Fins To The Left
Living as I do in a seaside community, I take news of shark sightings and shark attacks more seriously than do my friends in, say, Kansas. I understand the sharks that have been following kayakers up the coast from my home are mainly hunting seals, but these days it’s getting harder to tell seals from average Americans. I do pity the shark that gets confused and attacks a US Navy Seal. That’s why I’m booking this summer’s family vacation at scenic Camp Lejeune.
Don’t you just hate it when you think you’re doing everything right and then someone comes along and changes it all? It’s like that moment a decade ago when I was happily munching my third pack of low-fat creme-filled cookies and the news came out that Dr. Atkins was right all along. I had to stop chewing right then and wash my mouth out with bacon. Now that kind of thing may be happening with asthma treatment. In my practice we’ve spent years training providers and tweaking our electronic medical record to ensure that every asthmatic patient who coughs more than twice a year stays on inhaled corticosteroids (ICS), thereby fulfilling one of only two quality-care measures in all of pediatrics (the other involves how cute the little round bandages are that kids get after their shots).
Now, according to a report from an international meeting of the American Thoracic Society, the whole exercise may be wasted on large classes of patients, including girls, teenagers, and asthmatics without significant evidence of atopic disease. In a study of 288 children with mild-persistent asthma, daily ICS was no better than as-needed treatment for girls, kids over age 12, and children who had low markers of allergic disease. Of course the study needs to be replicated, but I’m already planning how I’m going to apologize to all those kids I’ve been hounding about taking their steroids. I wonder if they’d like some Snackwells?
Kids, too, appear to be paying the price for doing the right thing. Researchers writing in The Physician and Sportsmedicine report an alarming 36% rise in the number of injuries sustained by kids participating in track and field between 1991 and 2008. The authors blame this trend on an alarming rise in the number of kids participating in track and field. Most injuries occurred while kids were running, but nearly a quarter of injuries involved hurdling, a finding that surprised no one who has ever tried to jump over one of those things. My own kids reviewed the study, and they concluded unanimously that in order to minimize their risk of injury they should avoid any movement except getting to and from the television. I can agree to that, but not until I install a hurdle in the den.
There are many studies to suggest TV is killing us, but until recently it’s been hard to catch it in the act. Now, however, researchers think they’ve identified one of television’s most lethal weapons, aside from broadcasts of Lethal Weapon 1, 2, 3, and 4. Intensive analysis of the viewing and dietary habits of nearly 15,000 American demonstrated that people who watch fewer than 1 hour of television a day tend to eat healthier diets than those who view over 4 hours a day. Now that programmers and advertisers finally understand that all those commercials for unhealthy food are causing people to buy and eat unhealthy food, I anticipate they’ll stop airing them in one week, two tops. Personally, I’m saving up my television hours until next month. I’ll need them for Shark Week. Maybe I should wait just a little longer to install that hurdle.