Harry Potter Has Migraine Headaches?

June 29, 2007 -- Harry Potter, the fictional character known worldwide from author J.K. Rowling's books and the Harry Potter movies, likely has migraine headaches.

That diagnosis comes from Fred Sheftell, MD, and colleagues. Sheftell works in Stamford, Conn., at the New England Center for Headache.

Sheftell's team scrutinized all of J.K. Rowling's published Harry Potter books, looking for references to Potter's headaches.

Harry Potter's migraine headaches happen when the evil Lord Voldemort is nearby, and they strike in the area of Potter's head where he has a scar in the shape of a lightning bolt, note Sheftell and colleagues.

After considering several headache diagnoses, Sheftell's team settled on the diagnosis of "probable migraine." Why "probable"? Because Potter's headaches disappear faster than typical migraines, note the researchers.

Harry Potter's Headaches

Sheftell and colleagues aren't trying to make light of migraine headaches. Instead, they're using Potter's case to build awareness of migraines and other headaches.

"That even a young male Wizard has recurrent disabling headache is a reflection of the wider problem of headache in children and adolescents," the researchers write.

Is their diagnosis correct? The researchers note that migraines may be passed down genetically, but little is known about Potter's birth parents.

Headaches can also be connected to other illnesses, but so far as Sheftell's team knows, Potter is otherwise healthy.

Of course, all that may change when the final Harry Potter book is published later this month. Meanwhile, the details of Potter's diagnosis appear in Headache, the journal of the American Headache Society.

Stroke Risk Linked to Some Migraines

Aug. 9, 2007 -- Some migraines may increase young women's odds of having astroke, according to a new study.

The study -- published online today in the journal Stroke -- comes from experts including Leah MacClellan, MSPH, and Steven Kittner, MD, of the University of Maryland School of Medicine in Baltimore.

MacClellan, Kittner, and colleagues studied 1,000 African-American and white women age 15-49 living in and around the Baltimore-Washington, D.C. area.

The women were in their mid- to late-30s, on average (age range: 15-49). Stroke, which is America's third leading cause of death and a major cause of disability, usually strikes decades later.

The researchers asked the women about their history of headaches, including migraines.

Compared to the women who hadn't had a stroke, the stroke survivors were 50% more likely to report having a history of migraines with visual aura in the year or years before their stroke.

Symptoms of migraine with visual aura included ever seeing spots, lines, or flashing lights during a migraine.

Migraines without visual aura weren't linked to increased stroke risk.

Reducing Stroke Risk

Among the women who reported a history of migraine with visual aura, those who smoked and took oral contraceptives were seven times more likely to have had a stroke.

"Young women with probable migraine with visual symptoms can reduce their risk of stroke by stopping smoking and finding alternatives to the use of estrogen-containing contraceptives," Kittner states in an American Heart Association news release.

He uses the term "probable migraine" because the women's migraines weren't necessarily diagnosed by a doctor.

The researchers took many stroke risk factors into consideration. But they didn't have data on factors including the women's cholesterol levels, alcohol use,physical activity, and medications.

Migraines, Brain Lesions: New Links Seen

June 23, 2009 -- Women who experience migraine headaches with aura may be more likely to develop brain lesions when they are older, according to a new study.

Researchers say the results add to a growing number of studies that suggest migraines may be more than a transient condition and may cause long-term damage in the form of cell death and lesions in the brain over time.

Migraine headaches are a common problem, affecting about 11% of adults and three to four times as many women than men. About one-third of those who suffer the painful headaches experience aura -- visual or sensory disturbances just prior to the migraine.

The study, published in TheJournal of the American Medical Association, looked at the association between midlife migraines and brain lesions later in life among 4,689 men and women in Iceland who have been followed since 1967. The participants were interviewed about migraine symptoms in midlife and received brain scans 26 years later.

Brain lesions were found in 39% of men and 25% of women. After adjusting for other risk factors, such as age, heart disease, and stroke risk, researchers found that women who had migraines with aura during midlife were more likely to have brain lesions in the cerebellum part of the brain. Twenty-three percent of women with migraine with aura had these types of brain lesions, compared with 15% of women without headaches.

There was no such association between migraine with aura and brain lesions in men.

Researcher Ann I. Scher, PhD, of Uniformed Services University in Bethesda, Md. and colleagues say further long-term studies are needed to better establish this relationship between migraine with aura and brain lesions and determine the mechanism behind the link.

An editorial that accompanies the study also urges caution in interpreting these results.

"It is premature to conclude that migraine has hazardous effects on the brain," write Tobias Kurth, MD, ScD, of the University Pierre et Marie Curie in Paris and Christophe Tzourio, MD, PhD, of the University Pierre et Marie Curie and Harvard School of Public Health, Boston in the editorial.

"However," the editorial notes, "the study raises important questions. New studies examining the association of migraine with structural brain changes and brain function should improve understanding of the associations and perhaps further unveil migraine-specific mechanisms."

Craving Carbs: Is It Depression? Many people crave carbohydrates when they feel low

Does a bad day at the office or a tiff with your spouse send you marching to the cookie jar or the corner bakery?

Or do you find yourself at the vending machine every day precisely at 4 p.m. for some crackers or candy?

If either scenario fits, you're not alone. Many people crave carbohydrates -- especially cookies, candy, or ice cream -- when they feel upset, depressed, or tired.

"Carb craving is part of daily life," says Judith Wurtman, PhD, a former scientist at the Massachusetts Institute of Technology and co-author of The Serotonin Power Diet. She and her husband, MIT professor Richard J. Wurtman, have long researched carbohydrates and their link to mood and depression.

The Wurtmans published a landmark article about carbs and depression inScientific American in 1989. They are convinced that the carbohydrate craving is related to decreases in the feel-good hormone serotonin, which is marked by a decline in mood and concentration.

Other experts aren’t so sure. Some wonder if depressed mood and reaching for carbs are both related to an external event -- such as the stock market decline -- or to simply habit.

Carbohydrate Cravings: What's Known? What's Debated?

Carb cravings seem to be related to decreases in serotonin activity, says Wurtman.

"We discovered years and years ago that many people experience the 'universal carbohydrate craving time' between 3:30 p.m. and 5 p.m. every day," she says. "I suspect the tradition of English tea with its carb offering is a ritual developed to fill this need."

"It's a real neurochemical phenomenon," she says.

The Wurtmans’ work, however, has its skeptics.

Edward Abramson, PhD, a psychologist and professor emeritus at California State University, Chico, wrote the book Emotional Eating. He does not think the link is strong and clear-cut.

"You could be down because of loss of money in the stock market," he says. "The depression is triggered by an external event, not by [only] a dip in serotonin. It may be the external event causing the dip in serotonin, not the dip occurring, then the craving, he says.

Another possibility, says Abramson, is that carb craving may be just a habit, learned early. For instance, a woman brought up to believe that anger is not an acceptable emotion may turn to eating treats such as cookies instead -- because that's what she did as a kid and perhaps was encouraged to do by a parent.

Carb cravings can also result from diets, says Evelyn Tribole, RD, a dietitian in Newport Beach, Calif., and author of Healthy Homestyle Cooking.

She sees quite a few dieters who crave carbohydrates, especially if they’re on one of the high-protein, low-carb diets.

"You don't want to kill for a piece of broccoli, but you'd kill for a piece of bread. It's a clear signal,” she says, “that your body needs more carbs. It’s not an abnormal craving.”

Carbohydrate Cravings: The Research

Several research studies have uncovered interesting facts about carb cravers.

• Wurtman found that carb cravers can eat 800 or more calories a day than other people. While many carb cravers do become overweight or obese, others control their weight by exercising more, eating less at meals, or turning to low-fat carbs such as popcorn.
• Researchers at Rush University Medical Center in Chicago found that carb cravers who have a mildly depressed mood seem to be self-medicating. They studied women who were overweight and had a history of carb cravings. They gave them a choice between a protein-rich beverage or a carb-rich one. They found that when the women reported being in the worst moods, they picked the carb beverage more often than the protein one. In addition, the carb drink improved their mood better.
• Eating carbohydrates seems to help carb cravers feel better in about 20 minutes, according to Wurtman’s research. When you eat carbs, your body makes more serotonin, the feel-good hormone that is boosted when you are on an antidepressant. Eating the carbs, she says, is an attempt to undo the depressed mood.

Carbohydrate Cravings: Normal or Not?

Step back and analyze your cravings a bit, Wurtman suggests.

Do you crave carbs only when you see someone eating something you like? Then, says Wurtman, you may simply be succumbing to the power of suggestion.

Or do you crave carbs when you face an unpleasant task, like balancing the checkbook, and feel better after you’ve had some? Then you may be “self-medicating.” Your serotonin is up, and you are doing what you are supposed to, says Wurtman.

Late-afternoon carb cravings are also quite normal, Wurtman says, and don’t necessarily signal depression. "The reason we want to self-medicate with carbs late in the afternoon is not just that life is difficult and filled with frustration, but that it is a normal day-night cycle."

When is a carb craving over the top? If you go to great lengths for a carb-rich food continually, you may want to seek professional help, Wurtman says.

She recalls a woman who was driven to have a brownie from her favorite bakery many times a week. When a ride wasn’t available, she would go to great lengths to get it, even walking several blocks in the dark or bad weather.

That kind of persistent craving may be a sign of depression, not just a funky off mood, and perhaps a clue you should seek mental health care, Wurtman and others say. If your mood stays low and the carbs don't seem to be helping, you should also consider checking in with a health care provider.

Carbohydrate Cravings: Living With Them, Taming Them

If you're a carb craver, you can learn to cope with them -- at minimal or no expense to your health or waistline, experts say.

• Time your eating to accommodate your cravings. The carb cravings typically grow stronger as the day goes on, experts agree. So eat healthfully at breakfast and lunch and focus on protein-rich foods. "In the afternoon, by the time the sun and your mood start sinking, have a carb snack -- popcorn or breakfast cereal -- around 4 p.m.," Wurtman says. Then for dinner, pick pasta, rice or waffles, she suggests.
• Choose sensible carbohydrate-rich foods. Carbs don't have to be gooey and chocolatey every time, Wurtman says. She suggests low-fat crackers, for instance, or pretzels. It keeps the fat low but gives you the carbs you want.
• Don't buy into the guilt. "The current low-carb phase is making people feel guilty," Wurtman says. "There is nothing wrong with having a carb for dinner, or for a snack. You have to have it in a very low-fat form."
• Focus on carbs that are "slow foods." Think sip, not gobble, when eating these. One of Tribole's favorites: hot chocolate. "You get carbs in the milk and the sweetened chocolate," she says. "It's hard to guzzle hot chocolate, so you are going to savor it."

Natural Depression Treatments - 15 ways to help treat depression naturally

While therapy and medication are key in controlling depression, there’s also a lot you can do on your own to fight back. Making changes to your own behavior -- your physical activity, diet, and lifestyle -- can be effective natural depression treatments.

“Lifestyle changes are a very important part of treatment,” says Ian A. Cook, MD, director of the Depression Research Program at the University of California Los Angeles.

On their own, Cook says, natural depression treatments can beat back milder forms of disease. For more severe depression, they can complement other approaches. When medication and therapy aren’t enough, treating depression naturally through lifestyle can help push people toward full recovery.

“Fighting depression is a war that’s waged day to day, not just over weeks and months while you wait for other treatments to take effect,” says Dean F. MacKinnon, MD, associate professor of psychiatry at the Johns Hopkins Hospital in Baltimore.

So as bleak as things might seem, there are things that you can do, right now, that will help you feel better. Here’s what you need to know about natural depression treatments.

Get in a Routine to Treat Depression Naturally

If you’re depressed, or have been depressed, you need a routine. Depression can strip away the structure from your life, letting one day bleed into the next. That absence of order can also make your depression worse.

“It’s extremely stressful to wake up in the morning and have no idea what you’re going to do with the day,” says MacKinnon.

Cook agrees. “Having a routine gives you a sense of control over the day,” says Cook. “We know that helps, and we know that not having a sense of control makes people feel worse.”

What should you build into your schedule to help fight depression naturally?

1. Exercise. Study after study has found that physical activity can boost mood, says Cook. How much? You don’t need to run marathons to get a benefit. “It seems like half an hour several times a week may be enough,” Cook says. “More than that may not have a further effect on mood. There seems to be a plateau.”
The type of exercise you use as a natural depression treatment doesn’t seem to matter. “Your cardiologist might want you getting a lot of aerobic exercise for your heart,” says MacKinnon. “But for your mental health, just getting out and walking can be enough.”

2. Diet. There is no depression diet, but there are great benefits to healthy eating. “I don’t think there’s any particular dietary regimen you need to follow,” says MacKinnon. “A basic healthy eating plan should do.”
Nutrition is an important element in your effort to help treat your depression, MacKinnon says. “Healing from depression is a physiological process, just like healing from a physical injury,” he tells WebMD. He says that without good nutrition, medications for depression can’t work as effectively.
There are some other things to keep in mind. Ask your doctor if your medication might cause weight gain. If so, you may want to take special care with your diet. If your depression is associated with an eating disorder -- like anorexia or binge eating -- you need to be working with an expert.

3. Sleep. While sleep problems are a symptom of depression, they can also make it worse. Some people with depression sleep excessively. Many more depressed people suffer from insomnia. Either way, you need to do something.
Lying in bed and willing yourself to sleep won’t work. But one natural depression treatment is to make your life more conducive to getting a good sleep. Go to bed and get up at the same time every day. Try not to nap. Take all the distractions out of your bedroom -- no computer and no TV.

4. Goals. To help yourself during treatment for depression, it’s important to meet goals that you set for yourself. The trick here is to come up with realistic goals -- ones that you can really accomplish in a day. Drafting a 20-page to do list is not going to help. If you’re having trouble setting goals, Cook recommends working with a therapist, family member, or friend. Someone who can help you prioritize what’s most important and break larger tasks into smaller, more manageable ones.

5. Responsibilities. When you’re depressed, a natural inclination is to pull back -- to give up all your responsibilities at home and at work. It’s a feeling you should fight against. Staying active and having daily responsibilities can work as a natural depression treatment. They help ground you and give you a sense of accomplishment.
Obviously, don’t push yourself too far. If you’re not ready to go back to work or school, that’s fine. Think about part-time. If that seems like too much, consider a little volunteer work.
“If you’re volunteering to help clean up a playground, you’re still doing something,” says MacKinnon. “You’re getting out of the house, and at the end of the day you know that you accomplished something.”

6. Relaxation. Don’t assume that fun or relaxing things will happen naturally. They only way to make them happen is to plan them.

Cognitive Ways to Cope With Depression Naturally

In your fight against depression, a lot of the work is mental -- changing how you think.

“When you’re depressed, you become trained to see the world and yourself in a negative way,” says MacKinnon. These patterns of thought can have a lasting impact. They can linger on months or years after you’ve resolved the biological cause of the depression, MacKinnon says.

Automatic negative thoughts are particular sources of trouble. These thoughts occur spontaneously when you encounter a situation and affect how you feel. They can link to one another in a chain, dragging you downward.

An example: Your boss asks you to rewrite the opening of a proposal you worked on. Rather than just doing it, you dwell on it. In your mind, this incident becomes symptomatic of deeper problems. You’re incompetent. You’re going to be fired. You’ll be penniless. You’ll lose your house. Your family will hate you. You’re a complete screw-up. You don’t deserve to live. In seconds, your good mood disappears and you’re plunged into misery.

How can you battle automatic negative thinking?

7. Reflect. At first, it’s very hard to catch yourself engaging in automatic thinking, says Cook. By definition, you’re not completely aware that it’s happening. Instead, Cook says it’s often easier to look back on a bad day and figure out what happened in hindsight. How did you get from feeling pretty good in the morning to feeling horrible by noon? What events -- and what thoughts -- led you to such a depressive state of mind?
By reconstructing what happened, you learn how your mind works and what automatic thinking you’re prone to. Then you can do something about it. “In time, you get a lot better at recognizing automatic thoughts in the moment,” says Cook, “so you can stop them before they get out of control.”

8. Take a break. When you find yourself engaging in automatic thinking, clear your head. Cook recommends breathing exercises or simply getting up and walking around. “Taking a break from whatever you’re doing physically can create a break in the mental process,” he tells WebMD.

9. Use logic. The next time some problem is making you feel terrible about yourself, try to use logic as a natural depression treatment. Depression can make you think bad things about yourself that are grotesquely exaggerated. “Try to impose some reason,” says Cook. “Inject some reality.” Is it really true that no one likes you? Is there real evidence for that? Sure, you might feel like the most stupid and hateful person on the planet, but really, what are the odds?

Other Natural Depression Treatments

In addition to getting in a routine and making cognitive changes, there are other natural depression treatments you should consider. Here’s a rundown.

10. Reach out to friends and family. To get through a depression, you need the support of trusted family and friends. Talking about what you’re going through can be a good natural depression treatment. Try to develop a network of supports. That way, you’re not putting too much pressure on a single person.
A friend shouldn’t only be a shoulder to cry on. Sometimes, you might want to set aside your feelings for a few hours. “Taking a break from thinking about your depression can be helpful,” says Cook. “You can just try to enjoy being with that other person.”
MacKinnon agrees. “If you were recovering from pneumonia, you wouldn’t feel obligated to regale everyone with details about what you were coughing up,” says MacKinnon. “It’s OK not to talk to everybody about what you’ve been through with your depression.”

11. Get support. In addition to relying on your friends and family, joining a support group can also be a good natural depression treatment. There, you’ll meet people who really understand what you’ve been through – perhaps in a way that your family and friends can’t.

12. Check with your doctor before using supplements. While lots of supplements, like St. John’s wort, have been promoted as depression cures, the research has been mixed. One supplement that has shown some promise is fish oil, which is rich in omega-3 fatty acids. Always check with your doctor before starting any supplement, especially if you’re already on other medications.

13. Watch out for substance abuse. Lots of people deal with depression by relying on alcohol and other substances. Don’t. After a few hours, these substances only leave you feeling worse. If you think you have a substance abuse problem, don’t wait until your depression is resolved to deal with it. Get help now.

14. Do something new. When you’re depressed, you’re in a rut. A typical day might be spent cycling between the bed, the television, and the computer. Cook recommends that people push themselves to do something different and new as a natural depression treatment. Go to a museum. Pick up a used book and read it on a park bench. Volunteer at a soup kitchen. Take a language class.

15. Don’t ignore serious signs of depression. While using natural depression treatments on your own can help a lot, they have limits. “People are amazingly resourceful when it comes to helping themselves,” says Cook. “But when they become so depressed that they can no longer function, or they’re feeling like the world would be better without them, they need to get professional help.”

Don’t Forget: Make Time for Things You Enjoy

Experts agree: If you’re depressed, you have to make time for things you enjoy. You have to relax. You have to do things that are fun.

This may be advice you’ve heard before. And there’s a problem with this natural depression treatment. When you’re depressed, or recovering from depression, having fun can seem impossible. Things that used to be fun don’t feel fun anymore. So why bother?

It’s a common problem, experts say. “One of the insidious aspects of depression is that it trains you to become hopeless about finding anything in life pleasurable,” says MacKinnon.

But this is just another unhealthy thought pattern that depression instills in us. The key is to unlearn it. While we assume that having fun is supposed to be effortless, it isn’t. You’ve gotten out of practice.

So as perverse as it might sound, you may have to work at having fun. Schedule things you used to enjoy. Even if it feels like a chore, keep going out with friends. Keep going to the movies and keep playing tennis.

“Sometimes, you really have to take a leap of faith and force yourself to do these things,” says MacKinnon. The act of doing them is itself a form of rehab, he says. You’re retraining yourself. In time, fun things really will feel fun again.

Are You a Mosquito Magnet? Experts try to crack the code behind why mosquitoes like some humans more than others

You're flipping burgers for the neighborhood barbecue, and the mosquitoes have already begun their feast -- on you. As you swat madly at the pests, you notice other folks seem completely unfazed. Could it be that mosquitoes prefer dining on some humans over others? This may clear up the mystery.

It's true. Mosquitoes do exhibit blood-sucking preferences, say the experts. "One in 10 people are highly attractive to mosquitoes," reports Jerry Butler, PhD, professor emeritus at the University of Florida. Incidentally, it's not dinner they're sucking out of you. Female mosquitoes -- males do not bite people -- need human blood to develop fertile eggs. And apparently, not just anyone's.

Who Mosquitoes Like Best

While researchers have yet to pinpoint what mosquitoes consider an ideal hunk of human flesh, the hunt is on. "There's a tremendous amount of research being conducted on what compounds and odors people exude that might be attractive to mosquitoes," says Joe Conlon, PhD, technical advisor to the American Mosquito Control Association. With 400 different compounds to examine, it's an extremely laborious process. "Researchers are just beginning to scratch the surface," he says.

Scientists do know that genetics account for a whopping 85% of our susceptibility to mosquito bites. They've also identified certain elements of our body chemistry that, when found in excess on the skin's surface, make mosquitoes swarm closer.

"People with high concentrations of steroids or cholesterol on their skin surface attract mosquitoes," Butler tells WebMD. That doesn't necessarily mean that mosquitoes prey on people with higher overall levels of cholesterol, Butler explains. These people simply may be more efficient at processing cholesterol, the byproducts of which remain on the skin's surface.

Mosquitoes also target people who produce excess amounts of certain acids, such as uric acid, explains entomologist John Edman, PhD, spokesman for the Entomological Society of America. These substances can trigger mosquitoes' sense of smell, luring them to land on unsuspecting victims.

But the process of attraction begins long before the landing. Mosquitoes can smell their dinner from an impressive distance of up to 50 meters, explains Edman. This doesn't bode well for people who emit large quantities of carbon dioxide.

"Any type of carbon dioxide is attractive, even over a long distance," Conlon says. Larger people tend to give off more carbon dioxide, which is why mosquitoes typically prefer munching on adults to small children. Pregnant women are also at increased risk, as they produce a greater-than-normal amount of exhaled carbon dioxide. Movement and heat also attract mosquitoes.

So if you want to avoid an onslaught of mosquito bites at your next outdoor gathering, stake out a chaise lounge rather than a spot on the volleyball team. Here's why. As you run around the volleyball court, the mosquitoes sense your movement and head toward you. When you pant from exertion, the smell of carbon dioxide from your heavy breathing draws them closer. So does the lactic acidpouring from your sweat glands. And then -- gotcha.

Where Mosquitoes Lurk

Even if your body chemistry doesn't attract mosquitoes, where you're located might.

Some of the worst mosquito populations exist along coastal areas, Conlon tells WebMD. And being several miles inland does not guarantee your safety from the pests. "They'll fly 40 miles for a meal," Conlon says.

While any water source is potential breeding grounds for mosquitoes, they much prefer stagnant water. So if you crave a mosquito-free water oasis on your property, forgo the backyard pond and seek out a babbling brook instead.

"Even in a desert area, mosquito biting tends to be intense around a water source," Conlon says.

Can you find respite high in the mountains? Don't count on it. Although they're generally not active below 55 degrees Fahrenheit, mosquitoes have been sighted in the Himalayan Mountains, Conlon tells WebMD.

How about cold climates in places such as Alaska? You're safe for most of the year. But, says Conlon, mosquitoes flock there for a brief, three-week period between July and August. "The Arctic National Refuge is one big bog," Conlon explains, making the mosquito population there second only to that in the Florida Everglades.

With a long track record -- mosquitoes have been around for 170 million years -- and more than 175 known species in the U.S., these shrewd summertime pests clearly aren't going to disappear any time soon. But you can minimize their impact.

Keeping the Bite at Bay: Chemical-Based Repellents

Plenty of mosquito repellents line the shelves of drugstores and supermarkets each summer, but they're not all created equally.

The majority of available mosquito repellents derive their effectiveness from chemicals. Protecting the public from mosquitoes since 1957, DEET continues to be the chemical of choice used in repellents. In repeated studies, it's been proven the most effective chemical repellent on the market. Repellents with 23.8% DEET (most formulas contain between 10% and 30%) protect wearers for about five hours, according to a study led by Mark Fradin, PhD, a researcher with Chapel Hill Dermatology. The American Academy of Pediatrics and other experts suggest that it is safe to apply repellent with low concentrations of DEET (10% or less) to infants over 2 months old.

In 2005, the CDC began recommending alternatives to DEET for repelling mosquitoes. Picaridin, which is new to the U.S., has been used worldwide since 1998. It has proven to be as effective as DEET but is more pleasant to use because it has a light, clean feel and is virtually odorless. Picaridin is safe for children older than 2 months. This substance is marketed as Cutter Advanced.

Another CDC recommendation is oil of lemon eucalyptus, which is available under the Repel brand name. This product offers protection similar to low concentrations of DEET. Lemon eucalyptus is safe for children older than 3 years.

The chemical IR3535, better known as Avon's Skin-So-Soft, has also been marketed as a repellent in the U.S. in recent years. To date, research shows it's much less effective than DEET.

Safety of DEET Repellents

Just how safe is it to coat yourself in a chemical-based product like DEET just to keep from getting bitten by mosquitoes?

"[DEET] has been in use for over 40 years and has a remarkable safety record. Only few hospitalizations have been reported, mainly due to gross overuse," Conlon tells WebMD.

The Environmental Protection Agency (EPA), after extensively assessing the safety of DEET, concluded that "as long as consumers follow label directions and take proper precautions, insect repellents containing DEET do not present a health concern." The agency does, however, offer the following safety strategies for DEET use:

• Follow label directions and precautions.
• Use sparingly.
• Avoid spraying on or near open skin, eyes, mouth, and nose, under clothing, or near food.
• Wash treated skin with soap and water.

The American Academy of Pediatrics (AAP) provides these additional recommendations for DEET use on children:

• Select the lowest concentration effective for the amount of time spent outdoors.
• Avoid use on infants under 2 months of age.

Avoid repeated applications, which may increase the potential toxic effects of DEET.

Alternative Repellents

Want to avoid chemical-based repellents altogether? Alternatives do exist, with one or two showing promise.

"Of the products we tested, the soybean oil-based repellent was able to protect from mosquito bites for about 1.5 hours," Fradin reports. He and fellow researchers found other oils -- citronella, cedar, peppermint, lemongrass, and geranium -- provide short-lived protection at best. Oil of eucalyptus products, however, may offer longer-lasting protection, preliminary studies show.

Hate to spray or slather yourself with any product, either chemical- or plant-based? Mosquito traps, a relatively new product, may be the answer. They work by emitting substances that biting mosquitoes find attractive -- such as carbon dioxide, heat, moisture, and other mosquito-friendly byproducts. They attract, then trap or kill female mosquitoes. When placed strategically near breeding spots, "they have knocked [mosquito] populations down," Conlon tells WebMD.

So is it worth the effort it takes to prevent mosquitoes from nipping at your ankles? Yes, if you don't want to be bothered by bouts of mosquito-induced itching all summer long. Certainly, if you are one of the few unfortunate souls in whom mosquito bites result in severe allergic reactions. And most definitely if you believe you're likely to be exposed to potentially fatal mosquito-borne diseases, some of which are becoming increasingly common. Take the mosquito-transmitted West Nile virus, which Conlon says "is probably here to stay." And with it, the age-old, ever-adaptable mosquito.

The Secrets of Managing GERD and Heartburn

Are you still trying to manage your heartburn and GERD by drinking milk by the gallon and popping antacids by the fistful? Chances are you’re not getting the relief you want. But the good news is with the right GERD treatment you can find relief.

“We’re more aggressive about treating GERD today,” says Lawrence Cheskin, MD. Cheskin is a gastroenterologist and an associate professor at the Johns Hopkins Bloomberg School of Public Health. He tells WebMD there are two reasons for the change. One is that GERD treatments are better. And the other is that the long-term risks of untreated gastroesophageal reflux disease are better understood.

Who Needs GERD Treatment?

There are many good reasons to treat GERD. First, GERD treatment makes you feel better. Living with uncontrolled GERD -- the pain, the cough, the sleepless nights -- can be tough.

“GERD puts quite a burden on a person’s quality of life,” says Goutham Rao, MD. Rao is a board member of the National Heartburn Alliance and an associate professor at the University of Pittsburgh School of Medicine. “GERD,” he says, “can be truly debilitating.”

Second, GERD poses some serious long-term health risks. Over time, the damage to the esophagus can cause complications. One of those is a condition called Barrett’s esophagus, which is associated with a small but significant risk of esophageal cancer. Fortunately, GERD treatment can prevent Barrett’s esophagus from developing.

How do you know if you need treatment for GERD? What’s the difference between harmless heartburn and more serious GERD? It’s not so much the severity, experts say, but the frequency.

The usual recommendation is that anyone with symptoms two or more times a week should see a doctor. Cheskin is more cautious. He says that even symptoms that occur just once a week should be checked out. “Over the years,” he says, “even that level of heartburn can cause damage.”

Sometimes the most obvious sign of trouble is how often you use over-the-counter (OTC) treatments for heartburn relief.

“For me, it got to a point where I was using Tums like they were going out of style,” says Carmen Butschlick of Milwaukee, who was diagnosed with GERD in 2006. “And I was still having symptoms. That’s when I knew I had to go see a doctor.”

GERD Treatments: Medications

Medications -- both prescription and over-the-counter -- are the most common treatment for GERD and heartburn relief. Here’s a rundown of your options.

• Proton pump inhibitors (PPIs). If you have GERD, the odds are you’ll be prescribed one of these. This class of drugs -- which includes Aciphex, Nexium, Prevacid, Prilosec, and Protonix -- is now the standard GERD treatment. Not only do they help block the production of acid in the stomach, they also protect the esophagus from damage and allow it to heal.

“The proton pump inhibitors are a terrific class of medications,” says Rao. “They’re very effective, and they appear to be quite safe.” They’re even helpful in diagnosing GERD, Rao says. If they work, you probably have GERD. If they don’t, you probably have something else.

Like any medication, they can have side effects. There’s some concern that they may cause a small increase in the occurrence of weakened bones in older people. While the benefits of well-controlled GERD generally outweigh this risk, you should discuss it with your doctor.

• H2 blockers. These come as prescription and OTC medicines. They include drugs like Axid, Pepcid, Tagamet, and Zantac and were once the standard treatment for GERD. But they’re not used as often now. “They’re perfectly good medicines,” says J. Patrick Waring, MD, a gastroenterologist at Digestive Healthcare of Georgia in Atlanta and a board member at the International Foundation for Functional Gastrointestinal Disorders (IFFGD.) “But H2 blockers just aren’t as powerful as the proton pump inhibitors.”

Some doctors still recommend them as GERD treatment, at least for mild cases. They’re also sometimes added to PPIs to help treat occasional breakthrough symptoms. Cheskin tells WebMD that H2 blockers may have one significant advantage. Because most are generic, they can be less expensive than PPIs.

• Antacids. The old standbys from your grandparents’ medicine cabinet -- tablets like Tums and Rolaids and liquids like Maalox and Mylanta -- can still play a role in controlling GERD. These heartburn remedies aren’t suited for regular, long-term use. But their main advantage is that they work quickly, unlike more powerful GERD medications.

“If you’re suffering with heartburn after drinking or eating a big spicy meal, a proton pump inhibitor is not going to help,” Cheskin says. “But an antacid will.” Just as antacids offer heartburn relief to people without GERD, they can help GERD sufferers who have occasional breakthrough symptoms.

• Prokinetics. These prescription drugs -- like Reglan and Urecholine-- help speed up the emptying of the stomach. While they’re often mentioned alongside other GERD treatments, experts say that they’re rarely helpful. They might be of benefit to people who have GERD on top of another condition that’s slowing down their digestion. At the same time, prokinetics can have serious side effects.

Many potent drugs that were once only available by prescription -- like H2 blockers and the PPI Prilosec -- are now available over the counter. Experts say it’s fine for a person with occasional heartburn to use them, provided he or she follows the directions. Generally, they should never be used for more than two weeks.

GERD Treatments: Self-Care Tips

While drugs are often the main GERD treatment, there’s a lot you can do on your own. Here are some lifestyle tips for heartburn relief.

• Avoid trigger foods. Changing your diet can yield big benefits. Classic GERD triggers include chocolate, coffee, alcohol, peppermint, citrus juices, and tomatoes. The exact food triggers vary from person to person.

The prospect of life without coffee or chocolate may seem terribly depressing. But you don’t necessarily have to give them up entirely. “It’s about how much of these foods you eat,” says Cheskin. “So you can probably still have a half cup of coffee without a problem. The trouble starts if you’re having the coffee after a spicy meal.”

Butschlick says she misses chocolate the most, but she still eats it on occasion. “I just try to keep it to a small piece,” she tells WebMD, “and I’m prepared with some Tums for afterward.”

• Eat smaller meals. It’s not just what you eat, but how much. So avoid stuffing yourself. Instead of eating three big meals a day, try more frequent smaller meals.
• Don’t eat before bed. Waring says you shouldn’t eat two to three hours before bed. Not eating gives your stomach time to empty before you lie down.
• Loosen your belt. Tight belts or pants can aggravate your GERD symptoms. Wear looser clothing, especially at night.
• Prop up the bed. When you stick blocks under the head of your bed and raise it 6 to 8 inches, gravity will prevent the acids in your stomach from flowing into the esophagus during the night. While this used to be common advice, not everyone can do it. “Sleeping on an elevated bed just isn’t very comfortable,” says Waring.
• Lose weight. The heavier you are, the higher your risk of GERD. How much weight do you need to lose to control your symptoms? No one knows for sure, Rao says. But if you’re obese, aiming for a 10% weight loss is always a good idea.
  
• Evaluate your other medications. Many common medications -- aspirin and other NSAID painkillers, along with some drugs for high blood pressure -- can make GERD worse. Talk to your doctor about possible alternatives that may not worsen your symptoms.
• Stop smoking. Some experts believe that smoking may aggravate GERD symptoms. Add it to your list of good reasons to kick the habit.
• Take your GERD medicine as prescribed. GERD symptoms may come and go, but the underlying condition remains. Once you’re feeling better, you may be tempted to stop your long-term medication. That’s not a good idea. “Even if you’re not having symptoms, the GERD could still be causing damage,” Cheskin says. “You may feel fine right up until the acid bores a hole in your esophagus.” Never stop taking your medication unless you’ve talked to your doctor.

Can lifestyle changes be a person’s onlyGERD treatment? Experts disagree. Some believe that lifestyle changes can be enough on their own; others think that they should be added to medication. Talk to your doctor about the best approach in your case.

Some people opt for lifestyle changes because they don’t like the idea of being on lifelong medication. Al Kenny, a GERD sufferer from Englewood Cliffs, N.J., says he prefers to control his GERD with a better diet instead of his PPI. But it’s hard to find the motivation.

“My medicine lets me eat almost anything, which is the good news,” Kenny says. “But the bad news is that it works so well that I’m really not too careful about what I eat. So I can’t stop taking the drug.”

GERD Treatments: Surgery

Surgery for GERD can be effective. But because PPIs control symptoms so well, Rao says, rates of GERD surgery in the U.S. are falling rapidly.

Still, some patients -- Rao estimates less than 1% of all people with GERD -- might need it. Experts say that candidates for GERD surgery are people who

• Get some relief from medication, but still have symptoms anyway
• Can’t or won’t take GERD medication
• Already have complications, like Barrett’s esophagus, from GERD

Considering that the surgery does have a small risk of serious complications, it’s crucial that you get a correct diagnosis. You’ll need an endoscopy and probably other tests to make sure that you really do have GERD. To be certain, you may also want to consider a second opinion.

Finally, when finding a surgeon, choose someone with a lot of experience doing the specific operation you need. Waring recommends that he or she have a track record of at least 200 procedures.

The Importance of GERD Treatment

If you have GERD, there are a lot of effective ways you can control it. While newer, powerful over-the-counter medicines are one option, Cheskin notes a serious downside.

“These drugs provide such effective relief that there’s much less incentive for people with undiagnosed GERD to seek medical help,” says Cheskin.

That’s a problem. Self-diagnosis and self-treatment aren’t smart. If you have GERD, you need a doctor’s help. Together you can sort out the best GERD treatment -- and make sure that you don’t have another condition altogether.

GERD sufferer Chuck Alkin, 75, agrees. “My advice to people is to get treatment early,” says the New York City resident. He developed GERD about 45 years ago, and more recently, Barrett’s esophagus. Now, he’s concerned about his increased risk of cancer.

“It took me 20 years to get a diagnosis, and I regret that,” Alkin says. “If I’d been diagnosed earlier, and gotten treatment, I don’t think I’d be in this situation now.”

* Some patient names have been changed by request.