by Katie Neith

A recent USC Health Now poll indicated that nearly half of respondents are unlikely to take a vacation this summer. Economic worries have many Americans canceling their travel plans this season, but that doesn’t mean you can’t still have some fun.

Jennifer Siu, associate director of Recreational Sports at USC, recommends taking a “staycation.”

“Sometimes the greatest vacations are waiting for you right at home,” she says.

Sui points out that organizing family travel can often be full of stress and anxiety, but planning a staycation based around your hometown can relieve a lot of those worries.

Go Local

You can start by taking a closer look at your neighborhood and the area around you. Siu recommends going for a hike or a drive to somewhere you have never been before.

“Be sure you do a little research and figure out where you want to go,” she says. “Map out your journey just like you might if you were away from home.”

Spend some time in the vegetable and fruit section of your neighborhood market and invest in a well-rounded diet in conjunction with a healthy fitness routine.

“Be sure you get a diversity of fruits and vegetables,” says Siu.

Use your staycation time to try something new, like a new restaurant or sports activity. Take a tennis lesson or try your hand at piano or guitar. Learn something from your local Home Depot Center, like painting, sanding or gardening.

“Is there something that you’ve always wanted to try? Here’s your chance,” says Siu.

She points out that when you are trying something new, you should always invest in your safety as well. For example, learn about protective eye-gear if you are playing a sport with a ball and wear a protective helmet when you go biking or rollerblading.

“Don’t make the mistake of spending $250 on a bike and only $2.50 on your head,” she says.

Capture Your Staycation

Siu recommends drawing, painting or photographing images of your local museum, gardens, beaches or art galleries. Take some pictures of local buildings and outdoor treasures. Make sure to document special moments of your staycation.

“If you haven’t had a chance to look around recently, you may be wonderfully surprised by what your city and or neighborhood has to offer,” she says.

Treat Yourself

Treating yourself is what vacations and staycations are all about, says Siu. Sleep in, let go of your business calendar and take some time for yourself. Enjoy your breakfast and the morning paper. Do not feel guilty about hitting that “snooze” button on your alarm clock, she says.

Siu points to some ground rules for a successful staycation:
1. Remember that staycations mean time off.
2. No business e-mail. Don’t check your voice mail on a daily basis.
3. You can forget your household chores (if you can stand it).
4. Turn off the cell phone or BlackBerry (if you can stand it).
5. Take pictures! Relax! Have fun!

She also emphasizes that this is a time to indulge a bit if you can.

“A staycation is a great time to schedule a haircut, a facial or a visit to the spa,” she says.

In addition, it’s also a great time to think about making good investments, ones that are guaranteed to produce healthy returns.

“Invest in the time you spend brushing your teeth, flossing and going to regular dental checkups—because if you are not true to your teeth, they will be false to you!” says Siu.

She points out that daily brushing and regular cleanings will keep away the pain, and cost, of a possible root canal and/or drilling a cavity.

“Invest time and effort in your overall physical fitness, going for walks and maintaining a healthy weight, because if you don’t spend the time now—you may be spending your time and money dealing with diabetes, high cholesterol, dangerously high blood pressure, fatigue or heart conditions,” says Siu.

Physical fitness will guarantee paybacks such as feeling good, looking fit and overall increased energy.

“Investments in yourself and your health have close to a 100 percent return on investment,” says Siu.

May 18, 2009
by Sandra Levy

When Mayra* started having 10- 20-second episodes of staring out into space, her friends and family brushed it off as daydreaming. But when her staring episodes became more frequent, and began to take place during periods of physical activity, Mayra’s parents consulted their family doctor.

After performing an EEG to test her brain activity, the doctor determined that Mayra was experiencing a type of seizure called an absence seizure.

Seizures are defined as a sudden behavioral change because of abnormal electrical activity in the brain. When most people think of seizures, they often picture the grand mal or convulsive type of seizure in which a person loses consciousness and has severe muscle contractions. However, seizures can come in all shapes and sizes depending upon which parts of the brain are involved.

Some seizures, such as grand mal, are more obvious because they can cause a loss of awareness and uncontrollable twitching or shaking of various body parts. However, at other times, seizures can be hard to notice because they can consist of a behavior that seems commonplace, such as Mayra’s experience with staring.

According to Christianne Heck, M.D., assistant professor of clinical neurology at the Keck School of Medicine of USC, “Many events are initially so subtle they go unnoticed or ignored for months or even years.”

She says that some patients may experience odd sensations such as a strange and unexplainable smell or taste that no one else is experiencing. Events of repeated déjà vu are also common.

“These events may represent small seizures or auras and may go undiagnosed until a patient has a major convulsive seizure,” says Heck. “Then in retrospect, we find that they may have been having such auras for a long period of time prior to the convulsion.”

Epilepsy, a condition defined by repeated, unprovoked seizures, affects about 2.5 million Americans, according to the Centers for Disease Control and Prevention. While no one definite cause has been found, it is believed that genetics or injuries at birth may play a role for some people.

In addition, a number of medical issues may contribute to the formation of epilepsy, including traumatic brain injury, severe infections, brain tumors, stroke, drug and alcohol use, and other diseases or conditions such as diabetes or liver failure.

When seizures involve only a small part of the brain, they are called “focal” or “partial.” Further, focal seizures can be “simple,” meaning there is no change in memory or awareness, or “complex” with a change in memory or awareness. This includes the absence type of seizure that Mayra experienced.

If seizures involve the whole brain, they are called “generalized.” Generalized seizures—such as grand mal seizures—can affect the whole body or just parts of the body, and are defined by complete loss of consciousness. They are often accompanied by falls and severe injury, such as fractured bones.

There is a wide range of seizure symptoms; however, most patients experience one or more of the following:

• A disturbance in motor skills, including alternating contraction and relaxation of muscle groups; turning of the head to one side; inability to speak.


• Sensory signs including dizziness; unpleasant odors and tastes; seeing flashing lights, colors or hallucinations; or hearing humming, buzzing or hissing noises.


• Physical symptoms including sweating; nausea; vomiting; incontinence; flushing; goose bumps; dilation of the pupils; and rapid heart rate.


• Emotional symptoms including detachment; memory distortion; and time distortion.

“Patients must be their own best advocate,” says Heck. “Many general physicians are not fully aware of or comfortable with diagnosing and treating epilepsy.”

She says that patients should do their best to seek the care of a neurologist if they experience any symptoms of seizure, particularly if they are missing moments of their day, or are unable to account for time in the day.

“These symptoms suggest they may be suffering from partial seizures that they are unaware of. Most cases of epilepsy are easily treated, but to ensure a person’s safety and long term good outcome, the epilepsy should be treated early,” says Heck.

For more information on epileptic seizures, visit the National Institute of Neurological Disorders and Stroke at www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm.

To make an appointment with a USC doctor, visit www.doctorsofusc.com or call 1-800-USC-CARE.

(* Name changed to protect privacy)

May 11, 2009
by Katie Neith

In the United States, 17 percent of children ages 12 to 19 are overweight, according to the Centers for Disease Control and Prevention (CDC). For Americans age 20 years and older, the percentage more than doubles, tipping the scales at a staggering 66 percent of the population qualifying as overweight or obese.

While many obvious causal factors have been identified—not enough exercise, lack of access to healthy food options, etc.—researchers now believe that social networks among adolescents and adults may also play a key role in the obesity epidemic.

Recently, researchers from the Institute of Prevention Research at the Keck School of Medicine of USC reported a link between obesity and social networks among adolescents. In fact, overweight youths were twice as likely to have overweight friends.

“Although this finding was expected, it was surprising how strong the peer effect is and how early in life it starts,” says lead author Thomas Valente, Ph.D, professor of preventive medicine at the Keck School.

Previous data have shown that obesity tends to “spread” among adults and their social peers.

But this does not mean obesity is contagious in the same way as catching a cold or other infectious disease, says Michael Goran, Ph.D., professor in the Department of Preventive Medicine and associate director of the Institute for Health Promotion & Disease Prevention Research at the Keck School of Medicine of USC.

"It's more a function of who you interact with more frequently and the likelihood of being influenced or not by their behaviors and decisions," says Goran.

The study of adults, by researchers at Harvard, examined whether social interactions could account for any of the rapid increase in obesity that has occurred over the last few decades.

The analysis revealed that a person’s chances of becoming obese increased by 57 percent if he or she had a friend who became obese in a given interval. Among pairs of adult siblings, if one sibling became obese, the chance that the other would become obese increased by 40 percent. If one spouse became obese, the likelihood that the other spouse would become obese increased by 37 percent. However, these effects were not seen among neighbors in the immediate geographic location.

"The study also showed that closeness of the relationship was more important of a predictive factor than geographic distance," says Goran.

For the study of adolescents, USC researchers used more advanced statistical modeling techniques than previous research and the association remained strong, Valente says.

In-school surveys were conducted among 617 students ages 11 to13. In addition to finding that overweight adolescents were more likely to have overweight friends than their normal-weight peers, the researchers also found that overweight girls were more likely to name more friends, but less likely to be named as a friend than normal-weight girls.

“This suggests marginalization,” Valente says, “and a call to develop interventions that take peer constructs into account.”

For parents, he said this means being conscious of potential social consequences that their children may suffer as a result of being overweight.

“We tend to focus on health consequences when talking about weight in adolescents, but being popular resonates much more,” says Valente.

He said more study is needed on the relationship between being overweight and social status among adolescents. Since habits formed during adolescence often continue into adulthood, this is a particularly important connection to study in the fight against obesity.

For all populations, it is important to try and maintain a healthy weight—for your health, and perhaps even the health of your friends and family!

For more information on preventing weight gain or weight loss, visit the CDC’s “Healthy Weight” Web page at www.cdc.gov/healthyweight.

To make an appointment with a USC doctor to discuss weight control or other health concerns, visit www.doctorsofusc.com, or call 1-800-USC-CARE.

May 4, 2009
by Carrie St. Michel

Next Tuesday, May 12, marks National Fibromyalgia Awareness Day. While the millions living with fibromyalgia are acutely aware of this multi-symptom syndrome, many others—including some physicians—are wholly unfamiliar with this complicated, somewhat mysterious condition.

Brief History, Broad Spectrum of Symptoms

This lack of familiarity can be traced to several factors. First, fibromyalgia only entered the medical lexicon relatively recently. "When I was a fellow 18 years ago, many physicians had never heard of fibromyalgia," explains Daniel Arkfeld, M.D., associate professor of clinical medicine at the Keck School of Medicine of USC.

Another lack-of-familiarity factor can be attributed to, as Arkfeld puts it, the fact that "fibromyalgia isn't neatly packaged." Arkfeld is referring to fibromyalgia's seeming smorgasbord of symptoms. According to the National Fibromyalgia Association (NFA), "Chronic, widespread body pain is the primary symptom of fibromyalgia. Most people with fibromyalgia also experience moderate to extreme fatigue; sleep disturbances; sensitivity to touch, light and sound; and cognitive difficulties."

Arkfeld, who has worked with thousands of fibromyalgia patients, says, "The most prevalent symptoms are pain and fatigue. Depression also is a very common symptom."

Further, many fibromyalgia suffers also experience a variety of other symptoms, including: irritable bowel and bladder; migraine headaches; impaired memory; skin rashes; dry eyes and mouth; anxiety; depression; ringing in the ears; dizziness; vision problems; and impaired coordination. Those with fibromyalgia often face additional, simultaneous medical challenges such as arthritis, chronic fatigue syndrome, lupus, restless leg syndrome and sleep apnea.

Women suffer disproportionately from fibromyalgia. Based on NFA statistics, between 75 percent and 90 percent of those with fibromyalgia are women. Arkfeld attributes this gender gap to female hormones. Most fibromyalgia patients are diagnosed between the ages of 20 to 50.

Diagnosing Fibromyalgia

Although fibromyalgia presents in a plethora of forms, to meet the syndrome's diagnostic criteria patients must have widespread pain in all four quadrants of their body for a minimum of three months. Pain is considered widespread when all of the following are present: • pain in the left side of the body; • pain in the right side of the body; • pain above the waist; • pain below the waist; • pain in the neck, front of the chest, mid-back or lower back.

As there currently are no laboratory tests to confirm fibromyalgia, physicians apply pressure at 18 locations on the body—based on American College of Rheumatology guidelines—to determine the existence of tender points. Fibromyalgia is diagnosed when tenderness or pain is found in at least 11 of the 18 specified locations. Doctors also take into account a patient's medical history and self-reported symptoms.

Treating Fibromyalgia

For those requiring pain management, there are three FDA-approved prescription medications -- pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Localized areas of pain also can be addressed through lidocaine injections.

Sleep disturbances commonly associated with fibromyalgia can be countered by prescription sleep medications or low-dosage antidepressants; patients experiencing depression might receive higher-dosage antidepressants. Lifestyle modification—such as avoiding caffeine, sugar and alcohol before bed—also can prove beneficial.

Arkfeld additionally advocates exercise. "Medication is one pathway," he explains, "but exercise is an important part of treatment as well. Fibromyalgia patients need to gradually build up their endurance. Exercise helps reduce sleep disturbances and tender points."

The NFA gives a nod to a variety of other treatments, including: physical therapy, therapeutic massage, water therapy, light aerobics, acupuncture, yoga, aromatherapy, biofeedback and osteopathic or chiropractic manipulation.

Looking Ahead

Looking ahead, Arkfeld is "optimistic for the future. Twenty years from now, we'll have fibromyalgia well figured out."

For more information about fibromyalgia, visit www.fmaware.org.