Latest / Morning Medical with Dr. Chow / Holiday Interactions, Medical Documentation, and Health Risks of Red Number 3

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Holiday Interactions, Medical Documentation, and Health Risks of Red Number 3 · Morning Medical with Dr. Chow

0:00
Hello everyone, and welcome to another episode of Morning Medical with Dr.
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Chow.
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I'm your host, Dr.
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Chi-Ming Chow.
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As we dive into the holiday season, many of us are gearing up for gatherings with family and
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friends.
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While these occasions can be filled with joy and laughter, they also often come with a fair
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share of social awkwardness.
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Today, we're going to explore some tips on how to handle those uncomfortable moments, with
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insights from philosopher Alexandra Plakias, as featured on CNN.
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The holiday season is notorious for bringing people together, which can sometimes lead to
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awkward situations.
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Whether it's a heated political discussion or simply a room full of estranged relatives,
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social gatherings can leave us feeling uncertain and self-conscious.
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Alexandra Plakias, an associate professor of philosophy at Hamilton College, offers some
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thoughtful strategies to help us navigate these tricky interactions.
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First, it's important to know your goals and roles.
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Before engaging in a potentially awkward conversation, consider what you want to
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achieve.
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Are you hoping to ease the tension in the room, or perhaps just make sure your own views are
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heard?
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Being clear on your objectives can help you play your part more effectively and signal to
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others how they might engage with you.
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Next, remember that awkwardness isn't just about you.
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It's a collective experience, and focusing solely on your own discomfort can be
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counterproductive.
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Instead, pay attention to those around you and the cues they might be giving.
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This awareness can often provide a way out of an awkward moment.
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Planning and coordination can also be key.
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Just as you'd prepare for a trip, having a few conversation starters or topics ready can be
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helpful.
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If there's a sensitive topic to address, consider coordinating with a friend or family
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member to approach it together.
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This can diffuse tension and create a more comfortable atmosphere for everyone involved.
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And if all else fails, a little humor can go a long way.
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Sometimes a small joke or a light-hearted comment can break the tension and offer
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everyone an escape from the awkwardness.
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Even something as simple as a clumsy moment, like dropping a utensil, can shift the mood.
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Finally, consider the role that awkwardness plays in social interactions.
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While it can be uncomfortable, it also serves as a signal that something in the social
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dynamic is amiss.
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Addressing it can prevent more intense emotions, like anger or sadness, from
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surfacing.
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Sometimes, allowing a bit of awkwardness can actually be beneficial in maintaining peace at
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a gathering.
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So as you head into the holidays, keep these tips in mind.
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Social interactions are complex, but with a little preparation and a good sense of humor,
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you can navigate them with grace.
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Stay tuned for more insights and tips on Morning Medical with Dr.
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Chow.
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I'm your host, Dr.
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Chi-Ming Chow, wishing you a happy and socially smooth holiday season!
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In the ever-evolving world of healthcare, the question of how the medical record,
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particularly the 21st-century progress note, should be structured remains a pivotal issue.
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Dr.
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Fred Pelzman, an associate professor of medicine at Weill Cornell and a practicing
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internist for nearly three decades, sheds light on the journey of medical documentation from
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paper charts to electronic health records, and the challenges that lie ahead.
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Dr.
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Pelzman reflects on the days of paper charts, where the art of writing out patient
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complaints, histories, and examinations was a meticulous process.
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This involved long hours at nurses' stations, crafting notes by hand with the perfect pen—one
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that wrote smoothly, didn't smear, and was not enticing enough to be stolen.
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This era, while labor-intensive, fostered a deep connection with the documentation process,
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where every word was carefully chosen and considered.
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With the advent of electronic health records, some of these burdens were alleviated,
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especially for those proficient in typing.
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The digital shift brought with it tools like smart sets, macros, and copy-forward options,
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which expedited the documentation process.
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However, Dr.
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Pelzman notes that this shift has also led to a focus on billing and compliance over clinical
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accuracy, resulting in notes that are bloated with details that often don't reflect the true
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patient encounter.
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The requirements for documentation have evolved, with recent changes reducing the need
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for exhaustive detail to prove medical complexity.
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This shift offers a glimmer of hope that documentation can become more reflective of the
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actual patient interaction.
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Yet, the challenge remains to overcome ingrained habits and create records that
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accurately capture what transpires during consultations.
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Dr.
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Pelzman highlights the potential of new technologies, such as artificial intelligence
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and ambient listening systems, to transform the way we document patient interactions.
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These innovations promise to create a more truthful and efficient record of clinical
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encounters, freeing healthcare professionals to focus on patient care rather than exhaustive
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note-taking.
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Despite the promise of technology, there are concerns about its current capabilities.
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Many systems still struggle to accurately capture the nuances of the doctor-patient
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interaction, producing outputs that don't align with how clinicians think, speak, or write.
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Dr.
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Pelzman envisions a future where perhaps even video recordings of patient encounters could
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serve as comprehensive medical records, though this idea is fraught with potential for
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misinterpretation.
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Ultimately, the goal is to harness technology to build a better system—one that allows
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healthcare providers to efficiently document their work while dedicating more time to
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patient care.
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As we continue to innovate, it's crucial to keep the focus on creating records that truly
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reflect the clinical truth, enhancing the quality of care patients receive.
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The United States Food and Drug Administration is currently reviewing a petition that could
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lead to the ban of a widely used artificial food dye, known as Red Number 3 or Erythrosine.
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This synthetic dye, derived from petroleum, is commonly added to food and ingested drugs to
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impart a bright cherry-red color.
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The FDA's move to potentially ban this dye comes as part of a broader effort to address
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health concerns associated with artificial food colorings.
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The petition under review cites the Delaney Clause, which prohibits the FDA from
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classifying a color additive as safe if it has been found to cause cancer in humans or
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animals.
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Dr.
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Marc Siegel, a clinical professor of medicine at New York University Langone Health and a
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senior medical analyst for Fox News, recently discussed this potential ban, describing the
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situation as 'scary stuff.' He highlighted that Red Number 3 has been banned in products
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applied to the skin since the 1990s, raising questions about why it remains permissible in
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food products.
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Dr.
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Siegel pointed out the apparent delay in addressing the safety of Red Number 3 in the
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United States, especially considering that it has already been banned in the European Union,
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the United Kingdom, and most of Asia and Australia.
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He attributed the current momentum towards banning the dye to changes in leadership and
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increased responsiveness to public petitions, particularly those from consumers and the House
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of Representatives.
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Concerns about Red Number 3 are not new.
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Previous research has linked this dye to cancer in animal studies and associated it with
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behavioral issues in children, such as attention deficit hyperactivity disorder.
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Dr.
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Siegel expressed frustration over the fact that there are nine synthetic dyes approved for use
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in the United States, indicating that the FDA's post-market analysis has been insufficient in
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addressing potential health risks.
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The petition to remove Red Number 3 from foods, supplements, and medications was spearheaded by
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the Center for Science in the Public Interest and supported by 23 other organizations and
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scientists.
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Nearly 3,000 food products have been identified as containing this dye, according to the
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Environmental Working Group's Food Scores database.
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As the FDA deliberates on this issue, it underscores a broader conversation about the
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safety and regulation of artificial additives in our food supply.
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This decision could set a precedent for how similar substances are handled in the future,
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reflecting growing public concern over the health implications of synthetic dyes.
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Winter has arrived, and with it comes a unique opportunity to embrace the culinary abundance
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that the season offers.
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While the colder months might seem like a time when fresh produce is scarce, nutrition experts
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assure us that winter is actually the perfect time to experiment with seasonal ingredients
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and enjoy nutritious meals.
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Kristen Rasmussen, a culinary dietician and chef from the University of California
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Berkeley, encourages us to "embrace the cold, embrace the winter, and appreciate the bounty."
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Winter is an ideal time to explore new flavors and dishes that make the most of the season's
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produce.
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One of the key tips from nutrition experts is to remember that any form of produce is
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beneficial—be it fresh, frozen, canned, or dried.
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While staple fruits and vegetables are available year-round, winter brings peak
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freshness to certain items.
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Citrus fruits like lemons, limes, and oranges are at their best during this time.
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Root vegetables such as sweet potatoes, pumpkin, parsnips, beets, and radishes can be
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transitioned from holiday desserts to savory meals and snacks.
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Don't forget about winter greens, which include members of the chicory family like radicchio,
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escarole, and endive.
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Though they might have a slightly bitter taste, these greens are worth trying.
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You can also incorporate different types of kale and the leafy tops of root vegetables,
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like radish greens, into your meals.
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If fresh produce is hard to come by, canned and frozen options still hold significant
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nutritional value, provided they are not overcooked or laden with added salt or fat.
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Dried fruits such as apricots, dates, and raisins, along with nuts, can add a nutritious
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boost to salads, bakes, and more.
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For cozy, comforting meals, consider making stews, soups, or porridges.
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These dishes are not only versatile and easy to adapt to any flavor preference but also allow
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you to include a wide variety of ingredients.
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They are perfect for freezing and can be a great way to incorporate beans and legumes,
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which are affordable, accessible, and packed with protein and fiber.
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Porridges, whether for breakfast or beyond, offer a chance to experiment with different
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grains.
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They can serve as a base for various cultural flavors, from congee to atole to overnight
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oats.
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Add toppings like lemon, salsa macha, chili oil, or even an egg to enhance the dish's
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versatility.
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Spices and herbs can be the stars of your winter meals, bringing warmth and flavor beyond
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just the holidays.
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Rosemary, thyme, nutmeg, and star anise can add depth to your dishes all season long.
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Turmeric, known for its antioxidant and anti-inflammatory properties, is a particularly
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beneficial spice to include in your cooking.
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Experiment with spices in snacks and drinks as well.
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Adding smoky chilies or "warming" spices like cloves, ginger, and cumin to teas or popcorn
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can provide a flavorful twist while avoiding excess salt and fats found in pre-made snacks.
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Lastly, cooking for others during the winter months can nourish both mind and body.
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Sharing seasonal meals with friends and family not only fosters social connections but also
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allows for cultural exchange and an appreciation of the sources of our food.
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Consider starting a "soup group" as a fun way to socialize and try new recipes with loved
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ones.
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Microplastics are indeed everywhere, from the depths of our oceans to the tissues in our
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bodies.
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These tiny particles, which shed from larger plastic products, are a growing concern for
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both environmental and human health.
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As we continue to understand their pervasive nature, it's crucial to explore ways to
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minimize our exposure to them.
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Dr.
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Leonardo Trasande, the Director of Environmental Pediatrics at New York University
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School of Medicine, has spent two decades examining how environmental exposures,
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including microplastics, impact our health.
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He highlights that microplastics are not only ingested through our diet but also inhaled as
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dust, making them nearly impossible to avoid completely.
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Dr.
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Trasande warns that beyond the physical irritation caused by microplastics, the
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chemicals that leach from them pose significant health risks.
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Additives like phthalates and bisphenols, often found in everyday items such as food packaging
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and personal care products, can disrupt our endocrine system, which regulates critical
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bodily functions like metabolism and reproduction.
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Given these concerns, Dr.
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Trasande offers five practical tips to reduce exposure to microplastics and their harmful
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additives.
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First, he advises avoiding canned foods when possible, as even some so-called 'BPA-free'
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cans might contain other harmful substitutes.
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Opting for glass or stainless steel containers can be a safer choice.
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Secondly, it's important to keep plastic containers away from heat and harsh cleaners.
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These conditions can cause plastics to break down, releasing microplastics and chemicals
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into your food.
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If you notice etching or wear on plastic items, it's a sign that they should be replaced.
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Dr.
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Trasande also recommends avoiding plastics stamped with the numbers 3, 6, and 7.
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These codes indicate the presence of harmful chemicals like phthalates and polystyrene,
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which have been linked to various health issues.
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When it comes to cookware, choosing stainless steel or cast iron over non-stick options is
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advisable.
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Non-stick coatings often contain per- and polyfluoroalkyl substances, which are difficult
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to break down in the environment and can contaminate our food and water supply.
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Lastly, regular cleaning can help minimize exposure to microplastics in your home.
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Using a vacuum with a HEPA filter and a wet mop can reduce the accumulation of
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microplastic-laden dust.
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Air filtration systems can further help by trapping airborne particles.
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While it may seem daunting to reduce plastic exposure entirely, Dr.
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Trasande emphasizes that even small changes can make a difference.
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The key is to build consumer demand for safer materials, encouraging industry innovation away
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from harmful plastics.
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As we move forward, an ounce of common sense will go a long way in protecting our health
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from microplastics.
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In Canada, a recent report has highlighted the financial burden cancer patients face,
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estimating costs to be around thirty-three thousand dollars on average over their
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lifetime.
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This figure includes a mix of out-of-pocket expenses, lost wages, and time costs linked to
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the disease.
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While Canada's publicly funded healthcare system covers hospital costs such as
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chemotherapy and radiation, many patients still find themselves shouldering significant
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expenses for prescription drugs, travel, and the time lost attending appointments.
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The report, published by the Canadian Cancer Society in collaboration with Statistics Canada
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and the Public Health Agency of Canada, underscores the inequities that persist in
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cancer care.
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It suggests that these costs disproportionately affect lower and fixed-income patients, as well
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as those living in rural or remote communities who must travel long distances to receive
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treatment.
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The financial strain can, unfortunately, influence health outcomes, with some patients
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delaying or even opting out of necessary treatments due to the inability to afford
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travel or time away from work.
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The report calls for federal and provincial governments to address these disparities, with
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advocates suggesting measures like national drug coverage for take-home cancer medications
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to help alleviate the burden.
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As the population grows and ages, with better cancer survival rates, the report projects that
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out-of-pocket costs for cancer patients and their caregivers are likely to increase by
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almost twenty percent over the next decade.
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This anticipated rise in costs could widen the gap between those who can afford care and those
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who cannot, further complicating the landscape of cancer treatment in Canada.
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The report highlights that patients with lower family incomes are more likely to forgo care
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due to financial constraints, spending a significant portion of their monthly income on
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cancer-related costs.
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This is a stark reminder of the challenges faced by many in accessing the care they need,
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despite the presence of a publicly funded healthcare system.
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The Canadian Cancer Society suggests that consistent national coverage for take-home
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oncology medications could significantly reduce out-of-pocket costs.
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Currently, coverage varies across provinces, with some offering full coverage while others
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do not.
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Additionally, equitable travel and accommodation funds across the country would
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support patients who need to travel for care.
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At St.
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Michael’s Hospital in Toronto, Dr.
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Lisa Hicks, a malignant hematologist, observes the emotional toll that financial stress places
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on her patients.
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She notes that the complexity of cancer treatments, like those required for blood
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cancers, often means patients face a 'full-time job' managing their care without the benefit of
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income.
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As we conclude today's episode, it's clear that while medical advancements continue to improve
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cancer survival rates, the financial burden remains a significant hurdle for many patients.
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Addressing these challenges requires a coordinated effort from policymakers,
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healthcare providers, and communities to ensure equitable access to care for all.
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Thank you for joining me on this episode of Morning Medical with Dr.
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Chow.
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Stay informed and take care of your health.
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Until next time, I'm Dr.
19:30
Chi-Ming Chow, wishing you good health and peace of mind.