Rat poop, bug bits, mice hair: How many ‘unavoidable defects’ are in peanut butter and other foods you eat? | CNN



CNN
 — 

Brace yourselves, America: Many of your favorite foods may contain bits and pieces of creatures that you probably didn’t know were there.

How about some mice dung in your coffee? Maggots in your pizza sauce? Bug fragments and rat hair in your peanut butter and jelly sandwich?

Oh, and so sorry, chocolate lovers. That dark, delicious bar you devoured might contain 30 or more insect parts and a sprinkling of rodent hair.

Called “food defects,” these dismembered creatures and their excrement are the unfortunate byproduct of growing and harvesting food.

“It is economically impractical to grow, harvest, or process raw products that are totally free of non-hazardous, naturally occurring, unavoidable defects,” the US Food and Drug Administration said.

So while there’s no way to get rid of all the creatures that might hitch a ride along the food processing chain, the FDA has established standards to keep food defects to a minimum.

Let’s go through a typical day of meals to see what else you’re not aware that you’re eating.

The coffee beans you grind for breakfast are allowed by the FDA to have an average of 10 milligrams or more animal poop per pound. As much as 4% to 6% of beans by count are also allowed to be insect-infested or moldy.

As you sprinkle black pepper on your morning eggs, try not to think about the fact you may be eating more than 40 insect fragments with every teaspoon, along with a smidgen of rodent hair.

Did you have fruit for breakfast? Common fruit flies can catch a ride anywhere from field to harvest to grocery store, getting trapped by processors or freezing in refrigerated delivery trucks and ending up in your home.

Let’s say you packed peanut butter and jelly sandwiches for everyone’s lunch. Good choice!

Peanut butter is one of the most controlled foods in the FDA list; an average of one or more rodent hairs and 30 (or so) insect fragments are allowed for every 100 grams, which is 3.5 ounces.

The typical serving size for peanut butter is 2 tablespoons (unless you slather). That means each 2 tablespoon-peanut butter sandwich would only have about eight insect fragments and a teensy bit of rodent filth. (“Filth” is what the FDA calls these insect and rodent food defects.)

Unfortunately, jelly and jam are not as controlled. Apple butter can contain an average of four or more rodent hairs for every 3.5 ounces (100 grams) and about five whole insects. Oh, and that isn’t counting the unknown numbers of teensy mites, aphids and thrips.

Apple butter can also contain up to 12% mold, which is better than cherry jam, which can be 30% moldy, or black currant jam, which can be 75% moldy.

Did you pack some of the kid-size boxes of raisins for your child’s midafternoon snack?

Golden raisins are allowed to contain 35 fruit fly eggs as well as 10 or more whole insects (or their equivalent heads and legs) for every 8 ounces. Kid-size containers of raisins are an ounce each. That’s more than four eggs and a whole insect in each box.

Any Bloody Mary fans? The tomato juice in that 14-ounce Bloody Mary could contain up to four maggots and 20 or more fruit fly eggs.

And if you’re having a fruity cocktail, just be aware that the canned citrus juices that many bars use can legally have five or more fruit fly eggs or other fly eggs per cup (a little less than 250 milliliters). Or that cup of juice could contain one or more maggots. Apricot, peach and pear nectars are allowed to contain up to 12% moldy fruit.

Oh, gosh, the possibilities are endless! Did you know there can be 450 insect parts and nine rodent hairs in every 16-ounce box of spaghetti?

Canned tomatoes, tomato paste and sauces such as pizza sauce are a bit less contaminated than the tomato juice in your cocktail. The FDA only allows about two maggots in a 16-ounce can.

Adding mushrooms to your spaghetti sauce or pizza? For every 4-ounce can of mushrooms there can be an average of 20 or more maggots of any size.

The canned sweet corn we love is allowed to have two or more larvae of the corn ear worm, along with larvae fragments and the skins the worms discard as they grow.

For every ¼ cup of cornmeal, the FDA allows an average of one or more whole insects, two or more rodent hairs and 50 or more insect fragments, or one or more fragments of rodent dung.

Asparagus can contain 40 or more scary-looking but teensy thrips for every ¼ pound. If those aren’t around, FDA inspectors look for beetle eggs, entire insects or heads and body parts.

Frozen or canned spinach is allowed to have an average of 50 aphids, thrips and mites. If those are missing, the FDA allows larvae of spinach worms or eight whole leaf miner bugs.

Dismembered insects can be found in many of our favorite spices as well. Crushed oregano, for example, can contain 300 or more insect bits and about two rodent hairs for every 10 grams. To put that in context, a family-size bottle of oregano is about 18 ounces or 510 grams.

Paprika can have up to 20% mold, about 75 insect parts and 11 rodent hairs for every 25 grams (just under an ounce). A typical spice jar holds about 2 to 3 ounces.

By now you must be asking: Just how do they count those tiny insect heads and pieces of rodent dung?

“Food manufacturers have quality assurance employees who are constantly taking samples of their packaged, finished product to be sure they’re not putting anything out that is against the rules,” said food safety specialist Ben Chapman, a professor in agricultural and human sciences at North Carolina State University.

Sometimes they do it by hand, Chapman said. “They take 10 bags out of a weeklong production and try to shake out what might be in here,” he said. “Do we have particularly high insect parts or was it a particularly buggy time of year when the food was harvested? And they make sure they are below those FDA thresholds.”

What happens if it was a buggy week and lots of insects decided to sacrifice themselves? Can they get all those eggs, legs and larvae out?

“They really can’t,” Chapman said. But they can take the food and send it to a process called “rework.”

“Say I’ve got a whole bunch of buggy fresh cranberries that I can’t put in a bag and sell,” Chapman said. “I might send those to a cranberry canning operation where they can boil them and then skim those insect parts off the top and put them into a can.”

That’s gross. Will I ever eat any of these foods again?

“Look, this is all a very, very, very low-risk situation,” Chapman said. “I look at it as a yuck factor versus a risk factor. Insect parts are gross, but they don’t lead to foodborne illnesses.”

Much more dangerous, Chapman points out, is the potential for stone, metal, plastic or glass parts to come along with harvested food as it enters the processing system. All foods are subjected to X-rays and metal detectors, Chapman said, because when those slip through, people can actually be hurt.

Also much more dangerous are foodborne illnesses such as salmonella, listeria and E. coli, which can severely sicken and even kill.

“Cross-contamination from raw food, undercooking food, hand-washing and spreading germs from raw food, those are the things that contribute to the more than 48 million cases of foodborne illness we have every year in the US,” Chapman said.

Well, put that way, I guess my disgust over that rodent poop in my coffee seems overblown.

Maybe.

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No antibiotics worked, so this woman turned to a natural enemy of bacteria to save her husband’s life | CNN



CNN
 — 

In February 2016, infectious disease epidemiologist Steffanie Strathdee was holding her dying husband’s hand, watching him lose an exhausting fight against a deadly superbug infection.

After months of ups and downs, doctors had just told her that her husband, Tom Patterson, was too racked with bacteria to live.

“I told him, ‘Honey, we’re running out of time. I need to know if you want to live. I don’t even know if you can hear me, but if you can hear me and you want to live, please squeeze my hand.’

“All of a sudden, he squeezed really hard. And I thought, ‘Oh, great!’ And then I’m thinking, ‘Oh, crap! What am I going to do?’”

What she accomplished next could easily be called miraculous. First, Strathdee found an obscure treatment that offered a glimmer of hope — fighting superbugs with phages, viruses created by nature to eat bacteria.

Then she convinced phage scientists around the country to hunt and peck through molecular haystacks of sewage, bogs, ponds, the bilge of boats and other prime breeding grounds for bacteria and their viral opponents. The impossible goal: quickly find the few, exquisitely unique phages capable of fighting a specific strain of antibiotic-resistant bacteria literally eating her husband alive.

Next, the US Food and Drug Administration had to greenlight this unproven cocktail of hope, and scientists had to purify the mixture so that it wouldn’t be deadly.

Yet just three weeks later, Strathdee watched doctors intravenously inject the mixture into her husband’s body — and save his life.

Their story is one of unrelenting perseverance and unbelievable good fortune. It’s a glowing tribute to the immense kindness of strangers. And it’s a story that just might save countless lives from the growing threat of antibiotic-resistant superbugs — maybe even your own.

“It’s estimated that by 2050, 10 million people per year — that’s one person every three seconds — is going to be dying from a superbug infection,” Strathdee told an audience at Life Itself, a 2022 health and wellness event presented in partnership with CNN.

“I’m here to tell you that the enemy of my enemy can be my friend. Viruses can be medicine.”

sanjay pkg vpx

How this ‘perfect predator’ saved his life after nine months in the hospital

During a Thanksgiving cruise on the Nile in 2015, Patterson was suddenly felled by severe stomach cramps. When a clinic in Egypt failed to help his worsening symptoms, Patterson was flown to Germany, where doctors discovered a grapefruit-size abdominal abscess filled with Acinetobacter baumannii, a virulent bacterium resistant to nearly all antibiotics.

Found in the sands of the Middle East, the bacteria were blown into the wounds of American troops hit by roadside bombs during the Iraq War, earning the pathogen the nickname “Iraqibacter.”

“Veterans would get shrapnel in their legs and bodies from IED explosions and were medevaced home to convalesce,” Strathdee told CNN, referring to improvised explosive devices. “Unfortunately, they brought their superbug with them. Sadly, many of them survived the bomb blasts but died from this deadly bacterium.”

Today, Acinetobacter baumannii tops the World Health Organization’s list of dangerous pathogens for which new antibiotics are critically needed.

“It’s something of a bacterial kleptomaniac. It’s really good at stealing antimicrobial resistance genes from other bacteria,” Strathdee said. “I started to realize that my husband was a lot sicker than I thought and that modern medicine had run out of antibiotics to treat him.”

With the bacteria growing unchecked inside him, Patterson was soon medevaced to the couple’s hometown of San Diego, where he was a professor of psychiatry and Strathdee was the associate dean of global health sciences at the University of California, San Diego.

“Tom was on a roller coaster — he’d get better for a few days, and then there would be a deterioration, and he would be very ill,” said Dr. Robert “Chip” Schooley, a leading infectious disease specialist at UC San Diego who was a longtime friend and colleague. As weeks turned into months, “Tom began developing multi-organ failure. He was sick enough that we could lose him any day.”

Patterson's body was systemically infected with a virulent drug-resistant bacteria that also infected troops in the Iraq War, earning the pathogen the nickname

After that reassuring hand squeeze from her husband, Strathdee sprang into action. Scouring the internet, she had already stumbled across a study by a Tbilisi, Georgia, researcher on the use of phages for treatment of drug-resistant bacteria.

A phone call later, Strathdee discovered phage treatment was well established in former Soviet bloc countries but had been discounted long ago as “fringe science” in the West.

“Phages are everywhere. There’s 10 million trillion trillion — that’s 10 to the power of 31 — phages that are thought to be on the planet,” Strathdee said. “They’re in soil, they’re in water, in our oceans and in our bodies, where they are the gatekeepers that keep our bacterial numbers in check. But you have to find the right phage to kill the bacterium that is causing the trouble.”

Buoyed by her newfound knowledge, Strathdee began reaching out to scientists who worked with phages: “I wrote cold emails to total strangers, begging them for help,” she said at Life Itself.

One stranger who quickly answered was Texas A&M University biochemist Ryland Young. He’d been working with phages for over 45 years.

“You know the word persuasive? There’s nobody as persuasive as Steffanie,” said Young, a professor of biochemistry and biophysics who runs the lab at the university’s Center for Phage Technology. “We just dropped everything. No exaggeration, people were literally working 24/7, screening 100 different environmental samples to find just a couple of new phages.”

While the Texas lab burned the midnight oil, Schooley tried to obtain FDA approval for the injection of the phage cocktail into Patterson. Because phage therapy has not undergone clinical trials in the United States, each case of “compassionate use” required a good deal of documentation. It’s a process that can consume precious time.

But the woman who answered the phone at the FDA said, “‘No problem. This is what you need, and we can arrange that,’” Schooley recalled. “And then she tells me she has friends in the Navy that might be able to find some phages for us as well.”

In fact, the US Naval Medical Research Center had banks of phages gathered from seaports around the world. Scientists there began to hunt for a match, “and it wasn’t long before they found a few phages that appeared to be active against the bacterium,” Strathdee said.

Dr. Robert

Back in Texas, Young and his team had also gotten lucky. They found four promising phages that ravaged Patterson’s antibiotic-resistant bacteria in a test tube. Now the hard part began — figuring out how to separate the victorious phages from the soup of bacterial toxins left behind.

“You put one virus particle into a culture, you go home for lunch, and if you’re lucky, you come back to a big shaking, liquid mess of dead bacteria parts among billions and billions of the virus,” Young said. “You want to inject those virus particles into the human bloodstream, but you’re starting with bacterial goo that’s just horrible. You would not want that injected into your body.”

Purifying phage to be given intravenously was a process that no one had yet perfected in the US, Schooley said, “but both the Navy and Texas A&M got busy, and using different approaches figured out how to clean the phages to the point they could be given safely.”

More hurdles: Legal staff at Texas A&M expressed concern about future lawsuits. “I remember the lawyer saying to me, ‘Let me see if I get this straight. You want to send unapproved viruses from this lab to be injected into a person who will probably die.’ And I said, “Yeah, that’s about it,’” Young said.

“But Stephanie literally had speed dial numbers for the chancellor and all the people involved in human experimentation at UC San Diego. After she calls them, they basically called their counterparts at A&M, and suddenly they all began to work together,” Young added.

“It was like the parting of the Red Sea — all the paperwork and hesitation disappeared.”

The purified cocktail from Young’s lab was the first to arrive in San Diego. Strathdee watched as doctors injected the Texas phages into the pus-filled abscesses in Patterson’s abdomen before settling down for the agonizing wait.

“We started with the abscesses because we didn’t know what would happen, and we didn’t want to kill him,” Schooley said. “We didn’t see any negative side effects; in fact, Tom seemed to be stabilizing a bit, so we continued the therapy every two hours.”

Two days later, the Navy cocktail arrived. Those phages were injected into Patterson’s bloodstream to tackle the bacteria that had spread to the rest of his body.

“We believe Tom was the first person to receive intravenous phage therapy to treat a systemic superbug infection in the US,” Strathdee told CNN.

“And three days later, Tom lifted his head off the pillow out of a deep coma and kissed his daughter’s hand. It was just miraculous.”

Patterson awoke from a coma after receiving an intravenous dose of phages tailored to his bacteria.

Today, nearly eight years later, Patterson is happily retired, walking 3 miles a day and gardening. But the long illness took its toll: He was diagnosed with diabetes and is now insulin dependent, with mild heart damage and gastrointestinal issues that affect his diet.

“He isn’t back surfing again, because he can’t feel the bottoms of his feet, and he did get Covid-19 in April that landed him in the hospital because the bottoms of his lungs are essentially dead,” Strathdee said.

“As soon as the infection hit his lungs he couldn’t breathe and I had to rush him to the hospital, so that was scary,” she said. “He remains high risk for Covid but we’re not letting that hold us hostage at home. He says, ‘I want to go back to having as normal life as fast as possible.’”

To prove it, the couple are again traveling the world — they recently returned from a 12-day trip to Argentina.

“We traveled with a friend who is an infectious disease doctor, which gave me peace of mind to know that if anything went sideways, we’d have an expert at hand,” Strathdee said.

“I guess I’m a bit of a helicopter wife in that sense. Still, we’ve traveled to Costa Rica a couple of times, we’ve been to Africa, and we’re planning to go to Chile in January.”

Patterson’s case was published in the journal Antimicrobial Agents and Chemotherapy in 2017, jump-starting new scientific interest in phage therapy.

“There’s been an explosion of clinical trials that are going on now in phage (science) around the world and there’s phage programs in Canada, the UK, Australia, Belgium, Sweden, Switzerland, India and China has a new one, so it’s really catching on,” Strathdee told CNN.

Some of the work is focused on the interplay between phages and antibiotics — as bacteria battle phages they often shed their outer shell to keep the enemy from docking and gaining access for the kill. When that happens, the bacteria may be suddenly vulnerable to antibiotics again.

“We don’t think phages are ever going to entirely replace antibiotics, but they will be a good adjunct to antibiotics. And in fact, they can even make antibiotics work better,” Strathdee said.

In San Diego, Strathdee and Schooley opened the Center for Innovative Phage Applications and Therapeutics, or IPATH, in 2018, where they treat or counsel patients suffering from multidrug-resistant infections. The center’s success rate is high, with 82% of patients undergoing phage therapy experiencing a clinically successful outcome, according to its website.

Schooley is running a clinical trial using phages to treat patients with cystic fibrosis who constantly battle Pseudomonas aeruginosa, a drug-resistant bacteria that was also responsible for the recent illness and deaths connected to contaminated eye drops manufactured in India.

And a memoir the couple published in 2019 — “The Perfect Predator: A Scientist’s Race to Save Her Husband From a Deadly Superbug” — is also spreading the word about these “perfect predators” to what may soon be the next generation of phage hunters.

VS Phages Sanjay Steffanie

How naturally occurring viruses could help treat superbug infections

“I am getting increasingly contacted by students, some as young as 12,” Strathdee said. “There’s a girl in San Francisco who begged her mother to read this book and now she’s doing a science project on phage-antibiotic synergy, and she’s in eighth grade. That thrills me.”

Strathdee is quick to acknowledge the many people who helped save her husband’s life. But those who were along for the ride told CNN that she and Patterson made the difference.

“I think it was a historical accident that could have only happened to Steffanie and Tom,” Young said. “They were at UC San Diego, which is one of the premier universities in the country. They worked with a brilliant infectious disease doctor who said, ‘Yes,’ to phage therapy when most physicians would’ve said, ‘Hell, no, I won’t do that.’

“And then there is Steffanie’s passion and energy — it’s hard to explain until she’s focused it on you. It was like a spiderweb; she was in the middle and pulled on strings,” Young added. “It was just meant to be because of her, I think.”

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Don’t serve disordered eating to your teens this holiday season | CNN

Editor’s Note: Katie Hurley, author of “No More Mean Girls: The Secret to Raising Strong, Confident and Compassionate Girls,” is a child and adolescent psychotherapist in Los Angeles. She specializes in work with tweens, teens and young adults.



CNN
 — 

“I have a couple of spots for anyone who wants to lose 20 pounds by the holidays! No diets, exercise, or cravings!”

Ads for dieting and exercise programs like this started appearing in my social media feeds in early October 2022, often accompanied by photos of women pushing shopping carts full of Halloween candy intended to represent the weight they no longer carry with them.

Whether it’s intermittent fasting or “cheat” days, diet culture is spreading wildly, and spiking in particular among young women and girls, a population group who might be at particular risk of social pressures and misinformation.

The fact that diet culture all over social media targets grown women is bad enough, but such messaging also trickles down to tweens and teens. (And let’s be honest, a lot is aimed directly at young people too.) It couldn’t happen at a worse time: There’s been a noticeable spike in eating disorders, particularly among adolescent girls, since the beginning of the pandemic.

“My mom is obsessed with (seeing) her Facebook friends losing tons of weight without dieting. Is this even real?” The question came from a teen girl who later revealed she was considering hiring a health coach to help her eat ‘healthier’ after watching her mom overhaul her diet. Sadly, the coaching she was falling victim to is part of a multilevel marketing brand that promotes quick weight loss through caloric restriction and buying costly meal replacements.

Is it real? Yes. Is it healthy? Not likely, especially for a growing teen.

Later that week, a different teen client asked about a clean eating movement she follows on Pinterest. She had read that a strict clean vegan diet is better for both her and the environment, and assumed this was true because the pinned article took her to a health coaching blog. It seemed legitimate. But a deep dive into the blogger’s credentials, however, showed that the clean eating practices they shared were not actually developed by a nutritionist.

And another teen, fresh off a week of engaging in the “what I eat in a day” challenge — a video trend across TikTok, Instagram and other social media platforms where users document the food they consume in a particular timeframe — told me she decided to temporarily mute her social media accounts. Why? Because the time she’d spent limited her eating while pretending to feel full left her exhausted and unhappy. She had found the trend on TikTok and thought it might help her create healthier eating habits, but ended up becoming fixated on caloric intake instead. Still, she didn’t want her friends to see that the challenge actually made her feel terrible when she had spent a whole week promoting it.

During any given week, I field numerous questions from tweens and teens about the diet culture they encounter online, out in the world, and sometimes even in their own homes. But as we enter the winter holiday season, shame-based diet culture pressure, often wrapped up with toxic positivity to appear encouraging, increases.

“As we approach the holidays, diet culture is in the air as much as lights and music, and it’s certainly on social media,” said Dr. Hina Talib, an adolescent medicine specialist and associate professor of pediatrics at the Albert Einstein College of Medicine in The Bronx, New York. “It’s so pervasive that even if it’s not targeted (at) teens, they are absorbing it by scrolling through it or hearing parents talk about it.”

Social media isn’t the only place young people encounter harmful messaging about body image and weight loss. Teens are inundated with so-called ‘healthy eating’ content on TV and in popular culture, at school and while engaged in extracurricular or social activities, at home and in public spaces like malls or grocery stores — and even in restaurants.

Instead of learning how to eat to fuel their bodies and their brains, today’s teens are getting the message that “clean eating,” to give just one example of a potentially problematic dietary trend, results in a better body — and, by extension, increased happiness. Diets cutting out all carbohydrates, dairy products, gluten, and meat-based proteins are popular among teens. Yet this mindset can trigger food anxiety, obsessive checking of food labels and dangerous calorie restriction.

An obsessive focus on weight loss, toning muscles and improving overall looks actually runs contrary to what teens need to grow at a healthy pace.

“Teens and tweens are growing into their adult bodies, and that growth requires weight gain,” said Oona Hanson, a parent coach based in Los Angeles. “Weight gain is not only normal but essential for health during adolescence.”

The good news in all of this is that parents can take an active role in helping teens craft an emotionally healthier narrative around their eating habits. “Parents are often made to feel helpless in the face of TikTokers, peer pressure or wider diet culture, but it’s important to remember this: parents are influencers, too,” said Hanson. What we say and do matters to our teens.

Parents can take an active role in helping teens craft an emotionally healthier narrative around their eating habits.

Take a few moments to reflect on your own eating patterns. Teens tend to emulate what they see, even if they don’t talk about it.

Parents and caregivers can model a healthy relationship with food by enjoying a wide variety of foods and trying new recipes for family meals. During the holiday season, when many celebrations can involve gathering around the table, take the opportunity to model shared connections. “Holidays are a great time to remember that foods nourish us in ways that could never be captured on a nutrition label,” Hanson said.

Practice confronting unhealthy body talk

The holiday season is full of opportunities to gather with friends and loved ones to celebrate and make memories, but these moments can be anxiety-producing when nutrition shaming occurs.

When extended families gather for holiday celebrations, it’s common for people to comment on how others look or have changed since the last gathering. While this is usually done with good intentions, it can be awkward or upsetting to tweens and teens.

“For young people going through puberty or body changes, it’s normal to be self-conscious or self-critical. To have someone say, ‘you’ve developed’ isn’t a welcome part of conversations,” cautioned Talib.

Talib suggests practicing comebacks and topic changes ahead of time. Role play responses like, “We don’t talk about bodies,” or “We prefer to focus on all the things we’ve accomplished this year.” And be sure to check in and make space for your tween or teen to share and feelings of hurt and resentment over any such comments at an appropriate time.

Open and honest communication is always the gold standard in helping tweens and teens work through the messaging and behaviors they internalize. When families talk about what they see and hear online, on podcasts, on TV, and in print, they normalize the process of engaging in critical thinking — and it can be a really great shared connection between parents and teens.

“Teaching media literacy skills is a helpful way to frame the conversation,” says Talib. “Talk openly about it.”

She suggests asking the following questions when discussing people’s messaging around diet culture:

● Who are they?

● What do you think their angle is?

● What do you think their message is?

● Are they a medical professional or are they trying to sell you something?

● Are they promoting a fitness program or a supplement that they are marketing?

Talking to tweens and teens about this throughout the season — and at any time — brings a taboo topic to the forefront and makes it easier for your kids to share their inner thoughts with you.

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Scientists finally know why people get more colds and flu in winter | CNN

Editor’s Note: Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.



CNN
 — 

There’s a chill is in the air, and you all know what that means — it’s time for cold and flu season, when it seems everyone you know is suddenly sneezing, sniffling or worse. It’s almost as if those pesky cold and flu germs whirl in with the first blast of winter weather.

Yet germs are present year-round — just think back to your last summer cold. So why do people get more colds, flu and now Covid-19 when it’s chilly outside?

In what they called a “breakthrough,” scientists uncovered the biological reason we get more respiratory illnesses in winter — the cold air itself damages the immune response occurring in the nose.

“This is the first time that we have a biologic, molecular explanation regarding one factor of our innate immune response that appears to be limited by colder temperatures,” said rhinologist Dr. Zara Patel, a professor of otolaryngology and head and neck surgery at Stanford University School of Medicine in California. She was not involved in the new study.

In fact, reducing the temperature inside the nose by as little as 9 degrees Fahrenheit (5 degrees Celsius) kills nearly 50% of the billions of helpful bacteria-fighting cells and viruses in the nostrils, according to the 2022 study published in The Journal of Allergy and Clinical Immunology.

“Cold air is associated with increased viral infection because you’ve essentially lost half of your immunity just by that small drop in temperature,” said study author Dr. Benjamin Bleier, director of otolaryngology translational research at Massachusetts Eye and Ear and an associate professor at Harvard Medical School in Boston.

“it’s important to remember that these are in vitro studies, meaning that although it is using human tissue in the lab to study this immune response, it is not a study being carried out inside someone’s actual nose,” Patel said in an email. “Often the findings of in vitro studies are confirmed in vivo, but not always.”

To understand why this occurs, Bleier and his team and coauthor Mansoor Amiji, who chairs the department of pharmaceutical sciences at Northeastern University in Boston, went on a scientific detective hunt.

A respiratory virus or bacteria invades the nose, the main point of entry into the body. Immediately, the front of the nose detects the germ, well before the back of the nose is aware of the intruder, the team discovered.

At that point, cells lining the nose immediately begin creating billions of simple copies of themselves called extracellular vesicles, or EV’s.

“EV’s can’t divide like cells can, but they are like little mini versions of cells specifically designed to go and kill these viruses,” Bleier said. “EV’s act as decoys, so now when you inhale a virus, the virus sticks to these decoys instead of sticking to the cells.”

Those “Mini Me’s” are then expelled by the cells into nasal mucus (yes, snot), where they stop invading germs before they can get to their destinations and multiply.

“This is one of, if not the only part of the immune system that leaves your body to go fight the bacteria and viruses before they actually get into your body,” Bleier said.

Once created and dispersed out into nasal secretions, the billions of EV’s then start to swarm the marauding germs, Bleier said.

“It’s like if you kick a hornet’s nest, what happens? You might see a few hornets flying around, but when you kick it, all of them all fly out of the nest to attack before that animal can get into the nest itself,” he said. “That’s the way the body mops up these inhaled viruses so they can never get into the cell in the first place.”

READ MORE: Is it a cold, flu or Covid-19? A doctor helps sort it out

When under attack, the nose increases production of extracellular vesicles by 160%, the study found. There were additional differences: EV’s had many more receptors on their surface than original cells, thus boosting the virus-stopping ability of the billions of extracellular vesicles in the nose.

“Just imagine receptors as little arms that are sticking out, trying to grab on to the viral particles as you breathe them in,” Bleier said. “And we found each vesicle has up to 20 times more receptors on the surface, making them super sticky.”

Cells in the body also contain a viral killer called micro RNA, which attack invading germs. Yet EVs in the nose contained 13 times micro RNA sequences than normal cells, the study found.

So the nose comes to battle armed with some extra superpowers. But what happens to those advantages when cold weather hits?

To find out, Bleier and his team exposed four study participants to 15 minutes of 40-degree-Fahrenheit (4.4-degree-Celsius) temperatures, and then measured conditions inside their nasal cavities.

“What we found is that when you’re exposed to cold air, the temperature in your nose can drop by as much as 9 degrees Fahrenheit. And that’s enough to essentially knock out all three of those immune advantages that the nose has,” Bleier said.

In fact, that little bit of coldness in the tip of the nose was enough to take nearly 42% of the extracellular vesicles out of the fight, Bleier said.

“Similarly, you have almost half the amount of those killer micro RNA’s inside each vesicle, and you can have up to a 70% drop in the number of receptors on each vesicle, making them much less sticky,” he said.

What does that do to your ability to fight off colds, flu and Covid-19? It cuts your immune system’s ability to fight off respiratory infections by half, Bleier said.

READ MORE: Why people who qualify should get the RSV vaccine

As it turns out, the pandemic gave us exactly what we need to help fight off chilly air and keep our immunity high, Bleier said.

“Not only do masks protect you from the direct inhalation of viruses, but it’s also like wearing a sweater on your nose,” he said.

Patel agreed: “The warmer you can keep the intranasal environment, the better this innate immune defense mechanism will be able to work. Maybe yet another reason to wear masks!”

In the future, Bleier expects to see the development of topical nasal medications that build upon this scientific revelation. These new pharmaceuticals will “essentially fool the nose into thinking it has just seen a virus,” he said.

“By having that exposure, you’ll have all these extra hornets flying around in your mucous protecting you,” he added.

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Urinary tract infections in men: Here are 10 things to know | CNN

Editor’s Note: Dr. Jamin Brahmbhatt is a urologist and robotic surgeon with Orlando Health and president of the Florida Urological Society.



CNN
 — 

While urinary tract infections are more common in women, men can still get what’s commonly known as a UTI. Here are 10 things I’d like you to know about urinary tract infections, including who’s more at risk and how to get treatment.

UTI is short for urinary tract infection. It’s an infection of the organs in your body – I call them pipes – that are meant to funnel your urine out of your system and into the urinal. Most UTIs are caused by bacteria that work their way into the urethra, prostate, bladder or kidneys.

Way more women than men are diagnosed with UTIs. Anatomically, we feel this happens because women have a shorter urethra – the tube that connects the bladder to the outside world. The shorter length makes it easier for bacteria to travel to the urinary system. Men have longer urethras and therefore can be protected against urinary infections.

But the length of the urethra alone cannot protect men against UTIs – over their lifetimes, 12% of men will get urinary symptoms linked to a UTI. This by no means implies a urethra or penis are short or small. In men, there is usually a more clear pathologic cause to the infection beyond just the length of the urethra.

There are many reasons why a guy may get a UTI – all of them we take seriously and should not be ignored.

Men older than 50 tend to get more infections than younger men. As a urologist, I see men get recurrent infections when they do not properly empty their bladder because of an enlarged prostate. Beyond the prostate, men may not empty their bladder if they have nerve damage from stroke, uncontrolled diabetes or injury to the spine.

Men can also get infections that start from the prostate or testicles that seed up into the bladder, or the opposite can happen where the infection goes from the bladder to the other organs. Kidney stones can also be a cause of infection. (I know this from personal experience – I’ve had a kidney stone myself!)

Younger men may also present with urinary infections because of sexually transmitted diseases. Men can also get an infection if they have a recent procedure done in the urinary system.

4. What are the signs and symptoms of a UTI?

Burning with urination (dysuria), increased urinary frequency, urgency, incontinence, foul smell, blood in the urine, fevers, chills, pain in the abdomen near the bladder. Believe it or not, some men may have zero symptoms and still get diagnosed with a UTI based on urine cultures done for other purposes.

UTI is diagnosed by sending your urine off for a culture. This is when a sample of your urine is processed and evaluated for various strains of bacteria. The most common bacteria identified in urinary tract infections is E.coli. Once the culture is done, the results can guide treatment, which is usually oral antibiotics. There is a test called a urine analysis which can be done quickly in our office which can suggest an infection. However, the best test is an actual culture.

Doctors do not wait for the culture results – which can take one to three days – to start treatment. If an infection is suspected, an antibiotic will be started immediately and then adjusted based on the culture results.

UTIs generally are treated with oral or IV antibiotics. Most infections can be treated with oral antibiotics. However there are superbugs that may be resistant to what we can give you by mouth that may require the use of stronger antibiotics through an IV. Most treatments last seven to 10 days, but can be longer.

In severe cases of infection that has spread to the bloodstream, strong IV antibiotics are started immediately to control the infection. Patients are placed in the hospital to start these strong treatments. You do not have to stay in the hospital for weeks if you have infection in your bloodstream. As long as you are doing well – no fever, normal labs, heart and pulse OK – then you may continue these IV treatments from home. Each treatment is tailored to your condition.

As a doctor, my answer is: No. Men should not try to treat infections on their own. If you have symptoms, get yourself to a doctor or emergency room.

The best prevention is making sure first there is nothing anatomical that needs to be corrected, such as an enlarged prostate, kidney stone or blockage.

Proper hygiene can help prevent infections. Men with uncircumcised penises should make sure they can retract the foreskin and clean under the foreskin and the glans properly. Cranberry supplements have been shown to help prevent infections. Staying hydrated by drinking enough fluids/water during the day can also help. Making sure you don’t hold your urine can help, too. Staying in good health to avoid chronic medical conditions such as diabetes and heart disease will also protect against infections.

9. My infection is gone. Are there any long-term effects on my body?

Recurrent, untreated infections could cause strictures, or tight scars, in your urethra that would slow your stream and make it difficult to empty your bladder. Infections could also cause the bladder to lose its ability to fill and empty properly. In the long run, if you are getting constantly treated with antibiotics, we may run out of antibiotics to give you due to resistance.

The first priority is to clear the infection with antibiotics.

From there, we do a full workup with a detailed history, evaluation of chronic medical problems and exam of the genitals to look for anatomic issues such as a foreskin that won’t retract back. Imaging may include a CT scan of the abdomen and pelvis to look for kidney stones, blocked tubes and other abnormalities.

If you see a urologist, you will likely get a cystoscopy, where we place a camera inside of a small tube into the urethra to look at the inside of your urine channel. The cystoscopy helps look for strictures, large obstructing prostates and changes to the bladder walls. Once a cause is found, it’s aggressively treated with either medication or surgery.

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Nearly two years after Texas’ six-week abortion ban, more infants are dying | CNN



CNN
 — 

Texas’ abortion restrictions – some of the strictest in the country – may be fueling a sudden spike in infant mortality as women are forced to carry nonviable pregnancies to term.

Some 2,200 infants died in Texas in 2022 – an increase of 227 deaths, or 11.5%, over the previous year, according to preliminary infant mortality data CNN obtained through a public records request. Infant deaths caused by severe genetic and birth defects rose by 21.6%. That spike reversed a nearly decade-long decline. Between 2014 and 2021, infant deaths had fallen by nearly 15%.

In 2021, Texas banned abortions beyond six weeks of pregnancy. When the Supreme Court overturned federal abortion rights the following summer, a trigger law in the state banned all abortions other than those intended to protect the life of the mother.

The increase in deaths could partly be explained by the fact that more babies are being born in Texas. One recent report found that in the final nine months of 2022, the state saw nearly 10,000 more births than expected prior to its abortion ban – an estimated 3% increase.

But multiple obstetrician-gynecologists who focus on high-risk pregnancies told CNN that Texas’ strict abortion laws likely contributed to the uptick in infant deaths.

“We all knew the infant mortality rate would go up, because many of these terminations were for pregnancies that don’t turn into healthy normal kids,” said Dr. Erika Werner, the chair of obstetrics and gynecology at Tufts Medical Center. “It’s exactly what we all were concerned about.”

The issue of forcing women to carry out terminal and often high-risk pregnancies is at the core of a lawsuit filed by the Center for Reproductive Rights, with several women – who suffered difficult pregnancies or infant deaths shortly after giving birth – testifying in Travis County court this week.

Prior to the recent abortion restrictions, Texas banned the procedure after 20 weeks. This law gave parents more time to learn crucial information about a fetus’s brain formation and organ development, which doctors begin to test for at around 15 weeks.

Samantha Casiano, a plaintiff in the suit filed against Texas, wished she’d had more time to make the decision.

“If I was able to get the abortion with that time, I think it would have meant a lot to me because my daughter wouldn’t have suffered,” Casiano said.

When Casiano was 20 weeks pregnant, a routine scan came back with devastating news: Her baby would be stillborn or die shortly after birth.

The fetus had anencephaly, a rare birth defect that keeps the brain and skull from developing during pregnancy. Babies with this condition are often stillborn, though they sometimes live a few hours or days. Many women around the country who face the prospect choose abortion, two obstetrician-gynecologists told CNN.

But Casiano lived in Texas, where state legislators had recently banned most abortions after six weeks of pregnancy. She couldn’t afford to travel out of the state for the procedure.

“You have no options. You will have to go through with your pregnancy,” Casiano’s doctor told her, she claimed in the lawsuit.

In March, Casiano gave birth to her daughter Halo. After gasping for air for four hours, the baby died, Casiano said during her testimony on Wednesday.

“All she could do was fight to try to get air. I had to watch my daughter go from being pink to red to purple. From being warm to cold,” said Casiano. “I just kept telling myself and my baby that I’m so sorry that this had to happen to you.”

Casiano and 14 others – including two doctors – are plaintiffs in the lawsuit. They allege the abortion ban has denied them or their patients access to necessary obstetrical care. The plaintiffs are asking the courts to clarify when doctors can make medical exceptions to the state’s ban.

Casiano and two other plaintiffs testified Wednesday about hoping to deliver healthy babies but instead learning their lives or pregnancies were in danger.

 Plaintiffs Anna Zargarian, Lauren Miller, Lauren Hall, and Amanda Zurawski at the Texas State Capitol after filing a lawsuit on behalf of Texans harmed by the state's abortion ban on March 7 in Austin, Texas.

“This was just supposed to be a scan day,” Casiano told the court. “It escalated to me finding out my daughter was going to die.”

Lawyers representing the state argued Wednesday that the plaintiffs’ doctors were to blame, saying they misinterpreted the law and failed to provide adequate care for such high-risk pregnancies.

“Plaintiffs will not and cannot provide any evidence of any medical provider in the state of Texas being prosecuted or otherwise penalized for performance of an abortion using the emergency medical exemption,” a lawyer said during the state’s opening statement.

Kylie Beaton, another plaintiff, also had to watch her baby die. Beaton, who didn’t testify this week, learned during a 20-week scan that something was wrong with her baby’s brain, according to the suit.

The doctor diagnosed the fetus with alobar holoprosencephaly, a condition where the two hemispheres of the brain don’t properly divide. Babies with this condition are often stillborn or die soon after birth.

Beaton’s doctor told her he couldn’t provide an abortion unless she was severely ill, or the fetus’s heart stopped. Beaton and her husband sought to obtain an abortion out of state. However, the fetus’s head was enlarged due to its condition, and the only clinic that would perform an abortion charged up to $15,000. Beaton and her husband couldn’t afford it.

Instead, Beaton gave birth to a son she named Grant. The baby cried constantly, wouldn’t eat, and couldn’t be held upright for fear it would put too much pressure on his head, according to the suit. Four days later, Grant died.

Amanda Zurawski of Austin, Texas, center, is the lead plaintiff in the lawsuit.

Experts say that abortion bans in states like Texas lead to increased risk for both babies and mothers.

Maternal mortality has long been a top concern for doctors and health-rights activists. Even before the Supreme Court decision, the United States had the highest maternal mortality rate among wealthy nations, one study found.

Amanda Zurawski, the lawsuit’s lead plaintiff, testified Wednesday that her water broke 18 weeks into her pregnancy, putting her at high risk for a life-threatening infection. Zurawski’s baby likely wouldn’t survive.

But the fetus still had a heartbeat, and so doctors said they were unable to terminate the pregnancy. She received an emergency abortion only after her condition worsened and she went into septic shock.

Zurawski described during Wednesday’s hearing how her family visited the hospital, fearing it would be the last time they would see her. Zurawski has argued that had she been able to obtain an abortion, her life wouldn’t have been in jeopardy in the same way.

“I blame the people who support these bans,” Zurawski said.

Zurawski previously said the language in Texas’ abortion laws is “incredibly vague, and it leaves doctors grappling with what they can and cannot do, what health care they can and cannot provide.”

Pregnancy is dangerous, and forcing a woman to carry a non-viable pregnancy to term is unnecessarily risky when it’s clear the baby will not survive, argued Dr. Mae-Lan Winchester, an Ohio maternal-fetal medicine specialist.

“Pregnancy is one of the most dangerous things a person will ever go through,” Winchester said. “Putting yourself through that risk without any benefit of taking a baby home at the end, it’s … risking maternal morbidity and mortality for nothing.”

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What you should know if there’s no sexual attraction for your partner, according to a therapist | CNN

Editor’s Note: Ian Kerner is a licensed marriage and family therapist, writer and contributor on the topic of relationships for CNN. His most recent book is a guide for couples, “So Tell Me About the Last Time You Had Sex.”



CNN
 — 

A lot of heterosexual male clients are coming into my practice admitting they picked their partner without considering sexual attraction.

During couples therapy sessions with his partner in the room, the man will claim that he doesn’t know why he isn’t experiencing desire. Maybe it’s stress, low testosterone or feeling anxious.

But when I meet with him individually, he often tells a different story. He tells me he picked his partner without prioritizing sexual attraction.

Why would a person pick a potential life partner without feeling the spark of sexual attraction? And can these relationships survive and thrive? Can something like sexual attraction that wasn’t there in the first place be cultivated later?

I’ve talked with many men in their 30s who have told me, “When I found the woman I wanted to marry, she checked all the boxes. Except one.”

Characteristics on that list include “being my best friend,” “will make an amazing mother,” “our friends and families get along so well,” and “she really loves me.” The one box that didn’t get ticked? Sexual attraction — and often the men didn’t even list that quality to start.

I was stunned.

Sexuality is the one thing that really distinguishes a romantic relationship from a platonic one: I find that it’s one kind of “relationship glue” that helps couples stay together through hard times. That’s why I’m puzzled that so many people devalue sex in picking a partner for a long-term relationship.

Research shows that, while physical attractiveness is usually among the most important traits people desire in a romantic partner, it doesn’t actually top the list for men or women,” said Dr. Justin Lehmiller, a research fellow at the Kinsey Institute at Indiana University, a research center dedicated to sexuality. “Traits like intelligence, humor, honesty and kindness are often at least as important, if not more.”

Some men have internalized an “either/or” view of women: those who make great wives and mothers and those who are sexually adventurous, according to Chicago-based sex therapist Dr. Elizabeth Perri.

“I’ve observed this in male patients who are out in the dating world and feel the pressure to pick someone whom they perceive as ‘wife material’ but without sexual attraction, rather than waiting to find a partner who is a better fit both emotionally and sexually,” Perri told me.

This is what you need to fall in love (2014)

Good sex can help protect against psychological distress, including anxiety and depression, helps couples achieve a deeper connection, and improves relationship satisfaction.

“If a relationship is a meal, the sexual portion ought to be considered an integral part of it, such as the protein, instead of a frivolous part like dessert,” says Eva Dillon, a sex therapist based in New York City.

“In my experience, it’s possible for women to cultivate desire for a partner with considerable effort, but if a man does not have desire for his partner at the beginning of a relationship, he will never desire her,” Dillon told me. Why count on sexual attraction coming later when you can prioritize it in a partner and enjoy the benefits from the beginning?”

Still, lower levels of sexual attraction isn’t always a problem for couples, said sexologist Dr. Yvonne Fulbright.

“For some people, a lack of sexual attraction can lead to infidelity or divorce. For others, a lack of sexual attraction only becomes a problem when one tunes into societal expectations around sex and desire,” said Fulbright, who is an adjunct professorial lecturer in the department of sociology at American University in Washington, DC.

“A lot of pressure is being put on couples to maintain active sex lives, and hot ones at that. People have the sense that there’s a type and quality of desire that needs to be achieved, with any disinterest in such considered a problem that needs to be solved.”

Some of my therapist colleagues caution against putting too much emphasis on the importance of immediate sexual attraction.

“We have this misconception that we must be physically attracted to someone when we first meet or there is no relationship potential. That’s just not true,” said sex therapist Dr. Rachel Needle. “Attraction can grow as you get to know someone and experience increased closeness and connection.”

Better way for couples to argue Staying Well _00000411.jpg

The better way for couples to argue (2019)

What should you do if you and your partner are running out of sexual steam? Or if you want to turn up the heat on a relationship that didn’t have any to start with?

Fulbright cautioned against giving any sweeping advice. “Only partners can figure out the best way to manage this challenge in their relationship,” she said.

Non-monogamy may work for some, but not others. Couples need to decide how honest to be with each other, how much this matter is a dealbreaker in staying together versus not, and how much weight should be given to this issue in light of other good things they have going for them,” she added via email.

Don’t feel that all is lost if you’re in a long-term relationship. For some couples, sexual desire can grow over time if they focus on it. “It often isn’t until our 30s that we get comfortable enough to ask for what we want in bed,” Dillon said.

But I refuse to agree with anyone who thinks that married couples will stop having sex anyway so why bother prioritizing sexual attraction.

“Many couples in their 50s can explore and expand their sexuality thanks to maturity and empty nests. For couples in their 60s, 70s and beyond who are able to expand their definition of sex beyond orgasm and co-create intimacy, sex can continue to be vibrant and rich,” Dillon added via email.

And keep in mind, your sexual health is a barometer of your overall health. So if you really are experiencing an inexplicable drop in sexual interest, consider talking to your medical provider. Maybe your testosterone levels really have fallen.

Whatever the source of your lack of sexual interest, just be up front with your partner. Honesty, as it turns out, can be a turn-on (eventually).

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A 45-year-old got pregnant in a state with a ban on abortions. She flew across the country to get one | CNN



CNN
 — 

When 45-year-old Victoria realized she was five weeks late and the lines showed as positive on two pregnancy tests, the New Orleans resident dreamed up a plan to get an abortion.

Traveling out of state was the only abortion option for Victoria, who asked CNN to withhold her last name out of fear of backlash against her and her family. Louisiana is one of several states that have essentially banned all abortions.

“It was probably one of the hardest things I’ve had to go through, from the moment of discovering that I was pregnant at age 45 to actually having to have to take time off work, travel across the country, do a meeting with a doctor, and then take the pills and then skedaddle back home and then go to work like nothing had happened,” Victoria told CNN of her experience earlier this year.

Victoria’s story about the distance she traveled and the hardships she endured to get an abortion reflects a wider American reality, where women seeking the procedure must navigate through a patchwork of states with varying levels of access.

The average travel time to an abortion facility more than tripled, from less than 30 minutes to more than an hour and a half, after the US Supreme Court overturned Roe v. Wade in 2022, according to a November study in the Journal of the American Medical Association. And for women in Texas and Louisiana, average travel times to the nearest abortion facility were seven hours longer – almost a full workday in travel time to get an abortion.

Victoria says she was grateful she could drop everything and afford to spend $1,000 for the procedure, including same-week airfare with connections both ways and appointment and medication fees.

“It was so hard for me wrap my head around the fact that I was able to do this, but I’m one of the lucky ones and that there are so many women who are in much tighter positions,” Victoria said. “And, God, what are they going to do?”

Victoria says plans materialized quickly once she knew which states seemed more accessible.

She researched the parameters for abortion in a state, how long she would have to take off work, travel options and how soon she could get an appointment. She found abortionfinder.org to be a helpful and reliable source, she says.

“Because the situation is so fluid, it changes from day to day, that was really of paramount importance for me to be able to have a reliable source of information,” she said.

Driving to a neighboring state was not an option, as every state adjoining Louisiana has a similarly restrictive law that bans virtually all abortions. Victoria says she considered close states, like Florida, but she ultimately dismissed them because available appointments were farther out.

“Once I saw that Oregon was so, so protective of reproductive rights, I said, ‘Why would I think about going anywhere else?’” she said. “The second I got the definitive pregnancy result, I was like, ‘OK, let’s book a flight to Oregon. When can we do this?’”

She reached out to a friend from college and asked if she could stay with her, detailing the reason for her visit. She then made an appointment and booked a flight for that week, she says.

The provider sent instructions, including that the patient must be in Oregon for the telehealth appointment, according to documents provided to CNN. They contacted her within an hour of making the appointment to make sure she had proof of travel documents because she had made it from Louisiana, where the procedure is illegal.

Victoria planned to take a day off to fly across the country and work remotely for two days, which fits her hybrid work situation. She says she was grateful to have a supportive, female boss who showed understanding for why she had to take the unexpected time off.

“She was the only person I actually kind of broke down and cried for,” Victoria said. “I think it’s because I had been holding it back all week, and telling her was sort of the last thing that I needed to get in place before I could do everything.”

Victoria says the hardest part of her experience was telling her mother because she didn’t know how her mom would feel about it. Victoria and her siblings were raised Catholic. Her father had a strong faith and her mother was a non-practicing Catholic, her mother says. Victoria’s mom asked not to be named for privacy reasons.

Victoria’s mother says she wanted to support her daughter, even if she does not agree with what her daughter did. Victoria coming to her with tickets purchased and a full plan made it easy for her mother to support her, the mother says.

“I agreed to drive her to the airport and that that was the only thing I could do because this would be a real game-changing thing in her life,” her mother said. “I wanted to support what she wanted to do because she has supported me on several family crises. I just wanted to do it because I love her. “

Victoria said she appreciated her mom for being supportive in a way she didn’t expect. They talked about some of her mother’s friends who had abortions throughout the years, both say. Victoria’s mother even told her about when she tried to get her tubes tied, but her husband found out and she did not pursue it.

“I feel like, if anything, it’s made our relationship stronger,” Victoria said. “We already had a fantastically strong relationship, though. So, it’s another rock in the wall.”

After boarding early on a Wednesday in March, Victoria traveled for eight hours on two flights and landed in Portland, Oregon.

Victoria reunited with her friend, and they did the things that old friends do, from staying up late talking about college memories to talking about why Victoria was there. They both described the situation as surreal.

“The vast majority of reproductive conversations I have with friends at this point are people who are trying desperately to get pregnant,” said her friend, Emily, who asked that CNN not use her last name to keep Victoria’s privacy. “The sort of irony is that there could still be an unplanned pregnancy and it would still be just as devastating as it would have been when we were in our teens and twenties was kind of a shock to me.”

Emily, who has been friends with Victoria for about 25 years, says it took so little effort for her to drive to the airport and let her friend stay with her.

“I felt honored that she trusted me,” she said. “I was really proud of Victoria. I was impressed that she had taken this in stride and that she had reached out to someone she knew – I think a lot of people would have been ashamed or hidden it.”

After the telehealth appointment the next day, Victoria received an overnight package.

Victoria took two medications as part of a medication abortion. She took mifepristone at her friend’s home. The next day she took misoprostol before boarding her flight home – she was careful not to take them in her home state, where it’s illegal.

Misoprostol, taken after mifepristone, is a common combination prescribed for a medication abortion.

“It was like a heavy period,” she said. “I took some Aleve, had to get some extra jumbo pads, and I bled a lot on the flights home, but it was fine.”

Physically, she felt fine – it was more of what was happening psychologically that she noticed, she says.

“I had this feeling that I should be having some kind of deep, psychological moment of reckoning or something, but I didn’t really feel that,” Victoria said of the experience. “I’ve never wanted to have a kid. I wasn’t torn about this decision.”

When Victoria learned she was pregnant, a big part of the shock came from not thinking she could get pregnant at age 45, she says.

“You hear so much culturally out there about you’re in your forties, are told you’re too old to get pregnant and carry a child to term,” she said. “I feel like I had sort of a false sense of security.”

Victoria joked that she’s “careening toward menopause,” but she says she has not been diagnosed as perimenopausal.

Her pregnancy news came several months after she was treated for a uterine fibroid, a benign growth, in July 2022, according to medical records. Victoria also tested positive for a PALB2 gene mutation, which can lead to an increased chance of breast cancer, according to a study in the New England Journal of Medicine. She underwent a preventative double mastectomy and reconstruction earlier in 2022, according to medical records provided to CNN.

She says she got an excellent standard of care around her surgeries, but it felt dissonant with her state’s laws around abortion.

“It felt so surreal to get this really high standard of care around my secondary sexual characteristics, but then to have that freeze, slam shut when it comes to reproductive health, it just felt abrupt,” she said.

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The planet is getting hotter fast. This is what happens to your body in extreme heat | CNN



CNN
 — 

The Earth recently recorded its hottest day ever – a record experts warn will likely be repeatedly broken as the climate crisis drives temperatures higher and higher.

And it’s happening fast: a new report found last month was the planet’s hottest June by a “substantial margin,” meaning the nine hottest Junes have all occurred in the last nine years.

Extremely hot days – what could be considered the hottest days of the summer – are more frequent now than in 1970 in 195 locations across the US, according to the research group Climate Central. Of those locations, roughly 71% now face at least seven additional extremely hot days each year.

The effects have been devastating.

In one Texas county, at least 11 people died in just over a week during an unrelenting June heat wave. In Mexico, soaring temperatures have killed at least 112 people since March. A recent heat wave in India killed at least 44 people across the state of Bihar.

Here’s what happens to your body in extreme heat, what you need to watch out for and how to stay safe.

Normally, your body is used to a certain range of temperatures, usually between 97 to 99 degrees Fahrenheit. When your brain senses a change – either lower or higher than that – it attempts to help your body cool down or heat up, according to Dr. Judith Linden, executive vice chair of the department of emergency medicine at Boston Medical Center and a professor in the emergency medicine department at Boston University’s school of medicine.

“There are a number of different ways in which (the brain) attempts to cool the body down. One way, the most common way we think of, is that you sweat,” Linden said. “The pores open, the body sweats and the sweat evaporates, that cools the body.”

The second way your body cools itself down is by dilating vessels and upping your heart rate, which helps bring heat and blood to the surface of your body and helps releases that excess heat.

When you’re exposed to high temperatures, it becomes harder for your body to try and keep up with cooling itself down. And if your environment is hot and humid, sweat doesn’t evaporate as easily – which pushes your body’s temperature even higher, according to the Mayo Clinic.

“The higher the humidity, the lower temperatures you need for extreme heat,” Linden said.

High body temperatures can lead to damage to the brain and other vital organs, the CDC says. They can also lead to several heat-related illnesses.

Mild-heat related illnesses, including heat cramps, are most common, Linden said. Heat cramps can develop in people who sweat a lot, including during exercising. The excessive sweating uses up all of the body’s salt and moisture and can lead to muscle pains or spasms, usually in the abdomen, arms or legs, according to the CDC.

A heat rash can also develop. That’s a skin irritation caused by too much sweating in hot and humid weather, and is most common in young children, the CDC says. It is usually a red cluster of pimples or blisters, and tends to be in places including the neck, upper chest or in elbow creases.

When your body’s beginning to exceed its ability to cool itself down, you can develop what’s known as heat exhaustion.

“In this case you’re going to see excessive sweating because your body is really going to try and keep up with that extra heat. You’re going to feel light-headed, you may feel dizzy, often people present with nausea, headaches and their skin often looks pale and clammy and their pulse is often fast,” Linden said.

“This is the body’s last attempt to cool itself before it really goes into a point of no return.”

A heat stroke is the most serious heat-related illness, and, if left untreated, can lead to death.

“That’s where your body’s temperature goes above 104 to 105 degrees or so, and this is where your mechanisms are starting to fail,” Linden said.

Warning signs may include extremely high body temperatures, red and dry skin, a rapid pulse, headache, dizziness, nausea or loss of consciousness, according to the CDC.

The hallmark of a heat stroke is confusion and agitation, Linden said.

“So when somebody’s in the heat and they become confused and agitated, that’s heat stroke until proven otherwise and you need to call 911 for that or get help immediately and get the person out of the heat.”

Elderly, people with chronic medical conditions as well as children are at higher risk for severe heat-related illnesses.

The elderly and people with chronic medical conditions may be less likely to sense and respond to temperature changes and may be taking medication that make the heat effects worse, the CDC said.

“Very young (people) as well, because they’re less likely to recognize heat-related illness and they’re less likely to get out of the heat if they’re starting to feel overheated,” Linden said.

Student-athletes and pets are also at higher risk, she added.

“In this weather, you must never, ever, ever leave a child or a pet in the car for even a minute,” Linden added.

When your community is facing extreme heat, there are several things you can do to keep yourself and others safe.

First, keep an eye out for symptoms of heat exhaustion or other illnesses.

“If somebody starts feeling light-headed, dizzy, nausea or headache, that is the time to act immediately,” Linden said. “That means getting them out of the heat and into a cool environment.”

Putting water on someone who may be experiencing symptoms and giving them fluids can help cool them down. If someone is starting to lose consciousness or has nausea or vomiting, call 911.

“If you see anybody with any type of confusion, that’s an immediate red flag,” Linden added.

When it’s hot outside, try to avoid outdoor activities – especially between the hours of 11 a.m. and 3 p.m., according to Linden. If you have to go outside, wear light-colored clothing, cover your head and drink plenty of fluids.

Don’t wait until you’re thirsty to drink water – as that can be a sign of dehydration. Linden recommends drinking at least one glass of water – or more – an hour.

“If you do start to feel light-headed, dizzy, sweating, fast pulse, get out of the heat immediately,” Linden said.

Try to find air conditioning, or places in your area where you can go to stay cool, according to Ready.gov. Even spending a few hours in a shopping mall or public library can help.

When you’re home, fans can help, but don’t rely on them as your only way of cooling down – while it may feel more comfortable, they won’t help prevent heat-related illness.

“If you’re in a super hot room, if you’ve got a fan, is it helpful? No. I think, if you’ve got a fan, and you’re able to mist yourself … then fans can be helpful,” Linden said. “Fans are not foolproof.”

Finally, make sure you’re checking on your neighbors, parents and friends – especially older individuals who may be living alone or are isolated, Linden said.

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Laziness isn’t why you procrastinate. This is | CNN

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CNN
 — 

If you’re stuck in what seems like an endless cycle of procrastination, guilt and chaos, you might be wondering, “Why am I so lazy?” or “Why can’t I just get myself together?”

Despite that common perception, laziness usually isn’t the reason behind procrastination, said Jenny Yip, a clinical psychologist and executive director of the Los Angeles-based Little Thinkers Center, which helps children with academic challenges.

“Laziness is like, ‘I have absolutely no desire to even think about this.’ Procrastination is, ‘It troubles me to think about this. And therefore, it’s hard for me to get the job done.’ That’s a big difference.”

Knowing why you procrastinate and learning how to combat it are the only ways to change your behavior, according to experts. Psychologist Linda Sapadin sought to help this self-improvement effort with her book “How to Beat Procrastination in the Digital Age.”

You could be the perfectionist, the dreamer, the worrier or the defier — these are all procrastination styles that Sapadin lists in her book.

These procrastination types aren’t specific diagnoses and aren’t backed by research, but “they are psychological types or reasons why someone might procrastinate,” said Yip, who is also a clinical assistant professor of psychiatry at the University of Southern California’s Keck School of Medicine.

Procrastination can have practical consequences, such as falling behind at work or failing to achieve personal goals or to cross off errands from a to-do list. But there are also emotional or mental impacts. It has been associated with depression, anxiety and stress, poor sleep, inadequate physical activity, loneliness and economic difficulties, according to a January study of more than 3,500 college students.

“Particularly in America, where so much of our worth is tied up into what we do, how we work, what we produce — it can feel very shameful if you can’t do that,” said Vara Saripalli, a Chicago-based clinical psychologist. “It can leave people feeling very defeated and feeling like there’s no point in trying.”

Knowing why you procrastinate can make you self-aware, but you still need strategies to break the habit. “Otherwise, we’ll just keep repeating things,” Saripalli said. “The strategy you’re going to employ to beat procrastination is going to change based on the purpose procrastination is serving for you.”

Here’s how to explore which type of procrastinator you might be — though remember, you could embody the traits of more than just one type.

A procrastinator is usually a perfectionist, Yip said.

“Because the perfectionist needs things done perfectly — all Ts crossed and Is dotted — it takes an insurmountable amount of effort. And if (they) don’t have a plan of how to get this task completed, then the perfectionist will get lost.”

Worriers tend to be indecisive and dependent on others for advice or reassurance before taking initiative on their own. They also have a high resistance to change, preferring the safety of the known.

Both perfectionists and worriers might put off starting tasks due to a fear of failure or criticism, said Itamar Shatz, a researcher at the University of Cambridge in the United Kingdom and creator of the website Solving Procrastination.

Challenge those beliefs and your behavior by recognizing that perfectionistic standards are unrealistic, Shatz said. “Replace them with standards that are good enough instead while giving yourself permission to make some mistakes,” he added.

Avoid all-or-nothing thinking and give yourself a time limit for completing a task. (And then stick to that time limit — don’t just give up if you don’t meet it.)

A “dreamer” procrastinator doesn’t like the nitty-gritty logistical details often needed to get projects done, Saripalli said. “They like to have ideas,” she added. “That stuff is fun. It’s kind of difficult or boring to then execute these visions.”

Dreamers might also think of themselves as people for whom fate will intervene, making proactive hard work and efficiency appear unnecessary.

And like a perfectionist, a dreamer might always want something better, Yip said. Train yourself to differentiate between dreams and goals, and approach goals with six questions: what, when, where, who, why and how. Change “soon” or “one day” to specific times. Write your plans into a timeline, specifying each step.

People with defiant procrastination tend to view life in terms of what others expect or require them to do, not what they want. This pessimism diminishes their motivation to complete tasks.

If you have this mindset, find positive ways to feel in control, Shatz said. Strive to act rather than react and try to work with a team or supervisor, not against them.

“If something doesn’t sit well with you, rather than being passive-aggressive about it, acknowledge what is or isn’t working and then have a conversation with whoever is giving you this assignment,” Yip said. “Defiers usually don’t feel equipped to have these conversations with who they see as authority figures, or they don’t believe that having the conversations would give them any benefit or positive outcome. … That’s not necessarily true.”

Just like working on anxiety or other mental health issues, addressing procrastination can be hard, especially if it comes from deep-rooted issues, Shatz said.

For some people who procrastinate, “their sense of self is so fragile that the idea of doing something and failing would just tip them over into complete worthlessness,” said Sean Grover, a New York City-based psychotherapist specializing in group therapy.

In such cases, “consider contacting a professional, like a psychologist, who might be able to help you,” Shatz added.

“Visualization works,” Yip said. “If you can visualize yourself completing (a task), then it becomes more achievable simply because you have an idea that it can be done.”

At the end of the day, how you approach life is “all about your belief system,” Yip said. “If you believe you can, you can. If you believe you cannot, you can’t. So whatever you believe, you’re right.”

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