Common sense on kids and concussions, adult heart disease, frats and booze

cdcheadsup-300x111Common sense and moderation can matter a ton in maintaining good health, as recent news reports show, particularly with kids and concussions, middle-aged adults and heart disease, and collegiate alcohol abuse.

With youngsters returning to school and so many of them participating in sports and recreation programs, it’s good that the federal Centers for Disease Control and Prevention has issued evidence-based guidance on protecting kids who suffer mild traumatic brain injury or what most of us would call concussions.

These injuries have become a growing concern for parents and young athletes. Sports leagues and sporting groups are coming to a time of reckoning with just how harmful head trauma can be.

Pendulums always swing, however, and in an article published in the medical journal JAMA Pediatrics, the CDC warns against excesses that can result, especially through over testing youngsters with concussions, especially using complex, costly diagnostics like computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, as well as x-rays and SPECT scans.

Instead, the agency suggests, doctors should quickly make close observations of their young, injured patients, giving them a variety of cognitive tests and tools, and measuring them against available guidelines to decide the severity of their case and if it merits further steps.

Injured youngsters should be kept out of their sport and should refrain for a time from vigorous exercise, though the common prescription of getting them to abstain from activity may not be optimal. Instead, they may want to get much more rest, cut way back on their activity, and slowly ramp up exercise and recreation, under the supervision of their parents, coaches, and doctors.

The CDC says that treatment of concussions in the young is evolving. Its care — and the agency’s recommendations — can’t be effective without greater awareness and adherence to expert advisories, based on research and top-level experts’ experience. The agency has rolled out its “HEADS UP” campaign to assist adults in understanding and dealing with youth concussions.  And other experts continue to warn parents and young athletes to consider carefully the harms that contact sports may cause, both short- and long-term.

Preventing heart disease

Meantime, for youngsters’ parents and grown-ups, in general, the CDC also is campaigning against heart attacks and strokes. Doctors and public health officials had seen success in battling cardiovascular diseases but they’re now seeing a plateau in preventing the conditions’ millions of hospitalizations and hundreds of thousands of deaths annually.

And Anne Schuchat, the agency’s principal deputy director, was quoted by CBS News at a press briefing as warning that, “”Middle age can be a ticking time bomb for heart disease.” As the broadcast network reported:

Despite being largely preventable, heart attacks, strokes, heart failure and other cardiovascular-related conditions led to 2.2 million hospitalizations in 2016, resulting in 415,000 deaths [CDC researchers have found]. Strikingly, many of the heart events were seen in middle-aged adults, age 35 to 64. About 775,000 hospitalizations and 75,000 deaths occurred within this group in 2016. … That’s because many of the risk factors negatively impacting heart health tend to become more prevalent at that time. These include medical conditions like high blood pressure and high cholesterol, as well as unhealthy habits like smoking and lack of physical activity.

Evidence shows prevention campaigns work, the CDC has found.

That also has been affirmed by researchers, including from the independent, nonprofit RAND Corporation in a new scrutiny of a cooperative campaign in San Diego. There, according to a study published in Health Affairs, experts observed that the Be There San Diego heart health efforts helped lead to “a 22 percent drop over five years in the number of local heart attack hospitalizations, a result that is a full 14 percentage points better than the 8 percent decrease observed across the state,” and, “San Diego County saw 3,826 fewer heart attack hospitalizations than expected from 2011 to 2016, saving nearly $86 million in avoided medical costs.”

The CDC and the Centers for Medicare and Medicaid Services together lead the national Million Hearts Campaign, which has an announced goal of preventing 1 million heart attacks and strokes by 2022. Officials call that aim ambitious but attainable, particularly if each state and individuals nationwide act.

The campaign focuses on heart ABCs, including: Aspirin use when appropriate, Blood pressure control, Cholesterol management, and Smoking cessation. It also emphasizes, of course, sensible diet, weight control, and exercise.

Staying away from alcohol’s harms

In my practice, I see the harms that patients suffer while seeking medical services, and the havoc that can be wreaked on them, especially the young, by spinal cord and brain injuries, notably due to head trauma. I’ve come to see the great value in preventive measures, including changes in practices and behaviors, that keep us all healthy, and far away from doctors, hospitals, and other medical caregiving institutions where errors occur far too frequently. By some estimates, they’ve become the No. 3 killer in this country, claiming 685 American lives daily, and outpaced only by heart disease and cancer.

As a nation, we spend more than $3 trillion annually on health care, sums that overall aren’t the most productive for our economy, don’t improve our well-being so it matches our peers in the industrialized world, and instead, can be individually bankrupting and a cause for sorrow and stress. The same prescription for common sense and moderation, as applied to kids’ concussion care and adults heart disease prevention, can improve our well-being, longevity and long-term mental cognition. That’s if we eat right, exercise, control our weight, socialize, and don’t smoke or abuse substances, especially drugs and alcohol.

The news, by the way, has been full of excessive reports about one of Americans’ favorited pastimes: drinking. Tipplers need to keep in mind that here, too, common sense — especially — and care need to be applied, especially to prevent road deaths, excess calorie consumption, liver disease, and abuse. Binge drinking for young people, especially students in colleges and universities, persists as a serious health problem. Common sense demanded that its preventable injuries and deaths be addressed, so it’s welcome news to see a glimmer of moderation by organizations that have been at the sad fore of the problem: fraternities. Good for the North-American Interfraternity Conference, one of the largest groups of its kind, for adopting a ban on hard liquor in its members’ facilities.

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