Monthly Archives: December 2013

Better, Faster, Stronger Kids

Our kids are better, faster and stronger than we were, right? After all, when we were kids there weren’t so many organized sports like there are now. Kids are playing organized sports at a much younger age. Parents now are much more involved in their kids lives and in keeping their kids active, so they should be faster, right? Unfortunately, they aren’t. Well some might be. But overall, kids are much less fit than their parents were. In an analysis of studies on millions of children from around the world, the Milwaukee Journal reported that on average, it takes kids 90 seconds longer now than it did 30 years ago to run a mile. Overall, todays kids were found to be 15% less fit than their parents were and this was found for both boys and girls and across all ages.
The key conclusion from these studies is that children are not active enough today and there are a number of reasons for this, some we can change and some we cannot. What would be ideal would be for parents to recognize the importance of their children being active. We make sure our kids do their homework, brush their teeth, do chores, etc. 60 minutes or more of vigorous physical activity (accumulated throughout the day) should be included in one of those must do categories. Our challenge is to make it fun which we have the power to do. We were kids once too and had fun being active even though it wasn’t organized.

Joel D Mason, DPT, SCS, CSCS
Physical Therapist, Sports Certified Specialist
Sports, Spine and Work Center, Agnesian HealthCare

Seasonal Affective Disorder (SAD)

If you notice periods of depression that seem to accompany seasonal changes during the year, you may suffer from seasonal affective disorder (SAD). This condition is characterized by recurrent episodes of depression – usually in late fall and winter – alternating with periods of normal or high mood the rest of the year.

Most people with SAD are women whose illness typically begins in their twenties, although men also report SAD of similar severity and have increasingly sought treatment. SAD can also occur in children and adolescents, in which case the syndrome is first suspected by parents and teachers. Many people with SAD report at least one close relative with a psychiatric condition, most frequently a severe depressive disorder (55 percent) or alcohol abuse (34 percent).

What are the patterns of SAD?

Symptoms of winter SAD usually begin in October or November and subside in March or April. Some patients begin to slump as early as August, while others remain well until January. Regardless of the time of onset, most patients don’t feel fully back to normal until early May. Depressions are usually mild to moderate, but they can be severe. Very few patients with SAD have required hospitalization, and even fewer have been treated with electroconvulsive therapy.

The usual characteristics of recurrent winter depression include oversleeping, daytime fatigue, carbohydrate craving and weight gain, although a patient does not necessarily show these symptoms. Additionally, there are the usual features of depression, especially decreased sexual interest, lethargy, hopelessness, suicidal thoughts, lack of interest in normal activities, and social withdrawal.

Light therapy, described below, is now considered the first-line treatment intervention, and if properly dosed can produce relief within days. Antidepressants may also help, and if necessary can be used in conjunction with light.

In about 1/10th of cases, annual relapse occurs in the summer rather than winter, possibly in response to high heat and humidity. During that period, the depression is more likely to be characterized by insomnia, decreased appetite, weight loss, and agitation or anxiety. Patients with such “reverse SAD” often find relief with summer trips to cooler climates in the north. Generally, normal air conditioning is not sufficient to relieve this depression, and an antidepressant may be needed.

In still fewer cases, a patient may experience both winter and summer depressions, while feeling fine each fall and spring, around the equinoxes.

The most common characteristic of people with winter SAD is their reaction to changes in environmental light. Patients living at different latitudes note that their winter depressions are longer and more profound the farther north they live. Patients with SAD also report that their depression worsens or reappears whenever the weather is overcast at any time of the year, or if their indoor lighting is decreased.

SAD is often misdiagnosed as hypothyroidism, hypoglycemia, infectious mononucleosis, and other viral infections.

How is winter SAD treated with light?

Bright white fluorescent light has been shown to reverse the winter depressive symptoms of SAD. Early studies used expensive “full-spectrum” bulbs, but these are not especially advantageous. Bulbs with color temperatures between 3000 and 6500 degrees Kelvin all have been shown to be effective. The lower color temperatures produce “softer” white light with less visual glare, while the higher color temperatures produce a “colder” skylight hue. The lamps are encased in a box with a diffusing lens, which also filters out ultraviolet radiation. The box sits on a tabletop, preferably on a stand that raises it to eye level and above. Such an arrangement further reduces glare sensations at high intensity, and preferentially illuminates the lower half of the retina, which is rich in photoreceptors that are thought to mediate the antidepressant response. Studies show between 50% and 80% of users showing essentially complete remission of symptoms, although the treatment needs to continue throughout the difficult season in order to maintain this benefit.

There are three major dosing dimensions of light therapy, and optimum effect requires that the dose be individualized, just as for medications.

Light intensity. The treatment uses an artificial equivalent of early morning full daylight (2500 to 10,000 lux), higher than projected by normal home light fixtures (50 to 300 lux). A light box should be capable of delivering 10,000 lux at eye level, which allows downward adjustments if necessary.

Light duration. Daily sessions of 20 to 60 minutes may be needed. Since light intensity and duration interact, longer sessions will be needed at lower intensities. At 10,000 lux – the current standard – 30-minute sessions are most typical.

Time of Day of exposure. The antidepressant effect, many investigators think, is mediated by light’s action on the internal circadian rhythm clock. Most patients with winter depression benefit by resetting this clock earlier, which is achieved specifically with morning light exposure. Since different people have different clock phases (early types, neutral types, late types), the optimum time of light exposure can differ greatly. The Center for Environmental Therapeutics, a professional nonprofit agency, offers an on-line questionnaire on its website,, which can be used to calculate a recommended treatment time individually, which is then adjusted depending on response. Long sleepers may need to wake up earlier for best effect, while short sleepers can maintain their habitual sleep-wake schedule.

Side effects of light therapy are uncommon. Some patients complain of irritability, eyestrain, headaches, or nausea. Those who have histories of hypomania in spring or summer are at risk for switching states under light therapy, in which case light dose needs to be reduced. There is no evidence for long-term adverse effects, however, and disturbances experienced during the first few exposures often disappear spontaneously. As an important precaution, patients with Bipolar I disorder – who are at risk for switching into full-blown manic episodes – need to be on a mood-stabilizing drug while using light therapy.

What should I do if I think I have SAD?

If your symptoms are mild – that is, if they don’t interfere too much with your daily living, you may want to try light therapy as described above or experiment with adjusting the light in your surroundings with bright lamps and scheduling more time outdoors in winter.

If your depressive symptoms are severe enough to significantly affect your daily living, consult a mental health professional qualified to treat SAD. He or she can help you find the most appropriate treatment for you. To help you decide whether a clinical consultation is necessary, you can use the feedback on the Personalized Inventory for Depression and SAD at



National Alliance on Mental Illness
page printed from
(800) 950-NAMI;

For local resources go to

Make sure to get your fill of RED and GREEN this holiday season

The colors of the holiday season usually specifically bring to mind red and green.  The green of the Christmas trees, the holly and the berries, the pine garlands and Jell-O molds.  And you can’t forget the red Poinsettias, the red Christmas ornaments and the red bows on the wreaths decorating the streets.  But what about the other reds and greens- you know the fruits and veggies that we should normally be eating to improve our health?

Let’s look at the powerhouse RED foods first.  Our RED foods are packed with antioxidants that fight to keep us healthy by stabilizing the damage done by free radicals in our environment and warding off everything from heart disease to different types of cancers.  Berries are full of fiber, low in calories and pack a sweet punch.  Tomatoes are full of lycopene shown to keep our hearts healthy.  Beets and other root vegetables– including carrots and sweet potatoes- are loaded with vitamin C, folic acid, a host of B vitamins and potassium.  Studies funded by the National Institutes of Health (NIH) have demonstrated benefits of cranberries ranging from prevention of urinary tract infections to reducing dental plaque.  Preliminary research also shows that cranberries may even assist with the treatment and prevention of the H. Pylori bacteria that leads to stomach ulcers.  Pomegranate seeds make a beautiful adornment to winter salads and the juice is a good mixer for punches

Let’s move on to our amazing GREEN foods.  You have your basic iceberg and romaine lettuces but why not try something more adventurous this holiday season?  Mesclun salad mixes usually include a variety of greens such as arugula, dandelion greens and fresh herbs that will certainly add flavor to your basic salads.

Recently, kale has been in the spotlight with its long list of nutritional benefits.  Swiss chard and collard greens are full of calcium and are a delicious side dish for your holiday meal.And don’t forget the broccoli your parents always made you eat as a child.  As for fruits, green grapes and kiwi are a great addition to your boring cereal for breakfast this winter.   Pistachios are also a great snack for when you’re craving those salty chips.

So, this year as your pulling out your red Santa suit for your next holiday gathering, keep your belly from looking like a “bowl full of jelly” by following the USDA My Plate recommendations and fill those plates at least half-full of fruits and vegetables. Cut down your craving s for the Christmas cookies and fudge by eating your leafy greens and this just might be the year to finally avoid that extra holiday weight.

Heather Schmidt, DO

Agnesian HealthCare

Should Wisconsin lower the legal BAC level to .05?

Currently, in Wisconsin, the legal Blood Alcohol Content (BAC), level for a driver who has been drinking is .08.  The National Transportation Safety Board is recommending states lower that level to .05.  The lack of progress in decreasing the total number of people killed in crashes involving a driver who was impaired has been the main motivator behind this initiative.

Progress toward decreasing fatalities was made when the states lowered the BAC for driving under the influence from .10 to .08, the drinking age was raised to 21, and the states adopted a “zero tolerance” policy for those drivers under the age of 21.  The “zero tolerance” law states that any person under the age of 21 may have no trace of alcohol or other drugs present in their system.

The National Transportation Safety Board (NTSB), has stated its goal on reducing drunk-driving deaths in its new title: “Reaching Zero.”  This has sparked a huge debate across the country; some agree with lowering BAC tolerance levels, while others oppose the idea stating they believe this won’t bring enough change to the states considering the current laws.

NTSB estimates that a motorist with .05 BAC is 38 percent more likely to crash than one who is completely sober.  For the last 15 years, one-third of highway deaths have involved an alcohol-impaired driver.  One study found that lowering the BAC standard has saved some 360 lives a year. So NTSB concludes that lowering the BAC to.05 would save from 500 to 800 more lives per year.  Stay tuned as the debate for changes will continue.

Drug Free Communities of Fond du Lac County recommends that if you choose to drink, to keep yourself and others on the roads safe, have a designated driver or call a taxi.