“Overall, the results of this study do not support the role of estrogen in the treatment of AD,” wrote study authors, led by Ruth A. Mulnard, R.N., D.N.Sc., of the Institute for Brain Aging and Dementia at the University of California, Irvine.

The study, the largest and longest of its kind, randomly divided 120 women with mild to moderate Alzheimer’s disease into three groups: one receiving a low dose of estrogen, another receiving a high dose of estrogen and a third receiving a placebo pill, which did not contain estrogen. Only women who had had a hysterectomy prior to enrollment were eligible for the trial. Ninety-seven women completed the study.

Researchers followed the progress of the patients for up to 15 months, regularly assessing their overall mental ability in addition to their mood, memory, attention, language skills, motor function and daily living activities.

Estrogen replacement therapy did not slow the mental decline of the Alzheimer’s patients studied. Eighty percent of the patients taking estrogen showed deterioration in their conditions compared to 74 percent of the patients taking a placebo. Low doses of estrogen were associated with some initial, short-term improvements in mental ability, consistent with earlier studies. This progress, however, was not sustained for the study’s duration.

In an interview with the American Council on Science and Health, Mulnard said she and her colleagues were surprised and disappointed by the findings. But, Mulnard added, “the results are very important to women. Positive or negative, the study is an important contribution.”

Alzheimer’s disease is estimated to affect more than 4 million people in the United States. The majority are women. The disease, which typically begins after age 60, is characterized by a progressive deterioration of memory, language ability, visuospatial skills and judgment. Currently, there is no cure for Alzheimer’s, although some medications are effective in easing certain symptoms.

While the latest study indicates that estrogen is not effective in treating existing AD, study authors remain optimistic that estrogen may still prove useful in preventing or retarding the start of AD.

“This is a definitive study for the kind of women we studied,” Mulnard said. “But, it does not answer questions for all women with Alzheimer’s disease.”

“One thing is very clear,” Mulnard stressed, “Estrogen could still play a very big role in preventing disease.” She noted that there are already several large studies underway examining whether estrogen may prevent AD.

In an editorial accompanying the latest report, Yale researchers emphasized that the findings could only be limitedly generalized. They also encouraged more research on estrogen and Alzheimer’s disease.

“The conclusions are valid only for a very specific population, women of advanced age (approximately 75 years) with AD of mild to moderate severity,” commented Bennett A. Shaywitz, M.D., and Sally E. Shaywitz, M.D. “It remains for future studies to determine the role of estrogen, if any, in preventing or delaying the onset of AD.”

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Interestingly enough, a study of the intensity of music was avoided, and physical movements involved were concentrated on instead. It was concluded that “jumping up and down” could potentially disturb the ciliated cells of the inner ear and that, in turn, could result in a decline in hearing. Such a relationship has never been substantiated and probably never will. However, the fact that the intensity level of the music was not studied is untenable in light of the subjective evidence that the music level in such environments is often found to be extremely high.

The study(3) that did examine average intensity levels of music in health clubs revealed intensity levels in one-hour aerobics classes that consistently ranged from 100 db to 120 db.

In one instance, the music reached a level of 122 db for a 20-minute period during a high-impact aerobics class.

This led this investigator to conclude that a more extensive study of intensity levels of music in aerobics and body-conditioning classes was warranted. Such a study could provide owners and managers of health clubs with information to protect the residual hearing of participants and aerobics instructors who may not be aware of potentially damaging effects of music at its present levels.

However, research reported in the February 2000 issue of the Journal of the American College of Cardiology suggests that while very high doses of vitamin E may be helpful in improving short-term changes in artery function after smoking, it cannot reverse established blood vessel abnormalities in smokers.

Smokers’ arteries are more likely to develop fatty deposits, or atherosclerosis, and become less elastic than arteries of nonsmokers. One aspect of arterial function that worsens with smoking is dilation, or expansion, of the arteries when blood flow through them increases. Smoking appears to decrease an artery’s ability to widen when necessary. Such a lack of arterial dilation could lead to diminished blood flow to the heart. If it continues, a heart attack might result.

The researchers, from the Universities of Innsbruck and Vienna, Austria, studied the arterial dilation of 22 healthy young men, with an average age of 27, who smoked about a pack of cigarettes per day. Eleven of the men took a high dose vitamin E supplement (600 International Units) every day for four weeks; 11 others took an inactive compound for the same period. These groups were also compared with a matched group of 11 healthy nonsmokers.

To measure arterial function, the researchers used a blood pressure cuff to compress each subject’s brachial artery, a large artery in the upper arm, and then released the pressure. Normal response to such manipulation is a widening, or dilation, of the artery after the pressure is removed. The widening was measured by an ultrasound technique, which produced an image of the artery.

Before the study began, the investigators measured the dilation response of the brachial arteries of both smokers and nonsmokers. They found that the smokers’ arteries did not expand to the same degree as did the arteries of nonsmokers.

After four weeks of high-dose vitamin E supplementation, the subjects were examined again — at least two hours after they had smoked a cigarette. In these tests, there was no difference between the arterial responses of smokers who had taken vitamin E supplements and smokers who had not.

The arterial responses were measured again 20 minutes after the smokers had smoked a cigarette, and in this case, vitamin E did seem to affect arterial dilation. In smokers who had taken vitamin E, the arterial dilation was more normal than in the smokers who had taken the placebo pills.

The authors interpreted these results as indicating that four weeks of vitamin E supplementation could not reverse the chronic arterial dysfunction that accompanies cigarette smoking. They did note that there seemed to be “a partially beneficial effect of vitamin E supplementation. … it prevented the transient further impairment of vasodilatation after acute smoking.”

“The potentially beneficial effect of high doses of vitamin E on arterial widening in smokers is so short-lived as to be a nonfactor,” commented Dr. David Kritchevsky, institute professor at the Wistar Institute in Philadelphia. “If smokers want to preserve their blood vessels and heart, the best way to accomplish this is by quitting smoking. It can’t be done with a pill. The best way to get vitamin E is from the grocery, or the cheap pharmacy,” he added.

It should be noted that the level of vitamin E supplementation in this study — 600 International Units — was quite high compared to the dietary amount recommended for healthy adults, which is 12 to 15 International Units per day.

Although natural male hormones, such as testosterone, are legally available only with a doctor’s prescription, there are some substances, sold as dietary supplements, which promise to have the same effects. One such supplement is the hormone androstenedione.

New research reported in the Feb. 9 issue of the Journal of the American Medical Association begins to clarify some of the results of androstenedione supplementation — at least on young men.

While marketers tout androstenedione (often advertised as “Andro”) as a “natural” bodybuilding aid, little solid scientific evidence exists to support either its effectiveness or its safety.

The adrenal glands, testes and ovaries produce androstenedione. The body can convert it to testosterone (the main male hormone), and also to the female hormones estrone and estradiol. It is the possibility of conversion to testosterone, responsible for men’s greater muscle mass, that is the basis for androstenedione’s use as a muscle-building, or anabolic, supplement.

Researchers from Massachusetts General Hospital in Boston, University of Massachusetts Medical School in Worcester and University of California Los Angeles Medical School collaborated to investigate the effects of androstenedione supplementation on hormone levels of 42 young, healthy men (average age 26 to 32). The subjects were randomly assigned to receive either 100 milligrams or 300 milligrams of androstenedione daily for seven days. Another, matched group received no supplement.

Blood samples were drawn on the first day of the study before supplements were taken, and at intervals for up to eight hours later. The sampling was repeated on the last day of the seven-day study. The blood levels of several hormones were measured — androstenedione, testosterone, estradiol and estrone.

The investigators found that the androstenedione supplements, even when taken for only one week, did significantly increase levels of testosterone in the subjects’ blood, but only at the 300-milligram-per-day level. The level of the female hormone estradiol was also significantly higher in the supplemented groups of men — at both the 100-milligram and the 300-milligram dose. After seven days of supplementation, 12 of 15 subjects in the 100-milligram group, and 10 of 14 subjects in the 300-milligram group had estradiol levels that were above the upper normal limit for men.

The authors noted that because of these alterations in sex hormone levels, high-dose androstenedione supplementation could have feminizing effects in men, and possibly have masculinizing effects in women. They also suggested that in children such supplementation ” … could cause precocious puberty … thereby compromising final adult height.”

Dr. Benjamin Leder, lead author of the study, commented, “Androstenedione supplementation causes a variety of hormonal imbalances, and we don’t know what the health effects of these would be over the long term. There is certainly a potential for adverse effects.” He continued, “Until a long term clinical trial is completed, people who use these supplements should be aware that we have virtually no information about their future effects.”

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For example, smoking causes the skin to age more quickly and not drinking enough water can cause the skin to become dry and acne prone, even in your 50s, according to dermatologist Daniella Duke, M.D., who teaches laser skin surgery at Yale University.

Dryness is the most common skin problem women in their 50s will notice, along with more lines and age spots from years of sun exposure, Duke says. In her practice in Mystic, Conn., Duke recommends women switch to milder cleansers and thicker moisturizers to offset the dryness. And to help even out skin tone and reduce lines and age spots, she recommends starting with over-the-counter alpha-hydroxy products that can be found in many skin care lines, as well as topical vitamin A and vitamin C treatments.

The 50s are also a time when many women may first see signs of skin cancer. Red, scaly spots that don’t go away or come back in the same spot, or bumps that show up suddenly, may be precancerous and should be checked by a specialist. Which leads Duke to remind women that sunscreen should always be worn on exposed areas, even in the winter.

Changing Mental Outlook
Something else women in their 50s may face is depression. The trouble many women have is distinguishing between the blues that may accompany hormonal changes during menopause and clinical depression, according to Laurie Young, Ph.D., senior vice president of the National Mental Health Association.

“The biggest myth is that all people aging get depressed. You shouldn’t think that just because you’re aging or you’re going through menopause you should be depressed. The question to ask yourself is if you rebound or if you stay in those symptoms — such as a change in appetite, changes in your sleeping habits, the inability to concentrate or make decisions, loss of interest in sex. If those signs last more than two weeks, you should seek help,” she said.

Haddon could have easily lost herself in depression 10 years ago when her husband died suddenly, leaving her without financial stability and with a teen-age daughter to raise alone.

Instead, Haddon said, “Going through something like that gives us an opportunity to ask ourselves questions we wouldn’t ask otherwise — what’s a life for, what’s the value of it, am I wasting it? Through your struggle to right yourself you gain a deeper understanding about life, one that I think gives you perspective. I learned I can’t always control what’s going to happen, but I can control how I deal with it.”

Haddon finds that simple things such as deep breathing, taking a walk during lunch and a warm bath help her manage stress. And she highly recommends yoga and meditation, whether in a class or alone at home.

She believes women in their 50s and 60s are facing a bright future.

“These women know they have a lot of life left. They need to be encouraged, and we all need to change the way we decide what is beautiful. Really, the age you are is the best age — it’s all about attitude,” Haddon said.

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And 50-something women like Dayle Haddon, Cybill Shepherd and Cheryl Tiegs are proving it.

“Being in your 50s is great. You know more, you dare more, you can laugh more. You fight a little more for your body — but now it’s about being healthy, not being a size 4. Quite simply, you become a confident, strong woman who knows who she is from within,” said 52-year-old Haddon, who started her own business and became an author after being told she was too old to return to modeling and acting. The success of women such as Haddon, who is the face of L’Oreal’s Plentitude line and beauty and wellness contributor for CBS’s “The Early Show,” has made advertisers take notice that millions of baby boomers are entering their 50s, intent on looking and feeling healthy.

Why wouldn’t they be — after all, they’ve still got more than a third of their lives to live, according to the National Institute on Aging.

Lifestyle Enhancements
Making sure that life is a healthy one means nutrition and exercise are more important than ever, according to registered dietician Betty Nowlin, a spokeswoman for the American Dietetic Association.

Because women over 50 are generally more at-risk for diet-related illnesses such as cardiovascular disease, osteoporosis and gastrointestinal problems, it’s time to eat right, stop smoking and start exercising at least 30 minutes a day most days.

Eating a healthy diet, taking 1,000 milligrams of calcium a day (1,500 for those who are post-menopausal), drinking plenty of water and exercising, even in 10-minute intervals, are the best ways to ward off illnesses, Nowlin says. She also recommends women in their 50s take a multi-vitamin, get at least 30 grams of fiber a day, keep their fat intake to less than 30 percent of their daily calories, and make sure they get enough vitamin D, which helps the body absorb calcium.

Such a routine can help prevent the biggest health risk women in their 50s face — cardiovascular disease. The disease, which can cause heart attacks and strokes, is the No. 1 killer of women over 50, killing more women than men and killing more women than all the cancers combined, according to the American Medical Association.

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TYLENOL – 15mg/kg for high fever (12mg/kg for low grade fever but I don’t use anything for low grade fevers anyway so I just ignore this). May be repeated as needed every 4 hours.

IBUPROFEN (Advil or Motrin) for Children – usually comes as 100mg per tsp. (Always check the label for the strength) – give 10mg per kilogram for high fever or pain due to inflammation (injury, teething, etc.) and this can also be repeated as often as every 4 hours if needed although it usually lasts longer than Tylenol so you may not need to use it as often. I like this drug a lot.

BENADRYL (diphenhydramine) – usually used for allergic reactions or cold symptoms without worrying about agitating like ephedrine will do – sometimes misguidedly used to get the kid to sleep on the plane – it never works! Comes as 12.5 mg per tsp. Dose – 1mg per kilogram of weight so give your 25 pounder one tsp.

SUDAFED (pseudoephedrine) – used for congestion and colds but you should always be sure your child is well hydrated before using this or you can make symptoms worse – also know this tends to agitate so skip it at bedtime if your child tends to be high strung to start with. Comes as 15 mg per tsp. Dose is 1 mg per kilogram of weight so give your 60 pounder 2 tsp. 2 or 3 times per day (a day is 24 hours parents, so don’t overuse this stuff).

IMODIUM (loperamide HCl) – for diarrhea (check first with your doc if it’s OK to use this in your child’s particular situation) This one is easier – 1/2 tsp. for under 25 lbs. And 1 tsp. for 25-50 lbs. And 2 tsp. over 50 lbs. And you may repeat this after each loose stool to a maximum of 6 doses in 24 hours. If it hasn’t controlled things by then it isn’t going to and you better consult your pediatrician again.

These are of course only some of the various OTC cheap drugs out there but they are the most common ones you call me about. Some of you are probably thinking, “This is too complicated. Why don’t I just call the pediatrician and she’ll do all the figuring.” You can, but just know, pediatricians like to sleep through the night sometimes too! Good luck and stay healthy – and if you must, use OTC meds in the correct dosage or not at all!
Happy calculating!

First, you MUST know your child’s weight at least within a few pounds if she is over 25lbs. and within 1lb. if she is smaller than that. Weight to dose is everything in determining both a safe and effective dose of any med. Infants only gain 1 to 2 lbs. per month in the first year so you can usually guess from the last month’s visit but better to know exactly in the very young.

Most dosing is “per kilo”, not per pound, due to the medical basis of the calculation and medicine’s penchant for making things complicated – so get used to dividing your child’s weight in half (that’s close enough though not exact) to deal with dosing calculations. You might wonder why I don’t tell you to follow the package instructions on dosing and that’s because it’s usually way off in accuracy, partly because they group kids by age, not weight, or the weight guidelines are a huge spread and for “safety” they aim at the lowest weight in the range they offer so that no one will take too much – of course this also means no one will take the right amount and so many will get insufficient medicine to make a beneficial difference – and what’s the point of putting this stuff in your child’s body in the first place if you’re not going to see him feel better for it! In some cases this can even be quite dangerous, for instance when you are trying to control a very high fever and by following the package directions you keep giving too little acetaminophen (the active ingredient in Tylenol) and the fever just keeps on rising! Not smart! Many of us have complained to Tylenol about this but they just tell us we’re right but that’s our responsibility and they can’t change the packaging without major FDA hassle. I for one find this very annoying and irresponsible. While I’m busy bashing let me also tell you to be very aware of the difference in strength between infant’s Tylenol drops and children’s Tylenol (this is also true of other meds with both infant and children preparations) – YOU CANNOT USE THE CHILDREN’S MED AS IF IT WERE THE INFANT’S, ONLY IN A BIGGER BOTTLE! – You will hurt your child if you do this and yet it happens all the time. The concentrations are totally different so don’t stick the dropper you get with infant’s medicines into the children’s bottle and draw up the same amount! If you understand the dosage difference you can of course use any dropper but you will be using a different quantity. Fortunately this error usually results in severe UNDER dosing instead of over dosing but that is still not what you want for your child. Also most instructions on OTC bottles are written for people with superior mega-vision and nothing but peace and time on their hands, so know this – all suspensions (vs. Elixirs) MUST be shaken well or you will not be giving a dependable dose of medicine (but you sure may be giving a sugar jolt to Johnny!). Also note that some cold meds look like they are intended for your child’s nose (see Pediacare infant drops packaging) when in fact it is meant to be taken by mouth (Pediacare finally put a very tiny warning on the front of the package next to the HUGE picture of a nose that says “for oral use”.) Thank you for trying.

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Consider vacation time. Packing and traveling with a formula-fed baby is more complex than traveling with a nursing baby. Just the extra paraphernalia involved in taking bottles, nipples, etc. on the road is space consuming. Forgetting one of the needed items will mean an immediate trip to the store which, in a strange place at an odd hour of the day, can be difficult. For many vacations you would need to carry your own familiar (or bottled) water because babies are sensitive to changes in water just like adults. Or one could simply spend extra funds on ready-to-feed formula.

I get very sad when I see a baby in a public vacation spot (or anywhere for that matter) crying while s/he waits for mom or dad to make up a formula bottle — pouring (maybe spilling) the water into the bottle, shaking the dry mix, then attempting to feed baby a bottle with a clogged nipple full of unshaken powder.

It is so much easier to simply find a cozy spot and feed your baby. For moms who are uncomfortable nursing in public, try a dressing room at your local store and remember that some of the nicest vacation spots have nursing areas that are not attached to bathrooms (my personal LEAST favorite public places to nurse).

Consider the vacation gone awry. Perhaps you are headed home. Ready to be back in your own cozy bed and weather has caused a delay. You are in the midst of a LONG detour. No signs of *civilization* as you know it. Breastfeeding is a breeze in this situation. Simply pull the car over to a safe spot — nurse — and continue on your way. While many of us admit to having nursed a crying baby while s/he remains safe in the carseat (imagine if you will a mom draped VERY unsafely over the carseat admonishing dad to drive carefully), this is clearly NOT recommended. Safe happy and healthy is the KEY. And nursing makes that EASY.

Have a GREAT vacation.

The Station

Tucked away in our subconscious minds is an idyllic vision. We see ourselves on a long, long trip that almost spans the continent. We’re traveling by passenger train, and out the windows we drink in the passing scene of cars on nearby highways, of children waving at a crossing, of cattle grazing on a distant hillside, of smoke pouring from a power plant, of row upon row of corn and wheat, of flatlands and valleys, of mountains and rolling hillsides, of city skylines and village halls, of biting winter and blazing summer and cavorting spring and docile fall.

But uppermost in our minds is the final destination. On a certain day at a certain hour we will pull into the station. There will be bands playing and flags waving. And once we get there so may wonderful dreams will come true. So many wishes will be fulfilled and so many pieces of our lives finally will be neatly fitted together like a completed jigsaw puzzle. How restlessly we pace the aisles, damning the minutes for loitering, waiting, waiting, waiting for the station.

However, sooner or later we must realize there is no one station, no one place to arrive at once and for all. The true joy of life is the trip. The station is only a dream. It constantly outdistances us.

When we reach the station, that will be it! we cry. Translated it means, When Im 18, that will be it! When I buy a new 150 SL Mercedes Benz, that will be it! When I put the last kid through college, that will be it! When I have paid off the mortgage, that will be it! When I win a promotion, that will be it! When I reach the age of retirement, that will be it I shall live happily ever after!

Unfortunately, once we get it then it disappears. The station somehow hides itself at the end of an endless track.

Relish the moment is a good motto, especially when coupled with Psalm 118:24: This is the day which the Lord hath made, we will rejoice and be glad in it It isnt the burdens of today that drive men mad.

Rather, it is regret over yesterday or fear of tomorrow. Regret and fear are twin thieves that would rob us of today.

So, stop pacing the aisles and counting the miles. Instead, climb more mountains, eat more ice cream, go barefoot oftener, swim more rivers, watch more sunsets, laugh more and cry less. Life must be lived as we go along. The station will come soon enough.