Sunday, May 3, 2009

Good Friends Are Good for You

Good Friends Are Good for You
They might get on your nerves at times, but good friends have bigger benefits than you may realize.
By Tom Valeo

WebMD FeatureReviewed by Brunilda Nazario, MD"You got to have friends to make that day last long," sings Bette Midler. But good friends may help your life last longer, too, according to an Australian study. Conducted by the Centre for Ageing Studies at Flinders University, the study followed nearly 1,500 older people for 10 years. It found that those who had a large network of friends outlived those with the fewest friends by 22%.

Why is this so? The authors suspect that good friends discourage unhealthy behaviors such as smoking and heavy drinking. And the companionship provided by friends may ward off depression, boost self-esteem, and provide support. Also, as people age, they may become more selective in their choice of friends, so they spend more time with people they like.

Close relationships with children and relatives, in contrast, had almost no effect on longevity. Lynne C. Giles, one of the four researchers who conducted the study, emphasized that family ties are important; they just seem to have little effect on survival.

The Health Benefits of Good Friends
Lots of research has shown the health benefits of social support.

One such study, reported in the journal Cancer, followed 61 women with advanced ovarian cancer. Those with ample social support had much lower levels of a protein linked to more aggressive types of cancer. Lower levels of the protein, known as interleukin 6, or IL-6, also boosted the effectiveness of chemotherapy. Women with weak social support had levels of IL-6 that were 70% higher in general, and two-and-a-half times higher in the area around the tumor.

In 1989, David Spiegel, MD, a professor of psychiatry at Stanford University, published a landmark paper in Lancet. Itshowed that women with breast cancer who participated in a support group lived twice as long as those who didn't. They also had much less pain.

Sheldon Cohen, PhD, a psychology professor at Carnegie Mellon University, in Pittsburgh, has shown that strong social support helps people cope with stress.

"Friends help you face adverse events," Cohen tells WebMD. "They provide material aid, emotional support, and information that helps you deal with the stressors. There may be broader effects as well. Friends encourage you to take better care of yourself. And people with wider social networks are higher in self-esteem, and they feel they have more control over their lives."

Other studies have shown that people with fewer friends tend to die sooner after having a heart attack than people with a strong social network. Having lots of friends may even reduce your chances of catching a cold. That's true even though you're probably exposed to more viruses if you spend a lot of time with others.

"People with social support have fewer cardiovascular problems and immune problems, and lower levels of cortisol -- a stress hormone," says Tasha R. Howe, PhD, associate professor of psychology at Humboldt State University. "Why? The evolutionary argument maintains that humans are social animals, and we have evolved to be in groups. We have always needed others for our survival. It's in our genes. Therefore, people with social connections feel more relaxed and at peace, which is related to better health."
Friends Can Be Stressful
Friends can be a source of stress, though. In fact, friends can cause more stress than others precisely because we care so much about them.

Julianne Holt-Lunstad, PhD, an assistant professor of psychology at Brigham Young University, has found that dealing with people who arouse conflicted feelings in us can raise blood pressure more than dealing with people we don't like.

"My colleagues and I were interested in relationships that contain a mix of positivity and negativity," she says. "For example, you might love your mother very much, but still find her overbearing or critical at times."

By attaching people to portable blood pressure monitors, Holt-Lunstad and her colleagues found that blood pressure was highest when people were interacting with someone they felt ambivalent about.

What she found really surprising was that these interactions caused higher blood pressure than those with people the research subjects felt completely negative about. "We suspect that people we feel positive toward can hurt us that much more when they make a snide comment or don't come through for us because they are important to us. Friends may help us cope with stress, but they also may create stress."

So would we be better off having no friends at all?

Hardly. "One thing research shows is that as one's social network gets smaller, one's risk for mortality increases," Holt-Lunstad says. "And it's a strong correlation -- almost as strong as the correlation between smoking and mortality."

The Impact of Loneliness
What about loners? Are they at greater risk of dying because they prefer to be alone?

Only if they feel lonely. One study found that drug use among young people was higher among those who said they were lonely. Older lonely people tended to have higher blood pressure and poorer sleep quality. They also were more tense and anxious.

Another study found that college freshmen who had small social networks and claimed to be lonely had weaker immune responses to flu vaccinations. They also had higher levels of stress hormones in their blood.

Unfortunately, Americans have fewer friends than they used to, according to a recent study, "Social Isolation in America," published in the American Sociological Review. The authors found that from 1985 to 2004, the number of Americans who feel they have someone with whom they can discuss important matters dropped by nearly one-third. The number of people who said they had no one they could discuss such matters with tripled to nearly 25%. The authors suspect that long work hours and the popularity of the Internet may contribute to the decline in close relationships.

The study also found that the percentage of people who talk about important matters only to family members increased from 57% to 80%. Those who depend solely on their spouse for these talks increased from 5% to 9%.
How Women's Friendships Are Different From Men's
In general, women are better at maintaining friendships than men. Women "tend and befriend," says Shelley E. Taylor, PhD, a psychology professor at UCLA. They respond to stress by protecting and nurturing others ("tending"), and by seeking support from others ("befriending"). This pattern regulates the seeking, giving, and receipt of social support, Taylor says. It produces health benefits by reducing psychological and biological stress.

And Margaret Gibbs, PhD, a professor of psychology at Fairleigh Dickinson University, found that men and women relate to others differently throughout life.

"We found that women seemed more geared to empathy, while male friendships are more geared to companionship and altruism," she tells WebMD. "Male friendships are more about helping each other -- mending the lawn mower, that sort of thing. Women's friendships tend to have a more emotional content -- listening to friends' stories and coming up with helpful solutions."

Monday, April 27, 2009

Mexico Swine Flu Epidemic Worries World

Mexico Swine Flu Epidemic Worries World
Swine Flu Deaths in Healthy Young People Raise Fears of Pandemic
By Daniel J. DeNoon

WebMD Health NewsReviewed by Louise Chang, MDApril 24, 2009 -- Mexico's deadly swine flu outbreak is caused by the same virus identified in the U.S., says CDC Acting Director Richard Besser, MD.

The CDC is analyzing 14 virus samples sent from Mexico. Seven of them, the CDC learned today, are very similar to the unusual swine flu strain isolated from U.S. patients.



Swine Flu Outbreak:
Get the Facts
Get the latest swine flu information from the WebMD and the CDC, plus other facts you need to know.

Swine Flu FAQ
CDC Swine Flu updates
Swine Flu Case Count Rising
Swine Flu Sickens 2 California Kids

© 2009 WebMD, LLC. All rights reserved.


"People are concerned about this situation," Besser said at a news conference. "We are worried as well. Our concern has grown since yesterday."

Sixty people in Mexico have died of the flu -- and so far, 16 of the deaths are confirmed cases of swine flu, news sources quote Mexican officials as saying.

World Health Organization spokesman Gregory Hartl told the Canadian news agency CBC that there have been some 800 cases in Mexico City, where schools are closed due to the outbreak.

Alarmingly, the flu outbreak in Mexico is striking healthy young people -- a pattern that would be expected if a flu virus new to humans emerged.

"Because these cases are not happening in the very old or the very young, which happens with seasonal influenza, this is an unusual event and a cause for heightened concern," Hartl said in a CBC interview.

That's not the only eyebrow-raising feature of the swine flu outbreaks. Infections have occurred in Mexico, California, and Texas -- where warm weather should mean the end of the normal flu season, says William Schaffner, MD, president-elect of the National Foundation for Infectious Diseases and chair of preventive medicine and infectious diseases at Vanderbilt University.

"Will we see this flu virus transmitted in the warm months? That would give us heartburn," Schaffner tells WebMD. "And is this a harbinger of things to come during our next flu season?"

Another disconcerting feature of the outbreak is that it's probably too late to contain it to limited geographical areas.

"We are seeing cases in Texas and California with no connection between them. This makes us think there has been transmission from person to person through many cycles," Besser said. "For containment we need limitation to a confined geographical area, and we have not seen that here."

The World Health Organization is convening an expert panel to determine whether to raise its pandemic flu alert level. Because of bird flu, we're at level 3. If the panel finds evidence of "increased human-to-human transmission" it goes to level 4. If there's evidence of "significant human-to-human transmission," it goes to level 5.

A pandemic will be declared only if there is "efficient and sustained human-to-human transmission" of a new flu virus. That clearly has not happened yet.

"Whether or not this [swine flu] strain causes a widespread pandemic will depend on its transmissibility among humans. That has not yet been fully elucidated, but should be shortly," Pascal James Imperato, MD, MPH, professor and dean of public health at SUNY Downstate Medical Center, Brooklyn, N.Y., tells WebMD.

Should there be a pandemic -- something that is far from certain -- the CDC has already begun work on a vaccine. Would it be ready by next flu season?

"It would be an Olympic sprint -- a mammoth feat -- to produce a flu vaccine by October," Schaffner says.
What You Should Do Now
Infectious disease experts agree with the CDC that now is a good time to think about what you'd do if there were a widespread flu outbreak.

Here's what you can do right now: Wash your hands often and well.

The CDC has not yet warned travelers to avoid the San Diego or San Antonio areas, and it is not restricting travel to or from Mexico. However, travelers to or from those areas should be sure to use all normal precautions to avoid catching or spreading a cold or flu.

People who live in or visit those areas and who get flu-like symptoms should see a doctor to get tested for the swine flu virus.

Swine Flu FAQ

Swine Flu FAQ
WebMD Provides Answers to Your Questions About Swine Flu
By Daniel J. DeNoon

WebMD Health NewsReviewed by Louise Chang, MD The swine flu virus in the U.S. is the same one causing a deadly epidemic in Mexico. What is swine flu? What can we do about it? WebMD answers your questions.

What Is Swine Flu?
Like humans, pigs get the flu. Four different type A swine flu strains commonly circulate among pigs. Most recent swine flu viruses have belonged to the H1N1 and H3N2 subtypes. Pigs typically get sick but usually don't die from swine flu.

The new swine flu virus infecting humans is very unusual. It's somehow acquired genes from swine, bird, and human flu bugs. And it's also got genes from Eurasian swine flu viruses that aren't supposed to be in North America.

Do Humans Get Swine Flu?
Normally, swine flu bugs don't infect people. Historically, there's a case every year or two in the U.S. among people who have contact with live pigs.

But from December 2005 to January 2009 there was an uptick in swine flu cases. There were 12 human swine flu infections during this time. Eleven of these people had direct or indirect contact with pigs; in the twelfth case it was not known whether there was pig contact.

It's possible this uptick was due to improved reporting systems, but the CDC says "genetic changes in swine flu viruses and other factors might also be a factor."

The new swine flu virus is different. It's not yet clear that it's here to stay. But it is infecting humans, and that has world health officials keeping a close eye on it.

What Are the Symptoms of Swine Flu?
Swine flu symptoms are similar to regular flu symptoms and include cough, sore throat, fever, chills, headache, and fatigue. Some patients have also reported nausea and diarrhea. There is no easy way to distinguish swine flu from other types of flu or other germs. It takes a lab test to tell whether it's swine flu.

Can Swine Flu Spread From Person to Person?
The U.S. residents infected with swine flu virus had no direct contact with pigs. The CDC says it's likely that the infections represent widely separated cycles of human-to-human infections.

Have There Been Previous Swine Flu Outbreaks?
If swine flu sounds familiar to you, it's probably because you remember or have read about the 1976 swine flu outbreak at Fort Dix, N.J., among military recruits. It lasted about a month and then went away as mysteriously as it appeared. As many as 240 people were infected; one died.

The swine flu that spread at Fort Dix was the H1N1 strain. That's the same flu strain that caused the disastrous flu pandemic of 1918-1919, resulting in tens of millions of deaths.

Concern that a new H1N1 pandemic might return with winter led to a crash program to create a vaccine and vaccinate all Americans against swine flu. That vaccine program ran into all kinds of problems -- not the least of which was public perception that the vaccine caused excessive rates of dangerous reactions. After more than 40 million people were vaccinated, the effort was abandoned.
As it turned out, there was no swine flu epidemic

I Got a Flu Shot. Am I Protected Against Swine Flu?
No. There is currently no swine flu vaccine.

It's possible that the seasonal flu vaccine might provide partial protection against H3N2 swine flu bugs. But the strain that appeared in California is the H1N1 swine flu strain. It is very different from the H1N1 human flu strain included in the seasonal flu vaccine.

It's not known whether previous infection with human type A H1N1 flu might provide partial protection against the type A H1N1 swine flu in the current outbreak.

However, the CDC has made a "vaccine seed" from swine flu isolated from an infected person, and has begun the process of developing a vaccine should the need arise. Whether a vaccine could be produced in quantity by next flu season is a huge question.

How Serious Is the Public Health Threat of a Swine Flu Epidemic?
Any flu epidemic is worrisome, especially when a new strain of flu bug is involved.

"Influenza A viruses new to the human population that are able to efficiently transmit from person to person and cause illness may represent a pandemic threat," the CDC warns.

It's worrisome that, unlike seasonal flu, the swine flu outbreak in Mexico is attacking healthy young people. That's a hallmark of pandemic flu bugs.

But it takes more than a new virus spreading among humans to make a pandemic. The virus has to be able to spread efficiently from one person to another, and transmission has to be sustained over time. In addition, the virus has to spread geographically.

Is There a Treatment for Swine Flu?
Yes. While the swine flu bug is resistant to older flu medicines, it remains sensitive to Tamiflu and to Relenza.


Can You Get Swine Flu by Eating Pork?
No. You can only catch swine flu from being around an infected pig -- or, if it's the new swine flu virus, from an infected person.

Swine Flu: U.S. Declares Public Health Emergency

Swine Flu: U.S. Declares Public Health Emergency
CDC Has Reports of at Least 20 People in the U.S. Sickened by Swine Flu
By Miranda Hitti

WebMD Health NewsReviewed by Louise Chang, MDApril 26, 2009 -- The U.S. government today declared the swine flu outbreak a public health emergency. Swine flu has sickened at least 20 people in the U.S., by the CDC's latest count.

"We are declaring today a public health emergency," Secretary of Homeland Security Janet Napolitano said today at a White House news briefing. That declaration is "standard operating procedure," Napolitano said. "It is similar to what we do when we see a hurricane approaching a site. The hurricane might not actually hit but allows you to take a number of preparatory steps. We really don't know ultimately what the size or seriousness of this outbreak is going to be."



Swine Flu Outbreak:
Get the Facts
Get the latest swine flu information from the WebMD and the CDC, plus other facts you need to know.

Swine Flu FAQ
CDC Swine Flu updates
Swine Flu Case Count Rising
Swine Flu Sickens 2 California Kids

© 2009 WebMD, LLC. All rights reserved.


As part of the emergency, the Department of Homeland Security is releasing 25% of stockpiled antivirals -- Tamiflu and Relenza -- to the states.

Here's what officials want you to do: Stay home if you're sick, avoid close contact with people who are sick, wash your hands often, avoid touching your eyes, nose, and mouth, cover your mouth or nose with a tissue when coughing or sneezin g, and keep up with health information in your own community.

The CDC has gotten reports of lab-confirmed swine flu cases in eight people in New York City, seven people in California, two in Texas, two in Kansas, and one in Ohio.

All of those swine flu cases have been relatively mild, although one person was briefly hospitalized, according to Keiji Fukuda, MD, assistant director-general for health security and environment at the World Health Organization.

The eight swine flu cases in New York City involved students at Saint Francis Preparatory School in Queens. All have recovered fully, according to a news release from the New York City Department of Health and Mental Hygiene.

So far, U.S. cases of swine flu have been milder than those seen in Mexico, where the World Health Organization has confirmed that at least 20 people have died from swine flu; health officials are investigating dozens more deaths in Mexico.

More swine flu cases are likely in the U.S. as public health officials heighten their hunt for the new strain of swine flu virus, notes Anne Schuchat, MD, the CDC's interim deputy director for science and public health program. Her advice: Be prepared for the possibility that there may be severe cases, and even fatalities, in the U.S.

"I do fear that we will have deaths here," Schuchat said today at a news conference.

Countries around the world are watching for the virus, and scientists are scrambling to learn more about the virus and stop it before it becomes a pandemic.

Fukuda says the global health community is taking the swine flu threat "very seriously" but wants more information before deciding whether to raise the WHO's pandemic alert level from phase 3 to phase 4.

An influenza pandemic occurs when a new influenza type A virus emerges for which there is little or no immunity in the human population, begins to cause serious illness, and then spreads easily from person to person worldwide, according to background information from the U.S. Department of Health and Human Services.

The WHO has a scale ranging from phase 1 (low risk of a flu pandemic) to phase 6 (a full-blown pandemic is under way).
Swine Flu Symptoms
Symptoms of swine flu seen in U.S. patients so far have been "relatively nonspecific -- high fever, cough sore throat, muscle aches, possibly vomiting and diarrhea in some numbers," says Schuchat.

The problem is, those symptoms aren't unique to swine flu.

They "can be caused by so many different things," Schuchat says, which makes it "impossible" for a patient to tell if they have swine flu, as opposed to another flu virus or a different illness.

"This is a dilemma, a challenge, we're wrestling with," says Schuchat. She encourages patients to use their judgment about whether they're sick enough to see a doctor, and to definitely do so if they've recently been to a high-risk area, such as Mexico.

Schuchat also notes that there have been cases of the virus spreading from person to person in the U.S. The two confirmed cases in Kansas are a husband and wife, one of whom traveled to Mexico. Two days after returning home, the spouse became ill, says Schuchat.

WebMD Senior Writer Daniel J. DeNoon contributed to this report.

Saturday, April 18, 2009

Build a Better Date Night

Build a Better Date Night

Feature from "Good Housekeeping" MagazineBy Sarah Mahoney

Whether your trysts are regular or once in a blue moon, you can rev up your romantic routine. For more great dates, check out these 7 fun ideas.



Tell the truth: Did your date nights vanish years ago, along with sleeping in, Sunday brunches, and reading the newspaper over coffee? Or have they become as stale as, well, 15 years of the missionary position?

In either case, you're due for a refresher. Couples should give special time together a high priority, because it not only helps you stay connected, the latest research reports, but it also makes both partners happier. "Date night is one of the best ways couples have to pull back from the fray and remember there's an 'us' hidden in the swirl of their daily lives — and really focus on maintaining and celebrating their connection to each other," says Pepper Schwartz, Ph.D., a sociology professor at the University of Washington in Seattle and relationship expert from perfectmatch.com.

To help keep your marriage strong, date night should be fun — of course — but you should also make it novel in some way, or you'll grow bored with your time together and, possibly, with each other, says Arthur Aron, Ph.D., a psychology professor at the State University of New York at Stony Brook who researches couples' interactions. That doesn't mean that you have to give up your beloved French film nights or ballroom dancing sessions and start bungee jumping just for the sake of novelty. Rather, you should simply make the effort to think creatively about how to spend your time together. "My wife and I love the ballet," says Aron, "and my sister gave us a backstage tour at the local dance company, so we got a different perspective on something we already enjoy."

To discover how to spice up date nights, we found three couples who faced challenges and asked them to road-test expert fix-it advice. Read on to see what worked — and why.

The Kitchen Cure
Names: Nina and Jayme Deibler

Hometown: Pittsburgh

Married: 4 years; she's 37, he's 38

Kids: A daughter, 2

Their challenge: Making date night happen at all

"My husband and I used to have great dates," Nina says. "We both love good food, and we'd often spend five or six hours cooking and experimenting with different wines."

But since their daughter was born, finding couple time has gotten harder. "I travel frequently for my job, and Jayme often works evenings and weekends," she says. "So when we do have a few hours, we usually want to spend them with our daughter."

"Working parents worry that time spent as a couple subtracts from time spent with their kids," explains Schwartz. "But when couples feel guilty leaving a child with a sitter, I tell them, 'This isn't selfish, it's protecting both your marriage and your family.'"

Expert Makeover

"It's great that these two have such a strong common interest," says James M. Graham, Ph.D., assistant professor of psychology at Western Washington University in Bellingham. "I'd like them to indulge their passions in a project they can finish in a few hours — one with a unique twist. Experimenting together makes a date more satisfying, just as team-building exercises draw people closer."

When a couple has to overcome a new challenge, their sense of accomplishment after they succeed is magnified. "Dates that allow that kind of growth let you surprise yourself and your partner," he says, "and see each other in a new light." Just keep changes and challenges moderate. "This should be fun, not traumatic."

The Deiblers decided to try making sushi — a dish they love in restaurants but had never prepared themselves. They bought the basic equipment (including a book of instructions) at a favorite cooking store and arranged for Nina's mom to take care of their toddler for a few hours.

The verdict: A huge hit

Her take: "The expert really nailed it when he suggested a project for us — this was great. And it was a challenge: The rice had to be just the right temperature, and some of the chopping and rolling was tricky. We did need the time without our daughter, but several of my neighbors want to trade babysitting so we can all have date nights. I found this experience very inspiring — it made me feel like we were dating again. Next time, I want to try cooking Indian food."

His take: "The food turned out really well, and we had the kind of fun we haven't for ages. It reminded me how good we are at working together and how we complement each other: Nina did the organizing and the shopping, and got the rice going. Then we took turns chopping and wrapping, tasting as we went along. And because we did it all between 5 and 7:30, we are confident now that we can make something like this happen at least every other week."

5-Minute Fixes
Names: Cate and Dan Adams

Hometown: Salt Lake City

Married: 18 years; both are 49

Kids: Twin girls, 16

Their challenge: Making limited time together feel meaningful

"We've always tried to do date nights, even before we had kids," says Cate. "Then, after the girls were born, we didn't go out often. Now that they're older, we both work full-time and still don't go out much.

"After our last anniversary, we decided that we'd try to spend five minutes each day just talking and connecting. And it's helped. But we'd like to find a way to make that time more special."
Expert Makeover

The experts loved the five-minute ritual, which eases the scheduling pressure that prevents many date nights from happening at all. But Schwartz advised the Adamses to expand beyond their "How was your day?" conversations and get creative. She suggested that they develop ways to mix it up by brainstorming together and surprising each other. She emphasizes that no one, including the Adamses, should feel pressured to come up with something novel for every single date. There's nothing wrong with what the two do now: chat in the kitchen while Dan does the dishes. But sharing a glass of wine, going for a short walk, or just sitting on the deck once a week can make those few moments feel more special.

The overachieving couple decided that they would come up with something different to do every single day for an entire week. One night, they traded foot massages. The next, Cate asked Dan to show her how to fix a flat tire on her bicycle. Another evening, each drew a picture of the best thing that happened to them that day. And one night, after Dan noticed someone selling weird-looking rocks on eBay, they raced down to the creek that runs through their backyard to see who could find the most eBay-worthy stones.

The verdict: Sure, it was nice, but enough already!

Her take: "The night we brainstormed was funny, and we laughed a lot throughout the week. But the best part, honestly, was all the talking we did while we were doing these things. In almost every case, we wound up spending much longer than five minutes, and it was good to realize we could make that much time for each other."

His take: "We had some fun with this, but I missed the quietness — and the spontaneity — of just being able to sit down and talk with Cate and decompress. And having to think of something new to do every night just wouldn't be sustainable in the long run, obviously. But I can see doing something special more often than we do now."

The Active Answer
Names: Camille and Kent Boskovich

Hometown: La Grange, IL

Married: 22 years; both are 47

Kids: A son, 19, and a daughter, 17

Their challenge: Spicing up their tried-and-true routine

These two spend plenty of time together — and enjoy it. They work out at the same gym, they have dinner out once a week, and they often spend weekends driving to their daughter's hockey tournaments in other cities.

Still, "our dates are pretty boring," Camille says. And while they enjoy elaborate events — from opera to White Sox games — they're looking for date ideas that don't take much advance scheduling.

Dating can be complex for couples like this, as they anticipate an empty house — and a kid-less social calendar. Even people with common interests, like these two, need to expand their dating repertoire, says Aron. He advised them to explore more in the fitness realm. They already enjoy it, and his research shows that couples typically find shared physical activity one of the best ways to bond. Aron actually persuaded spouses to Velcro themselves together and crawl across gym mats — and found that it made them feel more in love than they had before this unusual exercise.

"It's really important that they pick something they're both new to," he says — maybe a swing-dance class or snowshoeing. But they shouldn't worry that every activity has to be a perfect fit, says Schwartz. "Think of yourself as an anthropologist doing research, and remember, if you don't like it, you don't have to try it again," she says. Plus, even a bad date can be a good bonding experience and provide a couple with a shared memory to laugh about later.

After looking at their options, Camille and Kent tried a fitness yoga class at their health club: She had taken a few classes in the past but was still a novice, and he had always been interested in giving it a go.

The verdict: Mixed reviews but headed in the right direction

Her take: "I was surprised Kent was game to try this, but it was really great. The instructor asked us to do some tough poses, and Kent kept shooting me a look like, 'Are you kidding me?' On the one hand, I worried that he wasn't enjoying it that much. On the other, it was funny — and it really felt good to do something besides going out to dinner, especially something physical and healthy. So this inspired us: We're going to do a few sessions with a trainer next."

His take: "Honestly, is this a better date than going out for dinner and sharing a bottle of wine? No way. But that said, it was OK, and I would try it again. I'm looking forward to the training sessions. I'm a treadmill guy, so it'll be good to add weights — and fun to do it with my wife."



Originally published on January 15, 2009

10 Ways to Catch a Liar

10 Ways to Catch a Liar

Experts have 10 tips that can let you know if someone isn't telling you the whole truth.
By Heather Hatfield

J.J. Newberry was a trained federal agent, skilled in the art of deception detection. So when a witness to a shooting sat in front of him and tried to tell him that when she heard gunshots she didn't look, she just ran -- he knew she was lying.

How did Newberry reach this conclusion? The answer is by recognizing telltale signs that a person isn't being honest, like inconsistencies in a story, behavior that's different from a person's norm, or too much detail in an explanation.

While using these signs to catch a liar takes extensive training and practice, it's no longer only for authorities like Newberry. Now, the average person can become adept at identifying dishonesty, and it's not as hard as you might think. Experts tell WebMD the top 10 ways to let the truth be known.

Tip No. 1: Inconsistencies
"When you want to know if someone is lying, look for inconsistencies in what they are saying," says Newberry, who was a federal agent for 30 years and a police officer for five.

When the woman he was questioning said she ran and hid after hearing gunshots -- without looking -- Newberry saw the inconsistency immediately.

"There was something that just didn't fit," says Newberry. "She heard gunshots but she didn't look? I knew that was inconsistent with how a person would respond to a situation like that."

So when she wasn't paying attention, he banged on the table. She looked right at him.

"When a person hears a noise, it's a natural reaction to look toward it," Newberry tells WebMD. "I knew she heard those gunshots, looked in the direction from which they came, saw the shooter, and then ran."

Sure enough, he was right.

"Her story was just illogical," says Newberry. "And that's what you should look for when you're talking to someone who isn't being truthful. Are there inconsistencies that just don't fit?"

Tip No. 2: Ask the Unexpected
"About 4% of people are accomplished liars and they can do it well," says Newberry. "But because there are no Pinocchio responses to a lie, you have to catch them in it."

Sir Walter Scott put it best: "Oh what a tangled web we weave, when first we practice to deceive!" But how can you a catch a person in his own web of lies?

"Watch them carefully," says Newberry. "And then when they don't expect it, ask them one question that they are not prepared to answer to trip them up."

Tip No. 3: Gauge Against a Baseline
"One of the most important indicators of dishonesty is changes in behavior," says Maureen O'Sullivan, PhD, a professor of psychology at the University of San Francisco. "You want to pay attention to someone who is generally anxious, but now looks calm. Or, someone who is generally calm but now looks anxious."

The trick, explains O'Sullivan, is to gauge their behavior against a baseline. Is a person's behavior falling away from how they would normally act? If it is, that could mean that something is up.

Tip No. 4: Look for Insincere Emotions
"Most people can't fake smile," says O'Sullivan. "The timing will be wrong, it will be held too long, or it will be blended with other things. Maybe it will be a combination of an angry face with a smile; you can tell because their lips are smaller and less full than in a sincere smile."

These fake emotions are a good indicator that something has gone afoul.

Tip No. 5: Pay Attention to Gut Reactions
"People say, 'Oh, it was a gut reaction or women's intuition,' but what I think they are picking up on are the deviations of true emotions," O'Sullivan tells WebMD.

While an average person might not know what it is he's seeing when he thinks someone isn't being honest and attribute his suspicion to instinct, a scientist would be able to pinpoint it exactly -- which leads us to tip no. 6.

Tip No. 6: Watch for Microexpressions
When Joe Schmo has a gut feeling, Paul Ekman, a renowned expert in lie detection, sees microexpressions.

"A microexpression is a very brief expression, usually about a 25th of a second, that is always a concealed emotion," says Ekman, PhD, professor emeritus of psychology at the University of California Medical School in San Francisco.

So when a person is acting happy, but in actuality is really upset about something, for instance, his true emotion will be revealed in a subconscious flash of anger on his face. Whether the concealed emotion is fear, anger, happiness, or jealousy, that feeling will appear on the face in the blink of an eye. The trick is to see it.

"Almost everyone -- 99% of those we've tested in about 10,000 people -- won't see them," says Ekman. "But it can be taught."

In fact, in less than an hour, the average person can learn to see microexpressions.

Tip No. 7: Look for Contradictions
"The general rule is anything that a person does with their voice or their gesture that doesn't fit the words they are saying can indicate a lie," says Ekman. "For example, this is going to sound amazing, but it is true. Sometimes when people are lying and saying, 'Yes, she's the one that took the money,' they will without knowing it make a slight head shake 'no.' That's a gesture and it completely contradicts what they're saying in words."

These contradictions, explains Ekman, can be between the voice and the words, the gesture and the voice, the gesture and the words, or the face and the words.

"It's some aspect of demeanor that is contradicting another aspect," Ekman tells WebMD.

Tip No. 8: A Sense of Unease
"When someone isn't making eye contact and that's against how they normally act, it can mean they're not being honest," says Jenn Berman, PhD, a psychologist in private practice. "They look away, they're sweating, they look uneasy ... anything that isn't normal and indicates anxiety."

Tip No. 9: Too Much Detail
"When you say to someone, 'Oh, where were you?' and they say, 'I went to the store and I needed to get eggs and milk and sugar and I almost hit a dog so I had to go slow,' and on and on, they're giving you too much detail," says Berman.

Too much detail could mean they've put a lot of thought into how they're going to get out of a situation and they've crafted a complicated lie as a solution.

Tip No. 10: Don't Ignore the Truth
"It's more important to recognize when someone is telling the truth than telling a lie because people can look like they're lying but be telling truth," says Newberry.

While it sounds confusing, finding the truth buried under a lie can sometimes help find the answer to an important question: Why is a person lying?

These 10 truth tips, experts agree, all help detect deception. What they don't do is tell you why a person is lying and what the lie means.

"Microexpressions don't tell you the reason," says Ekman. "They just tell you what the concealed emotion is and that there is an emotion being concealed."

When you think someone is lying, you have to either know the person well enough to understand why he or she might lie, or be a people expert.

"You can see a microexpression, but you have to have more social-emotional intelligence on people to use it accurately," says O'Sullivan. "You have to be a good judge of people to understand what it means."

Extra Tip: Be Trusting
"In general we have a choice about which stance we take in life," says Ekman. "If we take a suspicious stance life is not going to be too pleasant, but we won't get misled very often. If we take a trusting stance, life is going to be a lot more pleasant but sometimes we are going to be taken in. As a parent or a friend, you're much better off being trusting rather than looking for lies all the time."

Thursday, April 16, 2009

Can You Trust Your Mammogram?

Can You Trust Your Mammogram?

WebMD Feature from "Good Housekeeping" MagazineBy Fran Smith

Why even smart doctors miss breast cancer - and how to make sure you're getting the best care.
No matter what you know about other diseases, breast cancer is probably the one that scares you most. It is frightening, striking nearly 182,000 women this year and plunging them into a world of complicated, arduous treatment. So it's heartening to know that more women are being diagnosed early, when the odds of beating the cancer are as high as 98 percent. Prevention and treatment are becoming personalized, thanks to genetic tests and new types of drugs. And after decades of no change, the death rate has finally begun to drop — about 2 percent annually since 1990.

Yet behind these impressive statistics lies one dumbfoundingly scary fact: Just because better tools and treatment exist is no guarantee that you'll get any of them. Your mammogram could be interpreted inaccurately, a lump could be incorrectly diagnosed, and you may not receive the best treatment for you simply because of where you live, the type of surgeon you choose — or even the doctor's sex.

That's why it's more important than ever to know the right questions to ask. Breast cancer is a complex disease (some researchers suspect it's at least five genetically distinct conditions), and no single approach works best for everybody. At every step — when you have your annual mammogram or get a suspicious lump checked out or undergo treatment — you should, at the very least, receive care that meets the scientific guidelines issued by leading cancer organizations. Here's how to make sure you do.

Screening Snafus
When you get a mammogram, it's common to have a stab of anxiety about what the radiologist will find. What should also concern you: the doctor who's doing the detecting.

The news: In a new study, researchers reviewed nearly half a million mammograms performed at 44 facilities. At the best centers, doctors identified cancer when it was present just about 100% of the time; at others, that number was closer to 70%, says study leader Stephen Taplin, M.D., M.P.H., a senior scientist at the National Cancer Institute. Facilities with a breast-imaging specialist (defined here as a doctor who spends at least half her time reading mammograms) had the best record.

Why it matters: Getting a regular mammogram is key to finding breast cancer early. Five-year survival rates drop from a high of 98.1% for early, breast-only tumors to 27.1% for advanced cancer that has spread to distant organs.

What you should do: When you call for an appointment, ask if there's a breast-imaging specialist on staff. If not, shop around, advises Diana Miglioretti, Ph.D., a researcher with the Group Health Center for Health Studies in Seattle. "I'd go to someone who has been interpreting screening mammograms for at least 10 years."

Follow-up Foul-ups
If your screening mammogram is abnormal or you have a lump, the next step is often a diagnostic X-ray, which takes magnified close-ups of the suspicious tissue.

The news: In theory, diagnostic mammograms should be easier to interpret than screening ones because the doctor knows where trouble may be lurking. Yet the largest study analyzing how well radiologists do on these critical exams found they missed 21 percent of cancers on average. The real shocker was the range: The top performer found every tumor, while the worst missed an astonishing 73 percent. Doctors affiliated with academic medical centers did best: They correctly diagnosed 88 percent of cancers.

Why it matters: Missing a tumor at this step could mean a delay in diagnosis — possibly a dangerous one, if a tumor isn't detected and treated before the cancer has spread.

What you should do: As with screening X-rays, the doctor who reads your diagnostic X-ray should be someone who specializes in mammograms, says Miglioretti, who led the study. Unless you live in a rural area, you should be able to find such a specialist no more than an hour or two away. "It's worth the drive," she says.

Surgical Biases
The biggest decision many women face when they're diagnosed with breast cancer is whether to have a mastectomy (removal of the entire breast) or a lumpectomy (only the tumor and surrounding tissue are cut out). In many cases, breast-conserving surgery, including lymph node testing and follow-up radiation, has the same lifesaving benefits as mastectomy. Yet your surgeon may not explain the options and consequences clearly or evenhandedly.

The news: Clinical guidelines developed by leading organizations favor breast-conserving surgery because it's less drastic. That's true whether you live in Augusta, ME, or Augusta, GA. Yet a review of 800,000 patient records found that while 70% in the Northeast had breast-sparing surgery, only 58% of those in the South did (the numbers for the West and Midwest were 63 percent and 61 percent, respectively). The review didn't look for a why, but study leader Jack Sariego, M.D., professor of surgery at Temple University, notes that the more rural South likely has fewer radiation facilities and fewer academic medical centers to promote surgical advances.

Beyond your zip code, the type of surgeon and hospital you choose may affect the recommendation you'll receive. Doctors who treat a lot of breast cancer or who work in cancer centers or academic medical centers suggest lumpectomy more often than general surgeons in the community. Surgeons trained after 1981 are also more likely to recommend a lumpectomy than older doctors, past research from the University of North Carolina at Chapel Hill has shown.
Why it matters: In a survey of 1,132 women who had either a lumpectomy or a mastectomy, almost half indicated they did not understand the risks and benefits of their choice.
What you should do: Ask loads of questions, starting with, "Am I a candidate for breast-conserving surgery, and if not, why not?" advises Dr. Sariego. Do your own research. And don't be shy about asking the first surgeon to recommend another for a second opinion. Better yet, look on your own: A recent study shows you're more likely to wind up with someone experienced and affiliated with a cancer program, compared with women who rely on referrals from their doctor or health plan, says Steven Katz, M.D., professor of medicine and health management and policy at the University of Michigan.

While you're asking questions, find out how your lymph nodes will be tested to see if the cancer has spread. A newer procedure, called sentinel-node biopsy, is less invasive and far less likely to cause permanent arm swelling than old-fashioned lymph node removal, but about 35 percent of patients aren't getting it, a recent multicenter study found.

Post-Surgery Neglect
Lumpectomy is just as effective as mastectomy only if it includes lymph node testing and a course of radiation treatments — generally five days a week for about six weeks. That's something your surgeon should make clear before you choose one procedure over the other.

The news: In 2003, only 71 percent of lumpectomy patients followed through with radiation, down from 79 percent in 1992, University of Minnesota epidemiologist Beth Virnig, Ph.D., reported last December. "A lot of women with serious breast cancer are not getting comprehensive treatment," she says.

Why it matters: If you don't undergo a full course of radiation, your chances of local recurrence within 10 years are as high as 30 percent, says Dr. Katz. (If you do, they drop to about 8 to 10 percent.)

What you should do: Talk with a radiation oncologist before surgery. Ask how long your treatment will last and what the side effects might be. For that matter, talk with all the specialists who may be involved in your postsurgical care. Women often feel panicked and pressured to start treatment immediately, but it's usually safe to wait two to three weeks.

Reticence on Reconstruction
If a lumpectomy isn't right for you, a mastectomy followed by reconstruction is an alternative — but you may have to bring up the subject.

The news: Only about one-quarter of surgeons regularly send patients for a plastic surgery consultation before they make their lumpectomy or mastectomy decision, researchers from the University of Michigan found in a 2007 study. Who's most likely to make that referral? Women surgeons — as well as those who treat a lot of breast cancer. Reconstruction can be done during the same surgery as the mastectomy, but it requires the general and plastic surgeons to share turf and mesh schedules, which may be inconvenient for them — even if it's good for you.

Why it matters: Both procedures will alter your appearance, but in different ways. This may seem like a minor worry when you're newly diagnosed and terrified, but it's likely to become important when you're well.

What you should do: "Ask your surgeon how your breast will look, how your clothing will fit," says Amy Alderman, M.D., M.P.H., an assistant professor of surgery at the University of Michigan. Even if you're sure you want breast-conserving surgery, you may want to consult with a plastic surgeon. Lumpectomy sometimes changes the breast more than women expect; a specialist can help you assess what might happen in your case. This is not vanity: Women who end up with extremely uneven breasts are more likely to be depressed and to worry that their cancer will return, a brand-new University of Michigan study found. Or you may want to seek out a breast surgeon who's experienced in oncoplastic techniques, which can improve the look of the breast.

Thankfully, the days of "Doctor knows best" are behind us. But that means breast cancer patients have to work with their physicians to make tough choices. To do that, women must share their fears and desires. "The doctor only knows what's on your X-ray and pathology report," says Karen Sepucha, Ph.D., a senior scientist with the Health Decision Research Unit at Massachusetts General Hospital: "What you care about needs to get on the table."

And you have to be the one who makes sure it does.

More Ways to Get the Answers You Need
Going for a Third Opinion
Kim Friedrich, 37
Mastic, NY

Kim Friedrich was in shock. In February 2007, her left breast had a tumor one-and-a-half times the size of a golf ball; because it was so big and aggressive, the surgeon told her she needed to have that breast removed, as well as the other as a precaution. A second doctor agreed. "I kept seeing myself on my deathbed," Friedrich says. She'd look at her two daughters and seize up with grief — would they grow up without her? While she would have done anything to live, she wasn't convinced she had to lose her breasts. Neither doctor had taken much time with her, she realized. Friedrich began to do research and talked to everyone she could. When an acquaintance raved about her breast specialist, at a cancer center a three-hour drive away, Friedrich pressed for an appointment. The mastectomy recommendations did not surprise the doctor. "That's old thinking," he told her. His advice: a course of chemotherapy (which shrank the tumor down to the size of a pea), followed by a lumpectomy and radiation. It was very tough, but Friedrich has no doubt she chose the right treatment — and doctor: "I got two quick assessments, and felt like they were thinking, 'Let's just do what's fastest and move on to the next patient.'"

When It's Not "Nothing"
Amalia Rigoni, 50
Olympia Fields, IL

Although she'd had a normal mammogram just a few months earlier, in March 2000, Amalia Rigoni was uneasy about a lump she felt in her lower right breast. Both her gynecologist and internist said she was fine. A diagnostic mammogram detected nothing. Still, she insisted on seeing a surgeon. That doctor, a general surgeon, told her to come back in six months. So Rigoni tried another tack: "If your mother had breast cancer, where would you send her?" The surgeon recommended a breast specialist who'd been his professor. The specialist checked her by closing his eyes and palpating the breast. "I don't like the feel of that lump," he said. "It was surreal," Rigoni recalls. "But I said, 'Thank God. At least I know what's going on.'" Almost nine years later — after a mastectomy, reconstruction, radiation, and three years of the drug tamoxifen followed by five on Femara — she's fine. Now Rigoni's a hotline coordinator for Breast Cancer Network of Strength, counseling women who may be facing the same struggle to get answers. "I tell them that doctors may know medicine, but you know your body. If something doesn't feel right, get it checked out." And, she adds, "go to a specialist."

Filling the Info Gap
Evelyn White, 48
San Francisco, CA

Support groups can provide invaluable information that patients may not get from their doctors. Evelyn White, for example, says her medical care was "great." She was diagnosed with breast cancer in February 2006, and underwent a mastectomy. But the chemo that followed left her unable to move — and she was suffering terrible crying jags. A friend thought it might be the medicine that White was taking for nausea — Ativan, a powerful sedative. She asked her doctor about stopping the drug and then, at a meeting of a cancer survivors' organization, heard about an alternative. There was a newer drug, Emend, developed specifically to prevent the nausea of chemotherapy — without causing depression. Once her physician switched the meds, "I felt a thousand percent better, physically and emotionally," says White. Later, the group helped in another key way. White had assumed her cancer was genetic (her sister was a survivor as well), and she was worried that her daughter, 24, might be at increased risk. Armed with information she got from a meeting, she underwent testing and, last year, was thrilled to be able to strike that worry off her list.

Friday, April 10, 2009

7 Relationship Problems and How to Solve Them

7 Relationship Problems and How to Solve Them

Here's how to resolve the most common relationship problems and get your love life back on track.
By Carol Sorgen
FeatureReviewed by Louise Chang, MDIt's the rare couple that doesn't, sooner or later, run into a few bumps in the road. If you recognize ahead of time what those relationship problems can be, you'll have a much better chance of weathering the storm, experts say.

Ideally, a couple should discuss certain basic issues -- such as money, sex, and kids -- before they decide to start their life together. Of course, even when you do discuss these issues beforehand, marriage (or a long-term, live-in relationship) is nothing like you think it's going to be.

In spite of the fact that every marriage experiences relationship problems, couples who are successful have learned how to manage them and keep their love life going, says marriage and family therapist Mitch Temple, MS, author of The Marriage Turnaround. They gain success in marriage by hanging in there, tackling problems, and learning how to maneuver through the complex issues of everyday married life. Many do this by reading self-help books, attending seminars, browsing articles on the Web, going to counseling, observing other successful couples, or simply by trial and error.

Here are some common issues and ways to resolve them:

Relationship Problem: Communication

All relationship problems stem from poor communication skills, says Elaine Fantle Shimberg, author of Blending Families. "You can't communicate while you're checking your BlackBerry, watching TV, or flipping through the sports section," she says.

Problem-solving strategies:

Make time ... yes, an actual appointment with each other, Shimberg says. If you live together, put the cell phones on vibrate, put the kids to bed, and let the answering machine pick up your calls.
If you can't "communicate" without raising your voices, go to a public spot like the library, park, or restaurant, where you'd be embarrassed if anyone saw you screaming.
Set up some rules ... like not interrupting until the other is through, banning phrases such as "You always ..." or "You never ..."
Remember that a large part of communication is listening, so be sure your body language reflects that. That means, don't doodle, look at your watch, pick at your nails, etc. Nod so the other person knows you're getting the message and rephrase if necessary, such as, "What I hear you saying is that you feel as though you have more chores at home, even though we're both working." If you're right, the other can confirm, and if what the other person really meant was, hey, you're a slob and you create more work for me by having to pick up after you, perhaps they'll say so but in a nicer way.

Relationship Problem: Sex

Even partners who love each other can be incompatible sexually. Compounding these problems, says Mary Jo Fay, is the fact that men and women alike are sorely lacking in sex education and sexual self-awareness. Yet, having sex is one of the last things we should be giving up, says Fay, who addresses the topic in her new book, Please Dear, Not Tonight. "Sex brings us closer together, releases hormones that help our bodies both physically and mentally, and keeps the chemistry of a healthy couple healthy," she says.

Problem-solving strategies:

Plan, plan, plan, Fay says. Make an appointment -- not necessarily at night when everyone is tired. Maybe during the baby's Saturday afternoon nap. Or perhaps a "before-work quickie," Fay suggests. Or ask Grandma and Grandpa to take the kids every other Friday night for a sleepover. "When sex is on the calendar, it increases your anticipation," Fay says, adding that mixing things up a bit can increase your sexual enjoyment as well. Why not sex in the kitchen? Sex by the fire? Sex standing up in the hallway?
California psychotherapist Allison Cohen, MA, MFT, also suggests learning what truly turns your partner on by asking him or her to come up with a personal "Sexy List." And, of course, you do the same. What do each of you truly find sexy? "The answers may surprise you." Swap the lists and use them to create more scenarios that turn you both on.
If your sexual relationship problems can't be resolved on your own, Fay recommends consulting a qualified sex therapist, who can help you both address and resolve your issues.

Relationship Problem: Money

Money problems can start even before the wedding vows are said, from the expenses of courtship to the high cost of weddings. The National Foundation for Credit Counseling (NFCC) recommends that couples who have money woes take a deep breath and have a serious conversation about finances.

Problem-solving strategies: The NFCC offers the following advice for having that much-needed financial conversation:

Be honest about your current financial situation. If things have gone south, continuing the same lifestyle that was possible before the loss of income is simply unrealistic.
Don't approach the subject in the heat of battle. Instead, set aside a time that is convenient and non-threatening for both parties.
Acknowledge that one partner may be a saver and one a spender, understanding that there are benefits to both, and agreeing to learn from each other's tendencies.
Don't hide income or debt. Bring financial documents, including a recent credit report, pay stubs, bank statements, insurance policies, debts, and investments to the table.
Don't blame.
Construct a joint budget that includes savings.
Decide which person will be responsible for paying the monthly bills.
Allow each person to have independence by setting aside money to be spent at his or her discretion.
Decide upon short-term and long-term goals. It's OK to have individual goals, but you should have family goals, too.
Talk about caring for your parents as they age, and how to appropriately plan for their financial needs, if necessary.

Relationship Problem: Struggles Over Home Chores

Nowadays, most partners work outside the home -- and in today's economy -- often at more than one job, so it's important to equitably divide the labor at home, says Paulette Kouffman Sherman, PhD. She is the author of Dating from the Inside Out: How to Use the Law of Attraction in Matters of the Heart.

Problem-solving strategies:

Be organized and clear about your respective jobs in the home, Sherman says. "Write all the jobs down and agree on who does what." Be fair: Make sure each partner's tasks are equitable so no resentment builds.
Be open to other solutions, Sherman adds: If you both hate housework, maybe you can spring for a cleaning service. If one of you likes housework, the other partner can do the laundry and the yard. As long as it feels fair to both people, you can be creative and take preferences into account.

Relationship Problem: Not Prioritizing Your Relationship

If you want to keep your love life going, making your relationship a focal point does not end when you say "I do." "Relationships lose their luster," says Karen Sherman, PhD, author of Marriage Magic! Find It, Keep It, and Make It Last. "So make yours a priority."

Problem-solving strategies:

Do the things you used to do when you were first dating: Make gestures of appreciation, compliment each other, contact each other through the day, and show interest in each other.
Plan date nights. Schedule time together on the calendar just as you would any other important event in your life.
Respect one another. Say "thank you," and "I appreciate ... ." It lets your partner know that he/she matters.

Relationship Problem: Conflict

Occasional conflict is an inevitable part of life, says New York-based psychologist Susan Silverman, PhD, but if you and your partner feel like you are starring in your own nightmare version of the movie Groundhog Day, it's time to break free of this toxic routine. Recognizing these simple truths will lessen anger and enable you to take a calm look at the underlying issue.

Problem-solving strategies:

Conflict resolution skills can help you and your partner learn to argue in a more constructive manner, says Silverman, who offers this advice:

You are not a victim. It is your choice whether to react and how to react.
Be honest with yourself. When you're in the midst of an argument, are your comments directed toward resolution, or are you looking for payback? If your comments are blaming and hurtful, it's best to take a deep breath and change your strategy.
Change it up. If you continue to respond in the same way that has brought you pain and unhappiness in the past, you can't expect a different result this time. Just one little shift can make a big difference. If you usually jump right in to defend yourself before your partner is finished speaking, hold off for a few moments. You'll be surprised at how such a small shift in tempo can change the whole tone of an argument.
Give a little; get a lot. Apologize when you're wrong. Sure it's tough, but just try it and watch something wonderful happen.
"You can't control anyone else's behavior," Silverman says. "The only one in your charge is you."

Relationship Problem: Trust

Trust is an essential part of a relationship. Are there certain behaviors that are causing you to not trust your partner, or do you have unresolved issues that are hindering you from trusting others?

Problem-solving strategies: You and your partner can develop trust in each other by following these tips, suggested by Fay.

>Be consistent.
>Be on time.
>Do what you say you will do.
>Don't lie -- not even little white lies, to your partner or to others.
>Be fair, even in an argument.
>Be sensitive to the other's feelings. You can still disagree but don't discount how your partner is feeling.
>Call when you say you will.
>Call to say you'll be home late.
>Carry your fair share of the workload.
>Don't overreact when things go wrong.
>Never say things you can't take back.
>Don't dig up old wounds.
>Respect your partner's boundaries.
>Don’t be jealous.
>Be a good listener.

Although relationships have their ups and downs, there are things you can both do that may well minimize marriage problems, if not help avoid them altogether, says psychologist Karen Sherman. Be realistic. Thinking your mate will meet all your needs -- and will be able to figure them out without your asking -- is a Hollywood fantasy. "Ask for what you need directly," Karen Sherman says.

Use humor -- learn to let things go and enjoy one another more. And be willing to work on your relationship and to truly look at what needs to be done. Don't think that it will be better with someone else; the same problems you have in this relationship because of lack of skills will still exist

Sunday, March 29, 2009

Master Stress in Only 10 Minutes a Day



As I write this article, the stock market continues its wild gyrations and the economic and other rampant stress of our times is beginning to take its toll on our health.
This is not just my opinion, it’s also been shown in a recent poll published by the American Psychological Association (APA).1 Money and the economy topped the list of stressors for at least 80% of those surveyed. Finances now overshadow the more usual daily stressors of work and relationships, with 46% of people reporting that their stress is due to worries about providing for their family’s basic needs.

My own research clarifies that when you feel you have less control over your stress, it definitely causes you more concern. It raises your internal mind, body, and emotional threat level.2
Women Worse Off

Unfortunately, the brunt of this economic stress is falling upon women more than men. According to the APA’s poll, compared with men, more women say they are stressed about money, the economy, job stability, housing costs, and health problems affecting their families.
Ladies of the boomer generation (ages 44-62) and Matures (aged 63+) are most likely to report the economy as a significant stressor, while women in general rank financial worries above personal health. Female Boomers report increases in stress associated with their job stability and health problems affecting their families.

Moreover, mature women are reporting dramatic increases in stress associated with family health concerns (87%), the economy (92%), and money (77%).
Beyond that, Generation Xers (ages 30-43) and Millennials (ages 18-29) are not immune from financial worries either. Generation Xers are the women most concerned about money (89% report money as a source of stress) and Millennials are most concerned about housing costs as a source of stress (75%).

The current work from the APA clearly reveals that our economic stress is causing more than half of Americans to report irritability, anger, fatigue, headaches, and sleeplessness. What’s worse, these stress sufferers say they self-medicate by over-eating unhealthy foods, over drinking, and generally straying from healthy habits.1

In addition to the above-mentioned symptoms, the rise in stress-related issues can:
1. Weaken your immune system
2. Raise your blood pressure
3. Disturb your sleep
4. Lead to depression
5. Cause memory loss

So What Can You Do?
As seen in the picture below, in 1949, a Swiss physiologist named Dr. Walter Hess, won the Nobel Prize in Physiology and Medicine by revealing that two separate and distinct centers exist in your brain. The one on the left is the stress center, while the other one is an anti-stress center.3


An x-ray of the brain’s stress (left) and relaxation centers (right).
When you are able to activate the anti-stress spot by following the directions below, many wonderful health-promoting events occur. Your blood pressure goes down, your pulse decreases, your unhealthy stress chemicals plummet, and, perhaps most importantly, the amount of oxygen your body needs goes down.
This puts you into a true anti-aging zone, because, when you use less oxygen, you create fewer free radicals, which are a hallmark of the aging process.4
Additionally, as emerging medical research shows, the relaxation response changes your genetic expression for the better. The reason is because unbalanced stress shortens the tip of your gene called the telomere, and relaxation lengthens your telomere because it stops the harmful effects of stress on your genes. This new search shows that relaxation techniques such as meditation, actually “turn off” the disease-promoting process stress causes.5
Over the years, there have been hundreds, if not thousands of research studies revealing many health and healing benefits of regular relaxation techniques such as meditation, prayer, visualization, and so on, including the picture of a much younger brain. Regions involved in memory and attention were thicker in people who meditated regularly. While these areas tend to shrink with age, older meditators were able to ward off some of this shrinkage.6-7
Meditation has many other positive benefits as well. As seen in the illustration below, in many research studies over three decades, meditation has been shown to help your heart, reduce anxiety, soften chronic pain, and increase longevity.6


Regular meditation improves health and reduces disease.

A compilation of studies modeled after an article published by the Transcendental Meditation people many years ago. I wrote about it in Meditation as Medicine.
Here are the four steps needed to enter into the stress-mastering relaxation zone:

1. Comfort: You don’t have to sit like a pretzel to meditate. You can enter the zone in a soft chair. One caveat is that you don’t want to be so comfortable that you fall asleep.
Quiet: Your relaxation time is a special time, not to be interrupted by checking e-mail, blackberries, cell phones, or pets. Your time to meditate is sacred. If your spouse or significant other doesn’t meditate, they shouldn’t be in the room with you. The same holds true for children.

2. A Tool: In the basic form of relaxation, your tool can be any thought, sound, short prayer, or phrase upon that you wish to focus. It can literally be anything. Even paying attention to your breath works well. Ideally your word should be something easy. Examples are peace, love, heal, or the word one, which has a long history of being used in the research on basic relaxation and meditation.

3. An Attitude: Once you begin the process, you’ll be surprised to discover that your mind reacts like a four-year-old child. If you ask a four-year-old to sit still, they will probably end up running all around the room. It’s the same with your mind. At a time when you expect your mind to calm down, it actually speeds up. Why is this so? Well, all the pressure you have stored inside your mind is pent up in there. So, when we begin to elicit the response, it’s as if a trap door opens and “boom,” all these thoughts come flying out:

“Why didn’t I go to the bathroom before I started?
“I have to balance my checkbook.”
“I sure hope we get that mortgage.”
“Where’s my brother? He was supposed to be here an hour ago.”
“Whatever happened to Joan from the first grade?”

When you practice this technique, your mind will be bombarded by thoughts.

I’ve been doing it for three decades and it still happens to me every day. Not to worry. This is simply the normal stress-releasing process and is expected. It’s what you do with the thoughts that really count.

And what you do is — just let them go and return to your word.

As one of my patients from England once said in a great Beatles accent, “Oh, Dr. Dharma. You mean you just start all over again?” That’s right. When other thoughts enter your mind, you just start all over again. The way you do that is by going back to your focus word. For example, let’s say your word is one. When other thoughts enter into your mind, you simply say to yourself: “Oh, well, [your name], “relax, one.” That’s all there is to it.

To end the technique, simply inhale, hold your breath for a moment, and exhale. Then inhale again, slowly stretch your arms up, exhale, and relax. Slowly open your eyes and hold your gaze on whatever you see, for about one minute. Then inhale, exhale, and take your time getting up.
Believe it or not, you only have to do this for 10 minutes at least once every day, preferably before breakfast, to get the full effect. If you can do it a second time in the afternoon, all the better.

You can use a digital clock or even open your eyes and look at your wristwatch. Just don’t use an alarm, because it’s too startling. What you’ll find, with time, is that your mind will automatically know when the time is up.
It’s easy.

Best of Blessings,
Dr. Dharma

References
Stress In America; American Psychological Association Report, October 7, 2008.
Khalsa, D. 1998. Alternative therapies in Health and Medicine. 4(6): 38-43.
Hess WR. Dtsch Med Wochenschr. 1961; 86 3-8.
Beary, J,F, & Benson, H. (1974). Psychosomatic Medicine. 36, 115-120.
Dusek, J, et al. PLoS One 3(7): e2576, Published online July 2, 2008.
Khalsa, D. Meditation as Medicine. Atria Books 2001.
Lazar, S et al. 2005. Neuroreport. 16 17): 1893-1897.

Inspiration: The Power that Drives Your Creativity




When was the last time you felt truly inspired?
Can you remember the physical sensations that went with it?
How about the intense emotions that accompanied it?
Did your mind join in with ideas, plans and
possibilities for creative action?
Did this experience lead to something amazing
and wonderful in your life?
Is it something you would like to experience more often?

To be inspired implies an infusion of spirit — to be filled with a spirit of energy that can often feel powerful, exciting, stimulating, creative and even divine. Inspiration has been at the core of almost every great accomplishment known to human beings. But, for most people it seems to come and go at will, essentially uncontrollable. What if that was not the case? What if you could increase the frequency and intensity of inspiration with the proper use of certain techniques? Would you want to know more?

The experience of inspiration can become a regular part of your life if you are willing to follow the guidelines I have outlined below. They work for me and they will work for you.

Guidelines for Inviting Inspiration

Since we cannot control inspiration (trying to control it usually kills it), we need to learn how to invite it into our inner being. It is something that comes to us (or wells up within us) when we have created a receptive container. Here is how to do that.

1. Be willing to honor inspiration when it arrives. Be respectful.

2. Value imagination. Staying in your head (being rational and pragmatic) is the antithesis of creativity. Imagination is central and essential to the development of your inspiration.

3. Allow positive emotions to be part of the process. Feelings like wonder, excitement, joy, and enthusiasm nurture and encourage inspiration.

4. Practice stillness. Inspiration most often appears during times of quiet reflection. Excessive busyness will completely block the flow.

5. Pray for it. I often pray this simple prayer: “God open my heart and mind to receive your creativity and inspiration.”

6. Act on it. Action indicates that you are a trustworthy recipient of the gift. Once you have passed this “test” you will experience an increased flow of inspiration.

Let Providence Work It’s Magic

Finally, remember and trust in the following statement made by the great poet and philosopher, Johann Wolfgang von Goethe (1749-1832). I have posted it on the wall in my office. You might do the same.


“Concerning all acts of initiative (and creation) there is one elementary truth, the ignorance of which kills countless ideas and splendid plans: that the moment one commits oneself, then Providence moves too…


"Whatever you can do,Or dream you can, begin it,Boldness has genius,Power and magic in it.”

Sunday, March 22, 2009

The 7 Steps to Happily Ever After

The 7 Steps to Happily Ever After
Feature from "Redbook" Magazine

By Marjorie Ingall


What makes love last a lifetime? Affection? Yep. Respect? Sure. But a great marriage is not just about what you have. It's about what you do to make a relationship stronger, safer, more caring and committed. Here's how to make your "forever" fantastic.

Marriage is a home, a refuge against the outside storms. And like any house, it requires a strong, lasting foundation. To build one, every couple needs to take certain steps — seven, to be precise — that turn the two of you into not just you and me but we. You may not move through all the steps in order, and you may circle back to complete certain steps again (and again and again). But if you make it through them all, you'll be well on your way toward creating a marriage that will be your shelter as long as you both shall live.

Step 1: Find a shared dream for your life together.

It's easy to get caught up in the small stuff of married life: What's for dinner tonight? Whose turn is it to clean the litter box? Did you pay the electric bill? But the best partners never lose sight of the fact that they're working together to achieve the same big dreams. "Successful couples quickly develop a mindfulness of 'us,' of being coupled," says REDBOOK Love Network expert Jane Greer, Ph.D., a marriage and family therapist in New York City. "They have a shared vision, saying things like, 'We want to plan to buy a house, we want to take a vacation to such-and-such a place, we like to do X, we think we want to start a family at Y time.'"

This kind of dream-sharing starts early. "Couples love to tell the story of how they met," points out Julie Holland, M.D., a psychiatrist in private practice in New York City and a clinical assistant professor of psychiatry at the New York University School of Medicine. "It's like telling a fairy tale. But happy couples will go on creating folklore and history, with the meet-cute forming the bedrock of the narrative." As you write and rewrite your love story ("our hardest challenge was X, our dream for retirement is Y"), you continually remind yourselves and each other that you're a team with shared values and goals. And P.S.: When you share a dream, you're a heck of a lot more likely to make that dream come true.

Step 2: Ignite (and reignite) a sexual connection.

In any good relationship, sex is way more than just a physical act. It's crucial for the health of your emotional connection, too: It's something only the two of you share; it makes you both feel warm and loved; it draws you back together when you're drifting apart. And did I mention that it's a whole lot of fun?

Striking up those sparks when you first meet is easy. Nurturing a strong, steady flame? That's the hard part. When you've got a mortgage, a potbelly, and a decade or two of togetherness under your belts, it can be hard to muster up the fire you felt when you first got together. That's when it's even more important to protect your sex life and make it a priority. "You have to keep working to create allure and seduction for each other or your sex life will become lackluster," Greer points out. "Who wants the same turkey sandwich over and over? You want it on whole wheat! On toast! As turkey salad! On a roll!" (And now I will imagine my husband covered with Russian dressing. Thanks, Dr. Greer.)

As the years go by, you'll keep revisiting and realigning and reimagining the passion you have for each other. And if you keep at it, you'll have a sex life that transcends your marriage's lack of newness, the stresses of family and work, the physical changes that come with aging. Now that's something worth holding on to.

Step 3: Choose each other as your first family.

For years, you were primarily a member of one family: the one in which you grew up. Then you got married, and suddenly you became the foundation of a new family, one in which husband and wife are the A-team. It can be tough to shift your identity like this, but it's also an important part of building your self-image as a duo (and maybe, eventually, as three or four or...).

For me, making this transition meant stopping the incessant bitching to my mom when I was mad at my husband — my behavior was disloyal, and I had to learn to talk to Jonathan, not about him. My friend Lynn tells the story of her mother's reaction to a trip to the Middle East she and her then-boyfriend (now husband) had planned. Her mother hit the roof, calling incessantly to urge Lynn not to go. Eventually, Lynn's boyfriend got on the phone with Mom and explained why they were excited to share this experience. "It was clear then that we were the team," Lynn says now. "Not teaming up against my mother, but teaming up together to deal with her issues."

Whatever your challenges — an overprotective mom? an overly critical father-in-law? — you have to outline together the boundaries between you and all of the families connected to you. Not only will you feel stronger as a united front but when you stick to your shared rules, all that family baggage will weigh on you a lot less.

Step 4: Learn how to fight right.

I'm embarrassed to think of how I coped with conflict early in my relationship with Jonathan. I stormed out — a lot. I once threw an apple at his head. Hard. (Don't worry, I missed — on purpose.) I had a terrible habit of threatening divorce at the slightest provocation. But eventually I figured that this was pretty moronic. I didn't want out, and I knew that pelting someone with fruit was not a long-term marital strategy.

"Fighting is the big problem every couple has to deal with," says Daniel B. Wile, Ph.D., a psychologist and couples therapist in Oakland, CA, and author of After the Fight. That's because fights will always come up, so every couple needs to learn how to fight without tearing each other apart.

Fighting right doesn't just mean not throwing produce; it means staying focused on the issue at hand and respecting each other's perspective. Couples that fight right also find ways to defuse the tension, says Wile — often with humor. "Whenever one of us wants the other to listen up, we mime hitting the TV remote, a thumb pressing down on an invisible mute button," says Nancy, 52, an event producer in San Francisco. "It cracks us up, in part because it must look insane to others." Even if you fight a lot, when you can find a way to turn fights toward the positive — with a smile, a quick apology, an expression of appreciation for the other person — the storm blows away fast, and that's what matters.

Step 5: Find a balance between time for two and time for you.

Jonathan and I both work at home. This frequently leads to murderous impulses. Though I'm typing away in the bedroom and he's talking to his consulting clients in our small home office, most days it really feels like too much intimacy for me.

But that's my bias. When it comes to togetherness, every couple has its own unique sweet spot. "There are couples that are never apart and there are couples that see each other only on weekends," Greer says. With the right balance, neither partner feels slighted or smothered. You have enough non-shared experiences to fire you up and help you maintain a sense of yourself outside the relationship — not to mention give you something to talk about at the dinner table. But you also have enough time together to feel your connection as a strong tie rather than as a loose thread.

Your togetherness needs will also change over time, so you'll have to shift your balance accordingly. "My husband and I spend a lot of time together, but it's almost all family time," says Katie, 40, a mom of two in San Leandro, CA. "We realized a few months ago that we hadn't had a conversation that didn't involve the kids or our to-do lists in ages, so we committed to a weekly date. We were so happy just to go to the movies and hold hands, something we hadn't done in ages. It felt like we were dating again!"

Step 6: Build a best friendship.

Think about the things that make your closest friendships irreplaceable: the trust that comes with true intimacy, the willingness to be vulnerable, the confidence that the friendship can withstand some conflict. Don't those sound like good things to have in your marriage, too?

"Happy couples are each other's haven," says Holland. "They can count on the other person to listen and try to meet their needs." Greer adds, "When you're true friends, you acknowledge and respect what the other person is; you don't try to control or change them. This creates a sense of safety and security when you're together — you know you're valued for who you are and you see the value in your partner."

Then there's the way, when you've been with someone a while, that you become almost a mind reader. You have a shared history and inside jokes. Your guy knows what you'll find funny, you forward him links to articles you know he'll enjoy, and best of all, you two can make eye contact at a given moment and say volumes without opening your mouths. And is there anything more pleasurable than sharing the newspaper with someone? Sitting in companionable silence, absorbed in your respective reading, sipping coffee, occasionally reading something out loud, but mostly just lazing happily together, communing without needing to speak? Ahh....

Step 7: Face down a major challenge together.

You're sailing along through life, and suddenly you hit a huge bump. A serious illness. Unemployment. The loss of a home. A death in the family. How do you cope?

The truth is, you never know how strong your relationship is until it's tested. All too often, the stress of a crisis can pull a couple apart. But the good news is, when you do make it through in one piece, you might just find yourselves tighter than ever.

"What didn't happen to us?" says Daryl, 28, a preschool teacher in Harrisburg, PA. "My husband lost his job and took a minimum-wage job he was way overqualified for just to make ends meet. He was offered a better job in a mountain town outside San Diego, so we moved. Then during the California wildfires several years ago, our house burned down and we lost everything. We were living in a one-room converted garage with no running water and a newborn. But we found that this chaos somehow brought us even closer together. We took turns losing it. We really kept each other sane."

Hey, marriage is no roll in the hay. It's tough, real work. But the reward, the edifice you build together that will shelter you through years of tough times, is more than worth the effort. The small, friendly cottage you build — decorated with your shared history and stories, filled with color and laughter — will be the warmest and safest retreat you can imagine.

Friday, March 20, 2009

Your 12 Most Embarrassing Beauty Questions -- Answered

Your 12 Most Embarrassing Beauty Questions -- Answered

By Amy M. Keller.


When the normal bacteria on your feet interact with moisture trapped in your socks and shoes, they emit stinky sulfurous byproducts, says Doris J. Day, M.D., an assistant professor of dermatology at New York University.

1. What causes foot odor?

The fix: Since dry feet equals odor-free feet, wear absorbent cotton socks with shoes made from breathable materials, like canvas and leather, and sprinkle Zeasorb - an over-the-counter drying powder - into your shoes every morning. Three nights a week, pour a pot of tea made with several regular (not herbal) tea bags into a basin, then soak your feet for five to 10 minutes. The tannic acid in tea temporarily inhibits sweat production. See your doctor if your feet are also red, swollen or scaly to make sure a bacterial or fungal infection isn't causing the smell.

2. Why does my breath smell despite constant brushing?

Although brushing will help prevent cavities (so don't stop scrubbing), it can only mask bad breath, since the problem really lies within your throat and tongue, not your teeth. When the bacteria in your mouth lose access to oxygen (which can happen when you use alcohol-based mouthwashes, take certain prescription medications for depression or high blood pressure or simply sit with your mouth shut for a long time), they emit smelly sulfur compounds, says Harold Katz, D.D.S., founder of The California Breath Clinic in Los Angeles; this is the same principle at work with foot odor. Eating garlic and onion also makes your breath stink because they contain - surprise - those same sulfur compounds.

The fix: Contrary to popular belief, a tongue scraper won't banish bad breath - sulfur compounds cannot be removed manually. Instead, keep your mouth oxygenated by drinking water throughout the day and using an over-the-counter oral rinse with chlorine dioxide in both the A.M. and the P.M. to neutralize sulfur compounds. (Try TheraBreath Oral Rinse.) Chewing on oxygen-rich vegetables, like parsley and celery, can also diminish odors. If these tricks don't work, see your dentist.

3. I've started to sweat through my blouses. Should I be worried?

Most likely there's nothing to fear, says Joseph L. Jorizzo, M.D., chairperson of dermatology at Wake Forest University School of Medicine in Winston-Salem, NC. You probably just have a benign, hereditary tendency toward excessive sweating that can crop up at any age. But see your doctor to rule out an overactive thyroid, a low blood-sugar level and a number of other problems that can cause continual heavy sweating.

The fix: Before bed, towel-dry your armpits and apply the prescription antiperspirant solution Drysol (it contains a higher percentage of aluminum chloride - a drying agent - than regular deodorants do). Wash the solution off in the A.M. and don't reapply any deodorant. Repeat nightly. Still not satisfied? Ask your doctor about Botox injections - one treatment ($800 to $1,500) can paralyze sweat glands for six months to a year.

4. Every time I shave, I get a bumpy rash along my bikini line -- what's causing it?

A too-close shave or waxing can make hairs split and loop around just under the surface of the skin. As these off-kilter hairs grow, they push up against your skin, causing inflammation and redness, says Lawrence Moy, M.D., chief of dermatology at Harbor-UCLA Medical Center.

The fix: Put down your loofah; dermatologists now agree that rubbing the bumps to free trapped hairs will only make the problem worse. Instead, apply an OTC acetylsalicylic acid (a.k.a. aspirin) solution twice a day for two to seven days to gently exfoliate the top layer of your skin. (Try Soft Cell.) Once you shed this layer, the looped hairs will be able to poke through. A cortisone injection, administered by your dermatologist, will decrease inflammation in bigger bumps. If ingrown hairs are a persistent problem, you may want to consider laser treatment, which damages the hair follicles and prevents hair growth. You'll need about three treatments (each around $350) followed by a touch-up every six months to a year.

5. I've heard that spider veins are hereditary. My mom doesn't have them, so why do I?

Genetics isn't the only cause of these unsightly blue veins. Pregnancy and trauma to the leg (like bumping into something) can bring them on, says Esta Kronberg, M.D., a Houston, TX, dermatologist.

The fix: Though vitamin K cream has been touted by some as the next big thing in spider-vein treatment (possibly because of its ability to constrict blood vessels, which supposedly makes veins less visible), there's no way the molecules in the cream can penetrate the skin on your legs and be absorbed into your veins, says Jorizzo. The best option - with 95 percent of patients seeing improvement after one to three treatments (up to $300 per treatment, per leg) -- is still sclerotherapy, tiny injections of saline solution, which irritates veins and causes them to swell shut.

6. Are the bumps on my butt and on the backs of my arms pimples?

No. They're actually called keratosis pilaris - the cause is unknown, but some claim that it's a hereditary condition.

The fix: You can soften and help slough off bumps by rubbing them with a mixture of equal parts petroleum jelly and either water or cold cream. If that doesn't work, prescription Retin-A probably will, but it can irritate the surrounding skin. A better alternative: prescription LactiCare-HC Lotion 2 1/2%, which contains lactic acid to dissolve dead skin cells and hydrocortisone to soothe any acid-induced irritation. Rub lotion onto bumps twice a day until they clear up.

7. What's causing my toenail fungus?

Toenail fungus is actually athlete's foot (often picked up from shared showers or borrowed shoes) that has spread into your toenails.

The fix: The most effective treatment is a prescription antifungal pill like Lamisil or Sporanox, but be warned: These treatments are only 70 to 80 percent effective at best, and even when they work it takes nearly a year and a half for the toenail to fully grow out, says Day. Prevent a recurrence by wearing shower slippers every time you rinse off at the gym and by not borrowing shoes.

8. Why do my teeth look so dingy?

Smoking and excessive consumption of dark beverages (like coffee, tea, soda and red wine) are the main causes of stained teeth, says Lana Rozenberg, D.D.S., founder of the Rozenberg Dental Day Spa in New York City.

The fix: As with clothing stains, the longer discolorations remain on your teeth, the harder they are to remove - so keep up those twice-a-year dental visits. You can lighten your teeth several shades with a whitening toothpaste that contains carbamide peroxide, but use it only once a day to avoid drying out gum tissue. (Try Rembrandt Plus with Peroxide toothpaste.) Floss treated with the whitening agent silica has also been proven to polish away stains, which often form between teeth. (Try Johnson & Johnson Reach Whitening Floss.) For more dramatic results, your dentist can bleach your teeth up to eight shades brighter with a highly concentrated peroxide gel administered via laser ($800 to $1,500) or in a custom-fitted mouthpiece ($600 to $1,000) that you wear an hour a day for about 10 days, says Rozenberg. (Though drugstore bleaching kits are much less expensive, they aren't quite as effective -- the gel isn't as strong, and since the mouthpieces aren't created specifically for you, the gel can drip out of them and inflame your gums.)

9. Why do I have stretch marks?

You may suspect that the marks on your tummy, thighs or hips were caused by pregnancy or significant weight fluctuations. What you may not know, though, is that hormonal changes that occur during normal growth spurts can also cause your skin to stretch and scar, says Lawrence Moy, M.D. Red marks appear when your skin stretches and thins so much that you can see your blood flowing through the skin's thinned outer layers, says Joseph L. Jorizzo, M.D., When your skin stretches minimally or the stretched skin is thick, white marks result.

The fix: No treatment is guaranteed to remove stretch marks, but you can make them less noticeable. Try twice-daily applications of OTC Striae Stretch Mark Creme - several studies have confirmed that it can reduce red or white marks in about four weeks. Or ask your doctor about laser therapy ($450 to $700 per treatment), which can tone down the brightness of recently acquired red marks, or microdermabrasion ($50 to $150 per session), which can diminish the appearance of white marks.

10. Could there be a serious underlying cause for excess facial hair?

If you fight your follicles on a daily basis or sprout lots of hairs on your chin, see your doctor. Polycystic ovarian syndrome (a disorder characterized by high levels of male hormones) or an adrenal gland problem could be to blame. If you're moderately hairy (you tidy up your brows or upper-lip area once a month), you've probably just got your genes to thank.

The fix: Vaniqa - a new, odorless prescription cream- has recently been approved by the FDA to decrease light to heavy hair growth anywhere on the face ($50 for a two-month supply). Though it doesn't yield immediate results (you'll need to keep using your regular hair-removal methods at first), the cream blocks one of the enzymes responsible for hair growth, gradually slowing it down as long as you continue to use it, says Ken Washenik, M.D., director of dermatopharmacology at New York University School of Medicine. For those who don't respond to Vaniqa, six laser hair treatments ($150 each) can significantly decrease hair growth for months. A monthly electrolysis session for up to a year ($60 to $100 each) can remove hair permanently.

11. Why is my face so shiny?

If you are also losing hair and have stopped getting your period, a hormonal imbalance could be the culprit, and you should see your doctor. If not, your skin is just oversensitive to your male hormones (we all have them) - and this is triggering the production of excess oil. Another possibility: a too-harsh cleansing routine (some of you have written to us saying you use rubbing alcohol to nix shine!). Many derms believe that alcohol-based toners and gritty scrubs can overdry and irritate your skin and make it produce extra oil to compensate, says Doris J. Day, M.D.

The fix: Your best bet is to regulate oil without overdrying your skin. So in the morning, wash your face with an oil-free lotion cleanser, then rub on an alcohol-free toner. (Try Cetaphil Daily Facial Cleanser for Normal to Oily Skin and Bath & Body Works Bio Face Oil-Control Facial Toner.) Top with the OTC oil-absorbing gel Clinac OC. Sop up shiny spots throughout the day with blotting papers. (Try Hard Candy Shiny Sheets.) Repeat your A.M. routine - minus the gel - before bed. If you continue to shine, ask your dermatologist about Retin-A Micro. Less irritating than regular Retin-A, this prescription cream was created to treat acne but has also been proven effective against oiliness.

12. What causes hand warts?

The human papilloma virus is responsible for warts - but to get them you have to be both genetically predisposed and in close contact with an infected person, says Doris J. Day, M.D.

The fix: With a clean nail file, gently slough off the top layers of your warts daily to remove dead skin, says Day. (Do not use this nail file for anything but wart removal.) Then rub on over-the-counter Occlusal HP - its highly concentrated salicylic acid dissolves warts. If warts remain after several months, consult your dermatologist about other remedies, including laser therapy and liquid nitrogen treatments. Despite treatment, however, warts can come back. A warning: Be careful when engaging in sexual activity - though it's unlikely, hand warts can spread to your (or your partner's) genitals.