Finding balance: 3 simple exercises to steady your steps

A healthy life requires balance — and not just in a metaphorical sense. Being able to maintain physical balance is crucial to performing everyday activities from going up and down the stairs to reaching for an item on a shelf at the supermarket. But while many people squeeze in a daily walk and may even do some strength training exercises a few times a week, exercises to build balance don’t always make the workout list. They should, according to experts.

As you get older, the physical systems inside your body that help you maintain your balance aren’t as responsive as they were when you were younger. Maintaining balance is actually a complex task for your body, requiring coordinated action from not only your muscles, but also your eyes, ears, tendons, bones, and brain.

In addition, health problems that become more common with age, such as inner ear disorders, decreased sensation in feet, or postural hypotension (low blood pressure with standing) may leave you feeling unsteady.

Practicing exercises designed to improve your balance can help keep you upright and prevent a fall that causes injuries.

Building balance three ways

You may wonder, what exactly is a balance exercise?

Standing on one foot? Yes, that qualifies. It falls into a category called static balance exercises. These improve your balance when you’re standing still. But a good balance workout should also include dynamic exercises, which are aimed at building balance when you are moving. Ideally, you should try to incorporate a few of these exercises two or three times a week.

Below are three simple exercises that you can get use to get started. The first is a static balance exercise and the other two are dynamic balance exercises. For additional ideas, read this blog post on the BEEP program.

Tandem standing

Reps: 1
Sets: 1 to 3
Intensity: Light to moderate
Hold: 5 to 30 seconds

Starting position: Stand up straight, feet hip-width apart and weight distributed evenly on both feet. Put your arms at your sides and brace your abdominal muscles.

Movement: Place your left foot directly in front of your right foot, heel to toe, and squeeze your inner thighs together. Lift your arms out to your sides at shoulder level to help you balance. Hold. Return to the starting position, then repeat with your right foot in front. This completes one rep.

Tips and techniques:

  • Pick a spot straight ahead of you to focus on.
  • Tighten your abdominal muscles, buttocks, and inner thighs to assist with balance.
  • Keep your shoulders down and back.

Make it easier: Hold on to the back of a chair or counter with one hand.

Make it harder: Hold the position for 60 seconds; close your eyes.

Braiding



Reps: 10 to each side
Sets: 1 to 3
Intensity: Light to moderate
Tempo: Slow and controlled

Starting position: Stand up straight, feet together and weight evenly distributed on both feet. Put your arms at your sides.

Movement: Step toward the right with your right foot. Cross in front with your left foot, step out again with the right foot, and cross behind with your left foot. Continue this braiding for 10 steps to the right, then bring your feet together. Hold until steady. Now do 10 steps of braiding to the left side of the room. This completes one set.

Tips and techniques:

  • Maintain neutral posture throughout.
  • Look ahead of you instead of down at your feet.
  • Don’t turn your feet out.

Make it easier: Take smaller steps.

Make it harder: Pick up your pace while staying in control of the movement.

Rock step

Reps: 10 on each side
Sets: 1 to 3
Intensity: Moderate to high
Tempo: 2–2–2–2

Starting position: Stand up straight, feet together and weight evenly distributed on both feet. Lift your arms out to each side.

Movement: Step forward with your left foot and lift up your right knee. Hold. Step back with your right foot and lift up your left knee. This completes one rep. Finish all reps with the left foot leading, then repeat by leading with the right foot. This completes one set.

Tips and techniques:

  • Tighten the buttock of the standing leg for stability.
  • Maintain good posture throughout.
  • Breathe comfortably.

Make it easier: Hold on to the back of a chair with one hand for support; lift your knee less.

Make it harder: Hold each knee up for a count of four.


Exercise photos by Michael Carroll

Stuttering in children: How parents can help

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When a child starts to stutter, it can be alarming for parents. But most of the time, it’s nothing to worry about.

Stuttering is very common. In fact, according to the National Institute on Deafness and other Communication Disorders (NIDCD), 5% to 10% of all children stutter at some point, usually between 2 and 6 years of age.

Stuttering takes different forms

Children who stutter know what they want to say; they simply run into trouble when saying it. There are three different kinds of stuttering:

  • Repetitions, when children repeat a word or parts of a word (“Can I pet your d-d-d-d-dog?”)
  • Prolongations, when they stretch a sound for a long period of time (“Sssssssssstop it!”)
  • Blocks, when they have a hard time getting words out.

Stuttering is more common in boys than girls and can run in families. We do not understand exactly what causes it. Most likely, it occurs due to a combination of factors, which may differ in each child who stutters.

Developmental stuttering, the most common form of this speech disorder, happens as children are learning speech and language skills. Stuttering can be caused by a brain injury, but that’s far less common. Contrary to what many people believe, it is rare for stuttering to be caused by psychological factors.

Helping your child manage stuttering

Nonetheless, stuttering can cause distress and stress for children and parents alike. That’s why the best way to manage stuttering is not to focus on it, but rather to be patient and supportive. For example, the NIDCD suggests that parents of children who stutter should

  • create relaxed environments for conversation: set aside time each day to catch up with your child
  • speak in a slow and relaxed way yourself
  • resist the temptation to finish your child’s words or sentences yourself; let them finish
  • focus on the content of the message rather than how it is delivered.

To the extent that you can, ignore the stuttering — but if your child brings it up or seems bothered by it, be open and accepting. Acknowledge that it is happening, but tell your child that it is fine and they shouldn’t worry. Also see additional tips from the American Academy of Pediatrics on ways parents can help toddlers and preschoolers with stuttering.

When to get more help with stuttering

Most stuttering goes away by itself within about six months; overall, 75% of children who stutter stop completely. You should talk to your pediatrician or a speech-language pathologist if

  • the stuttering has continued for more than 6 to 12 months
  • the stuttering started after ages 3 to 4 years, as this may make it more likely to continue
  • the stuttering has increased in severity or frequency
  • there is a family history of stuttering that continued past early childhood
  • your child is upset or frustrated by the stuttering.

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Paso a paso para aplicar el corrector en ojeras sin ninguna textura – Nueva Mujer

Una buena aplicación ayudará a que tu maquillaje luzca hermoso

Las mujeres disfrutamos usar maquillaje porque su objetivo es realzar nuestras facciones y crear looks que vayan con nuestro estilo personal. Sin embargo, todo puede resultar mal si no aplicas las técnicas adecuadas, de modo que te presentaremos la manera acertada de aplicar el corrector en ojeras sin ninguna textura.

Sabemos que el maquillaje es perfecto para cubrir imperfecciones e, incluso, disimular algunas arrugas. Pero esto solo es posible con los productos y técnicas correctos.

En ocasiones aplicamos el maquillaje de una forma errada, con exceso de productos en ciertas áreas, colores que no son pertinentes o herramientas equivocadas.

El área de los ojos suele ser una zona crucial para el maquillaje, ya que en esta es donde más líneas de expresión suelen concentrarse, de tal manera que una mala aplicación puede acentuar aquello que, realmente, nos gustaría atenuar.

Además, tiene una de las pieles más delicadas, por lo que las malas técnicas no solo te resaltarán arrugas, sino que podría profundizarlas.

En este sentido, es crucial que no solo cuentes con una buena técnica de maquillaje, sino una buena rutina de cuidado de la piel que te ayude a lograr un buen acabado.

Así debes aplicar el corrector en ojeras para evitar texturas

Existen varios factores que debes cuidar al momento de maquillar los ojos y es importante conocerlos, ya que si fallas en uno de estos podrías estar afectando a cada paso que sí cuidas realmente.

La hidratación de la piel, la cantidad de cada producto que utilizas, la selección de los tonos adecuados para tu tez y la técnica que usas, son algunas de las principales características que debes conocer al momento de maquillar los ojos.

Además, es importante que entiendas que el área se conforma por diversas texturas y cada una de estas debe ser atendida de forma diferente.

Prepara la piel antes del corrector

La hidratación y protección de la piel es crucial antes de maquillar, pues no solo hará que los productos luzcan mejor en la piel, sino que la ayudará a mantenerse saludable y joven.

Con una buena hidratación, el corrector se acentuarán mucho mejor y no se acumularán en áreas.

Aplica una cantidad adecuada

En nuestro deseo de crear un efecto mate perfecto, muchas de nosotras cometemos el error de aplicar demasiado corrector.

Si seleccionas el color incorrecto y se pone una capa demasiado gruesa, terminarás resaltando sus arrugas y haciendo que la cara se vea envejecida.

Construye la cobertura capa por capa

Existen ciertas técnicas que debemos seguir al momento de aplicar cada una de las capas de nuestro maquillaje, sin embargo, muchas personas suelen hacer demasiada presión en la piel, frotar con fuerza o tallar demasiado, esto puede promover el envejecimiento prematuro y dejar un acabado indeseado.

What to do when elective surgery is postponed

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Each time a wave of COVID-19 engulfs a community, overwhelmed hospitals wind up postponing elective surgeries. The schedule changes are needed to make room for COVID patients, allow all hands on deck for crisis care, and shield people in the community from unnecessary COVID exposure. This scenario may grow worse if the flu season isn’t mild this year –– a good reason to get that flu shot!

Postponement of an elective surgery is upsetting, and automatically presents you with two dilemmas:

  • You’ll have to cope with your ailment while you wait for the all-clear.
  • You’ll have to be prepared for your surgery when you get the call that’s it’s back on.

Read on for steps you can take to cope with both situations.

First, what’s considered elective surgery?

All surgical procedures involve cutting skin and tissue using a variety of tools and techniques. But unlike heart surgery done in response to blocked arteries, elective surgery is not an emergency. It’s a procedure that can be safely scheduled in advance. That’s not to say it isn’t important.

An elective surgery could be

  • major, such as a hip or knee replacement, or surgery to repair a prolapsed (fallen) uterus
  • minor, such as surgery to relieve carpal tunnel syndrome (an entrapped nerve in the wrist), or surgery to remove a cataract (cloudy lens) in the eye.

The determination of whether surgery is elective isn’t always clear-cut. Sometimes it depends on your health circumstances. For example, surgery to replace a heart valve might or might not be an emergency, depending on the person’s condition.

Coping while you wait for elective surgery

Waiting for your surgery has potential consequences. Maybe you won’t be able to work, or maybe your condition, pain, or anxiety about the situation — or all three — will get worse.

While you’re in limbo, here are four steps you can take:

  • Keep lines of communication open with your health care providers. That could mean having important phone numbers for your physician on hand, or logging onto your patient portal and emailing your doctor or nurse. Ask your doctor how often you should check in. 
  • Report changes in symptoms. When you scheduled your surgery, your condition wasn’t life-threatening. But things can change. Don’t wait until you experience an emergency; report symptom changes as soon as you notice them.
  • Get prescriptions refilled. You don’t want to be without medications when you need them, especially if you’ll need your doctor to sign off on refills.
  • Arrange for additional help. Perhaps a friend or family member can assist you with grocery shopping, meal preparation, housekeeping, or getting through daily activities. If you can afford it, consider hiring someone to assist you temporarily. Prices average about $25 per hour in the US, with a minimum of several hours per week.

When surgery is back on schedule

Eventually, you’ll get the call that your surgery is a go. That doesn’t mean it will occur soon. Most likely there will be a backlog of postponed surgeries, which may add more time to your wait. Prepare for the possibility that you’ll need to extend the arrangements that have been getting you through your waiting period.

It’s equally wise to prepare for the chance that your surgery will happen with little notice. Alert friends, family members, or your private-duty care agency about this possibility, so they can arrange to jump in to help when you need them.

And make sure you have the answers to these questions ready well in advance:

  • How will you get to and from surgery? (Will you count on a friend, a ride service, or a hired health aide?) 
  • How will you obtain medications prescribed after surgery?
  • Which equipment (if any) will you need after your surgery? For example, if you’re going to have a joint replacement, you’ll need a walker and shower chair afterward. See if you can arrange to get it now, so you’ll have it ready.

It may not be easy dealing with your condition until your surgery takes place, but at least you’ll have both a plan A and a plan B. That preparation may give you a little peace of mind and a feeling of some control over your situation.

Cuatro atuendos con maxifaldas que te harán lucir más joven y elegante – Nueva Mujer

Estos look destacarán tu lado más sofisticado.

Los atuendos con maxifaldas se han convertido en una de las tendencias más relevantes de las últimas temporadas, pues son prendas versátiles que demuestran elegancia hasta en los momentos más informales.

Sin embargo, para llevar este tipo de piezas siempre es importante saber con qué prendas son compatibles, de lo contrario puede generar un efecto negativo que luzca anticuado y te sume algunos años.

En la temporada de otoño-invierno todas nos emocionamos por llevar esas combinaciones audaces con las prendas más hermosas para estas estaciones y las maxifaldas son opciones que puedes mezclar de muchas maneras.

Tenis, zapatos de tacón, botas y zapatillas, cualquiera de estos calzados te hará lucir hermosa con maxifalda.

Lo que debes tener en cuenta en primer momento es que saber exactamente qué es lo que quieres lograr con tu look, pues es crucial saber si prefieres lucir elegantes, informal, sofisticada o urbana, todo esto influirá en el estilo.

Así será más sencillo para ti escoger un tipo de falda que se adapte a lo que deseas, ya que puedes seleccionar entre faldas rectas, con volumen, coloridas o básicas.

Estas decisiones te ayudarán a tener una base para escoger los complementos de tu look.

Aquí te presentaremos varios atuendos que te servirán de inspiración para armar ese estilo que tanto deseas.

Atuendos con maxifaldas que te inspirarán

Atuendo clásico con tenis blancos

Los tenis blancos con faldas siempre serán un acierto. El truco está en mezclar piezas y estampados clásicos para deslumbrar de una manera acertada.

Un print de lunares y una chamarra de cuero te harán destacar sin dejar la sencillez de lado.

Selecciona un estampado llamativo para destacar

Ser arriesgada también es válido, por eso no tengas miedo en seleccionar una falda con estampado más llamativo, además de colores intensos.

La recomendación es que tu combinación sea con prendas básicas y en tonos neutros para que siempre destaque la falda.

Las botas te ayudarán a lucir más elegante

No tengas miedo de combinar diferentes tipos se zapatos. Las botas son ideales para la temporada de otoño-invierno, además de proporcionar un estilo mucho más elegante y sobrio.

La clave de la elegancia es el equilibrio

Si tu intención es que la elegancia sea la protagonista de tu look, busca una combinación equilibrada, en la que sea la falda la única y real protagonista con un estampado que destaque.

Icy fingers and toes: Poor circulation or Raynaud’s phenomenon?

If your fingers or toes ever turn pale (or even ghostly white) and go numb when exposed to cold, you might assume you just have poor circulation. That’s what I used to think when I first started noticing this problem with my own hands many years ago. It usually happened near the end of a long hike on a spring or fall afternoon, when the temperature dropped and I didn’t have any gloves handy. My pinkie, third, and middle fingers would turn white, and the fingernails took on a bluish tinge. As I soon discovered, I have Raynaud’s phenomenon, an exaggeration of normal blood vessel constriction.

Raynaud’s phenomenon: Not just poor circulation

When you’re exposed to a cold environment, your body reacts by trying to preserve your core temperature. Blood vessels near the surface of your skin constrict, redirecting blood flow deeper into the body. If you have Raynaud’s phenomenon, this process is more extreme, and even slight changes in air temperature can trigger an episode, says rheumatologist Dr. Robert H. Shmerling, senior faculty editor at Harvard Health Publishing and corresponding faculty in medicine at Harvard Medical School.

"Cold weather is the classic trigger for Raynaud’s phenomenon. But it can occur any time of year — for example, when you come out of a heated pool, walk into an air-conditioned building, or reach into the freezer section at the supermarket," he says. In addition to the hands, Raynaud’s can also affect the feet and, less often, the nose, lips, and ears. During an episode, the small arteries supplying the fingers and toes contract spasmodically, hampering the flow of oxygen-rich blood to the skin. Some of these vessels even temporarily collapse, and the skin becomes pale and cool, sometimes blanching to a stark white color.

Technically, Raynaud’s phenomenon is a circulation problem, but it’s very different than what doctors mean by poor circulation, says Dr. Shmerling. Limited or poor circulation usually affects older people whose arteries are narrowed with fatty plaque (known as atherosclerosis), which is often caused by high cholesterol, high blood pressure, and smoking. In contrast, Raynaud’s usually affects younger people (mostly women) without those issues — and the circulation glitch is generally temporary and completely reversible, he adds.

Preventing and treating Raynaud’s phenomenon

As I can attest, the best treatment for this condition is to prevent episodes in the first place, mainly by avoiding sudden or unprotected exposure to cold temperatures. I’ve always bundled up in the winter before heading outside, but now I bring extra layers and gloves even when the temperature might dip even slightly, or the weather may turn rainy or windy. Other tips include preheating your car in winter before getting in, and wearing gloves in chilly grocery store aisles.

In general, it’s best to avoid behavior and medicines that cause blood vessels to constrict. This includes not smoking and not taking certain medications, such as cold and allergy formulas that contain phenylephrine or pseudoephedrine and migraine drugs that contain ergotamine. Emotional stress may also provoke an episode of Raynaud’s, so consider tools and techniques that can help you ease stress.

If necessary, your doctor may prescribe a medication that relaxes the blood vessels, usually a calcium-channel blocker such as nifedipine (Adalat, Procardia). If that’s not effective, drugs to treat erectile dysfunction such as sildenafil (Viagra) may help somewhat. You may not need to take these drugs all the time, but only during the cold season, when Raynaud’s tends to be worse.

Warm up affected areas quickly

Once an episode starts, it’s important to warm up the affected extremities as quickly as possible. For me, placing my hands under warm running water does the trick. When that’s not possible, you can put them under your armpits or next to another warm part of your body. When the blood vessels finally relax and blood flow resumes, the skin becomes warm and flushed — and very red. The fingers or toes may throb or tingle.

What else is important to know?

Some people with Raynaud’s phenomenon have other health problems, usually connective tissue disorders such as scleroderma or lupus. Your doctor can determine this by doing a physical exam, asking you about your symptoms, and taking a few blood tests. But most of the time, there is no underlying medical problem.

Thinking about COVID booster shots? Here’s what to know

Vaccination against the virus that causes COVID-19 is the most important lifesaving tool we have in this pandemic. Fortunately, the vaccines authorized in the US have proven remarkably safe and effective. And we’ve known from the start that the strong protection they provide would likely wane over time.

But has protection declined enough to warrant booster shots? Studies published in the last few months by researchers in the UK, Israel, and the US (reviewed here and here) raised this possibility, and Israel and the UK have already started ambitious booster programs.

First things first: Vaccinate everyone

In the US, the CDC and FDA have reviewed the necessity, safety, and effectiveness of boosters for the Pfizer/BioNTech, Moderna, and Johnson & Johnson vaccines. I’ll discuss these recommendations in a moment.

But first, it’s important not to overlook this fact: vaccinating the unvaccinated should be a much bigger priority than giving booster shots to those who’ve received vaccines. That goes for people in the US who have been unable or unwilling to get the vaccine, and people in places throughout the world with limited access to vaccines.

Broadening the pool of people with initial vaccinations would not only save more lives than promoting boosters, but would also reduce COVID-related healthcare disparities between richer and poorer countries. That’s why the World Health Organization (WHO) called for a moratorium on booster doses. Meanwhile, the Biden administration has announced a promise to donate another half billion vaccines to countries with low vaccination rates, bringing the total US commitment to donate 1.1 billion doses. The administration emphasizes that starting a booster program in the US and helping other countries get their citizens vaccinated are not mutually exclusive.

Is there a difference between a booster dose and a third shot?

It’s not trick wording: not all extra vaccine doses are boosters. In August 2021, the FDA approved a third dose of the Pfizer or Moderna vaccine for people who are immunocompromised. This includes people who have HIV and those receiving treatment for cancer that suppresses the immune system. For them, the extra dose is not a booster; it’s considered part of their initial immunization series.

Getting the timing and dose right on vaccine boosters

Ideally, vaccine boosters are given no sooner than necessary, but well before widespread protective immunity declines. The risks of waiting too long are obvious: as immunity wanes, the rates of infection, serious illness, and death may begin to rise.

But there are downsides to providing boosters too early:

  • Side effects might be more common. While studies published to date suggest that boosters are safe, we don’t yet have long-term data.
  • The benefit may be small. It may be better to wait on boosters if most people are still well-protected by their initial vaccinations.
  • Current boosters may not cover future variants. If new variants of concern emerge in the coming months, boosters may be modified to cover them.
  • Waiting longer before a booster might lead to a stronger immune response. As noted by Dr. Anthony Fauci recently: “If you allow the immune response to mature over a period of a few months, you get much more of a bang out of the shot.”

The recommended dose for the Pfizer/BioNTech booster and Johnson & Johnson booster is the same as the initial dose. For the Moderna booster it’s a half-dose, which may reduce the risk of side effects and increase the number of doses available to others.

Recommendations for vaccine boosters

For the Pfizer/BioNTech and Moderna vaccines, a booster is recommended at least six months after the second dose for those who are

  • 65 or older
  • 18 to 64 and at high risk for severe illness from COVID, such as people with chronic lung disease, cancer, or diabetes
  • living or working in a high-exposure setting, such as residents of long-term care facilities, healthcare workers, teachers and day care staff, grocery workers, and prisoners.

No Pfizer/BioNTech and Moderna boosters are recommended for the general population yet. That’s because the initial doses still appear to be providing good protection against severe illness and death for those at lower risk of severe COVID-related illness.

For the Johnson & Johnson vaccine, a booster is recommended for everyone 18 or older two or more months after the first dose. 

Mixing or matching booster shots

The FDA and the CDC have concluded that mixing or matching vaccines when getting a booster dose is safe and effective. Regardless of the initial vaccine you received, any of the three available vaccines may be given as a booster.

Plenty of unknowns

The release of these new recommendations for vaccine boosters raises a number of questions:

  • How convincing is the safety data? Reports to date suggest boosters are safe, but we need more research and real-world data.
  • Will the boosters be modified to protect against emerging variants of concern?
  • Will additional boosters be needed in the future? If so, how often?

There are important gaps in our knowledge of how well vaccine boosters work. We need larger and longer-term studies involving a broad range of participants representing all races and ethnicities and people with compromised immune systems. Look for further information in coming months.

What’s next?

You can expect the FDA and CDC to expand booster recommendations based on continued review and analysis of ongoing research. In the meantime, we should redouble our efforts to vaccinate people who haven’t yet received vaccines. Boosters can play an important role in protecting individuals. But, as CDC director Dr. Rochelle Wallensky notes, “we will not boost our way out of this pandemic.”

Is a common pain reliever safe during pregnancy?

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For years, products containing acetaminophen, such as the pain reliever Tylenol, were largely viewed as safe to take during pregnancy. Hundreds of widely available over-the-counter remedies, including popular cold, cough, and flu products, contain acetaminophen. Not surprisingly, some 65% of women in the US report taking it during pregnancy to relieve a headache or to ease an aching back.

But recently, a group of doctors and scientists issued a consensus statement in Nature Reviews Endocrinology urging increased caution around acetaminophen use in pregnancy. They noted growing evidence of its potential to interfere with fetal development, possibly leaving lingering effects on the brain, reproductive and urinary systems, and genital development. And while the issue they raise is important, it’s worth noting that the concerns come from studies done in animals and human observational studies. These types of studies cannot prove that acetaminophen is the actual cause of any of these problems.

An endocrine disruptor

Acetaminophen is known to be an endocrine disruptor. That means it can interfere with chemicals and hormones involved in healthy growth, possibly throwing it off track.

According to the consensus statement, some research suggests that exposure to acetaminophen during pregnancy — particularly high doses or frequent use — potentially increases risk for early puberty in girls, or male fertility problems such as low sperm count. It is also associated with other issues such as undescended testicles, or a birth defect called hypospadias where the opening in the tip of the penis is not in the right place. It might play a role in attention deficit disorder and negatively affect IQ.

Risks for ill effects are low

If you took acetaminophen during a current or past pregnancy, this might sound pretty scary — especially since you’ve probably always considered this medicine harmless. But while experts agree it’s important to consider potential risks when taking any over-the-counter or prescription medicines during pregnancy, you shouldn’t panic.

“The risk for an individual is low,” says Dr. Kathryn M. Rexrode, chief of the Division of Women’s Health, Department of Medicine at Harvard-affiliated Brigham and Women’s Hospital.

Chances are pretty good that if you took acetaminophen during a pregnancy, your baby likely did not, or will not, suffer any ill effects.

The research on this topic is not conclusive. Some information used to inform the consensus statement was gathered from studies on animals, or human studies with significant limitations. More research is needed to confirm that this medicine is truly causing health problems, and to determine at what doses, and at what points during a pregnancy, exposure to acetaminophen might be most harmful.

Sensible steps if you’re pregnant

Three common-sense steps can help protect you and your baby until more is known on this topic:

  • Avoid acetaminophen during pregnancy when possible. Previously during preconception and pregnancy counseling, Dr. Rexrode had warned patients against using NSAID drugs, such as Advil and Aleve, and suggested taking acetaminophen instead. “Now I also tell people that some concerns have been raised about acetaminophen use during pregnancy, and explain that its use should be limited to situations where it is really needed,” says Dr. Rexrode. In short, always consider whether you really need it before you swallow a pill.
  • Consult with your doctor. Always clear acetaminophen use with your doctor, particularly if you are going to be using the medicine for a long period of time. They might agree that taking it is the best option — or suggest a safer alternative.
  • Minimize use. If you do need to take acetaminophen during pregnancy, take it for the shortest amount of time possible and at the lowest effective dose to reduce fetal exposure. “This advice about the lowest necessary dose for the shortest period of time is generally good counseling for all over-the-counter medication use, especially during pregnancy,” says Dr. Rexrode.

While all of this is good advice for using acetaminophen, there are times when it’s riskier not to take it. For example, if you have a high fever during pregnancy — which can harm your baby — acetaminophen may be needed to bring your fever down. Provided it’s advised by your doctor, the benefits of acetaminophen use in this case outweigh the potential risks.

What happened to trusting medical experts?

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In all aspects of our lives, we rely on experts, from home repairs to weather forecasting to food safety, and just about everything else that’s part of modern society. There’s just no way to know everything about everything. Yet when it comes to medicine, people seem to be taking their health in their hands in ways they’d never consider if, say, their car brakes needed repairs and they weren’t auto mechanics.

What if your brakes were shot?

Suppose a well-recommended car mechanic tells you your brakes need repair. Hopefully, they explain why this is necessary and review the pros and cons of your options, including no repairs. You certainly could get additional opinions and estimates. But to make a decision, you’d have to accept that a mechanic has specialized knowledge and that their advice is sound. Quite likely, you’d get the brakes fixed rather than risk injury.

Would you berate the mechanic personally because they told you something you didn’t want to hear about your beloved car? Let's hope not. And unless you knew a lot about cars, you probably wouldn’t tinker with the brakes yourself, or take the advice of a neighbor to spray the tires with vegetable oil because a friend of his cousin said it worked for his car. And you wouldn’t take your car to a veterinarian — it just wouldn’t make sense, right?

Yet hundreds of thousands of people in the US are rejecting advice on getting a COVID vaccine from well-respected health authorities like the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA). Healthcare providers have somehow become the target of taunts, hostility, and even death threats for encouraging people to protect themselves and others.

Fear of the proven and an embrace of the unproven

What’s driving this? It seems to be some combination of distrust ("these so-called experts don’t know what they’re talking about"; "they rushed the vaccines just to help the drug companies") and unfounded suspicion ("they’re trying to control us, experiment on us, inject microchips in us"). Some people see recommendations regarding COVID-19 as attacks on American values ("mask and vaccine mandates infringe on my personal freedom").

At the same time, many who dismiss the advice of true experts are embracing unproven and potentially dangerous remedies, such as ivermectin pills and betadine gargles.

How did we get here?

Some reasons we’ve seen erosion in trust placed in public health experts are

  • Politics. COVID-19 quickly became a political issue in the US. For example, trust in the CDC varies markedly by political affiliation, with Democrats giving much higher marks to the CDC, FDA, and NIH than Republicans.
  • Social media. Misinformation spread through social media is rampant, and much of it has been linked to a small number of people.
  • "Pseudo-experts." Even impressive credentials don’t automatically qualify everyone to be experts in a pandemic disease. Recent examples include radiologists, cardiologists, and chiropractors who have made headlines with their controversial views.
  • Personal gain. Some have profited financially, politically, or otherwise by deliberately spreading health disinformation and denouncing expert advice.

Confusing changes in message

Public health messaging about protecting ourselves from COVID-19 also affects trust. For example, recommendations around wearing masks were inconsistent early on, and have continued to change since then.

While some confusing, seemingly contradictory messages were true missteps, most are simply changes in recommendations based on a change in circumstances, such as spiking virus cases or a more easily spread variant causing severe illness, hospitalizations, and deaths.

Particularly in the early months, no one had all the answers. But as we have accumulated information from research and real-world experience, changes in recommendations should not only be expected but embraced. It’s usually a reflection of the close attention experts are paying to changing circumstances.

Doing your own research?

A wait-and-see policy can be risky — and not just when it comes to fixing your car brakes. The virus that causes COVID-19 was only discovered 18 months ago, and vaccines have been in use for less than a year. Yet already we have an enormous amount of data from research and real-world experience from many millions of people.

So, when someone says they want to "wait and see" or "do their own research" rather than accept the advice of their own doctors or public health experts, what exactly does that mean? Are they waiting to see if something bad will happen to those who were vaccinated? How long is long enough?

Unless you’re a cutting-edge virologist, immunologist, epidemiologist, or public health expert, doing your own research isn’t likely to provide more reliable data than studies published in peer-reviewed medical journals that guide the CDC and FDA. Of course, most people "doing their own research" are relying on others who are also not doing actual research, yet they discount the findings and recommendations of true experts.

It’s important to ask questions. But pose them to your doctor. Rely less on people who tell you what you want to hear, and more on those who trained in science and whose careers have been devoted to improving health.

Can vaping help you quit smoking?

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Lately it seems like everywhere I look, someone is vaping as they walk by, stand outside a store, or roll up in the car next to me at a stoplight. It’s not surprising: e-cigarette use, or vaping, has become remarkably popular in recent years. About 6% of adults in the US now report vaping. That’s about 15 million people, double the number from just three years ago. Of course, regular cigarettes are known to cause cancer and a host of other health problems.

While considered less harmful than smoking tobacco, vaping isn’t risk-free. We know some, but not all, of its risks. We also know vaping is increasingly popular among teens and young adults, and this makes the recent FDA announcement authorizing sales of three additional vaping products surprising.

A surprise announcement from the FDA

In its announcement, the FDA authorized the R. J. Reynolds Vapor Company to market and sell its Vuse Solo device with tobacco-flavored vaping liquid to adults.

The FDA denied marketing authorization for 10 flavored products made by the same company. It also reports having denied more than a million flavored vaping products from other companies.

By the way, the agency emphasizes it is not actually approving these vaping products, or declaring them safe. The announcement states that marketing authorization will be reversed if

  • the company directs advertising to younger audiences
  • there is evidence of “significant” new use by teens or by people who did not previously smoke cigarettes
  • R. J. Reynolds does not comply with extensive monitoring requirements.

Why did the FDA take this action?

The decision was reportedly based on data from the company — unfortunately not provided in the press release — demonstrating these products would benefit individuals and public health. How? By helping smokers quit.

Some studies have suggested that e-cigarette use can be modestly helpful for smokers trying to quit. For example, an analysis of 61 studies found that e-cigarette use was more effective than other approaches to quitting smoking. The study authors estimated that out of every 100 people who tried to quit smoking by vaping, nine to 14 might be successful. When only using other methods, such as nicotine patches or behavioral counselling, only four to seven smokers out of 100 might quit. A separate study suggests vaping may help smokers who aren’t able to quit reduce the number of cigarettes smoked per day — at least for six months, the duration of the study.

Does vaping harm health less than smoking cigarettes?

Despite claims that vaping is less harmful than smoking cigarettes and that it might help smokers quit, concern about its risks is well deserved.

  • Nicotine addiction. Whether in cigarettes or vapes, nicotine is highly addictive. And the amount of nicotine in many vaping products is much higher than in regular cigarettes. Side effects include reduced appetite, increased heart rate and blood pressure, nausea, and diarrhea.
  • Harm to lungs and heart. Vapors from e-cigarettes may contain cancer-causing toxins, metals, and lung irritants. Vaping raises risk for lung diseases, such as emphysema, asthma, chronic bronchitis, and chronic obstructive pulmonary disease. It’s also linked to an increased risk of heart attacks. Even secondhand exposure to e-cigarette vapors may trigger asthma.
  • Severe, potentially fatal lung injury. In 2019, doctors began seeing people who had recently vaped and developed shortness of breath, cough, fever, and extensive lung damage. Dubbed EVALI (e-cigarette or vaping product use-associated lung injury), more than 2,800 cases and 68 deaths were reported. The condition has been linked to vapors containing THC and a form of vitamin E (called vitamin E acetate) used as a thickening agent when vaping THC. Cases have fallen markedly since 2020. Possibly because of falling case numbers, the FDA announcement of new vaping products didn’t even mention EVALI, which seems odd. If you do vape, see these recommendations to reduce the risk of EVALI.
  • Health risks during pregnancy. Nicotine can damage a baby’s developing brain and lungs; some flavorings may be harmful as well. As a result, experts recommend that people who are pregnant not vape.

For teens and children, vaping has additional risks

An alarming number of middle-school and high-school age kids report vaping, despite the nationwide prohibition against selling e-cigarette products to anyone under age 18 (21 in some states). Its popularity is partly related to the marketing of flavors known to appeal to minors, such as bubblegum and berry-flavored products. According to one national survey, approximately 85% of teen vaping involved non-tobacco flavored products.

It’s important to know that

  • nicotine negatively affects the developing brain
  • the high exposure to nicotine and other toxic chemicals through vaping may be particularly harmful to kids because of their smaller body size
  • the addictive potential of nicotine may mean that kids who vape are more likely to become cigarette smokers.

The bottom line

For nonsmokers and teens, there is no controversy: don’t start smoking and don’t vape.

If you’re an adult smoker trying to quit, be aware that the balance of risks and benefits and the long-term health consequences of vaping are uncertain. We need more solid research to help people make decisions. Meanwhile, the FDA has come down on the side of a limited authorization to help adult smokers quit. We’ll know only in retrospect if that was the right move.