Thursday, December 13, 2012

Ideas for Coping with Holiday Season Stress

While the holiday season can be full of fun, there are also aspects of it that can be extremely stressful. Here it's important to note that not all stress is actually bad - there are both good and bad stressors. However, both types of stress can take a toll on you emotionally and physically, so it's important to have some ideas about how to make sure you are able to relax during the holidays.

Here are a few tips for some of the more common stressful situations:

  • Grief and sadness - Holidays can be especially hard if you have recently lost someone, but even if the loss was not recent it can still cause feelings of sadness and grief. It's important to recognize those feelings and take time to express them. Make use of your support system during these times, or consider contacting a professional counselor, who can help you find productive ways to work through your emotions.
  • Interpersonal relationships - It can be difficult to juggle all of the demands on our time and attention over the holidays! It's important, though, to learn to carefully and realistically assess your situation, and to learn to say "no" when that is what best fits your needs. If you will be around others with whom you typically have differences, try to have a plan for how to avoid conflict, if possible. Also, plan ahead to schedule in time for yourself - even if it's only a few minutes alone! - so that you can regroup and refresh. 
  • Money and societal ideals - Commercialism is rampant during this time of year, and it can be easy to feel especially stressed if you are on a tight budget. Create a list and decide how much you can afford to spend before you go out and shop, and then stick to it! Remember that many of the idealized versions of the holiday that we see in the media are truly unrealistic. Dig down to what you and your family consider to be the true meaning of the season and focus on celebrating in your own way. This is how traditions get started! 
For more tips on how to beat stress this season, check out these helpful articles: 
Do you have any tips you can share on how you beat holiday stress? We would love to hear your comments!

Thursday, December 6, 2012

Staying Healthy Over the Holidays

With the turning of the calendar to December, winter will be upon us before we know it! Here are a few tips from the CDC on how to stay healthy over the holidays:

  • Wash your hands often - Dr. Ignaz Semmelweis is credited with discovering in the late 1840's that hand washing saves lives. We now know that a truly thorough hand washing actually takes at least 20 seconds. (Time yourself the next time you wash your hands and see how long 20 seconds is - you may be surprised!) Be sure to use warm water and to scrub the surface of your hands well. You may also want to carry a small bottle of hand sanitizer with you for when washing your hands is not an option.
  • Cover your mouth and nose if you sneeze or cough - Try not to spread any extra germs around, if possible. While instinct may prod you to use your hand as a cover, it is actually more healthy to use a tissue, or even the crook of your elbow. If you can keep from touching your face with your hands, it will provide additional protection from germs. 
  • Stay warm - While being in the cold itself is not going to necessarily make you sick, it does take more effort for your body to keep warm. This additional effort can divert energy your body would normally use to fend off germs - making you more likely to become ill. Hypothermia can also be a concern during the coldest months of the year, and is a special risk for the elderly and children. 
  • Manage your stress level - The holidays are one of the most stressful times of year! Try to take some extra time for yourself to relax and get plenty of sleep. Additionally, remember that overspending can be a big contributor to your stress level, so create a reasonable budget for your holiday spending.
  • Travel safely - The National Highway Traffic Safety Administration reports that in December 2010, almost 3,000 people died in car crashes and 30% of these involved a driver under the influence of alcohol. Buckle up when you are on the road and don't drink and drive! The holidays are a prime time for parties, so be sure to plan ahead for a designated driver before you head out to that gathering.
For more information on how to stay healthy this winter, check out these helpful links:
Do you have any winter health tips that you can share? Please feel free to give us more ideas in the comments area! 

Thursday, November 29, 2012

Lung Cancer Awareness

November has been designated as Lung Cancer Awareness Month by the Lung Cancer Alliance. The National Cancer Institute estimates that there will be over 226,000 new cases of lung cancer, and over 160,000 deaths from lung cancer, within the year 2012 alone. Clearly this is a disease that we need to know more about and become more active in combating.

Lung cancer specifically forms on the lung tissue and cells lining the air passageways, and there are actually two types - small and non-small cell - based upon how the cells appear under a microscope. The Lung Cancer Organization has a link to a documentary that provides more in-depth information about the disease. One thing that is important to remember is that, while smoking cigarettes is definitely a risk factor for lung cancer, there are many other risk factors that individuals should be alert for, such as

  • exposure to asbestos, radon, or other industrial substances
  • radiation exposure
  • air pollution
  • tuberculosis, and
  • genetic predisposure
Some of the symptoms that individuals experiencing lung cancer may exhibit are
  • coughing (especially persistent and/or intense coughing)
  • pain in the chest, should, or back unrelated to pain caused by coughing
  • changes in color or volume of sputum
  • shortness of breath
  • changes in voice or a hoarse voice
  • harsh sounds with each breath
  • recurrent lung problems (bronchitis or pneumonia)
  • coughing up phlegm
Additionally, individuals may experience symptoms in other parts of their bodies
  • loss of appetite or unexplained weight loss
  • muscle wasting
  • fatigue
  • headaches, bone or joint pain
  • unexplained bone fractures
  • neurological symptoms
  • neck and/or facial swelling
  • general weakness
  • bleeding
  • blood clots (http://www.lungcancer.org/reading/symptoms.php)
While some types of lung cancer, such as that caused by genetic factors, are hard to circumvent, there are some things that individuals can do that will help lessen their risk of contracting lung cancer. Stopping smoking and/or reducing exposure to environmental factors that are known to increase risk is your best bet. Additionally, if you or someone you love feels that they may be at risk, you can talk to your doctor about screening techniques that can help identify problems more quickly.





Monday, November 26, 2012

TWU's Student Health Services will be observing World AIDS day on November 27th, in the Student Union Purple Lounge from 11:00 a.m. to 1:00 p.m. with an awareness event. The Red Ribbon Fashion Show will begin at 12:30. Come join in!



Thursday, November 22, 2012


Wishing everyone a happy and safe Thanksgiving holiday from the TWU Health Studies department! What are you thankful for this year?

Thursday, November 15, 2012

37th Annual Great American Smokeout!

Today marks the 37th Great American Smokeout, the day every year that smokers are encouraged to commit to quitting, or actually quit, smoking.  The American Cancer Organization states, "Tobacco use remains the single largest preventable cause of disease and premature death in the U.S."; however, almost 44 million Americans are still smoking. While cancer is probably the most widely known disease that is connected to smoking, the Centers for Disease Control (CDC) report that smoking is also estimated to increase the risk of contracting various diseases. For example, it can increase the risk of

  • coronary heart disease by 2 to 4 times,
  • stroke by 2 to 4 times,
  • men developing lung cancer by 23 times,
  • women developing lung cancer by 13 times, and 
  • dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times (CDC Fact Sheet).
Smoking may also cause cancer in parts of the body other than the lungs, and there are reproductive and early childhood effects - such as infertility, stillbirth, and sudden infant death syndrome - that are linked to smoking. So, stopping now - or not starting! - is one of the best health choices that you can make for yourself.


In addition to significantly impacting an individual's health, tobacco also has a drastic affect on individual's - and society's - wallets! This helpful infographic shows the true cash impact of tobacco on healthcare costs, productivity, and other aspects of daily life: Tobacco - The True Cost of Smoking.

Once started, smoking can be a very difficult habit to quit! The American Cancer Society realizes this, so the home page for the Great American Smokeout has a variety of helpful information, including steps you can take to quit, a guide to quitting, a list of the numerous health benefits to be gained from quitting, and desktop helpers to provide you with motivation: The Great American Smokeout. I encourage you to make a healthy decision for yourself today and "be a quitter"!



Monday, November 12, 2012

Repost - Guest Post: The State of Health of Student Veterans

This guest post originally appeared on our blog in July. However, the topic is so appropriate for Veterans Day that we decided to repost!

As a health educator at an urban institution of higher education that currently serves approximately 350 GI Bill benefit students, I have recognized a need for those of us working in college health to better understand our student veterans. I am also a U.S. Army veteran that served a tour of duty in Saudi Arabia, Iraq and Kuwait during the 1991 Persian Gulf War. When I attended university during the mid-to-late 1990's, there were no campus veteran support services available, nor was there a student veteran organization. The transition for me was difficult and involved a lot of self medication. I, as many servicemembers before and after me, was trained to take care of myself and my buddies - to show weakness in any way is not what a soldier does. The world has evolved since - the reduced stigma of mental health and the many support organizations that are available to meet the needs of all veterans is amazing. However, we still have a long way to go to completely eliminate the stigma of mental illness in the military.

Military servicemembers and veterans are attending college in record numbers. In part, this is the result of the implementation of the Post 9/11 GI Bill. The Post 9/11 GI Bill is a robust education benefit that makes the pursuit of a degree in higher education available to our nation's next Greatest Generation at virtually no cost to them. The number of student veterans is expected to continue to increase as more servicemembers transition out of the military. Many of these veterans are first generation students who also require additional support to successfully navigate the hurdles of pursuing a degree in higher education. This is not to say that institutions of higher education must create new programs to support student veterans, but they must evaluate and enhance existing services to meet the specific needs that student veterans bring to campus.

Student veterans often are not comparable to traditional students in their motivation to achieve higher education. Many look at this as their next mission that they must complete. They are often older than traditional students and have a more global life experience. Many have families they must support that necessitate the need for them to work a full-time job while they are also a full time student. Most have served in an area of hazardous duty where their life, or the lives of their comrades, has been threatened or tragically lost. The impacts of combat are not always visible and may not manifest themselves immediately. The transition from military to civilian and from boots to books may be a significant challenge for many student veterans. The visible wounds of war are easy to recognize, treat and accommodate. It is the invisible wounds of war - post traumatic stress (PTS), anxiety, traumatic brain injuries (TBI), or military sexual trauma (MST) to name a few - that present a challenge not only for the veteran, but also for those around them - family, other students, faculty and staff.

As professionals in college health, we are in a position to gain a better understanding of what the impacts of not only combat but also military service in general may have on student veterans. How do we accomplish this? By doing what we do best. Assess, assess, assess. Again this does not mean that we have to create new assessment tools, but rather that we augment existing tools in order to pull out veteran specific data. This is what was done by the Missouri Partners In Prevention (PIP) in 2009. Each spring PIP conducts the Missouri College Health Behavior Survey (MCHBS) on 17 campuses both public and private. This survey looks specifically at college students behaviors around alcohol and drugs, mental health, gambling, sexual assault, suicide, distracted driving, etc. In 2009, the MCHBS was augmented with approximately 40 veteran specific questions related to PTS, MST, TBI, engagement, alcohol and drug behaviors, and suicidality. Participants who indicated military service were directed to these additional questions in addition to the general MCHBS survey. In 2011, PIP received an additional SAMHSA grant to develop a stand alone Veterans Behavior Survey that will be piloted in fall 2012  by PIP schools who choose to participate.

The American College Health Association (ACHA) - National College Health Assessment (NCHA) began asking veteran status  in 2011. Campuses that participate in the ACHA-NCHA now have a mechanism to reference veteran responses to this comprehensive college health assessment tool.  ACHA also has a Coalition for the Wellness Needs of Military Veteran Students.The Coalition is open to all members of ACHA who are interested in working with, advocating for, and supporting veterans in higher education.
The challenge now for campuses is to move beyond being veteran friendly to being genuinely veteran supportive. This can only happen when higher education professionals gain an understanding of student veterans and work to positively support and impact their lives. After all they have given of themselves to support and defend our freedoms; it is now up to us to support and advocate for them so that they may be successful college students.

This post contributed by Bill Smith.


Bill Smith currently lives in Kansas City, Missouri and is the Health Educator with Student Health & Wellness at the University of Missouri – Kansas City (UMKC). He holds a Bachelors of Social Work from Washburn University (2000) and a Master of Science in Management from Baker University (2003).

He has worked in college health for nearly twelve years with a special emphasis on sexual health, alcohol and other drug use, and stress management. Prior experience includes six and a half years as a health educator at the University of Kansas and ­five years working in a community mental health center and with a community based HIV/AIDS service organization in Topeka, Kansas.

Bill has been asked to speak on the topic of student Veterans success by various organizations including:
  • The National Science Foundation
  • Substance Abuse and Mental Health Services Administration
  • Missouri Partners In Prevention
  • Metropolitan Community College – Longview Campus
  • The Community College of Philadelphia
  • The Illinois Higher Education Center
  • Region 10 Association of College Unions International

He is a former soldier having served in the Army both on active duty and in the reserves. You can reach Bill at

Thursday, November 8, 2012

November is American Diabetes Month

November is American Diabetes Month, which I find interesting coming so closely behind Halloween and all it's sugary excess, but that's another story (see Sweets for the Sweet!). The American Diabetes Association reports that "nearly 26 million children and adults in the United States have diabetes". Additionally, "another 79 million Americans have prediabetes and are at risk for developing type 2 diabetes," and the "national cost of diagnosed diabetes in the United States is $174 billion" - a staggering figure. The problem is becoming critical, since "recent estimates project that as many as 1 in 3 American adults will have diabetes in 2050" unless steps are taken to make some significant changes (http://www.diabetes.org/in-my-community/programs/american-diabetes-month/).

Coverage of our nation's obsession with sugar is commonplace, so it is likely that most of us are aware of the connection between excess sugar and diabetes. At it's most basic, diabetes can be described as an inability of your body to efficiently process glucose (sugar). The end result is that excess sugar builds up in the bloodstream leading to potential health complications such as

While excess sugar is definitely a contributor to this disease, there are actually many reasons for why people contract diabetes, and there are also different types of diabetes


  • Type 1 diabetes - An individual's immune system begins attacking insulin-producing cells in the pancreas depleting the insulin in their system and allowing sugar to build up in the bloodstream. This type of diabetes is typically genetic, or inherited.
  • Type 2 diabetes - An individual's cells become resistant to insulin and the pancreas is not able to create enough insulin cells to overcome the resistance. As a result, sugar builds up in the bloodstream. This is the more common type of diabetes and it is often preceded by prediabetes.
  • Gestational diabetes - Sometimes changes caused by pregnancy can cause a woman's cells to become more resistant to insulin, which can cause sugar to build up in the bloodstream (http://www.mayoclinic.com/health/diabetes/DS01121/DSECTION=causes).
Symptoms of diabetes, or prediabetes, can vary depending upon how much sugar is currently in an individual's system. Some warning signs to look for are
  • increased thirst
  • frequent urination
  • extreme hunger
  • unexplained weight loss
  • presence of ketones in the urine - a byproduct produced when the body begins breaking down muscle and fat, instead of using the sugar in the system
  • fatigue
  • blurred vision
  • slow-healing sores
  • mild high blood pressure
  • frequent infections - especially gum and skin, or vaginal or bladder (http://www.mayoclinic.com/health/diabetes/DS01121/DSECTION=symptoms)  
If you suspect that you or someone you love may have diabetes, it is important to see the doctor as soon as possible. 

Diabetes is a disease that can seriously impact your life. I watched one of my grandmothers suffer from this disease for many years. She lost most of her sight, and had problems with her feet. Both of these things made her life much harder and kept her from fully enjoying many things that she had previously regularly done, such as crocheting and gardening. I have been working hard to take precautions that will hopefully help prevent this disease by working on eating healthy and avoiding extra sugar whenever possible. I try to save sugary treats for truly special occasions and not partake on a daily basis. I also check ingredients on prepackaged foods to determine if there is added sugar - you would be surprised at the amount of sugar that can be hidden in foods that we don't normally think of as "sweet"! I have also been working on being more active on a regular basis and keeping my weight down to a healthy level. The Mayo Clinic says, "If you're overweight, losing even 5 percent of your body weight - for example, 10 pounds if you weigh 200 pounds - can reduce the risk of diabetes" (http://www.mayoclinic.com/health/diabetes/DS01121/DSECTION=prevention). Focusing on healthy eating and lifestyle can be hard at times, but I keep myself motivated by regularly assessing how much better I feel when I eat right and stay active, and by thinking about how good it feels to know that these, sometimes hard, decisions mean that I am taking care of myself.

The American Diabetes Association will be working all month to raise awareness for this disease. This year's campaign has the theme "A Day in the Life of Diabetes". Individuals are encouraged to participate by sending in photos showing what it is like to live with this disease on a daily basis. CVS has partnered with the American Diabetes Association to donate $1 for each photo uploaded. To upload your photos and participate in this awareness raising campaign, see this site: http://www.diabetes.org/in-my-community/programs/american-diabetes-month/.

What motivates you to stay healthy? Please share your ideas with us!

Thursday, November 1, 2012

Health Benefits of Walking

This time of year in northwest Texas is great! I took a walk after work last night at one of the local parks, and I thoroughly enjoyed myself. The temperature was great, there wasn't too much wind, the sky was bright blue, and the lake had several ducks on it still enjoying the water before it gets too cold. At the end of my walk not only did my mind feel cleared and fresh, my body felt pleasantly exercised and relaxed.

In fact, there are many health benefits to be gained from walking. The Mayo Health Clinic states that it can help

  • Lower low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol)
  • Raise high-density lipoprotein (HDL) cholesterol (the "good" cholesterol)
  • Lower your blood pressure
  • Reduce your risk of or manage type 2 diabetes
  • Manage your weight
  • Improve your mood
  • Help you stay strong and fit (http://www.mayoclinic.com/health/walking/HQ01612)
In addition to these benefits, a recent article at the American Association of Retired People (AARP) called it "the easiest exercise" and went on to say that "it will help you maintain your independence and ability to do daily tasks as you age" (http://www.aarp.org/health/healthy-living/info-12-2011/walking-health-benefits.html). And, there is the additional benefit of it being an activity that you can share with others - even pets! - which can lend a more social aspect.

Even though this is a task that we perform every day, if you have not previously been walking for long periods of time, there are some precautions you should take before you get started:
  • Be sure to have comfortable shoes and clothing - consider layering clothes to make it easier to adjust to temperature
  • Use correct posture
  • Warm up by starting out walking slowly and then gradually increase your pace
  • Stretch your muscles - ideally both before and after you walk
  • Cool down after your session to help reduce the stress on your heart and muscles (http://www.mayoclinic.com/health/walking/HQ01612)
There are many mental benefits to walking, as well, and as I was walking yesterday I remembered that Charles Dickens was a great walker. I knew that he routinely walked many miles on a daily basis, but I was surprised at just how many - up to 20 miles a day according to this article: http://sportsillustrated.cnn.com/vault/article/magazine/MAG1067056/index.htm! I found it interesting that these walks not only helped spur his creativity, but they also helped relieve some of the mental pressure that he seems to have faced as a serious writer.

I plan to keep with my walking habit. When it gets too cold outside, I will move indoors to the treadmill. Walking indoors loses some of the atmosphere that I enjoy while being outside, but I still get most of the great benefits of this type of exercise. Do you have any thoughts to share on walking as a health benefit?

Thursday, October 25, 2012

Guest Post: Cyberbullying


Since October is National Bullying Prevention month, I decided to interview Health Studies' Dr. Katie Crosslin and get her input on this social problem. Dr. Crosslin focuses her research on an aspect of bullying that is becoming more and more prevalent - cyberbullying.



What exactly is cyberbullying? How is it defined? 

“My boyfriend’s ex-wife relentlessly texts me 15 times per day, leaves multiple voice messages on my phone, and has even stalked me at college.” 

Cyberbullying is becoming a significant issue with how we increasingly utilize technology to communicate. The above scenario is a real-life example of what can happen when people use technology to harass, inflict harm, and stalk others. There are several reasons why bullying may occur via digital means, whether it be to intimidate, gang up on others, or even for a good laugh. While some cyberbullies may be unaware of the damage they inflict on their victims, research suggests that these actions can be intentional, too.

The word “cyberbullying” implies that unwanted harassment occurs via the Internet; however, it is difficult to define cyberbullying with the plethora of communication methods. Not only do we use the Internet along with several social networking sites (Facebook, Twitter, Instagram, etc.), but other forms of digital communications are also utilized such as email, text, and instant messaging. Research is currently underway to better understand and define cyberbullying, although an accepted definition is referred to as “being cruel to others by sending or posting harmful material or engaging in other forms of social aggression using the Internet or other digital technologies” (1).

What are the potential issues that can arise with students who are bullied? What about the students who do the bullying – are there potential health risks for them? 

“I was very angry and it made me re-evaluate all the people I had met at school. I thought I was close to everyone, but I withdrew and made very few friends.”

Several research studies have been conducted among K-12 students to understand the psychological effects from cyberbullying. The fact that some attacks are anonymous can leave a victim feeling fearful and anxious about who might be behind the attack. Victims also have reported feeling anger, sadness, depression, and thoughts of suicide (2). In some circumstances, individuals have taken their own lives due to online harassment. Only about 10% of children tell their parents or another adult about being cyberbullied (3). It can be very difficult for a young person to handle this type of harassment, and parents are recommended to monitor their children’s online/digital communications.

Bullies themselves also face consequences. Alarmingly, over half of bullies in middle school have a criminal conviction by their early 20’s. In regards to suicide, bullies are at an even higher risk for suicide attempts than victims (4). More research is needed to understand how cyberbullies are affected in the long-term and ways to intervene to reduce future criminal offenses.

Although the majority of research has been directed toward young children, cyberbullying is a problem for adults and can even occur in the workplace. I currently conduct research to learn how college students are affected and have seen that there are many psychological ramifications. For instance one victim reported the following: “I didn't see the point in living this way. When it got really bad, I didn't see the point of living at all. I felt trapped, because I was surrounded by these girls, who wrote hate messages on Facebook and prank called me once a week. I felt very helpless and that no one really cared.” There are many other situations that are similar to this one in which the victim is emotionally tormented by others usually due to a relational conflict or recent break-up (5).

What are some of the warning signs that individuals should be aware of that could alert them to the possibility of cyberbullying going on in someone’s life? Or, maybe some warning signs that bullying is becoming a critical issue that needs immediate intervention?

“Emotionally I was scared. I was threatened and always afraid to look at the computer or phone.”

If someone you are close with suddenly becomes apprehensive about using the computer or another electronic device, it is worth discussing it before the problem escalates. Other signs may include depression or anger after receiving a text or instant message (6). At times, a victim may retaliate against the cyberbully to seek revenge and may use several accounts on a social networking site to communicate with the cyberbully without be linked to the conversations. If parents discover that their child is being cyberbullied, it is best to work with the child and help him/her to be part of the process in communicating with the school and/or the bully to resolve the issue.

What can people do if they are concerned about particular cyberbullying incidents? 

“I was very angry for a while, but I rose above it. Once they realized I wasn't  going to retaliate, it seems that they stopped.”

Victims of cyberbullying tend to spend more time on the Internet than non-victims. People who utilize social media sites should pay attention to their privacy settings to ensure that only trusted friends see their information online.  Remember that what you say online stays forever, so don’t write anything that you will regret later on. Young people should keep track of any cyberbullying incidences to show an adult (i.e., parent or teacher) in the event that it worsens or you need law enforcement to intervene. If you are ever a witness to cyberbullying, you have the opportunity to do something to help the victim.

Health educators are trained to work with communities to reduce or eliminate health problems through the processes of assessment, program planning, implementation, and evaluation. Violence prevention, which includes cyberbullying, is an important area to include when designing programs within schools and communities and is the key to raise awareness at the societal level.

References

1. Willard N. Cyberbullying legislation and school policies. Center for Safe and Responsible Use of the Internet Web site. Retrieved online July 1, 2012, from ttp://csriu.org/cyberbully/docs/cblegislation.pdf.

2. Hoff D, Mitchell S. (2009). Cyberbullying: Causes, effects, and remedies. Journal of Educational Administration, 47(5), p. 652-665.

3. Bullying statistics. (n.d.). Cyberbulling statistics. Retrieved online March 24, 2011, from
http://www.bullyingstatistics.org/content/cyber-bullying-statistics.html.

4. Bostic, J.Q., & Brunt, C.C. (2011). Cornered: An approach to school bullying, cyberbullying, and forensic implications. Child &  Adolescent Psychiatric Clinics of North America, 20, p. 447-465.

5. Crosslin, K.L., & Crosslin, M.B. (2012). College students and victimization experiences. Unpublished raw data.

6. Hinduja, S.H., & Patchin, J.W. (2009). Safe and responsible social networking. Retrieved on October 21, 2012, from http://www.cyberbullying.us/safe_responsible_social_networking.pdf


Dr. Katie Crosslin is an Assistant Professor for Texas Woman's University's Department of Health Studies. Her research interests include violence prevention, acculturation in Hispanics and effects on health, medically underserved populations, and chronic diseases and quality of life.

Thursday, October 18, 2012

Sweets for the Sweet! (With a Little Moderation...)

That notorious candy celebrating holiday is right around the corner! Most of us have some kind of weak spot  for a sugary sweet treat, and we have been warned for years that too much candy will rot our teeth out. So, just how bad for us is sugar? Do we have to avoid it entirely? (Is that even possible?!?)

Research has suggested that possibly our craving for sweets (and fats) goes back through our evolutionary history to times when food was more difficult to come by, and when more calories were needed just for survival. Our bodies began to seek out the foods that provided the most calories, and some researchers theorize that even though we no longer need this survival response, it is still there in our bodies and we still crave sweetness. However, WebMD suggests that while your friend may insist that she cannot go without her 3:00 p.m. candy bar treat, it is still unclear whether sugar is actually addictive. Since in healthy individuals no physical withdrawal symptoms are experienced when sugar intake is halted, it is more likely that sugar is more of a habit or psychologically motivated dependence (http://www.webmd.com/food-recipes/features/health-effects-of-sugar).

While excessive sugar consumption may not be a true addiction or actually cause particular diseases, it can lead to obesity in both children and adults. Childhood obesity in particular is becoming a serious concern in the United States. Complications of obesity can include heart disease, diabetes, breathing problems, joint problems, and liver and gallbladder disease, as well as psychological and social problems. Additionally, individuals who are obese as children are more likely to be obese adults, and their level of obesity in adulthood could be more severe (http://www.cdc.gov/obesity/childhood/basics.html).

Because of the variety of different serious health conditions that can be caused by obesity, the problem has gained a lot of attention in the United States. Some of the focus has been on soda and candy machines in schools, but in reality much of the food we consume on a daily basis has added processed sugars of which we aren't even aware. Because much of this sugar is hidden in foods that we wouldn't normally associate with being sweet, it is easy to consume substantially more sugar than we are aware of eating. A report in 2009 determined that Americans consume an average of 355 calories a day in sugar - over 20 teaspoons! This is much higher than the recommended amounts for average-sized women (6.25 teaspoons) and men (9.4 teaspoons) (http://www.slashfood.com/2011/05/02/how-much-sugar-do-americans-consume-daily-hint-way-too-much/).

To protect our health, we all should consider watching our sugar intake more closely on a daily basis. If we practice healthy eating habits with sweets throughout the year, then we can feel a little better about indulging and enjoying ourselves (within reason!) on fun holidays like Halloween! Do you have any tips or tricks for beating sugar cravings that you would like to share? We would love for you leave a comment with your ideas!

Thursday, October 11, 2012

National Health Education Week - October 15 - 19


October 15th through 19th is National Health Education Week. The Society for Public Health Education (SOPHE) explains that this celebration has been held the third week of October since 1995 and "focuses national attention on a major public health issue and promotes consumers' understanding of the role of health education in promoting the public's health" (http://www.sophe.org/NHEW.cfm).

This year's focus is on the youth of America with the theme "Adolescent Health: Planting Seeds for a Healthier Generation." Each day during the week there is a focus on a different aspect of health:

  • Monday - Nutrition and Physical Activity
  • Tuesday - Alcohol, Tobacco, and Other Drug Use
  • Wednesday - Sexual Health
  • Thursday - Emerging Trends in Adolescent Injury & Violence
  • Friday - Lesbian, Gay, Bisexual and Transgender Youth

SOPHE will be keeping the public informed through communications during the week on Facebook and Twitter. Check out their Facebook page here: https://www.facebook.com/pages/Society-for-Public-Health-Education/217171689055?fref=ts. And, participate during the week via Twitter using #NHEW to spread awareness about adolescent health.

In addition to celebrating National Health Education Week, SOPHE will also be honoring health education specialists who are making a difference in adolescent health. 

For more information and ideas about how you can participate during National Health Education Week, check out the SOPHE page full of information and activities here: http://www.sophe.org/NHEW.cfm.

What are your ideas on improving adolescent health in America? We would love to hear from you in the comments!

Thursday, October 4, 2012

October is Breast Cancer Awareness Month - TWU Pink Promises Walk on the 9th

In honor of Breast Cancer Awareness Month, TWU will be hosting it's Pink Promises Breast Cancer Walk on Tuesday, October 9th, from 5:30 to 7:00 p.m. Free T-shirts, pink bandannas and bags with breast cancer information will be available for participants, while supplies last. For more information contact TWU Student Health Services at 940-898-3833.

 
Additionally, Texas Health Resources will be bringing a mobile mammography unit to the TWU campus Pioneer North parking lot on Thursday, November 1st. Most insurance will be accepted, and it is possible that those who are uninsured may be eligible for a free mammogram. To schedule an appointment or for more information contact Moncrief Cancer Institute at 1-800-405-7739.

Thursday, September 27, 2012

Back to School Tips

With the Fall semester getting underway, I thought it would be nice to again review a few tips for students who may be managing school on top of other responsibilities, like work and/or family. So, here are some helpful ideas for keeping on top of things throughout the semester:

Creating a Schedule, Staying Organized, and Prioritizing 
I always tell people that "if it's on my calendar, then it will get done." Over the years I have trained myself to let my calendar help me through the week and it has helped me tremendously to stay organized and on top of things. I actually use Google Calendar to help me with this. I plug in all of the things that I know happen at the same time every week (for example, backing up files at work, weekly tasks that I do the same time every week, or, if you are a student this could be discussion board posts, and, if you have kids, it might be soccer practice), every month (for example, days to sit down and pay bills), and every year (for example, Aunt Matilda's birthday). Using the online tool allows me to have it help "remember" for me and I can quickly create repeating instances of the same thing. I then use this tool to help me plan my week by adding in everything else that I have to do that week. When do I have to get to the grocery store? When is a particular work project due? These are all things that get plugged in, and I can even set a reminder to send me an email or give me a pop-up in my computer screen. When I was a student, I would also add things like assignment due dates and then look over my schedule to see when I needed to plug in time for studying - and then I would put that on the calendar and actually use that time to study. Having a visual calendar like this with time slots for everything really helps me stay organized. And, since we are all juggling many roles these days, the reminder aspect of the tool is a life saver!

You don't have to use an online tool, though, and instead you might want to consider getting a paper yearly calendar book that also has hourly time divisions for each day. I have also used the paper format and it can also be very handy! The bonus here is that you can carry this calendar around with you to meetings and pencil in things as they come up. Or, if you are extremely phone friendly, most of the new smart phones have calendar type options that will allow you to have the best of both online and portable benefits.

Actively keeping on top of tasks during the week and month allows me to stay organized. In addition, having things laid out for me in visual form with due dates lets me prioritize my days, weeks, and months more effectively. The end result of this type of effort is that I am more successful in accomplishing my goals, I feel less worried that I might be forgetting something important, and I am able to enjoy my free time - those spaces on the calendar that are blissfully empty - to the fullest!

For more on time management, check out our previous post: http://twuhealthstudies.blogspot.com/2011/11/time-management-tips.html

The TWU Counseling Center also has a couple of good handouts on Prioritizing - http://www.twu.edu/downloads/counseling/A-11_Prioritizing.pdf - and how to manage Reading and Study Time - http://www.twu.edu/downloads/counseling/A-12_Reading_and_Study_Time.pdf

Do you have some tips to share for how you keep your life organized? We would love to hear your ideas in a comment!

Thursday, September 20, 2012

World Alzheimer's Day is September 21st

Friday, September 21st is World Alzheimer's Day and throughout the month several organizations are attempting to raise awareness for the different forms of dementia. Alzheimer's disease is named after the man who first described the disease, Alois Alzheimer. This disease "destroys brain cells and nerves disrupting the transmitters which carry messages in the brain, particularly those responsible for storing memories" (http://www.alz.co.uk/info/alzheimers-disease). Part of the degenerative aspect of the disease causes the brain to actually shrink and the brain becomes unable to produce certain chemicals that help transfer information. The Fisher Center for Alzheimer's reports that "5.4 million Americans are living with Alzheimer's" and "[e]very 68 seconds, someone develops Alzheimer's disease. At current rates, experts believe the number of Americans living with Alzheimer’s will quadruple to as many as 16 million by the year 2050" (http://www.alzinfo.org/08/alzheimers/world-alzheimers-day).

While you may be familiar with the terms "Alzheimer's" and "dementia", what you may not know is that dementia is actually a classification that encompasses several different forms of diseases with common characteristics, of which Alzheimer's is possibly the most well-known and which seems to account for the largest amount of dementia cases. Other forms of dementia include:
  • Vascular dementia -- which results from damaged blood vessels that impact the supply of oxygen to brain cells
  • Dementia with Lewy bodies -- which results from an abnormal collection of protein (known as Lewy bodies) in the nerve cells of the brain resulting in degeneration and death of those cells
  • Fronto-temporal dementia -- a more rare situation in which the frontal lobe of the brain is most affected and which typically occurs in younger individuals (in their forties or fifties).
Dementia diseases are personalized, so two people may not exhibit symptoms in quite the same way. However, there are broad early symptoms that typically apply to most forms of dementia:
  • Memory loss
  • Difficulty performing familiar tasks
  • Problems with language
  • Disorientation to time and place
  • Poor or decreased judgement
  • Problems with keeping track of things
  • Misplacing things
  • Changes in mood or behavior
  • Changes in personality
  • Loss of initiative (http://www.alz.co.uk/info/early-symptoms)
There is no sure way to determine if someone is at risk for dementia, but some factors that could indicate a risk are a family history of others with the disease, smoking, excessive alcohol consumption, head injury, heart disease, or being overweight (http://www.alz.co.uk/info/risk-factors). If you are concerned that you or someone you know might be developing symptoms of dementia, please consult a doctor. There are also associations that can help individuals and families manage dementia. Here are a few places to go for more information:
If you have other resources or information to about dementia, please feel free to share them in a comment!

Thursday, September 13, 2012

National Yoga Awareness Month

September is National Yoga Awareness Month! While most of us associate yoga with bendy twisty postures and would probably feel confident that we could identify it if we saw it, what we see today is actually compiled from a variety of different practices that have been utilized throughout approximately 5000 years of history. Yoga seems to have arrived in the U.S. with the Indian guru Swami Vivekananda in 1893, and has continued to grow in popularity over the years (http://www.yogajournal.com/wisdom/467).

Yoga practice also encompasses more than just a physical aspect and is typically described as being comprised of "eight limbs". The article "Ashtanga Yoga: The Eight Parts of Yoga Practice" (http://www.dadaveda.com/eightpartsofyoga.htm) gives a really nice brief discussion of these different parts. Here is just a brief overview:

  • Yama - covers "moral guidelines for human development"
  • Niyama - this is "self-regulation"
  • Asana - this is the part we are typically familiar with, postures "which have specific effects on the endocrine glands, joints, muscles, ligaments and nerves"
  • Pranayama - this is "control of vital energy", and includes a variety of breathing exercises
  • Pratayahara - which is to "withdraw the mind from its attachment to external objects"
  • Dharana - this is the "concentration of the mind at a specific point"
  • Samadhi - this is the result of practicing all of the other elements
So, while we may typically only think of the physical aspect of yoga, it is actually a complete mind/body practice designed to bring our systems into balance.


Additionally, the term "yoga" can cover a variety of different styles of practice. Here are a few of the more popular styles:

  • Ashtanga - this is what has sometimes been called "power" yoga and fairly physically demanding. Breathing is coordinated with movement through various posture series.
  • Hatha - this style is what was probably the first to gain popularity in the U.S. Here you engage in postures, series, and breathing exercises. There is less emphasis on fluidity of movement and more focus on stretching within postures.
  • Iyengar - this style of yoga probably spends the most time in individual postures and focuses on working within the poses.
Yoga, however, is continually evolving. For example, Bikram yoga is a form that is more recent. This style is sometimes called "hot" yoga because it takes place in a very warm room. Additionally, Ana Forrest has adapted her own style of yoga that encompasses both physical and emotional recovery.

There are a variety of health benefits to be obtained from practicing yoga. It can help you increase your strength, regain good posture, and improve lung capacity. There are emotional benefits to be gained such as stress relief and increased concentration. Additionally, yoga can help to lower blood pressure, which helps keep your heart healthy. Many individuals also report relief from a variety of other ailments. However, you should definitely consult with your doctor before undertaking yoga, since this can be a challenging form of exercise. WebMD has some good information on cautions to be considered, as well as the benefits that you can reap from practicing yoga: http://www.webmd.com/balance/guide/the-health-benefits-of-yoga.

To celebrate National Yoga Awareness month, many yoga studios will be offering a week of free yoga! So, if you think that this may be something you would like to try, now is a great time! For more information on National Yoga Awareness month events, check out their web page: http://www.yogahealthfoundation.org/yoga_month

Do you already practice yoga? Or, are you interested in taking up a new challenge like this? Share your ideas about this form of exercise with us in the comments below!

Thursday, September 6, 2012

Ovarian Cancer Awareness Month




Dr. Sandra Cesario, professor of nursing at the TWU Institute of Health Sciences-Houston Center, is spreading the word that September is Ovarian Cancer Awareness Month.  As pink has become synonymous with breast cancer awareness, teal is the color to symbolize awareness of ovarian cancer — the most lethal of women’s cancers. For Dr. Cesario, the issue is personal.

“I made a promise to my daughter Anna prior to her death in 2009 that I would spread the word about early warning signs of the disease so others do not have to die simply because they were diagnosed too late,” she said.


Tomorrow, Friday, September 7th, is Wear Teal Day. For those of you in Houston, the Houston City Hall is lit in teal from Sept 1 through Sept 7.  Check it out if you are downtown tonight or tomorrow night.  There is a particularly stunning view from the Ferris Wheel at the Aquarium.

October will be filled with pink ribbons, but spread the word that September is the month to display teal and increase awareness of ovarian cancer - the most lethal of all of the gynecological cancers.  One in 71 women will be diagnosed with ovarian cancer. With early detection about 94% will survive longer than 5 years after diagnosis. However, only 15% of ovarian cancer is caught early. Ovarian Cancer is the most lethal of the women's cancers. Every year, 22,000 women will be diagnosed with ovarian cancer in the US and 16,000 women will die.

Research suggests that the following symptoms may be associated with ovarian cancer:

· Bloating

· Pelvic or abdominal pain

· Difficulty eating or feeling full quickly

· Urinary urgency or frequency


If you or a loved one experiences any of these symptoms more than three times per week for a couple of months, please seek medical attention.

For more information or to make a donation, please consider the following organizations:

OCRF
Ovarian Cancer Research Fund
OCRF is the largest independent organization in the United States dedicated exclusively to funding ovarian cancer research-- and to finding a cure. Through our three active research programs, we fund the best researchers and the most innovative projects.

OCNA
Ovarian Cancer National Alliance
The Ovarian Cancer National Alliance is the foremost advocate for women with ovarian cancer in the United States. To advance the interests of women with ovarian cancer, the Alliance advocates at a national level for increases in research funding for the development of an early detection test, improved health care practices, and life-saving treatment protocols. The Ovarian Cancer National Alliance educates health care professionals and raises public awareness of the risks, signs and symptoms of ovarian cancer.

NOCC
National Ovarian Cancer Coalition
The mission of the NOCC is to raise awareness and promote education about ovarian cancer. The Coalition is committed to improving the survival rate and quality of life for women with ovarian cancer.

Peggy and Charles Stephenson Cancer Center at the University of Oklahoma http://www.oumedicine.com/cancer In 2001, the Oklahoma Legislature charged OU with providing statewide leadership in cancer research, prevention and education, and treatment and seeking designation as a National Cancer Institute (NCI) comprehensive cancer center designation.  A major recruiting effort was launched in 2009 to bring nationally-recognized cancer physicians and researchers to Oklahoma. In 2011, the Oklahoma Cancer Institute opened and there is a beautiful gynecologic-oncology waiting area named in Anna's memory.


Sandra K. Cesario, PhD, RNC, FAAN
PhD Program Coordinator and Professor
College of Nursing, Texas Woman's University
6700 Fannin Street
Houston, TX  77030-2343

Friday, August 31, 2012

Health Studies First Short Story Contest: Entry from Brieanna Casey

Our first Health Studies short story contest has officially come to a close! We are pleased to share with you Brieanna Casey's short story entry on healthy eating!


What Could Have Bean 
So here we were again—another super long, annoying night at the dinner table. It was nine o’clock, and I had just barely managed to swallow my last half of a half of cold, soggy, stinky, green beans. But at least this time I won! Andrew had to stay at the table, in the dark, with only the light of the TV in the living room, because he wasn’t done yet. Dad even made him turn around to face the wall, while we watched. I always hated when Dad did that, because he knew very well that we could still here the TV from the kitchen, but every time we tried turning around, he’d see our reflection in the screen, and bark at us to “Turn back around!”
I think my record is four hours at the table, Andrew’s is like nine! I hated sitting at that table, staring at the wood circles for hours, but I hated green beans even worse! One time Mom made beets, these awful red vegetables, and they made me gag and spit up red for like an hour! Although the best story was when Mom and Dad said we could go roller-skating after dinner, so they only gave us half as much beans, and we started dinner an hour early. They said we couldn’t go until we finished dinner—our whole dinner—but I figured out that Mom just gave us less so we’d just take one big bite and get to go out for once.
See green beans are real hard to get rid of. Grapes and broccoli were easy because there was this big plant with a huge pot of dirt sitting right next to me, and when Mom and Dad weren’t looking, it was pretty easy to throw them in the under the big leaves. Sometimes Andy would even bribe me to pass his to me under the table and have me throw it away!
This was only plan B though, because one time Dad found Andrew’s stash of Flintstones vitamins in there, and now he keeps checking now and then. The best plan was to give it to the dog, ‘cause he’d eat it, and they’d never know! Except that Jake didn’t really like vegetables either, and as it turns out, especially not green beans. But who could blame him?
Oh, so the time we were going to the roller-skating rink, we’d been sitting there for like an hour; I guess Mom didn’t plan ahead so good after all. Finally, he said he was done (I had finished way earlier), and he began to get down from the table.
            “Lemme see! Open your mouth” Mom said. Andy opened wide enough for Mom to see that his tongue was clean, and we jumped in the car and left. Only when we got to the rink, and Dad started asking him stuff, and we noticed he wasn’t talking right. Mom went over, and already knew. “You still got green beans in your mouth, don’t you?!” I knew she was right, Andy had been practicing stuffing the beans in his cheek so his mouth looked empty when he opened for Mom. I guess that one was blown now though. “Let me see, open that mouth all the way! Oh my God, Andrew! Go spit that out!” You should’ve seen Mom’s face! I heard her say to Dad that those green beans looked like an alien! That’s what he liked to do, keep one bite in his mouth, after chewing, but not swallow. Me, I preferred just swallowing a whole bite without chewing, hoping it wouldn’t get on my tongue and I’d have to taste it! I’m twelve now, so I’m much smarter than Andrew now, he’s only eight.
Well, after watching us sitting at the table all night for months, Mom decided to teach Andy a lesson, but I had figured it out! I heard Mom and Dad talking in their bedroom about him not eating right when I went to ask them if we could open up another of Andy’s birthday presents, but their door was shut. That always means bad things, so I just listened, but I didn’t tell Andy, ‘cause Mom’s pretty smart too, and I wanted to see how she was gonna trick Andy into eating his vegetables!
The next night at dinner, Andy and I still sat for hours staring at our green beans, except only half way through the night, Mom said we could get down. We both looked up kinda surprised.
“Yep, just get down. I don’t know what to do with y’all anymore. I thought you could just eat your food because I had taken the time to make it for you, after working all day, but I guess I was wrong. So I guess we’re just gonna have to go to the doctor instead.” She didn’t even look up, (she was pretty good at foolin), but I looked over at Andy, and he was petrified!
“The doctor?!”
“Yep, I guess she’s the only one who can help you to eat right.” She still hadn’t looked up, just kept on clearing the table. “You know, I thought if I told you how important it was to eat healthy, to eat your fruits and vegetables, you would listen. Well I’m not going to let you kids get sick, just because you don’t like to listen. So we’re going to the doctor right after school, so she can give you your vitamins.” Now Andy also looked a little confused.
“How she gonna do that?”
“How do you think?” Mom replied, as she walked off outta the kitchen. I thought, this is gonna be great! She’s gonna just scare the crap outta him ‘cause he knows going to the doctor always means getting shots!
The next day, sure enough, she picked us up and we went. We didn’t say much when we got in the car, but then Mom started asking about our days, and we thought she’d forgotten. But then we passed our street and kept driving—you should’ve seen the look on Andy’s face!—he looked like he was gonna pass out!
He finally got up the nerve to ask, “Was that our street?”
“Yep!” Mom had a way of answering with cold, quick ‘yeps’ and ‘nopes’ that usually meant she was mad, and this was one of those kinds.
We drove all the way to the doctor’s office, except it wasn’t the one we usually go to. It was in a different part of town from the one we went to last time. When we got there, Andy’s hands were slapping the sides of his legs as he walked, and opening and closing his fingers. Mom told us to zip up our jackets good and tight, and we walked in. The place certainly wasn’t as nice as our other doctor’s office, it was clean, with white and tan walls, and other kids and parents, but there was only sad looking people on dirty and broken chairs here.
“Why’d we come to this doctor, Mom?” I asked. Andy looked over too, I don’t think he realized this wasn’t the one we came to last time until I said, he was probably too scared to notice.
“This is the doctor for people who aren’t going to get better.”
“What do you mean, ‘aren’t going to get better’? Andy asked. I was pretty confused too.
            She sat down in the one seat that wasn’t taken, and so we had to stand while other sick people went by, and sometimes they bumped into us. There were a lot of people in the small room. They didn’t look very nice either. Some were big or dirty, or old, and there was really loud coughing the whole time we were there. And it smelled too. There was only one family with a lot of kids in the other corner, but they were real quiet, they didn’t even look up.
I was staring at them when Mom answered. She kind of pulled us closer so she could talk in our inside voice and said, “This where you come when you’re always sick, and you have to keep coming back because you didn’t do what the nicer doctors said to. When the nice doctors tell you to do stuff, and you don’t do it, they make you come here, ‘cause they don’t like telling people to do stuff over and over.” She kind of pointed her head toward the door we came in at the other side of the waiting room, “See those people?” We were both staring at her now. I thought she was just joking with Andy, but she wasn’t foolin with this place, these people really were sick. “These people didn’t eat right when they were kids. You remember I tried telling you that good foods keep you from getting sick? Well these people didn’t eat good foods, and they got sicker and sicker when they got older, and now they have to come here all the time.”
“All the time?” I asked.
“Yep. Go ask that guy over there if you don’t believe me.” She pointed to a creepy looking guy standing by the door with a tank sitting next to him, and a plastic cup over his mouth.
“That’s okay.” I answered. We waited in silence after that for a long time. Then she got up suddenly. “Where you going!?” I asked again, and grabbed her jacket.
She looked down at me and said, “I have to go check in.”
“Why?”
“Well you can’t just check in as soon as you get here, you gotta wait after everyone else who was here before you! Don’t you think that’s fair?”
“Yeah,” I said.
She went up to the window, and talked to the lady there for a few minutes. Then another older lady came wearing the doctor’s coat, and they talked for a while. I thought I saw the older lady look over at us while they talked, but I quickly just put my head back down. Then Mom wrote something on the clipboard on the counter, and came back with some sheets of paper and those crayon bags the restaurants give you at dinner.
“Here.” She gave us each a coloring sheet and made us share the crayons. Andy suddenly grabbed my sheet outta my hand. I grabbed it back, and then Mom picked them both up, “Hey! You either share nice, or no one has one! Here, let Andrew have the monkey, you take this one, he’s cooler anyway.” She handed me the leprechaun one instead.
“Yeah. Mine is cooler, and yours is better for you, ‘cause you’re more like a monkey anyway!”
“Hey, none of that now!” said Mom. But I knew I was right, I’d heard Dad call Andrew a monkey before, ‘cause he has a lot of energy. I hear them say sometimes it’s ‘cause he has a dee-dee, whatever that means, but I didn’t care to ask.
We were finally feeling a little better when we were coloring, even though there was a lot of coughing still, when the nurse called me and Andrew by name. They never do that, they usually call Mom’s name. We took our papers and our crayons with us, but Mom took them up and stuffed them into our backpacks. The younger lady walked us down the dark, skinny hallway, and into a really small room, with a bed and a couple chairs. She told us to wait here for the doctor, and then shut the door behind her. Finally Andrew had enough, I guess he finally got too scared, because his voiced started to shake.
“Can we go now? I’ll eat my vegetables, I promise! Pleeeeeease!?”
“Nope.” He started crying now, and even I was getting kind of worried for him, this place didn’t seem like Mom was messin’ around, maybe I didn’t really hear what they said last night after all. “No, Andrew. You had your chance to eat right, but you didn’t want to.”
“But I will, I will, I promise!”
            Mom came over, and took his hands in hers, and said sweetly, “Andrew. Do you want to be sick like those people we just saw?”
            “Nooo-oooh,” he said, through his crying.
            “Well I don’t want you to be sick either, that’s why we’re here, so you can get your vitamins with the doctor.” He started crying harder again, when Mom, continued, “Now, Andy, it’s not gonna be bad, just a little shot, and then we’ll go, and we’ll see if you can’t eat some vegetables at home this week.” He continued crying, although he tried to stop, but then he just started breathing real funny instead. “Marian, what are you crying about?”
            I hadn’t even realized I was crying until Mom asked me. “I was just watching Andy, he looks scared Mom, you sure we can’t go?” Andy stopped crying for a second and looked up at me both surprised and hopeful, but he started again when Mom answered.
            “Well, I’m sorry he’s scared, but it scares me when you kids don’t eat right, and I think you’re going to get sick.”
            Suddenly the doctor came in. She was the same older lady from behind the counter, with long, curly gray and gold hair, and kinda big too.
            “Soooo. Who do we have here? Andrew?” Andrew didn’t speak, he just looked at her, and back at Mom, still crying pretty bad. “Hey there, what’s wrong with you?” Mom pulled him off her jacket and turned him to stand facing the doctor. I heard him mumble something. “Sorry what was that?”
            Mom gave him a little swat on his bottom and then he said, “Mommy brought us here, but I wanna go home, I don’t like it here.”
            “Well why did your mother bring you here then, didn’t you guys go to the nice doctor first?”
            Mom spoke up, “Yes doctor. We’ve already been to the nice doctor, but when I called for an appointment today they said we couldn’t come anymore.”
            “Oh. I see. Well why’d they say that?”
            “Tell the doctor why we came here Andrew.” He grumbled again, and after another urging from Mom he spoke again.
            “Because we didn’t eat our vegetables like she said last time, so now we can’t come back because we didn’t listen the first time.”
            “Oooh.” The doctor answered. “Well yes, I’ve seen a lot of little boys and girls who have to come here for that.” Then she looked over at me, “And you? Do you eat all your vegetables,” she stopped to look back down at her papers, and then back up at me, “Marian?”
“Well, I eat most of them,” I said. But then I felt Mom swat the back of me too.
“Marian.” Mom said loudly. Mom also had a way of just saying your name that also meant you were this close from being in trouble. I looked at Mom, and when I looked back,  the doctor was staring back at me. She looked almost happy about us having to be here.
“How old are you know Marian?” She asked.
“Twelve.”
She flipped through some more papers on her clipboard, “Twelve,” she repeated slowly, “It says here that twelve-year-old girls should be eating at least two cups of vegetables every day. You think you eat that much, Marian?” I looked back to Mom, but she only shook her head, while looking down, with her lips curled over to the side, like she does when she’s not happy.
“I guess not,” I answered.
“Well!” the doctor said almost happily, “luckily, we have an easy way to help the both of you here!” And as she said that, she pulled out a huge needle, with green liquid vegetables in the middle. Andrew let out a scream so loud it hurt my ears! I was pretty much bawling by then too. Mom had her hand over her mouth, but I could see she was probably upset now too, ‘cause I could see her eyes were squinting up, and her shoulders were shaking like was crying. Mom started pulling Andrew up onto the bed, and he was screaming and screaming. Then the doctor spoke again, but she was yelling so Mom could hear over Andrew, “You know Mrs. Vaughn, usually kids at this age are old enough to eat their vegetables without getting shots!’
“WE ARE!” I shouted before Mom could answer.
            “Well Marian, you both don’t seem very grown up, in here crying and screaming like this!” Andrew heard this, and tried to sit better, and cry quieter, even though he was still shaking a whole lot, now up on the blue plastic bed.
“We are old enough, we just don’t like shots!” I continued.
“Well we usually only use shots for kids who don’t have families that can afford good healthy food. I don’t like wasting shots on kids who just don’t like to eat them for no reason!”
Andrew perked up at this, just as the doctor went to draw the sleeve of his shirt up, and pleaded, “You shouldn’t waste them, we can eat right, we’ll eat whatever Mommy gives us,” then he jerked his head back toward Mom, “pleeeeease Mommyyyy, pleeeeeease?!”
The doctor set down the needle, and looked mad back to Mom too. “Mrs. Vaughn. Do you think we could speak for a moment in private?”
Mom looked down at us, looking a little mad, and kind of confused too, “Kids, could you please wait outside while I talk to the doctor?” Andrew jumped off that bed so fast, and ran to the door, but I was afraid Mom was going to get yelled at by the doctor, because she didn’t look very happy with her.
They were in that room for a long time, and we could only hear raised voices now and then; I kinda started feeling bad for Mom now too. Me and Andrew were sitting on the floor just outside. He was holding my hand, and wiping his face on his jacket sleeve. Finally Mom came out. She didn’t look too happy either.
“Come on, let’s go.” She headed out around the hallway, and we had to run to catch up. We walked carefully past all the people still in the waiting room, and got in the car as fast as we could. There was dead silence for a while.
Andrew finally asked, “Mommy?”
“Yes, Andrew?”
“What the doctor want to say about us?”
“Well,” she began, (just like she’d say the ‘yeps’ and ‘nopes’) the doctor was mad at me!”
“You?”
“Yep. She said that I should be ashamed of myself for not raising kids who ate their vegetables, and then make such a big scene in the doctor’s office. She said that as a doctor, she’s allowed to give us all one more chance to all eat our vegetables, or next time we come back, she’s gonna have the nurses come in and hold the both of you down because she’s too old to put up with unruly children! See there? You got me in trouble too!”
“So we don’t have to come back here again?” I asked.
“I don’t know. She said she talked to our other doctor, and told her to expect us back there in a month to see if we’ve been eating all our fruits and vegetables!”
“How she gonna know, Mommy?” Andrew asked.
“Is that what you’re thinking about, huh Andrew? How to get away with not eating good again?”
“No, I just—”
“Don’t you think doctors have ways of knowing whether you ate your fruits and vegetables or not?!”
“Yeah.”
Well the drive home was a long, quiet one after that. We got home, and waited for dinner. Dad asked us how it went, if the doctor gave us our shots, and we told him what happened.
Before we finished he shouted, “Mom!? These kids didn’t get their shots?”
“No! The doctor got mad at us, and told us we had one more chance before we had to come back again in a month,” she yelled back over the kitchen wall.
Dad looked back down at us, “Hmmph. Yeah, like you guys are just going to start eating all your food, huh?
“We are,” Andrew started.
“Uh huh. I bet you’ll be right back at the other doctor’s office, and this time your mother will make sure you actually get your shot!”
“No, we’re gonna eat good now, Dad” I answered.
“Yeah, well, I guess we’ll see, won’t we.”
At dinner an hour later, Andy and I made it down in time to watch TV with Mom and Dad. It was nice, we watched some cartoons this time! I hated eating green beans, but I hated getting shots even worse!
*          *          *
“That was fifteen years ago, but needless to say, I never forgot it. When I had finally found out what Mom and Dad, and Dr. Brown, and even that receptionist had plotted for us just to get us to eat better—I thanked them. It was later discovered that our grandfather contracted diabetes, due to his own poor eating habits. I often wonder what my brother and I would have been like today if Mom had not been clever enough to keep us healthy. He sadly did not live many years after his diagnosis; after years of over-eating, his attempts at dieting and exercise just were not enough, not that he was motivated quite like we were. That threat of diabetes still looms over our family, but the constant reminder of that consequence, is a far better persuasive tool now that I am an adult, than shots would have been. However, today I understand why it really did upset Mother so; if we had not grown to learn the importance of health, and developed those healthy eating habits as children, it would have been much harder, perhaps impossible, to make the necessary healthy changes as adults. I still hate green beans though.”     --Marian Vaughn 

Author’s Note: This story is a fiction, but like all fiction, contains elements of truth. I hope that in whatever manner the TWU Health Studies chooses to display this work, that it serves to encourage parents of young children to never give up on building those healthy eating habits at an early age. Although I certainly suggest using the far more effective and enjoyable, (and potentially less traumatic strategies than those described herein), which are available from a variety of print and online sources. Thank you for your consideration. --Brieanna Casey, 01 August 2012