Asthma and acid reflux can often go hand and hand
Asthma and acid reflux often occur together. It isn’t clear why, or whether one causes the other. But we do know that acid reflux can worsen asthma and asthma can worsen acid reflux — especially severe acid reflux, a condition known as gastroesophageal reflux disease (GERD).
Asthma and acid reflux can occur together in children as well as in adults. In fact, about half the children with asthma also have GERD.
When asthma and acid reflux do occur together medications may not work as well to control signs and symptoms of either condition, such as coughing, shortness of breath, wheezing and chest pain.
Treating acid reflux may help ease symptoms. You may be able to control acid reflux with over-the-counter medications — for example, a proton pump inhibitor, such as omeprazole (Prilosec OTC). Avoiding reflux triggers, such as fatty foods, alcohol and tobacco, also may help. If that’s not enough, prescription medications may be needed. If you have asthma and think you might have acid reflux, talk to your health care provider about the best treatments.
In some cases, asthma medications can worsen acid reflux. This is particularly true of theophylline (Theo-24, Elixophyllin, Theocron). But don’t quit taking or change any asthma medications without getting your doctor’s OK first.
COVID’S foggy glasses spawning Lasik revival
Lasik eye surgery is making a comeback.
After months of face masks fogging up their glasses and contacts drying out from all the extra Zoom meetings while working from home, Americans are fed up and are boosting demand for the corrective surgery that had waned in popularity over the past decade.
During the COVID-19 pandemic, consumers have cut back on activities, such as overseas travel and entertainment, and for many that has left a big pot of cash to be spent elsewhere. A lot of that has been poured into home improvement and buying cars. And now consumers are shifting to upgrading themselves with procedures like Lasik and its starting price tag of about $4,500.
In Los Angeles, Dr. Neda Shamie, an opthalmic surgeon, has seen a 30 percent jump in Lasik procedures at her practice, the Maloney Shamie Vision Institute. It’s being driven by younger adults, with the average age of a patient falling to 34 years old, a seven-year drop from the early 2000s, she said. Her group did an informal survey of other big eye care practices around the country, and they reported similar gains.
“People have budgets set aside for travel and are converting their travel budget into self improvement,” Shamie said. And our patients are “telling us the glasses-mask conundrum is real.”
More than 30 Lasik systems have been approved since Laser Sight Technologies Inc.’s Kremer Excimer Laser System won U.S. approval for the surgery in 1998. After an initial boom in the early 2000’s, Lasik’s growth slowed as the Great Recession reduced disposable income and the Food and Drug Administration warned of dodgy advertising practices.
Online searches in the U.S. for the procedure peaked in 2004 and had bottomed out earlier this year before spiking when the pandemic hit, according to Google Trends. The industry is now forecast to hit $4.1 billion in sales by 2027, more than doubling 2018’s total, according to consulting firm Coherent Market Insights.
Lasik’s revival is part of an industry-wide boom in elective procedures during the pandemic. Quarantines and social-distancing caused weight gain and more self-consciousness with all the time on video chats. That’s led to spikes in Botox injections, breast implants and repairing droopy eyelids for the group of Americans who haven’t suffered financially during the COVID-triggered recession.
People who are working remotely are also more confident to go under the knife because they can recover at home, according to Jared Holz, a health strategist at Jefferies.
“You could get a lot of these procedures done without anybody you work with knowing about it,” Holz said. “Before, it was almost taboo to have to take some time off to get these elective procedures done.”
The rise in demand for smoothing wrinkle lines could boost AbbVie Inc.’s Allergan unit that sells the Botox injection. And as more invasive elective surgeries — like knee, hip and ankle replacements — pick up after a slowdown during the initial COVID wave, medical device makers such as Stryker Corp. and Zimmer Biomet Holdings Inc. will likely benefit.
BlackRock’s iShares U.S. Medical Devices ETF rebounded from a March 23 low, as investors bet on a return for elective surgeries. The ETF’s 18 percent gain this year is triple the return on State Street’s $24 billion Health Care Select Sector SPDR Fund and more than double that of the S&P 500 Index.
Lasik, which uses lasers to reshape the front of the eye and often improves vision to better than 20/20, has an advantage over other procedures because it has a minimal recovery period. Following a brief consultation, a patient could have surgery the same day and better vision within a few hours, Dr. Shamie said. After a post-surgery nap to let the eyes rest and heal, the patient can return to their regular routine and work the next day, she said.
Like many Americans during the pandemic, Dana Johnson, who had worn glasses since she was 6-years-old, had extra cash on hand as plans for travel and entertainment options evaporated.
“Due to not being able to eat out or vacation, I had what I felt like was a good amount of money saved to put down,” the 25-year-old nurse in Nashville, Tenn., said in an interview. She had the procedure in late September.
Don’t delay cancer screenings
Fewer breast cancers are being diagnosed because of the COVID-19 pandemic. Earlier in the year, when the pandemic began to intensify, many health care institutions suspended their screening programs and weren’t offering mammography to patients. This resulted in a nearly 50 percent drop in new diagnoses of breast cancer, according to a study in JAMA.
Fewer people are being diagnosed with breast cancer because of the COVID-19 pandemic.
Dr. Katie Hunt, a Mayo Clinic radiologist, wants patients to know it’s safe and important to resume their regular breast cancer screening.
“If you delayed getting your screening mammogram because of the pandemic, schedule it now.
“The biggest risk of skipping breast cancer screening is that cancer has more time to grow and potentially progress into a more advanced stage.
“Screening mammography has been incredibly successful because we detect cancers when they’re small and treatable, which results in better outcomes for our patients. We don’t want to miss that window of opportunity. So, again, if your mammogram has been delayed by the pandemic, please don’t wait any longer and come in and get your mammogram done.”
Dr. Hunt recommends women start yearly screening mammograms at age 40.
Beetle armor gives clues to tougher planes
NEW YORK — It’s a beetle that can withstand bird pecks, animal stomps and even being rolled over by a Toyota Camry. Now scientists are studying what the bug’s crush-resistant shell could teach them about designing stronger planes and buildings.
“This beetle is super tough,” said Purdue University civil engineer Pablo Zavattieri, who was among a group of researchers that ran over the insect with a car as part of a new study.
So, how does the seemingly indestructible insect do it? The species — aptly named diabolical ironclad beetle — owes its might to an unusual armor that is layered and pieced together like a jigsaw, according to the study by Zavattieri and his colleagues published in Nature on Wednesday. And its design, they say, could help inspire more durable structures and vehicles.
To understand what gives the inch-long beetle its strength, researchers first tested how much squishing it could take. The species, which can be found in Southern California’s woodlands, withstood compression of about 39,000 times its own weight.
For a 200-pound man, that would be like surviving a 7.8-million-pound crush.
Other local beetle species shattered under one-third as much pressure.
Researchers then used electron microscopes and CT scans to examine the beetle’s exoskeleton and figure out what made it so strong.
As is often the case for flightless beetles, the species’ elytra — a protective case that normally sheaths wings — had strengthened and toughened over time. Up close , scientists realized this cover also benefited from special, jigsaw-like bindings and a layered architecture.
When compressed, they found the structure fractured slowly instead of snapping all at once.
“When you pull them apart,” Zavattieri said, “it doesn’t break catastrophically. It just deforms a little bit. That’s crucial for the beetle.”
It could also be useful for engineers who design aircrafts and other vehicles and buildings with a variety of materials such as steel, plastic and plaster. Currently, engineers rely on pins, bolts, welding and adhesives to hold everything together. But those techniques can be prone to degrading.
In the structure of the beetle’s shell, nature offers an “interesting and elegant” alternative, Zavattieri said.
Because the beetle-inspired design fractures in a gradual and predictable way, cracks could be more reliably inspected for safety, said Po-Yu Chen, an engineer at Taiwan’s National Tsing Hua University not involved in the research.
The beetle study is part of an $8 million project funded by the U.S. Air Force to explore how the biology of creatures such as mantis shrimp and bighorn sheep could help develop impact-resistant materials.
“We’re trying to go beyond what nature has done,” said study co-author David Kisailus, a materials scientist and engineer at the University of California, Irvine.
The research is the latest effort to borrow from the natural world to solve human problems, said Brown University evolutionary biologist Colin Donihue, who was not involved in the study. Velcro, for example, was inspired by the hook-like structure of plant burrs. Artificial adhesives took a page from super-clingy gecko feet.
Donihue said endless other traits found in nature could offer insight: “These are adaptations that have evolved over millennia.”
Out of ideas for physically distanced greetings? We’ve got a few
The simplest human joy of all — the joy of meeting and greeting other humans — has gotten pretty complicated these days thanks to the highly contagious coronavirus. Outside-your-household handshakes, hugs and even friendly slaps on the back are out. The European style of kissing both cheeks? Fuhgeddaboudit.
We may be truly thrilled to see friends, or determined to make firm impressions on new business associates, but distance rules the day. How can you extend the appropriate hello while maintaining lots of breathing room?
Maybe viewing it as a matter of local pride will boost morale and help us stay focused on safety as this tough situation drags on. So try waving your Van Hands, which are so much cooler (that is, ‘Couver) than normal Jazz Hands. Or try the Burnt Bridge Bow, honoring the city’s main waterway.
Ever notice how your crooked elbow forms a proud capital V? We envision a Van Bump, performed only by people who are masked up and stepping quickly forward to touch the points of those Vs, and away again.
Cute, but public health officials don’t recommend elbow bumping because that still involves both real physical contact and merging your airspace. Better to perform the physically distanced version from at least 6 feet away: the Pan(demic) Van Bump.
The same goes for the Toe Bump, also known as the Wuhan Shake, which may seem safer because it involves no hand contact but still brings people’s mouths and noses too close together. The mighty Fist Bump, alas, is a definite violation of both principles: no contact, no sharing airspace.
In a culture that’s grown markedly informal, some people don’t feel the need for any particular demonstration of greetings.
“I say hi. That’s all that’s needed,” Jeremi Smith wrote on The Columbian’s Facebook page when we asked what readers are trying.
“Well I’ve never really hugged people nor shook hands so I am all good,” added Allison Bell.
If you’re old-fashioned enough to feel that some form of greeting is always required, the following guide is for you. Some are classics of world history, others come from pop culture — and a few swirl those together into something playful for a time that’s anything but.Namaste and gasshō
If you’ve ever tried yoga, you probably ended the session with a group bow from the waist with hands pressed prayerfully together while your instructor intoned the word “namaste.”
“Namaste” is a traditional, respectful, noncontact form of greeting in the Hindu world. The original Sanskrit meaning is simply “I bow to you” or “I honor you.” Cosmic elaborations — “The divine within me salutes the divine within you” — appear to have come with the arrival of modern yoga as a form of calisthenics flavored with quasi-spiritual sauce.
John Kowalski of Vancouver has been performing a Japanese-Buddhist version of the prayerful greeting bow for decades. Influenced by Japanese culture and his own philosophical leanings, he became a Buddhist in the 1980s, he said.
“It’s not out of character or even that unusual for me to greet folks with the traditional ‘palms together’ (gasshō in Japanese) greeting, along with a slight bow,” he said.Vulcan salute
“Live long and prosper” seems a truly on-point greeting for an era dominated by a deadly virus and a massive economic downturn. The fact that it’s the motto of an extraterrestrial civilization that adopted cool logic after ravaging itself with hatred and violence seems pretty on-point too.
The phrase and the accompanying hand gesture both come to us across the final frontier from planet Vulcan, the home of “Star Trek’s” Mr. Spock, where pointy-eared people greet one another by raising one hand, displaying the palm and separating the thumb, middle and ring fingers. (There, it’s another V. Sort of.)
The gesture was invented by Mr. Spock himself, actor Leonard Nimoy, who drew inspiration from the Jewish Priestly Blessing that impressed him as a child. The Vulcan Salute was reportedly recommended to members of Congress by an attending physician last spring, but it didn’t take. (Even if they did it, would they really mean it?)Fives
When you and your friend used to slap palms together in pre-pandemic fashion, that was a High Five. When you make the gesture from 6 feet apart and without contact, it’s an Air Five.
(And when Vulcans make their special gesture from across the light years? Let’s call it a Space Five.)Hand on heart
It’s good enough for our pledge to the flag and it’s also good enough for Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, who suggested this instead of elbow bumping as the pandemic took hold earlier this year. Tedros likes showing respect and sincerity by putting a hand over his heart.
“Hand on heart and a slight head bow,” Samantha Meyer agreed on Facebook.Embrace the air
Here’s one that’s probably not for greeting business associates but definitely for family and good friends: ” ‘Air hug’ where you make the motions of a hug from a distance,” said Linda Jellison.
Some prefer wrapping their arms around themselves in a warm, sincere demonstration. Others enjoy indulging in a staggering-zombie squeeze that tells their besties how they really feel: I love you so much, I’d eat your brains if only Dr. Fauci let me!Finger pistols
On the other hand, even a comedic mock-shooting doesn’t necessarily seem like the nicest greeting. But it’s probably welcomed warmly by some. Stick up for your constitutional right to bear digits with a little pretend bang-bang. Add a wink so your friend knows it’s meant with love.Faux-blowing kisses
Kissing your palm and then powering the result over to your sweetie with a burst of breath – what’s wrong with this picture? The breath, of course. Make the gesture but refrain from pushing out any air. Make it a breathless, exaggerated faux-blow.Cool nod
Just a flick of the head in casual acknowledgment. No need to get too excited. Yo, bruh, down for some distanced chillaxin’? Dope.
“I find a small head bow to be nice,” said Rebecca Bristow. “Simple and elegant.”Peace sign
At a time like this, in all seriousness: What’s so funny about peace, love and understanding?
Clark County interchange projects on Highways 14 and 500 result in fewer accidents
It’s been a year since the Washington State Department of Transportation installed a pair of roundabouts on state Highway 14 in Washougal, and two years since the department removed two traffic signals along state Highway 500 in Vancouver.
The strategies were different — Highway 14 traffic has to slow down to pass through the roundabouts, while Highway 500 drivers can now zip through at full speed — but the projects shared a goal of reducing accident rates.
Early data from both corridors suggests that the changes are working as intended, particularly when it comes to stopping rear-end crashes.
The Highway 500 project ripped out the traffic signals at the intersections with Northeast 42nd Avenue/Falk Road and Northeast 54th Avenue/Stapleton Road, extending the median barrier through the intersections and converting the roads to right-in/right-out interchanges.
The Highway 14 roundabouts replaced the intersections at Washougal River Road/15th Street, which previously had a traffic signal, and 32nd Street, which did not.
The big caveat when evaluating the performance of both projects is that the updated intersections are all still too new to make apples-to-apples comparisons.
Both projects were designed based on traffic data compiled over a five-year period, WSDOT spokeswoman Tamara Greenwell said, so a true comparative analysis will require another three or four years of data. The study period needs to be long enough to account for unique weather conditions such as big snow storms, she said, as well as general fluctuations in accident rates from year to year.Traffic lights
Data from the two years since the removal of the Highway 500 traffic lights shows a 68 percent reduction in crashes through the corridor, Greenwell said, compared with the five years that were used as the baseline beforehand. It’s almost an exact match for what WSDOT engineers hoped to see.
“When we looked at this project, the data supported that we’d see about a 70 percent reduction in crashes,” Greenwell said.
Highway 500 used to be notorious for rear-end crashes, which WSDOT attributed to drivers being caught off guard by the two traffic signals in the middle of a corridor that is otherwise built like a freeway. Those crashes have all but vanished in the past two years, Greenwell said, and other types of crashes, such as sideswipes, are down too.
The Stapleton Road intersection saw 193 crashes from 2012 to 2016, Greenwell said. From November 2018 to October 2020, there have been four. The Falk Road intersection also saw four crashes in the past two years, down from 109 during the earlier five-year period.
The decline in multi-vehicle crashes has been slightly offset by an increase in fixed-object crashes, meaning when a driver hits a stationary object like a road sign or a plastic delineator pole. There were 14 such accidents at the Stapleton Road intersection during the original five-year monitoring period, Greenwell said, and 19 in the past two years.
WSDOT generally tends to see slightly higher numbers of fixed-object crashes in the first year after new traffic configurations are implemented, she said, which is another reason why it’s important to wait the full five years before drawing official conclusions.
“Oftentimes people drive on autopilot, and more and more we’re seeing distracted driving,” she said.Roundabouts
The initial data from the Highway 14 roundabouts shows a marked decrease in the severity of accidents, although not a major decrease in the number of accidents overall. However, Greenwell stressed that a true comparison will need five years of data, and it’s barely been a year since the traffic circles debuted.
There were five crashes in corridor in the past 11 months, compared with 28 during the five-year study period. But the earlier crashes included 25 rear-end collisions at the Washougal River Road intersection, Greenwell said — and in the past year, there’s been just one. Fixed-object crashes have risen slightly, from zero before to two in the past year.
The removal of the traffic signal at Washougal River Road makes a big difference, Greenwell said, because it eliminates the risk of drivers trying to run the light or mistakenly thinking they have more time before it changes — two of the most common causes of accidents before the roundabout project.
It also gets rid of a potentially unexpected stop; the Washougal River Road intersection was the only traffic signal on Highway 14 in all of Clark County.
The traffic circle design naturally results in less-severe accidents because the Highway 14 lanes go through chicane curves as they approach the intersection, she said, prompting drivers to slow down.
The $7.5 million roundabout project was a more extensive update than the roughly $860,000 traffic signal removal on Highway 500, but both methods were chosen in part because they could be implemented relatively quickly and cheaply.
A full freeway interchange on either highway would have been far more expensive, Greenwell said, because of the need to build a bridge to grade separate the roads. For comparison, the 2017 upgrade to the Interstate 5 interchange near ilani cost $32 million, and the Interstate 205 interchange at Northeast 18th Street cost of $40.6 million.
Ambrose: Some things to scream about
You look at it, a copy of “The Scream,” the famous 1893 expressionist painting by the Norwegian artist Edvard Munch, and you ask yourself whether this is America today, a scene that sizzles with human anxiety. There is a hand on each side of a large, mesmerizing, petrified face, waters for drowning purposes nearby and a sunset of blood above.
No, we don’t go around looking like the screamer, but there’s ongoing peril in the pandemic, a distraught economy, widespread disruption in violent riots, high racial tensions, the demolition of the family, the decline of faith, the decay of norms, intellectualism gone awry and an election dangerous to talk about.
You are in real trouble if you point out, for instance, that President Donald Trump has some exceptional achievements to his name, varied foreign policies far superior to those of his predecessor, for instance.
Yes, he does remain a constant embarrassment, someone who recently called his initially appointed virus chief an idiot, for instance. He at one point wanted to delay help to virus victims and their communities until after the election, and now wants to outspend House Speaker Nancy Pelosi, whose political ends know no end.
She is worse than Trump, and, look, I am in trouble again because Pelosi is, after all, a hero to many, but she scares me, given the way she plays politics with everything as she simultaneously presents herself as morally superior, outraged at anyone saying that she does what she does.
The bigger question, of course, is what happens if basement boy Joe Biden is elected president, the House stays Democratic and the Senate goes Democratic. In that case, given the ideological inanities of the day and the fact that freebies win votes, I expect disaster.
We don’t know for sure all that would happen, although Supreme Court packing could well occur, thereby making the court a political plaything and just maybe a political tool. Getting rid of the Electoral College looks likely, a way of telling large numbers of states that, well, we are sorry, but you just don’t count anymore. The possible end of the Senate filibuster will mean democracy will count for less in the Senate than progressive regression.
A major flaw of Trump’s has been the debt, and Biden intends to hit the rich with huge tax increases still some $2 trillion short of his spending ambitions as they put a dent in free market wealth production. Will the Democrats be better on free trade? It doesn’t look like it.
The spending will include forgiveness of some student loan debt. Understand that the federal loan program was a large part of what caused tuition to go up so much in the first place and that the forgiveness will reward imprudence of the mostly better off at the expense of everyone else.
Medicare-for-all could come into being because of Biden’s public option insurance evolving sufficiently to displace other insurance because it’s cheaper. The program will almost certainly be a convoluted mess costing a fortune that we don’t have.
Trump’s deregulation will be replaced by regulations taking away more of our freedoms and stymieing the economy. The Democrats have long wanted to limit free speech in elections and just may move ahead on that ambition through a constitutional amendment or a packed court. At least prior to campaign millions, they saw corporations as evil and could fix that by making them less workable and owners and managers less in charge.
Owing to ties with teacher unions, they don’t like charter schools that are also public schools if short on unions. They have proven to be a huge advantage for Black students, in research by the brilliant scholar Thomas Sowell.
For their own advantage, Democrats want to make Washington, D.C., and Puerto Rico states, giving them four more Democratic senators. Many Puerto Ricans don’t like the idea and it would be unconstitutional to do that to Washington, although tricks are at hand.
There’s more, but this is enough to scream about.
Letter: U.S. fails in COVID-19 response
I recently attended a virtual business meeting with a colleague in Taiwan. During the chitchat prior to starting the meeting we were discussing COVID-19 and its impacts in our countries. I asked him how things were going in Taiwan, and he responded that things were “mostly normal,” everyone was wearing masks in public but going about their business.
He asked me why the U.S. didn’t believe masks were useful in preventing the virus spread, and I told him that I really didn’t understand why U.S. citizens had such a hard time believing the science on this, and asked him what the Taiwanese thought about the situation in the U.S. He stated most people there felt very sorry for the U.S. and had a hard time believing our actions.
Now to give some context to the differences between us. Taiwan has had about 550 confirmed cases of the virus and seven deaths in a population of almost 24 million people (tiny impact). The U.S. has had over 8.5 million confirmed cases and 225,000 deaths with a population of 330 million people (2 percent illness rate).
The difference here is Taiwanese people have a government that cares about them and the science about COVID-19. Wish I could say the same of our country.
Letter: Keep Herrera Beutler in Congress
On Capitol Hill, The Problem Solvers Caucus is an equal group of Democrats and Republicans that are committed to finding common ground on key issues facing the nation. Their aim is to champion ideas that benefit all Americans. They are united in the idea that there are commonsense solutions to many of our toughest challenges. The caucus members agreed to find solutions on issues including criminal justice reform, health care, and infrastructure. Jaime Herrera Beutler, R-Battle Ground, is a member of this caucus.
Let’s vote for someone who works for all Americans by working with all Americans. Vote for Jaime.
Letter: Support James for county council
I urge all voters to vote for Jesse James for Clark County councilor, District 3. He will bring a responsible voice to a council that includes a member who believes there is no systemic racism in the county, and who disagreed with early advice that masks should be worn.
I attended one of his online town halls and found him friendly, responsive and well-informed. He would protect our natural resources and seek to control urban sprawl that causes traffic congestion, as well as address our lack of affordable housing and our local homeless crisis. He believes in teamwork, not rancor.