content. So what happens to the extra carbon dioxide? It goes to the upper levels of the atmosphere, where it behaves much like a blanket akin to the temperatures in a greenhouse—it lets sunlight into our atmosphere but will not let some of the heat generated on earth back out." —News release, University of Alabama. HOME WATER DISTILLER 111 I ha us pers.onal distiller art, de, for 10 years .1 r.1 out service needed W FRED CONWAY MONEY CAN BUY! Mk, 11:1 U HOME SAFETY sells more water distillers than any other distributor in the United States, and has TOLL-FREE order and service lines foryour convenience? DMZ 1 TI 2110131011 NOME SAFETY EQUIPMENT CO. IN . P 0 DRAWER 709LN NEW ALBANY IND. 7150 1-800-457-2400 or_a, T ,, —JUNE 1981 29 BOOKSHELF Review or listing of books does not constitute endorsement. Books reviewed by Ella Rydzewski. former editorial secretary. LIFE & HFALTH. Not for Doctors Only, Dr. James Wasco. Addison-Wesley Publishing Company, Inc., Reading, Massachusetts 01867, 1980, 306 pages, $7.95 paperback, $12.95 hardback. This volume claims to present more than 100 medical discoveries and inventions that even your doctor may not know about. Dr. Wasco is an experienced television medical reporter, and in Not for Doctors Only systematically writes on a spectrum of topics that will be interesting to the healthy and give hope to the ill. The author feels, and he uses a recent University of Michigan study to back him up, that many physicians are so busy working that they are behind in their knowledge of up-todate medical advances. In this book he tells about new treatments for herpes, heart disease, acne, cancer, psoriasis, and many other conditions. A few of Dr. Wasco's "breakthroughs" seem not so new, and in fact may become outdated very rapidly as medicine continues on with its dizzying advances in treatment and prevention of disease. Citrus, How to Select, Grow and Enjoy, Richard Ray and Lance Walheim. HPBooks, P.O. Box 5367, Tucson, Arizona 85703, 1980, 176 pages, $7.95 paperback (plus 750 postage). This profusely illustrated volume on citrus has been written as a guide for citrus growers or anyone who enjoys knowing more about these beautiful, healthful fruits. Maps show the areas of citrus growing, and charts provide information about citrus pests. For easy recognition, pictures are included of those pests that are the most destructive. More than 100 varieties of citrus are described, and instructions are given on how to grow them. Of special interest are the dwarf varieties that allow small-space gardeners to enjoy the benefits of growing citrus. According to the author, these can produce 50 to 60 percent of the amount of fruit provided by a standard tree. 30 LIFE 8 HEALTH-JUNE 1981 The more than 300 full-color photos make this an attractive as well as useful volume. Why Seek Ye the Dead Among the Living? A guide for widows, Alan C. Tibbetts. Dorrance & Company, Inc., Cricket Terrace Center, Ardmore, Pennsylvania 19003, 1981, 95 pages, $5.95 hardback. As an Army chaplain in 1964 Dr. Alan C. Tibbetts began counseling widows when he came in contact with women whose husbands had been killed in Vietnam. In this volume he presents an eleven-part, step-bystep guide for widows. Dr. Tibbetts takes a direct, but compassionate, common-sense approach toward widowhood. His advice is directed to that most difficult initial period, as he helps widows evaluate their life and its priorities. Jackie's Book of Household Charts, Jacqueline Hostage. Betterway Publications, White Hall, Virginia 22987, 1980, 113 pages, $5.95 paperback. Jackie's Book of Household Charts is a welcome addition to every wellorganized household. Have you ever wished you had all your household information in one place within easy reach? Now you can do that with this handy little comb-back book. It covers subjects from family diet/nutrition guidelines to directions on how long and where to keep important papers. Included are charts on safe food storage and information on how to care for seventy-five well-known houseplants. There is a guide on the safe use of medicines and another on energyconservation methods. It tells you how to file consumer complaints and how to cook with herbs and spices. Another helpful addition is a number of charts you can fill in to keep on file such things as household inventory, family health, dates to remember, clothing sizes, and other family and financial records. This book can be an asset for anyone—families, couples, and singles. Diet Against Disease, Alice A. Martin and Frances Tenenbaum. Houghton Mifflin Company, 2 Park St., Boston, Massachusetts 02107, 1980, 325 pages, $11.95 hardback. Diet Against Diseasecovers a lot of ground in the area of preventing illness through better nutrition. It begins by presenting the evidences that link disease and faulty diet and then goes on to discuss various aspects of dietary needs. In Part I are sections on fat, vitamins and minerals, salt, cholesterol, protein, starch, sugar, fiber, and additives. The second part of the book discusses putting this knowledge about diet into practical use by giving guidance in selecting, storing, and preparing foods. Part III provides recipes and cooking procedures. In the appendix 41 pages detail. the nutritive value of commonly used foods. The appendix also includes the dietary guidelines that were issued in 1980 by the U.S. Department of Agriculture and the U.S. Department of Health, Education, and Welfare. Though this "new plan for safe and healthy eating" is not vegetarian, the guidelines proposed therein can be modified and are valuable to everyone who aspires to a more healthful life style. Best Practical Parenting Tips, Vicki Lansky. Meadowbrook Press, 18318 Minnetonka Blvd., Deephaven, Minnesota 55391, 1980, 139 pages, $3.95 paperback. This volume boasts more than 1,000 parent-tested ideas for the first five years of a child's life. These tips are presented under the headings of fifty different topics having to do with childrearing, including new-baby care, feeding, toilet training, fears, discipline, sibling rivalry, and many more. Vicki Lansky is a well-known American author of books on babies and children. This book grew out of a newsletter that she originated to enable parents to share ideas that had worked for them. 4 A I 4 I BASIC Ifpfils GROUPS Vegetable-fruit group four or more servings Citrus fruits, tomatoes, cabbage, peppers, melons, berries, dark- green or deep-yellow vegetables, potatoes, and others Bread- cereal group four or more servings Breads, cereals, and other grain products made from whole ( preferred ), enriched, or restored grains Protein group two or more servings Dry beans, dry peas, lentils, garbanzos, nuts, peanuts, peanut butter, eggs, cottage cheese, soy cheese, vegetable proteins Milk group children- - 3 to 4 cups adults- -2 or more cups Whole, evaporated, or skim milk, reconstituted dry milk, buttermilk, or soybean milk Eat additional food as needed for more calories Is your kitchen suffering from the decorative "ho-hums"? Do you want to brighten things up and at the same time have a daily rernino, of your nutritional needs":' Health is making available to you this beautiful full-color poster on the basic food groups for only 51.00. Order your 21 \ 20 poster today' Please send me C a_ _<2 a_ basic-food-groups poster(s) at $1 00 each. I have enclosed $ Name 0 Address City O State Review and Herald Publishing Assoc., Periodical Dept.. 6856 Eastern Ave.. Zip NW., Washington. D.C.20012 Dental Fact or Fiction—#2 Answers to the most common dental questions The size, form, and arrangement of teeth encourage some to shed and others to hold tooth-decaying food. This is often an inherited trait. Nevertheless, what we eat, rather than heredity, more often influences our dental health. Even though.' parents have good teeth, their children must brush and floss properly and reduce their intake of refined starches and sugars to a -6 minimum to reduce dental decay. Technique equals effectiveness Learning how to brush and floss your teeth properly is a very important part of personal dental care . It's not how hard you brush your teeth that really matters, but, how thoroughly you clean them. Do you know the best way to brush and floss your teeth? Learn how in the new Life & Health supplement, the Dental Health Special. This 16-page booklet is full of all kinds of practical information on personal dental care, including articles on preventing chil dren's dental injuries and the hidden sugars in food. Find out more about your teeth. your copy of Dental He. to Get the facts straight about teeth. Order your copy of the Dental Health Special. copy(s) of the new Dental Health Please send me Special. I have enclosed my check or money order for US$.70 per copy. Address City State lip Please mail this to: Periodical Dept., Review and Herald Publishing Association, 6856 Eastern Avenue NW., Washington, D.C. 20012. Price subject to change without notice. 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