Think you’re in the clear because your sweetie isn’t sneezing? Not quite—once you’re infected, you typically become contagious within 24-72 hours, often before you show any outward signs of the illness. And contrary to popular belief, you don’t catch colds from being in the cold—you catch them from other people. Same with the flu.

So does this mean you need to zip up that biohazard suit until spring? Of course not. Just take some reasonable precautions:
Don’t share glasses or utensils, even with the one you love. Couples should share things, but not their germs. Aside from cold and flu risks, your loved one might have be getting a cold sore, which is highly contagious.
Don’t kiss or have bodily contact with anyone if you’re feeling unwell. Yes, your sniffles could be allergies, but do you really want to risk both of you being chained to the couch for a decidedly un-romantic Valentine’s Day? Give yourself a few days to get better, even if it means taking a few days off work or keeping your honey at arm’s length.
Get a flu shot. It’s the best way to prevent the flu. Remember it takes a few days to take effect, so get it early to be in good shape for Valentine’s Day.

Love Your Heart

February is filled with heart- clad images celebrating Valentine's Day. Although the history and evolution of Valentine's Day are attributed to a number of different legends, what is certain is that February 14 is associated with love, care, and the heart.

Further cementing the ever- present symbol of the heart in February was the establishment of American Heart Month nearly 50 years ago, the intent of which was to raise awareness about the nationwide problem of heart disease and the importance of supporting research to solve the problem.

Given that February is recognized as a time to celebrate love, caring, and heart health, what better time to improve your own heart health or help loved ones improve theirs by quitting smoking? As indicated in the 2010 Surgeon General's Report, How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease, cigarette smoking greatly increases one's risk for heart disease. Being smoke-free and eliminating exposure to secondhand smoke are important to heart health.

Antibiotics Do Not Reduce
Symptoms of Sinus Infection

Patients may want to pause before asking for antibiotics to treat a sinus infection.

A new study involving more than 150 patients ages 18 to 70 suggests that the antibiotic amoxicillin may be no better than a placebo in improving symptoms for those with sinusitis -- a common inflammation of the nasal passages and sinuses.

Findings from the trial -- published in the Journal of the American Medical Association -- show that when adults with a standard case of sinusitis were treated with either a 10-day course of amoxicillin or a placebo, by the third day both groups fared about the same in terms of recovery.

“The major implication might be a paradigm shift in how these patients are cared for,” Jane Garbutt, MD, a research associate professor of medicine and pediatrics at Washington University School of Medicine in St. Louis, tells WebMD. “So most people didn’t derive any clinical benefit from the antibiotic, so most people likely don’t need any antibiotic treatment.”

Garbutt and her colleagues used CDC guidelines for the evaluation and treatment of adults with sinusitis, which suggested that doctors only prescribe antibiotic treatment for the condition when patients have moderately severe or severe symptoms.

All the patients in the new study met the clinical guidelines for having sinusitis -- they had sinus- related symptoms, for at least seven but less than 28 days, that included facial pain, nasal congestion, and cough.

Sinus infections are most often caused by viruses or bacteria. Antibiotics can be used to treat bacterial infections, but they do not treat viruses.

“Nobody disputes that some of these patients have a bacterial infection and would benefit from an antibiotic,” she says. “The problem is we don’t know who they are.”

Garbutt writes that 1 in 5 of all adult antibiotic prescriptions in the U.S. is for the treatment of sinusitis, “and we’re suggesting that might not be the best plan,” she says, adding that 80% of patients with sinusitis get better on their own within 10 days.

By Joanna Broder
WebMD Health News

Reviewed by Louise Chang, MD

Do You Know Which Symptoms Signal a Heart Attack in Women?

Women’s heart attacks can be different than men’s. Learn the warning signs.

Most women know the symptoms of a heart attack -- squeezing chest pain, shortness of breath, nausea. But as it turns out, these symptoms are more typical for males.
Female heart attacks can be quite different -- and it’s important for all women to learn the warning signs.

Rhonda Monroe's story is a cautionary tale. She was mystified when strong pain struck her left breast and left arm. Monroe, who was a 36-year-old mother of three, didn’t know it at the time, but she was having early symptoms of a heart attack. “I certainly wasn’t thinking about my heart because I was young and healthy and had been skinny,” she says.

As the pain moved into her shoulder and back, Monroe took pain relievers and showered for relief. But the next day, she was overwhelmed with nausea, sweating, vomiting, and chest pain. An ambulance rushed her to the emergency room.

Her next hurdle: getting the doctors to believe her. “They didn’t take me seriously,” Monroe says. She didn’t fit the profile of a heart attack patient. The doctors told her she was too young, she was not overweight, and there was no family history of heart disease.

Bedeviled by worsening pain and weakness and convinced she was dying, Monroe returned to the hospital several times over the days that followed, only to come home with no answers. “I was angry and frustrated,” the West Virginia resident says.

Monroe turned to her primary care doctor about her situation and went through more tests at the hospital. Finally, she got her diagnosis -- a week after the initial breast and arm pain. As Monroe recalls, a cardiologist who had previously dismissed her complaints made the diagnosis. “The doctor told me, ‘Well, it’s a good thing you’re persistent because you’re having a heart attack.’”

Heart experts say Monroe’s situation is all too common. Women who have “atypical” symptoms, such as arm or back pain or nausea, might not realize at first that they’re having a heart attack. Then when they do seek emergency care, doctors sometimes misdiagnose them.

Female heart attack symptoms

“Typical” heart attack symptoms include chest pressure or squeezing or stabbing sensations in the center or left side of the chest, says Myung H. Park, MD, FACC, who is director of the Pulmonary Vascular Diseases Program at the University of Maryland Medical Center. “It’s very typical for people to make a fist when they’re describing their symptoms,” she says. “Some people describe it as feeling like a vise encasing their whole chest area.”

But in women, symptoms can be less typical. Although women can experience chest pain or discomfort, many don’t. In a 2003 Circulation study of female heart attack patients, scientists found that during an attack, 43% of the 515 women studied had no “acute chest pain, a ‘hallmark symptom in men.’”

The study noted some common female heart attack symptoms:

• shortness of breath (57.9%)

• weakness (54.8%)

• unusual fatigue (42.9%)

Women had other atypical heart attack symptoms, too:
nausea, dizziness, lower chest discomfort, upper abdominal pressure or discomfort that feels like indigestion, and upper back pain.

Often, women are unaware that these symptoms can be a sign of a heart problem, and blame them on heartburn or indigestion, arthritis, or stress, experts say. If women become short of breath with little exertion, they tell themselves they are out of shape, overworked, or fatigued.

Pay attention to heart attack symptoms

Experts urge women to learn the various heart attack symptoms and to call 911 promptly at the appearance of these signs.

Though most women feel indigestion once in a while, experiencing a cluster of unusual symptoms or a persistent sensation in the chest, back, or stomach never felt before is reason to seek emergency care. Park has seen too many patients wait too long. Because women have lots of competing demands -- jobs, families, and sometimes caregiving duties -- “taking care of themselves, even if they don’t feel well, usually doesn’t make it to the top of the list,” she says.

That can be dangerous, experts say.

“The longer a woman waits before getting treatment to open the blocked blood vessel to the heart, the more damage is done to the heart muscle. If a large amount of the heart muscle is damaged, the woman will be at risk for heart failure,” says Teresa Caulin-Glaser, MD, co-author of The Woman’s Heart: An Owner’s Guide and director of preventive cardiology and research at McConnell Heart Health Center in Columbus, Ohio.

Assert yourself if you have heart attack symptoms

Unfortunately, doctors may also be unfamiliar with atypical symptoms and may overlook a woman’s heart attack, experts tell WebMD. In fact, according to the Circulation study, women have more unrecognized heart attacks than men and are more likely to be “mistakenly diagnosed and discharged from emergency departments.”

Be direct with doctors and other medical staff, Caulin- Glaser says: “Women arriving at the emergency room should state clearly that they think they are having a heart attack and need to be evaluated.”

At a minimum, an immediate evaluation should include being placed on oxygen, being given an aspirin, having blood drawn, having an electrocardiogram performed, and receiving a cardiac monitor within minutes of arrival, she says.

Being bold can save women’s lives, Caulin-Glaser adds. “If the triage nurse or emergency room physician does not take their concerns seriously and begin the immediate evaluation for a heart attack, then all women should tell the emergency room physician they want to be seen by a cardiologist.”

Shortly after Monroe’s heart attack was finally diagnosed, she underwent emergency quadruple bypass surgery. She reports that she didn’t know all the right questions to ask when she first felt symptoms, “but I definitely knew that something was wrong.”

Now she urges other women who believe they might be having a heart attack to advocate for themselves. “Persist. No one knows your body the way you do,” Monroe says. “I really believe the only reason I’m alive today is that I wouldn’t give up, and I wouldn’t relent.”

Learn about your local heart attack resources

One of the most important ways you can advocate for yourself is doing research. “Take action before you ever have a heart attack,” Caulin-Glaser says.

“It’s important for women to do their homework regarding the hospitals in their neighborhoods. Find out which hospitals specialize in heart disease,” she says. Some questions for women to ask: Does the hospital have a cardiac catheterization lab that performs procedures such as angioplasties and stents? Is this “cath lab” available 24 hours, seven days a week? Is there a coronary bypass surgery program? Once a woman arrives in the emergency room with a heart attack, how quickly is she sent to the cath lab? Can doctors open a blocked blood vessel within the acceptable range of 90 minutes?
Are all of the doctors in the emergency department board- certified in emergency medicine

Should Blood Pressure Be Taken in Both Arms?
Differences in Blood Pressure Between Arms May Signal Blood Vessel Problems

Differences in blood pressure readings taken from the left and right arms may be a sign of heart and blood vessel disease and death risk, according to a new review of recent research.

Researchers found that a difference of 15 points or more in the readings between the left and right arms raised the risk of peripheral vascular disease, a narrowing or blockage of the arteries, by two-and-a-half times.

That same 15 point-difference in systolic readings (the top number in a blood pressure reading) also increased the risk of cerebrovascular disease by 60%. Cerebrovascular disease is associated with thinking problems, such as dementia, and an increased risk of stroke.

Researchers say the results suggest that doctors should routinely compare blood pressure readings from both arms to prevent unnecessary deaths.

Although the practice of taking blood pressure from both arms as a part of heart disease screening has been adopted in Europe, and some guidelines in the U.S. recommend it, American Heart Association spokesman Richard Stein, MD, says it’s not routinely done in the U.S.

Why Your Lips Are Chapped

Has winter chapped your lips? Find out why it happens and what to do about it.

When it comes to battling the elements, your skin serves as your front line of defense. But it's your lips that really bear the brunt of the attack from sun, wind, cold, and dry air. It's a wonder our mouths don't suffer more in the line of duty-we bundle up in extra layers during the winter months, leaving our lips exposed.

"Lips are mucous membranes, so they have very thin surface layers of skin," says Los Angeles dermatologist Jessica Wu, MD, a clinical instructor of dermatology at the University of Southern California (USC) Medical Center. When compared to the skin on the rest of your face, Wu says, lips are the most vulnerable to drying out. In fact, research shows you lose up to 10 times more moisture through your lips than you do elsewhere on the face or body.

Arid winter air, arctic blasts of wind, and the low humidity indoors all lead to a crisis for your lips in the form of dehydration. Once moisture is sapped from skin cells, they become fragile so your lips develop tiny splits and cracks. These tiny tears are what make chapped lips so painful -- heat, acidic food, even toothpaste can aggravate raw skin, Wu says.

Licking Your Lips: The Problem

We can be our own worst enemy, says Scottsdale, Ariz., dermatologist Jennifer Linder, MD, clinical instructor at the University of California San Francisco. The instinct to lick your lips makes the chapping worse, Linder says.

"As saliva evaporates, it dehydrates skin further," Linder tells WebMD. Saliva also contains acids that help break down food. Those acids only cause irritation when sitting on compromised lip skin, Linder says.

Another mistake people make in the effort to treat chapped lips: scrubbing, peeling or biting off skin flakes. "Picking at the already thin skin of the lips can lead to bleeding and severe discomfort," Linder says. "This slows the healing process and irritates the skin further."

Worst case: You can develop an infection from dirt and bacteria entering the cracks and splits on your mouth. A common complication is cheilitis, Wu says, which can be related to a yeast infection in the corners of the mouth. It's treatable with topical antifungal cream.

In addition, stressing or irritating the skin around the mouth can awaken a dormant herpes virus, and potentially trigger a cold sore, Wu says. Chapped lips also expose nerve endings, where the herpes virus lives. This exposure can stimulate the virus as well.

Keep Balm and Carry On

Your lips need a shield to stay in shape. A balm acts like a winterizing layer -- like a hat or scarf -- to provide a buffer between delicate skin and brutal weather, Linder says. Not to mention you have hot, dry indoor air to contend with, so never let your lips go nude

"Skin heals better when it's kept moist," Wu says. "So I suggest wearing an emollient balm or ointment rather than a waxy stick treatment." The goal is to form an occlusive barrier that seals in moisture while providing additional hydration with beneficial oils, Linder says. Plus, an occlusive agent will help seal deep cracks and splits from infection and irritation. For a non-waxy stick, the experts interviewed for this story like Avene Cold Cream Lip Balm, Fresh Sugar Lip Treatment, and Softlips Pure Pomegranate Organic Lip Conditioner.

Petrolatum is one of the most common occlusive agents, but also look for castor seed oil, shea butter, sunflower seed oil, or squalane to nourish cracked lips. Linder suggests ingredients such as hyaluronic acid, sodium PCA, and glycerin to ensure your lips stay moist. Wu suggests Kiehl's Lip Balm #1 containing squalane and natural oils. The experts interviewed for this story also like the petrolatum- based Aquaphor Healing Ointment and Vaseline Lip Therapy.

Another ingredient to look for: SPF, even if you're closer to a Pole than the Equator. The sun's rays can cause damage even in sub- Arctic temperatures. If your lip skin has been compromised by UV rays, you're more susceptible to dry lips. So a sun shield is crucial in the fight against lip flakes. Aveeno Lip Conditioner Essential Moisture SPF 15 and Blistex Lip Infusion SPF 15 won praise from the experts interviewed for this story.

Balms Away

There are some lip treatments that do more harm than good, says Steven K. Grekin, DO, clinical associate professor of dermatology at Des Moines University College of Osteopathic Medicine and Surgery in Iowa.

"Many ingredients can cause dryness and irritation, including eucalyptus, menthol, and camphor," Grekin tells WebMD.

Acne-prone people may want to look for a petrolatum-free product, Wu says. Some people may find the ingredient clogs pores and causes blackheads or acne.

And avoid the products that come in little pots. "Dipping your finger in a jar just isn't as sanitary as a tube applicator," Linder says.

Sealing Your Lips

The key to avoiding cracked, flaky lips is to balm early and often. Wu advises wearing a thick layer of ointment to bed. "Many of us sleep with our mouths open, causing our lips to dry out." Applying a treatment at bedtime means you'll be less likely to wake up with chapping. One expert favorite: Neosporin Lip Health Overnight Renewal Therapy.

Buy a few tubes at the drugstore and keep them within arm's reach at all times -- stash one in the car, near the bed, at your desk. That way you don't have to hunt down a tube to reapply.

Grekin also suggests using a humidifier in your home, especially at night, to keep your skin's moisture levels replenished. Drinking plenty of water will also help fight dehydration, another cause of chapped lips, Wu says.

Lip Balm Addiction?

For some reason, the word "addiction" is on everyone's lips when it comes to lip balm. But that word is widely misused in many situations -- including this one.

"You may be ‘addicted' to the feel of balm on your lips," Wu says, "but there's nothing addicting in nonmedicated balms."

Some ingredients like camphor and menthol may also cause a vicious cycle, but not addiction, Linder says. "Drying ingredients in a balm may leave lips feeling less moisturized than before application, making a person feel as though she needs to apply more." The reality is that her lips are not dependent on the balm," Linder says.
By Liesa Goins WebMD Feature
Reviewed by Louise Chang, MD

Subconjunctival Hemorrhage (Bleeding in Eye)

The conjunctiva is the thin, moist, transparent membrane that covers the white part of the eye (called the sclera) and the inside of the eyelids. The conjunctiva is the outermost protective coating of the eyeball.

The conjunctiva contains nerves and many small blood vessels. These blood vessels are usually barely visible but become larger and more visible if the eye is inflamed. These blood vessels are somewhat fragile, and their walls may break easily, resulting in a subconjunctival hemorrhage (bleeding under the conjunctiva). A subconjunctival hemorrhage appears as a bright red or dark red patch on the sclera.

Subconjunctival Hemorrhage Causes

Most subconjunctival hemorrhages are spontaneous without an obvious cause. Often, a person may discover a subconjunctival hemorrhage on awakening and looking in the mirror. Most spontaneous subconjunctival hemorrhages are first noticed by another person seeing a red spot on your eye.

The following can occasionally result in a spontaneous subconjunctival hemorrhage:

Sneezing
Coughing
Straining/vomiting
Eye rubbing
Trauma (injury)
High blood pressure

Bleeding disorder (a medical disorder causing bleeding or inhibiting normal clotting)

Subconjunctival hemorrhage can also be non-spontaneous and result from a severe eye infection or a trauma to the head or eye, or it can occur after eye or eyelid surgery.

Subconjunctival Hemorrhage Symptoms

Most of the time, no symptoms are associated with a subconjunctival hemorrhage other than seeing blood over the white part of the eye. Very rarely people experience pain when the hemorrhage begins. When the bleeding first occurs, you may experience a sense of fullness in the eye or under the lid. As the hemorrhage resolves, some people may experience very mild irritation of the eye or merely a sense of awareness of the eye.

The hemorrhage itself is an obvious, sharply outlined bright red area overlying the sclera. The entire white part of the eye may occasionally be covered by blood.

In a spontaneous subconjunctival hemorrhage, no blood will exit from the eye. If you blot the eye with a tissue, there should be no blood on the tissue.

The hemorrhage will appear larger within the first 24 hours after its onset and then will slowly decrease in size as the blood is absorbed.

When to Seek Medical Care

Call your health care provider or eye care provider (optometrist or ophthalmologist) if the subconjunctival hemorrhage does not get better within two weeks or if you have had multiple subconjunctival hemorrhages.

If you have a hemorrhage in both eyes at the same time or if the subconjunctival hemorrhage coincides with other symptoms of bleeding, including easy bruising, bleeding gums, or both, contact your health care provider or eye care provider.

Go to your health care provider, eye care provider, or emergency department immediately if you have a subconjunctival hemorrhage and you have any of the following: Pain associated with the hemorrhage

Changes in vision (for example, blurry vision, double vision, difficulty seeing)

History of a bleeding disorder

History of high blood pressure

Injury from trauma to the eye

Muscle Spasms, Cramps, and Charley Horse

You could be out for a run or drifting off to sleep when it happens: The muscles of your calf or foot suddenly become hard, tight, and extremely painful. You are having a muscle cramp.

Sometimes called charley horses -- particularly when they are in the calf muscles - - cramps are caused by muscle spasms, involuntary contractions of one or more muscles. In addition to the foot and calf muscles, other muscles prone to spasms include the front and back of the thigh, the hands, arms, abdomen, and muscles along the rib cage.

Almost everyone experiences muscle cramps, which come without warning. What causes them, and what can you do to relieve them?

Possible Causes of Muscle Cramps

Muscle cramps can have many possible causes. They include:
Poor blood circulation in the legs
Overexertion of the calf muscles while exercising
Insufficient stretching before exercise
Exercising in the heat
Muscle fatigue
Dehydration
Magnesium and/or potassium deficiency
Calcium deficiency in pregnant women
Malfunctioning nerves, which could be caused by a problem such as a spinal cord injury or pinched nerve in the neck or back

Muscle cramps can also occur as a side effect of some drugs. Medications that can cause muscle cramps include:
Lasix (furosemide), Microzide (hydrochlorothiazide), and other diuretics ("water pills") used to remove fluid from the body Aricept (donepezil), used to treat Alzheimer's disease Prostigmine (neostigmine), used for myasthenia gravis Procardia (nifedipine), a treatment for angina and high blood pressure Evista (raloxifene), an osteoporosis treatment Brethine (terbutaline), Proventil and Ventolin (albuterol), asthma medications Tasmar (tolcapone), a medication used to treat Parkinson's disease Statin medications for cholesterol such as Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Pravachol (pravastatin), or Zocor (simvastatin).

Treatment of a Muscle Spasm

When muscle cramps occur, there are several things you can do to help ease them, such as massaging, stretching, or icing the muscle, warming the muscle, or taking a bath with Epsom salt.

For a charley horse in the calf or a cramp in the back of the thigh (hamstring), try putting your weight on the affected leg and bending your knee slightly, or sit or lie down with your leg out straight and pull the top of your foot toward your head. For a cramp in the front of the thigh (quadriceps), hold onto a chair to steady yourself and pull your foot back toward your buttock.

To help reduce the risk of cramps in the future, try the following:
Eat more foods high in vitamins and calcium.
Stay well hydrated.
Stretch properly before exercise.

In most cases, self-care measures are sufficient for dealing with muscle cramps, which typically go away within minutes. But if you experience them frequently or for no apparent reason, you should speak to your doctor. They could signal a medical problem that requires treatment.

Why Am I So Tired? 7 Causes of Fatigue

Getting plenty of sleep but still exhausted? Before you blame your multi-tasking, super-woman lifestyle, learn more about what might be at the root of your unexplained fatigue.

Fatigue Cause # 1: Anemia

"If you are in your reproductive years, and particularly if you experience heavy menstrual cycles, have fibroid tumors or uterine polyps, or if you've recently given birth, the blood loss may have caused you to develop anemia - - a leading cause of fatigue in women," says Amaru.

Problems occur, she says, when the bleeding leads to a deficiency of hemoglobin, the iron-rich protein in red blood cells that carries oxygen from the lungs to other parts of your body. When your tissues and organs don't get enough oxygen, she says, the result is fatigue.

Other causes of anemia include internal bleeding, or a deficiency of iron, folic acid, or vitamin B12. Anemia may also be caused by chronic diseases like kidney disease, for example. Symptoms can include dizziness, feeling cold, and irritability.

To confirm a diagnosis of anemia, your physician will give you a blood test. Treatment, she says, usually consists of iron supplements if iron deficiency is the cause, and adding iron-rich foods -- such as spinach, broccoli, and red meat -- to your diet.The good news: With effective treatment, your fatigue should begin to lift in thirty days or less.

Fatigue Cause # 2: Underactive thyroid (hypothyroidism)

If you are generally sluggish, run down, and even a little depressed, Goldberg says the problem may be a slow thyroid, also known as hypothyroidism. The thyroid is a small, butterfly shaped gland that sits at the base of your neck and controls your metabolism, the speed at which your body operates.

"I believe that undiagnosed thyroid disorder is one of the major female health problems in this country. I think it is even more widespread than anyone realizes," says Goldberg.

According to the American Thyroid Foundation, by age 60 approximately 17% of all women will have a thyroid disorder and most won't know it. The most common cause, they say, is an autoimmune disorder known as Hashimoto's thyroiditis. This condition causes the body to destroy the cells responsible for producing thyroxin and other hormones secreted by the thyroid gland. The result is hypothyroidism, or a slow metabolism.

Blood tests known as TSH, T3, and T4 will detect thyroid hormones. If these tests indicate that your thyroid is underactive, Goldberg says synthetic hormones can bring you up to speed and you should begin to feel better fairly rapidly.

Fatigue Cause # 3: Undiagnosed Urinary Tract Infection (UTI)

Although most women associate a urinary tract infection with symptoms such as burning or urgency, Goldberg says in some instances fatigue may be your only clue.

"Not every woman has obvious symptoms of a UTI. Some have no symptoms or mild symptoms that go unnoticed, except for the fatigue," she says.

In most instances, a UTI is caused by bacteria in the urinary tract, often the result of improper bathroom hygiene (wiping back to front, for example). Sexual intercourse can increase the risk because it can push bacteria from the vagina into the urethra.

If your physician suspects that you have a UTI, your urine will be tested. Treatment is quick and easy, and usually involves an oral antibiotic medication. Goldberg says the fatigue will lift within a week or less.

If your symptoms return, get tested again, she says, because in some women, UTI's are chronic. If this is the case, talk to your doctor about preventive care, including low dose antibiotics.

Fatigue Cause # 4: Caffeine Overload

Many of us grab a coffee or cola for a quick burst of energy, but for some women, caffeine can have the opposite effect.

In an article published in the journal US Pharmacist, author W. Stephen Pray, PhD, RPh, reports that caffeine is a stimulant, but if you take too much, the tables can turn.

"In some patients, continued abuse results in fatigue," according to Pray. And if you think this means you simply require more caffeine to get the kick, this isn't the case. "Any attempts to solve the problem by increasing caffeine intake causes the fatigue to worsen," he says.

The solution: Eliminate as much caffeine from your diet as possible. This means not only cutting out coffee. Chocolate, tea, soda and even some medications also contain caffeine and could be causing unexplained fatigue.

Fatigue Cause # 5: Food Intolerances

While food is supposed to give us energy, some doctors believe hidden food intolerances can do the opposite. According to Rudy Rivera, MD, author of Your Hidden Food Allergies Are Making You Fat, even mild food intolerance can leave you feeling sleepy. Eat the offending food long enough and you could find yourself feeling continually exhausted.

"Evidence indicates food intolerance as a cause of fatigue, and even suggests that fatigue may be an early warning sign of food intolerance," he says.

If you suspect that food may be behind all that yawning, Rivera says to start with an elimination diet, cutting out foods that cause you to feel sleepy within 10 to 30 minutes of eating them.

Fatigue Cause # 6: Sleep Apnea

If you're not getting enough sleep, it stands to reason you'll be tired. But what if you don't know that you aren't getting sufficient sleep? This is often the case with a condition called sleep apnea -- a sleep disorder that causes you to momentarily stop breathing, often many times during the night. Each time you stop breathing, you awaken just long enough to disrupt your sleep cycle, usually without being aware of it. Your only clue, says Goldberg, is that you experience constant fatigue no matter how many hours you sleep each night.

According to Goldberg, sleep apnea, which is caused by an upper airway obstruction, often occurs in women who are overweight or obese. Snoring is often a sign of sleep apnea. Diagnosis requires a visit to a sleep lab, or to a doctor specializing in sleep apnea.

If you have sleep apnea, your physician will recommend lifestyle changes, including losing weight and quitting smoking. Medical treatment includes devices that keep airway passages open while you sleep. In extreme cases, surgery may be necessary to ensure proper airway flow. Left untreated, sleep apnea can increase your risk of stroke or heart attack.

Fatigue Cause # 7: Undiagnosed Heart Disease

If you find yourself becoming exhausted after activity that used to be easy, it may be time to talk to your doctor about the possibility of heart disease.

According to Goldberg, when overwhelming fatigue sets in after ordinary tasks -- such as vacuuming the house, doing yard work, or commuting from work each day -- your heart may be sending out an SOS that it needs medical attention.

"This doesn't mean that you should panic every time you yawn," says Goldberg. "Most of the time, fatigue is not the first sign of heart disease, and it's usually linked to something far less serious."

At the same time, Goldberg points out that heart disease is the leading cause of death in women. "If fatigue following activity is significant, and no other possible reason comes to mind, see your doctor for a check-up," she advises. If your fatigue is related to your heart, medication or treatment procedures can usually help correct the problem, reduce the fatigue, and restore your energy.

Acute Bronchitis

This topic is about acute bronchitis in people who don't have other health problems. Acute bronchitis may be treated differently if you have a long-term lung disease, such as chronic obstructive pulmonary disease (COPD). For more information, see the topics Chronic Obstructive Pulmonary Disease (COPD) and Pneumonia.

What is bronchitis?

Bronchitis means that the tubes that carry air to the lungs (the bronchial tubes) are inflamed and irritated. When this happens, the tubes swell and produce mucus. This makes you cough.

There are two types of bronchitis:
Acute bronchitis usually comes on quickly and gets better after 2 to 3 weeks. Most healthy people who get acute bronchitis get better without any problems. See a picture of acute bronchitis . Chronic bronchitis keeps coming back and can last a long time, especially in people who smoke. Chronic bronchitis means you have a cough with mucus most days of the month for 3 months of the year for at least 2 years in a row.

This topic focuses on acute bronchitis. Both children and adults can get acute bronchitis.

What causes acute bronchitis?

Acute bronchitis is usually caused by a virus. Often a person gets acute bronchitis after having an upper respiratory tract infection such as a cold or the flu. In rare cases, acute bronchitis is caused by bacteria.

Acute bronchitis also can be caused by breathing in things that irritate the bronchial tubes, such as smoke. It also can happen if a person inhales food or vomit into the lungs. What are the symptoms?

The most common symptom of acute bronchitis is a cough that is dry and hacking at first. After a few days, the cough may bring up mucus. You may have a low fever and feel tired.

Acute bronchitis symptoms usually start 3 or 4 days after an upper respiratory tract infection. Most people get better in 2 to 3 weeks. But some people continue to have a cough for more than 4 weeks.

Pneumonia can have symptoms like acute bronchitis. Because pneumonia can be serious, it is important to know the differences between the two illnesses. Symptoms of pneumonia can include a high fever, shaking chills, and shortness of breath.

How is acute bronchitis diagnosed?

Your doctor will ask you about your symptoms and examine you. This usually gives the doctor enough information to find out if you have acute bronchitis.

In some cases, the doctor may take a chest X-ray to make sure that you don't have pneumonia or another lung problem.

How is it treated?

Most people can treat symptoms of acute bronchitis at home. Drink plenty of fluids. Use an over-the- counter cough medicine with an expectorant if your doctor recommends it. This can help you bring up mucus when you cough. Suck on cough drops or hard candies to soothe a dry or sore throat. Cough drops won't stop your cough, but they may make your throat feel better.

What is Dyslexia

Dyslexia is a learning problem that makes it hard to read, write, and spell. It occurs because the brain jumbles or mixes up letters and words. Children with dyslexia often have a poor memory of spoken and written words.

Having dyslexia does not mean that your or your child’s ability to learn is below average. In fact, many people with dyslexia are very bright. But not being able to read well can make many areas of learning difficult.

Dyslexia is also called specific reading disability, reading disorder, and reading disability.

What causes dyslexia?

Experts don't know for sure what causes dyslexia. But it often runs in families. So it may be passed from parents to children (genetic disorder). Also, some studies have found problems with how the brain links letters and words with the sounds they make.

Dyslexia is not caused by poor vision, and people with dyslexia do not see letters and words backward.

What are the symptoms?

Signs of dyslexia in children who are too young for school include:

Talking later than expected. Being slow to learn new words.
Problems rhyming.
Problems following directions that have many steps.

After a child begins school, the signs of dyslexia include:

Problems reading single words, such as a word on a flash card.
Problems linking letters with sounds.
Confusing small words, such as "at" and "to."
Reversing the shapes of written letters such as "d" for "b." For example, the child may write "dat" instead of "bat."
Writing words backward, such as "tip" for "pit."

If your child has one of these signs, it does not mean that he or she has dyslexia. Many children reverse letters before age 7. But if your child has several signs and reading problems, or if you have a family history of dyslexia, you may want to have your child checked for the problem.

How is dyslexia diagnosed?

A doctor or a school professional (such as a reading specialist) will ask you what signs of dyslexia you and your child’s teachers have seen. He or she will ask your child questions too. Your child may be offered to take reading and skill tests. Tests may include those that look at your child's personality and how he or she learns, solves problems, and uses words. Your child may also have an IQ test.

These tests can help find out if your child has dyslexia or another learning problem.

How is it treated?

Treatment uses a number of teaching methods to help your child read better. These methods include: Teaching how letters are linked to sounds to make words.

Having the child read aloud with a teacher’s help.
Teaching the child to listen to and repeat instructions.

United States law requires schools to set up a learning plan to meet the needs of a child with dyslexia. This plan is called an Individualized Education Program (IEP). You, your child's teachers, and other school personnel will have a say in designing the plan. The plan is updated each year based on how well your child is doing and what your child's needs are.

Medicines and counseling usually are not a part of treatment for dyslexia.

Dyslexia is a lifelong problem, but early treatment during childhood can help. Support from family, teachers, and friends is also important.

Prevent and Soothe Chapped Winter Hands

Dry, cracked hands are a common cold weather complaint. Here's how to get a grip on the problem.

Winter is brutal on our hands. Smooth, supple, and soft in September, hands can turn red, chapped, and rough by February

The main culprit? Lack of moisture.

During the winter months, the humidity in the outside air plunges. Inside, things are even more arid, with indoor heating creating desert-like conditions in our home and office. What's more, follow the advice of health care experts to wash your hands frequently to avoid catching a cold or the flu and you'll sap whatever natural oils are left in your skin.

The effect -- hands so dehydrated they may crack, peel, bleed, and become painful -- can be alarming.

"People will have fissures in their hands and they'll come to see me saying they can't figure out what's happening," says New York City dermatologist Ellen Marmur, MD, author of Simple Skin Beauty: Every Woman's Guide to a Lifetime of Healthy, Gorgeous Skin. "It's just extremely dry skin."

The good news, Marmur says, "is once you recognize that, you're halfway on your way to fixing the problem."

Here's what you need to know to help your hands weather winter.

Hereditary Plays a Role

Just how well our hands can withstand winter's harsh conditions has a lot to do with the strength of our skin barrier, says Charles Crutchfield III, MD, a dermatology professor at the University of Minnesota Medical School. A combination of proteins, lipids, and oils, the skin barrier is what protects our skin from assault, and just how good a job it does is largely genetically determined.

If you have a weak barrier, you're more prone to symptoms of sensitive skin, like itching, inflammation, and eczema. You're also more likely to experience excessively dry hands in winter.

The bottom line: If you suffered from chapped hands last year, you can count on that happening again this season and every winter.

Moisturize, Moisturize, Moisturize

To treat parched, scaly hands, you need to replace the moisture that your thirsty skin is missing. Drinking water, experts point out, won't do that.

"It's the moisturizer applied directly to the skin that will keep water from evaporating and give your skin a healthy, dewy appearance," says dermatologist Amy Wechsler, MD, author of The Mind- Beauty Connection: 9 Days to Reverse Stress, Aging and Reveal More Youthful, Beautiful Skin.

For effective treatment, apply moisturizer early and often. "The best prevention is to begin using a moisturizer before your hands show signs of dryness," Marmur says.

Putting moisturizer on just once a day is inadequate. "That's probably enough protection for about five minutes," Marmur says.

With more frequent application, however, the effects of a moisturizer last longer. Five or six applications a day, Marmur says, will provide round-the- clock protection.

To reach that goal, Marmur suggests practicing what she calls "good product placement." Along with keeping a big jar or tube of your favorite over-the- counter moisturizer in your bathroom, stow smaller sizes in your purse, gym bag and on your desk so application becomes a habit.

And remember to rub the hand cream or lotion over your cuticles and nails. "Nails can become dry, just like the skin of the hands," Crutchfield says.

You'll find a dizzying array of hand creams and body lotions on your drugstore shelves. Wechsler says to cut through the clutter by remembering that just two types of ingredients do most of the work when it comes to keeping your skin soft and hydrated: emollients and humectants.

Emollients act as lubricants on the surface on the skin. They fill the crevices between cells that are ready to be shed and help the loose edges of the dead skin cells that are left behind adhere together.

"The slippery feeling you get after applying a moisturizer is most likely coming from emollients," Wechsler says. "They help keep the skin soft, smooth, and pliable." Look for ingredients such as lanolin, jojoba oil, isopropyl palmitate, propylene glycol linoleate, squalene, and glycerol stearate.

Humectants draw moisture from the environment to the skin's surface, increasing the water content of the skin's outer layer. Scan the ingredients label for common humectants such as glycerin, hyaluronic acid, sorbitol, propylene glycerol, urea, and lactic acid.

Thicker Products for More Damaged Skin

When your hands go from being merely dry and rough to having little cracks, or fissures, and are tender or bleeding, it's time to move on to more therapeutic moisturizers.

Petroleum jelly is a reliable standby. Or choose a thick, rich moisturizer in a formula that contains heavier ingredients such as dimethicone, cocoa or shea butter, or beeswax.

Slather on at bedtime, slip on a pair of cotton gloves or socks, and keep on overnight.

How to Wash Your Hands

To protect your hands while you're protecting your health with frequent hand washing, choose a mild soap, use warm not hot water, pat your hands dry and apply a moisturizer right away.

If you've got severely dry hands or you wash your hands a dozen or more times a day, substitute a hand-sanitizing gel or wipes for some of the soap-and-water sessions.

"These alcohol-based sanitizers do dry the skin," Marmur says, "but for people who do a ton of hand washing -- whether they're doctors, moms, or dog- walkers -- it's actually a bit gentler on the skin than soap and water."

Consider a Humidifier

You can't do anything about the weather, but you can add moisture to your home or office with a humidifier.

The higher humidity levels will not only salve your super dry hands, they'll help ease dry itchy skin all over your body, including chapped lips, and soothe a stuffed up nose.

Just be sure to maintain the appliance regularly or you could end up releasing bacteria or mold into the air, Marmur says.

Put a Glove on It

Remember the advice your mom gave you: Wear gloves or mittens if you're going to be outdoors for longer than a dash to a car on cold days. Dry your hands after a snowball fight (then apply moisturizer, of course).

And if redness, peeling, and tenderness persist, see a dermatologist. He or she can prescribe a strong topical steroid cream to help fight inflammation, and also investigate the possibility that your dry hands may be caused by a skin condition like eczema or psoriasis.

But barring that, there's no reason to wring your hands over winter's wrath. Just resist the urge to warm up in hot water, keep simple and effective remedies on hand, and bundle up until the seasons turn toward the sun.
By Shelley Levitt -WebMD

Cold Comfort

10 Natural Ways to Ease the Common Cold

Cold Remedy 1:
Have Some Soup or Tea Chicken soup and tea are traditional common cold remedies that have some good sense behind them.

Why?

"When you swallow a hot drink, some of the heat will get transferred from the esophagus to the windpipe," says Norman Edelman, MD, chief medical officer at the American Lung Association. "That heat can help loosen up the mucus and make it easier to cough out."

Since the heat is what matters, what you drink doesn't matter all that much. "Some people like chicken soup when they have a cold," he says. "My grandmother liked hot water with lemon, and some go with hot tea. But they probably all have the same effect."

Cold Remedy 2:
Drink Fluids
"There's absolutely no evidence that anybody really needs to go through life drinking eight glasses of water a day," says Edelman. But when you're sick, he says, you should make a special effort to stay hydrated.

Why?
Getting enough fluid will help keep the mucus thinner and less sticky. Edelman also points out that when you have cold symptoms, you're losing moisture -- every time you sneeze or blow your nose. Any kind of drink is OK, but limit caffeinated or alcoholic drinks, which may not hydrate you as well as other beverages.

Cold Remedy 3:
Moisturize the Air
Since dry air is bad for cold symptoms, using a vaporizer or humidifier will probably make you a little more comfortable. Edelman suggests that you aim to keep the humidity in your house between 50% to 60%. Which is better, a steam vaporizer or a cool mist humidifier?

"Whichever one you choose, the moisture will be room temperature almost immediately," says Edelman. "So it doesn't make a difference." That said, since steam vaporizers can cause burns if mishandled, don't put one where a child could get at it.

Using a vaporizer or humidifier for cold symptoms does require some commitment on your part.

"You have to keep it clean and change the water regularly," Edelman says. "Mold and bacteria grow very readily in those things."

If you're not up to the grave responsibility of humidifier cleaning, you can also moisturize your nasal passages directly -- just use a saline spray. It will also help thin out the mucus.

Cold Remedy 4:
Breathe in Some Steam
Sitting in the bathroom and running the shower can help. The warm moisture can get into the airways and loosen up mucus. Applying a warm compress over your nose and mouth might achieve the same effect.

Cold Remedy 5:
Soothe Your Nose With a bad cold often comes a miserable chapped nose. What can you do? First, make sure that you have some reasonably soft tissues, so you're not using anything too abrasive against your skin.

Second, dab some petroleum jelly on and under your nose. It will help both soothe irritated skin and prevent it from getting worse.

Cold Remedy 6:
Gargle
If one of your cold symptoms is a sore throat, try gargling with salt water. A salt water gargle can help relieve your pain and that uncomfortable scratchy throat feeling -- for a little while at least.

Cold Remedy 7:
Get Some Rest
A lot of people have trouble slowing down when they get sick. They feel self- indulgent if they opt out of work and spend the day lying on the couch watching movies while under a blanket. But really, it's what you ought to do.

"When you have a really bad cold that's causing a fever and making you feel really crummy, rest is really important," says Edelman. "It will help you heal."

With a more run-of-the-mill cold that causes minor cold symptoms, rest is less of a medical necessity, Edelman says. But you're still perfectly justified in taking it easy.

"In that case, the most important reason to stay home from work is to prevent you from spreading the cold to your co-workers," he says. "That's a nice thing to do."

Cold Remedy 8:
Get Some Help
If you're usually the one running the household, now is the time to give yourself a break and call in some favors. Ask a friend to bring over dinner. See if your spouse can pack the kids' lunch boxes for a few days. When you're sick with cold symptoms, trying to do everything you normally do will just run you ragged -- and that could just prolong your illness.

Cold Remedy 9:
Consider Medicine
Again, no medicine will speed your recovery from a cold. But some over-the- counter drugs, like decongestants, could ease your cold symptoms a bit and make you more comfortable, Edelman says. Painkillers like acetaminophen, aspirin, and ibuprofen can help with fever and body ache. Always follow the dosing instructions on the bottle.

Avoid taking medicines for symptoms you don’t have. Look at the label on the bottle to match your symptoms to the medicine that makes sense for you.

When your kids are suffering a cold, over-the-counter medicines can help relieve the symptoms. Remember to read and follow the labels carefully. Make sure to give your child no more than the recommended dose. And make sure not to use more than one cold and flu medicine with the same ingredient. If your child is under 4, do not use cold medicine. You should talk to your doctor to find out how best to relieve symptoms.

Cold Remedy 10:
Ask Your Doctor About Supplements
Cold supplements are another option for adults, but the evidence that supplements like vitamin C, echinacea, or zinc is mixed at best, Edelman says. If you want to try one, talk to your doctor first -- and make sure it won't interact with any medicines that you take.

Cold Symptoms:
Protecting Others
The best way to fight the common cold is to prevent it. When you're sick with cold symptoms, you need to think a little about the comfort of the people around you. That means protecting them from your germs.

When you have a cold, wash your hands regularly. Cover your mouth when you cough or sneeze. If you've got young kids, piling used tissues on the floor by the living room couch isn't a good idea. If you do have to go to work -- or in public -- despite your cold symptoms, try to protect other people. Bring along some hand sanitizer and apply it regularly.

Nonallergic Rhinitis

Nonallergic rhinitis is a medical term that describes a set of symptoms that resemble an allergy but that occur without a known cause. It produces symptoms such as:

Postnasal drip
Runny nose
Sneezing
Stuffy nose

Usually, it develops in adulthood, and symptoms last year-round.

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Unlike allergic rhinitis, nonallergic rhinitis does not involve the immune system. About 58 million Americans have allergic rhinitis. By comparison, 19 million have nonallergic rhinitis.

Nonallergic rhinitis can cause just as much misery as allergic rhinitis. It can also be associated with the same complications, such as:
Sinusitis, which is inflammation or swelling of the tissue that lines the sinuses.
Eustachian tube dysfunction.
Eustachian tubes connect the middle ears to the back of the throat.
Chronic ear infection, known as otitis media.
Loss of smell or anosmia.
Asthma.
Obstructive sleep apnea.

Both types of rhinitis are associated with:
Decreased production at work.
Increased doctor visits.
Side effects from treatment, such as drowsiness, nosebleed, and nasal dryness.

Because the two are so similar, it's often necessary to perform allergy tests and blood tests to tell them apart.

Causes of Nonallergic Rhinitis

Often, what causes nonallergic rhinitis is unknown. And the condition is often confirmed only after other conditions such as allergic rhinitis or infection are ruled out.

"Environmental" irritants are common triggers of nonallergic rhinitis. Some are found in the home and others are more common in the workplace.

Examples of what can trigger symptoms include:
Car exhaust
Chlorine
Cigarette smoke
Cleaning solutions
Glues
Hair spray
Latex
Laundry detergents
Metal salts
Perfume
Smog
Wood dust

When such triggers cause nonallergic rhinitis, they also often cause asthma.

Some medications can trigger non-allergic rhinitis.
Examples include:
NSAIDs -- nonsteroidal anti- inflammatory drugs such as aspirin and ibuprofen
Oral contraceptives Blood pressure medicines such as ACE inhibitors and beta-blockers
Antidepressants
Tranquilizers
Drugs used to treat erectile dysfunction

Foods and beverages may also sometimes be triggers.
Examples include:
Hot foods, such as soup Spicy foods
Alcoholic beverages, especially beer and wine

Other triggers include:
Illegal drugs. Cocaine and other snorted street drugs often cause chronic nonallergic rhinitis. Weather changes. Sudden changes in weather or temperature can trigger nonallergic rhinitis. Skiers, for instance, often develop a runny nose. And some people are affected by any cold exposure. In some cases, people even start sneezing after leaving a cold, air-conditioned room. Hormone changes. Nonallergic rhinitis often occurs during periods of hormonal imbalance. For instance, it may occur during puberty, menstruation, or pregnancy. It usually starts during the second month of pregnancy and lasts until childbirth. Hormonal conditions such as hypothyroidism can also trigger symptoms.

Treatment of Nonallergic Rhinitis

Nonallergic rhinitis can't be cured. But it can be controlled by:
Avoiding rhinitis triggers.
Using home remedies such as nasal irrigation.
Taking over-the-counter and prescription medications.

Allergy shots --
immunotherapy -- are not used to treat nonallergic rhinitis.

If you have nonallergic rhinitis, it's important that you not smoke and not allow smoking in your home.

Other strategies to reduce exposure to triggers include:
Avoid wood-burning stoves and fireplaces if they cause symptoms.
Avoid cleaning agents, household sprays, perfumes, and scented products if they cause symptoms.
Ask family, friends, and co- workers not to use scented products that cause symptoms.
Avoid any chemical or material that tends to make you sneeze or have a runny nose.
Talk to your doctor about the medications you now take.If your nonallergic rhinitis is triggered by a medicine you need, your doctor may suggest a substitute.

Many people with nonallergic rhinitis benefit from performing nasal irrigation. This refers to rinsing of the nostrils with a salt water -- saline -- solution one or more times a day. Over-the-counter products for doing this include bulb syringes, neti pots, and bottle sprayers.

During each irrigation, rinse each nostril with at least 200 mL (about 3/4 cup) of commercially or home- prepared solution.

When performed once or twice a day, nasal irrigation may especially help treat postnasal drip. It's also a helpful technique to clear the sinuses before using medicated nasal sprays.

Medications for nonallergic rhinitis include:

Nasal antihistamines.
Prescription products such as azelastine (Astelin) and olopatadine (Patanase) can relieve symptoms of postnasal drip, congestion, and sneezing within minutes. They are most effective when used on a regular basis.

Nasal glucocorticoids. Daily use of products such as fluticasone (Flonase) or mometasone (Nasonex) may help relieve symptoms. But it may take days or weeks to notice the full effects. Sometimes, people benefit from using a combination of nasal antihistamines and nasal glucocorticoids.

Nasal ipratropium.
Ipratropium bromide (Atrovent) is considered the best treatment for the watery nasal discharge that comes from eating and drinking certain foods and beverages.

Decongestants. Oral decongestant medications -- such as pseudoephedrine -- may help relieve congestion. But these are not generally recommended unless nasal antihistamines and nasal glucocorticoids do not help symptoms. Decongestant nasal sprays containing oxymetazoline (Afrin) and phenylephrine (Neo- synephrine) should not be used for more than two to three days at a time. Doing so can cause overuse (rebound) congestion.

In some cases, surgery to remove nasal polyps or correct a deviated septum can improve the way medications for nonallergic rhinitis work. Surgery is only considered as a treatment by itself, though, when other treatments have failed to reduce symptoms.