Debby Krzesni is a busy woman. The registered dietitian and STRONG coordinator for Area 1 Agency on Aging travels to senior centers with dining sites in Humboldt and Del Norte counties fielding questions about nutritional health and wellness.

Dehydration is always a topic of conversation. Too many older adults fail to drink enough fluids. Some are not aware that certain health conditions — fever and gastrointestinal illness, for example — increase the risk of dehydration and the need for fluid intake.

”Studies show one in three older adults may not get enough fluid,” Krzesni said. “What they don’t realize is that dehydration can be dangerous and even fatal.”

Fluid helps to carry oxygen and energy to the body and take away waste products.

“without fluids, the body can’t do any of those things. our bodies cannot store fluid, so it must be replaced every day,” she said.

That can be especially challenging for older adults, who often have a decreased thirst sensation.

”they may not even recognize they are thirsty,” Krzesni said.

Below, Krzesni gives some clues to preventing dehydration.

Why is dehydration more common in older adults?

Generally speaking, older adults have less body water than younger adults — 50 percent of their weight is water versus 60 percent for younger adults. also, the thirst sensation isn’t the only thing that declines with age. Kidneys may also function less efficiently.

Changes in physical condition also have an impact. People who have a hard time walking, reaching for a glass or feeding themselves may have a hard time getting to fluids. Then there are the cognitive declines in aging — confusion and deteriorating memory — that can make it hard to stay on top of fluid intake.

What other things affect our ability to stay hydrated?

The environment, medications and physical activity play a role. People perspire more in a hot or humid environment or when they walk, weight lift or garden. sometimes medications, especially diuretics, can result in fluid loss.

Diuretics are used to treat heart failure and hypertension, which are common ailments in older adults. You need to know if your medicines are diuretics as they will make you go to the bathroom with greater frequency. Lasix and Hyzaar, for example, are diuretics. Laxatives are another cause of fluid loss.

What are the signs and symptoms of dehydration?

Dehydration is identified many different ways. Weight loss, increased heart rate and low blood pressure are three symptoms. Decreased skin firmness is another. The skin of a dehydrated person lacks its normal elasticity and sags back into position slowly when pinched up into a fold. Normally, the skin springs back into position.

Other signs are dry mouth and tongue, decreased urination, constipation or fecal impaction, nausea, anorexia, sunken eyeballs and decreased functional ability. In some cases, dehydration can cause weakness, trembling, lethargy or confusion.

Some of these are easily observed. Decreased urination, for example, often results in darker, more concentrated urine that has a strong odor, which can be ammonia-like.

How much fluid does a person need every day?

Contrary to popular lore, it’s not eight 8-ounce glasses of water each day. Fluid needs are based on a person’s body size and health conditions. A registered dietitian can help you figure out your fluid requirement. It’s better to drink too much than too little.

What are the best sources of fluids?

Milk, juice, coffee, tea and water all count as fluids. keep in mind that caffeinated coffee and tea act like diuretics — they increase the need to go to the bathroom. Milk provides protein, calcium and vitamin D. Juice does not have the same nutritional value as whole fruit, but can add significant calories that may not be needed.

Is there fluid in foods?

Yes. Individuals who eat well can get the equivalent of two to three 8-ounce glasses of water from the fluids found in the foods they eat. Fruits and vegetables have high water content. So do soups, gelatin and pudding. Dry foods — think snack foods, cookies, and cheeses — have low water content. If a person is not eating well, they may need additional fluids to make up for the fluids they are not consuming.

How can you prevent dehydration in an older adult?

Given that we can’t rely on feeling thirsty as we age, a good idea is to establish a habit of drinking favorite fluids at every meal and at set times between them. Build habits early in life that encourage fluid intake without relying on feeling thirst.

Give these suggestions a try:

– Include a beverage with each meal and snack.

– keep fluids handy. A pitcher of water with lemon slice in the refrigerator can be very appealing.

– when sitting to watch a TV show, bring a beverage with you to enjoy.

– when you take your medications, drink more water than you need to swallow them.

– If you have trouble remembering to drink enough, pour a half-gallon of water in a pitcher every morning. Use it for any beverage needs during the day. when it’s empty, you’ve likely had enough fluid.

– Eat the recommended 5 to 9 servings of fruit and vegetables each day for essential nutrients and fluids.

– make a healthy soup meal, but look for lower sodium varieties.

– Take a water bottle on outings.

For more information, contact Krzesni at 442-3763, ext. 203 or email .

But most importantly, there are numerous legitimate medical and surgical indications for birth control pills and hormones. Oral contraceptives are used in dysfunctional uterine bleeding, in polycystic ovarian disease, unremitting dysmenorrhea or painful periods, in female hirsutism, in women who have had premature menopause due to autoimmune ovarian failure, in women who have had ovarian failure after their pituitary or hypothalamic tumors have been radiated or removed, in women who have lost both their ovaries to infections, tumors or cysts, in women with endometriosis, in Turner’s Syndrome (to prevent osteoporosis and to induce breast development and menstrual cycles).

Then there are those women who have lost ovarian function after chemotherapy and radiation for various cancers, mentally challenged girls in whom parents want to prevent disastrous and inadvertent pregnancies, female adrenogenital syndromes where deficiencies in various adrenal enzymes cause hirsutism and irregular periods. Also, there are women with bulimia and anorexia nervosa where the risk of osteoporosis and loss of periods is high due to poor nourishment, young girls withCrohn’s Disease and other conditions that can also cause them to become malnourished and suffer ovarian malfunction.

How about during perimenopause in women who have symptoms of hormone deprivation, or premature osteoporosis and bone fragility, or to help out of control diabetics in whom an unplanned pregnancy can result in fetal wastage and maternal complications? And there are so many other conditions where an unplanned pregnancy can endanger the life of the mother and the child.

Rush Limbaugh is an embarrassment to conservatives, and he has repeatedly misused his bully pulpit. but the conservatives have not repudiated him categorically and keep on providing him with platforms where he can spew his bombast, bile and lame excuses for his flammable declarations. Hopefully, the ditto-heads will put their thinking caps on and divest him of the power they confer on him.

Usha Nellore, Bel Air

The teen who opened fire at a high school in Chardon, Ohio, appears to have been a victim of bullying, Rolling Out and other sources are reporting.

Within the last few years bullying among teenagers has gotten the media’s attention countless times, especially involving LGBT youth. many teens have turned to suicide in order to end the years of harassment, including Tennessee high school student Jacob Rogers. Although T.J. Lane’s case is dramatically different, people who knew him and local authorities say that he was bullied.

Lane, 17, has been accused of killing three students and wounding two others in a shooting that occurred at Chardon High School, which is 30 miles east of Cleveland, the Associated Press reported. Lane was a former student of Chardon High but was enrolled in an alternative school for trouble students. His lawyer has entered the juvenile equivalent of a guilty plea.

Lane used Twitter and Facebook to tell classmates he would bring a gun to school and that was tired being called "mainstream" from other students.

"His only company to confide in was the vermin in the street. he longed for only one thing, the world to bow at his feet. They too should feel his secret fear. the dismal drear. His pain had made him sincere," a Facebook post says, which was made the day before the shooting. "he was better than the rest, all those ones he detests, within their castles, so vain. Selfish and conceited. They couldn’t care less about the peasents they mistreated. the world is a sandbox for all the wretched sinners," the post continues. "They simply create what they want and make themselves the winners. But the true winner, he has nothing at all. Enduring the pain of waiting for that castle to fall. Through his good deeds, the rats and the fleas. he will have for what he pleads, through the eradication of disease. so, to the castle he proceeds, like an ominous breeze through the trees."

Studies from the American Academy of Children and Adolescent Psychiatry say that half of all children have experienced bullying while attending school and 10 percent of kids are bullied regularly.

"Bullying is a well-known adversity among school-age children. according to data, approximately 10 percent of US children and adolescents are the victims of frequent bullying by peers," the study says. "in the aftermath of being bullied, victims may develop a variety of psychological as well as somatic symptoms, some of which may persist into adulthood. Psychological symptoms may include social difficulties, internalizing symptoms, anxiety, depression, suicidal ideation, and eating disorders (i.e., anorexia or bulimia nervosa)."

"Bullying behavior can be physical or verbal. Boys tend to use physical intimidation or threats, regardless of the gender of their victims. Bullying by girls is more often verbal, usually with another girl as the target. Bullying has even been reported in online chat rooms, through e-mail and on social networking sites," the study also says. "Children who are bullied experience real suffering that can interfere with their social and emotional development, as well as their school performance. some victims of bullying have even attempted suicide rather than continue to endure such harassment and punishment."

Celebrities have helped spread awareness about teen bullying. Rolling Out points out that rappers 50 Cent and Waka Flocka Flame have joined anti-bullying organizations. a number of stars have participated in the "It gets Better Project", which focuses on helping LGBT youth who have been bullied because of their sexual orientation. Celebrities such as, Justin Bieber, Chaz Bono, Ke$ha, Tim Gunn, Kathy Griffin and many more have made videos in hopes of helping harassed teens.

Lady Gaga has also participated in the campaign and has made it one of her missions to end teen bullying. the pop star recently visited Harvard University to launch her nonprofit "Born this way Foundation," which will help empower kids in hopes of reducing bullying in schools, as reported here.

She told a new York Times columnist that, when she was in high school, she was a victim of bullying.

"I was called really horrible, profane names very loudly in front of huge crowds of people, and my schoolwork suffered at one point," she said. "I didn’t want to go to class. And I was a straight-A student, so there was a certain point in my high school years where I just couldn’t even focus on class because I was so embarrassed all the time. I was so ashamed of who I was."

Gaga also told the newspaper that the scars from bullying are still with her but she hopes the foundation will prevent teens from having the problems she faces.

"the Born this way Foundation is not restitution or revenge for my experiences," Lady Gaga said. "I want to make that clear. this is: I am now a woman, I have a voice in the universe, and I want to do everything I can to become an expert in social justice and hope I can make a difference and mobilize young people to change the world."

Researchers have shown that acute cannabis consumption can lead to a host of medical issues, including, now, automobile accidents.

In laboratory and simulator settings, cannabis consumption impairs driving skills, but whether the same is true for real-world driving has remained unclear. in a new meta-analysis of nine observational studies involving nearly 50,000 participants, investigators examined whether recent cannabis consumption (determined by toxicologic analysis of whole blood or by self-report) raises risk for motor vehicle accidents.

Driving under the influence of cannabis was associated with significantly higher risk for motor vehicle accidents than driving unimpaired, the researchers found. (The full study, “Acute Cannabis Consumption and Motor Vehicle Collision Risk: A Systematic Review of Observational Studies,” is published in the British Medical Journal.)

Acute cannabis consumption has now been proven to substantially increase the risk for motor vehicle accidents, whether fatal or not. And we are learning that cannabis can lead to a whole host of other medical problems.

There is abundant circumstantial evidence pointing to a plausible biological relationship between marijuana smoking and lung cancer. we may be lacking the smoking gun, but few juries could fail to convict on this evidence.

We have the advantage of knowing that consistent smoke inhalation, whether tobacco, marijuana, or anything else, is a really bad thing. for instance, the high incidence of lung cancer among non-smoking Chinese women in Hong Kong has been linked, at least in part, to cooking fumes associated with frying. Smoke in wildland fires in the United States has at least 15 carcinogens, and risk assessment for firefighters with chronic smoke exposure includes a significant excess of cancers.this allows us to be even more certain of a probable link between marijuana smoking and lung cancer, and not to be too hung up about wanting more evidence.

Several studies link marijuana use to psychosis, anxiety, and panic attacks. the heavier the use, the greater the propensity toward psychologic symptoms. Additionally marijuana has been associated with gum disease according to a recent prospective study. Heavy usage is also linked to a loss of intelligence and even a marijuana withdrawal syndrome (PDF).

Studies on marijuana used medicinally as opposed to recreationally are lacking; this is, at least in part, because of the current restrictive scheduling of the drug. However, the available evidence shows that marijuana is effective in the treatment of chronic pain, muscle spasms resulting from various diseases (including multiple sclerosis), severe nausea, anorexia and wasting, glaucoma, and seizure disorders. each state that allows the medical use of marijuana has ratified its own set of approved indications.

Marijuana is a drug that poses significant risks to our overall well-being. Therapeutic interventions will require further study in order to determine the efficacy of this drug.

Image: Gordon Swanson/Shutterstock.

By Wynne ParryLiveScience

Holidays bring holiday memories, and, often a sense of nostalgia for good times long gone, perhaps even loved ones long gone.

This bittersweet nostalgia helps us feel connected, both around the holidays and at other times. and, it can be a salve to those suffering through hard times, according to nostalgia expert Krystine Batcho, a professor of psychology at Le Moyne College in New York.

LiveScience spoke with Batcho about this seemingly universal emotional state, why it’s important and why it seems to peak around the holidays. Here’s what she had to say.

Q. What is nostalgia?

It has been defined differently by different theorists over time. For instance, it was originally coined in 1688 by a medical physician as a term to indicate homesickness in young soldiers. he viewed homesickness as a physical illness experienced by soldiers away from home for the first time. without email or telephones, being away from home for the first time was pretty traumatic for many young men. Homesickness was viewed as an illness that caused all kinds of interesting symptoms, even anorexia resulting from loss of appetite. 

Today theorists make an important distinction between two different types of nostalgia, historical and personal. both are considered psychological entities and both are viewed as emotional states.

One is referred to as historical. That kind of nostalgia refers to feeling good sentiments or feeling attracted to times in the past when the individual might not even have been alive yet. if I said I feel nostalgia for or feel attracted to the Victorian time period, that would be an example of historical nostalgia.

The second type is the type most people have been researching and we refer to it mostly as personal nostalgia, and as you might suspect from the name, it means someone misses or feels emotions toward the past they themselves lived through, you might call it the autobiographical past. You might feel nostalgia for your childhood or your teen years.

To some extent what confused the research in this area is that some people are talking about it as a personality trait — more nostalgic or less nostalgic individuals — and other people are talking about it as a transient mood state — for example, “I feel more nostalgic around the holidays.”  You can define it either way.

It’s fair to say that, as a mood state, almost everyone would agree today that it is universal, it cuts across cultures, it cuts across historical periods, it even cuts across the developmental stages or across the age span.

Even a child can be nostalgic. if we’re talking about a 12 year old, a 12 year old might be nostalgic for toys he or she had as a toddler.

Q. your research has shown benefits associated with nostalgia. please tell me about that.

It seems to help people maintain a constant sense of who they are. You might refer to that as sense of self or understanding of one’s identity. and that is no small thing. from the time you are born, and as you go through life, there are so many changes, there are too many to even mention.

At a certain point, if there is something traumatic that occurs, a crisis, it could be anything from going off to war, immigration, a death in the family, whenever there is a major change it can be very helpful to kind of keep grounded in the sense of who you are. That sense of nostalgia helps to link you to your own personal past; it helps you remember who you have been. [ 10 Things You Didn't know About You ]

Q. do we feel more nostalgic as we age?

Right now, the consensus appears to be that the peak years for nostalgia might actually be early adulthood and the reason for that has to do with change and transition, because early adulthood is a very important psychological and developmental state where individuals figure out who they want to be. there is really a psychological assault on that sense of identity at that time — some people go off to college, some start their jobs, some get married, so there are a lot of significant changes, and it seems that nostalgia peaks around that time as a reaction to all the shifts, to all the transition.

Q. why do the holidays in particular tend to evoke nostalgia?

They can do that in a number of important ways, we have been talking about continuity or grounding, one of the ways individuals ground themselves is in terms of who they are relative to other people. In other words, we define ourselves in terms of our relationships, in terms of how we are connected to other people, that helps us identify our sense of self, and nostalgia helps us maintain those connections and a sense of belonging. That is one of the primary benefits of personal nostalgia.

Now move onto the question, as you can tell everyone from advertising to marketing to religion, everything about the holidays centers around relationships. People want to travel home to be with relatives, people are more inclined to participate in religious traditions or cultural customs. So in a way, holidays bring together people when they cannot be together. Nostalgia is almost like a psychological substitute for the real thing, if you think about the song, “I’ll Be Home for Christmas,” that is almost the quintessential holiday nostalgia that helps to re-unite us across time and space.

Holiday surprise for two parents with cancerFor the same reason, if you think about someone who lost a loved one during the year or around the holiday season, now they can no longer physically re-unite with the deceased loved one, but nostalgia once again becomes a psychological substitute, and all of those good memories that revolve around the time spent with the person really help us to cope with loss.

For one thing, loneliness has been shown to be a trigger for heightened nostalgia. it is interesting because then the nostalgia helps someone feel connected again. it helps to decrease the negative feelings of being alone. When you are lonely, it is because you are separate from others in one way or another; and the holidays are really notorious for making people feel alone, even when they are not physically alone.

Q. we hear about stress and depression related to holidays, could nostalgia during the holidays offer the opposite, an emotional benefit?

Absolutely, the most common definition of nostalgia today is that it’s a bittersweet sentiment. the idea of bitter and sweet, that’s what really captures why nostalgia is so special or unique. it is not just a happy-go-lucky feeling. Sometimes people confuse it with a warm-and-fuzzy feeling or looking through rose-colored glasses at the past, but actually it is more complicated than that, because the bitter part is knowing that the past is irretrievable, it will never be again, and that particular feeling is clearly negative.  it is clearly a very bad feeling, but what rescues us from despair around the holidays or any other time is the sweet part.

Sometimes in the literature you will see people talk about a redemptive quality. there is a redemptive quality when you feel nostalgic about the past that can never be again, because you have learned lessons from it and they can give you hopes for the future and it can also give you a sense of self-worth or self-value. So, if someone feels separated or lonely or unhappy for whatever reasons, it could be they lost their job or they are physically ill or they lost someone they love, the emotion of nostalgia can remind someone that there was a better time in life, there was a time when you were successful or healthy or happy but most importantly there was a time when someone loved you for how you are.

That can be really psychologically helpful, because it reminds you your value doesn’t depend on how much money you earn, whether you have a job or not, how healthy you are, any of those superficial things, all of which are important, but the most important thing was that someone loved you, it might have been your mother, father, sister, brother, wife, husband, whoever. we are talking about people in difficult or tough times, there was a time when they were loved by someone just for how they are.

Q. Does nostalgia serve less of a purpose in good times?

When people are feeling happy, when you think about the party scene, then nostalgia can take on more of the sweet tones, when people start telling funny stories about the things that have happened, that is true at any age, you can even see it cross generational boundaries. at those family gatherings nostalgia is very likely, even when things are very happy, because when you have family coming together, you have let’s say, a grandfather and grandmother telling stories about the past to grandchildren and that helps unite the family around a sense of connectedness, a sense of identity as a family and it’s true that nostalgia-prone people, if we are now talking about it as a personality dimension, they are people for whom relationships are very important.

Stress-less holidays for fractured families: It’s all in the planningSo in these gatherings, some of which can just be parties or dinners, some of them can be religious rituals or ceremonies, there is a way nostalgia even in the best of times helps someone feel part of something bigger than themselves.

Holidays bring cultural beliefs and even myths, whether it is reindeer and Santa Claus or whatever. and it makes people feel they are connected to a past and to other people across time, across cultural barriers, it is a uniting phenomenon, a unifying phenomenon.

What triggers your feelings of holiday nostalgia? Share your memories with us on Facebook

Editor’s Note: This interview has been condensed.

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PALM BEACH COUNTY, Fla. — The Palm Beach County Health Department is warning resisdents of a locally acquired case of the mosquito borne illness, Dengue Fever.

“we have been closely monitoring the county for the possibility of Dengue being reintroduced in our area since we have seen it in counties north and south of us,” said Health Director Alina Alonso, MD. “with today’s confirmation I am issuing a Mosquito Borne Illness Advisory.”

In 2009 locally acquired cases of Dengue were diagnosed in Key West and since then, others have been found in South Florida. this is the first locally acquired case in Palm Beach County although eight others have been reported this year and acquired out of the country.

Classic dengue fever is characterized by acute onset of high fever, 3-14 days after the bite of an infected mosquito. Patients develop high fevers, severe headache, muscle and bone aches, rash, severe pain behind the eyes and mild bleeding from the nose or gums. Acute symptoms, when present, usually last about 1 week, but weakness, malaise, and anorexia may persist for several weeks. Treatment emphasizes relief of symptoms, avoiding aspirin and other non steroidal anti-inflammatory medications and drinking plenty of fluids. Severe manifestations (e.g., dengue hemorrhagic fever and dengue shock syndrome) are rare but may be fatal.

Dengue is carried by the Aedes aegypti mosquito which is commonly known as the household mosquito but unlike others it is a day biter. The advisory encourages all to drain any standing water from around the home or business as these mosquitoes can leave their eggs in the smallest water reservoirs. all are also advised to cover their windows with screens in good condition, use air conditioning when possible and cover themselves with light weight long sleeve clothing and pants. Insect repellants containing DEET or picaridin are also effective in preventing the mosquito from biting.

Mosquito control has been notified and is stepping up its spraying efforts to reduce the Aedes mosquito population.

Persons experiencing symptoms should see their medical provider or if severe visit the nearest hospital or clinic.

What is dengue?

Dengue (pronounced den—gee) is a disease transmitted to humans by the bite of an infected mosquito. in the Western Hemisphere, the Aedes aegypti mosquito is the most important transmitter or vector of dengue viruses. it is estimated that there are over 100 million cases of dengue worldwide each year.

What is dengue hemorrhagic fever (DHF)?

DHF is a more severe form of dengue infection. it can be fatal if unrecognized and not properly treated in a timely manner. DHF is caused by infection with the same viruses that cause dengue fever. with good medical management, mortality due to DHF can be less than 1 percent.

How is dengue spread?

Dengue is transmitted to people by the bite of an Aedes mosquito that is infected with a dengue virus. The mosquito becomes infected with dengue virus when it bites a person who has dengue virus in their blood. The person can either have symptoms of dengue fever or DHF, or they may have no symptoms. after about one week, the mosquito can then transmit the virus while biting a healthy person. Dengue cannot be spread directly from person to person.

What are the symptoms of dengue?

The principal symptoms of dengue are high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash and mild bleeding (e.g., nose or gums bleed, easy bruising). Generally, younger children and those with their first dengue infection have a milder illness than older children and adults.

What is the treatment for dengue?

There is no specific medication for treatment of a dengue infection. Persons who think they have dengue should use analgesics (pain relievers) with acetaminophen and avoid those containing aspirin. They should also rest, drink plenty of fluids and consult a physician. If they feel worse (e.g., develop vomiting and severe abdominal pain) in the first 24 hours after the fever declines, they should go immediately to the hospital for evaluation.

Where can outbreaks of dengue occur?

Outbreaks of dengue occur primarily in areas where Ae. aegypti (sometimes also Ae. albopictus) mosquitoes live. this includes most tropical urban areas of the world. Dengue viruses may be introduced into areas by travelers who become infected while visiting other areas of the tropics where dengue commonly exists.

What can be done to reduce the risk of acquiring dengue?

There is no vaccine for preventing dengue. The best preventive measure for residents living in areas infested with Ae. aegypti is to eliminate the places where the mosquito lays her eggs, primarily artificial containers that hold water. Items that collect rainwater or to store water (for example, plastic containers, 55-gallon drums, buckets, or used automobile tires) should be covered or properly discarded. Pet and animal watering containers and vases with fresh flowers should be emptied and cleaned (to remove eggs) at least once a week. this will eliminate the mosquito eggs and larvae and reduce the number of mosquitoes present in these areas. Using air conditioning or window and door screens reduces the risk of mosquitoes coming indoors. Proper application of mosquito repellents containing 20-30 percent DEET as the active ingredient on exposed skin and clothing decreases the risk of being bitten by mosquitoes. The risk of dengue infection for international travelers appears to be small. there is increased risk if an epidemic is in progress or visitors are in housing without air conditioning or screened windows and doors.

Park City High School senior Kevin Whiting has felt pain in his lower abdomen all his life.

He felt it each time his body hit a growth spurt, and by the time he was 13 and a student at Treasure Mountain Middle School, the pain was so severe, he couldn’t eat, let alone function as a normal teenager.

His parents Vicki and Jeff took him to doctors and specialists but were told the same thing.

Kevin was anorexic.

The problem was, he wasn’t. Kevin had been misdiagnosed and was actually suffering from Wilkes Syndrome, an ailment where the Superior Mesenteric Artery cut off his small intestines so food couldn’t pass through.

The symptoms were severe weight loss and pain, said his mother Vicki Whiting during a joint interview she and Kevin had with The Park Record.

“Kevin was treated with anti-anxiety medication and anti depressants to cure his anorexia,” Vicki Whiting said. “That was when Kevin became suicidal because he was taking medicines he shouldn’t have been on.”

Unfortunately, once her son was labeled as anorexic, it became the de facto diagnosis.

“It precluded Kevin from getting the diagnostics he should have received, and to get the medical system to move past the short-hand explanation was one of the hardest things we had to go through,” she said.

After going to four or five specialists, the Whitings went to a family friend who was a colorectal surgeon.

“He knew me well enough to run the diagnostics that needed to be done, and the remedy was surgery,” Kevin said.

The Whitings’ plight is documented in a new book called “In Pain we Trust: A Conversation Between Mother and Son on the Journey from Sickness to Health.” The book will be released on Oct. 10.

The idea for the book came after Kevin’s duodenojejunostomy, which is an operation that forms a passage between the beginning and middle of the small intestine.

“The last time the surgery had been done at Primary Children’s Hospital was 10 years ago but at that point, Kevin was taller than five feet and weighed only 65 pounds,” Vicki said.

After the surgery, Kevin still was being nourished through a pick line that ran through his veins, said Vicki Whiting.

“We spent a lot of time in the car going from doctor appointments to school,” she said. “Usually his spirits were high, but one particular day, they weren’t and he said, maybe there was some way we could make it so someone didn’t have to go through what he did.”

The idea stuck with Vicki, who is a professor at Westminster College, and she decided to write a book.

“Since I do write as part of my occupation and my articles are meant to inform and share ideas, it was the only thing I had to share from my skill set,” she said.

The book was different than writing about mentorships, global leaderships and social entrepreneurship articles she was used to writing, but in some ways easier.

“Kevin and I both felt we had an important story to share,” she said. “We felt it could make a difference for other kids who may be suffering through chronic, complex illnesses, or who were having trouble having their voices heard as they worked through the medical system.”

At other times, it was more difficult.

“Going back through and reliving the painful story and realizing at many junctures, the outcome could have been much different, was hard for us,” Vicki said. “My husband Jeff would come home and know we had been writing because of the heaviness in the air.”

Kevin had a difficult time writing because it brought back scary events that he had tried to block out of his mind.

“It did help therapeutically, though,” he said. “It also put forward memories that I didn’t recall, because sometimes when something happened I was trying to distract myself form the pain or I was so drugged up that I didn’t remember.”

However, the writing sessions were important to both, so they continued.

“Because the book is chronological, I would write my section and tell Kevin what I was writing about and ask him about his takes on the events,” Vicki said. “He would give me his story or essay and I would transcribe it or edit it. to have Kevin’s voice in the book is brilliant and I think is a contribution that I haven’t found anywhere else.”

Another challenge was knowing when not to open the door too wide on the family’s privacy.

“I tend to live my life pretty open, so it wasn’t hard for me to write my part, but the tricky part of it all is the fact that it’s the story of our family,” Vicki said. “My husband tends to be the one who makes it through a problem and march forward, and still it’s hard for him to see the pictures. My oldest son, Philip is a private person, and then we have our youngest daughter Katie, so we had to make sure we weren’t bringing in aspects of our private life that others would feel uncomfortable having out in the public.”

Book publishers had different ideas of how to distribute the book.

“McGraw-Hill publishers saw it playing a role in nursing school as a comprehensive case to go along with a nursing fundamentals text,” Vicki said. “So we ultimately left it up to Kevin to choose.”

“I thought the book meant more as a story than as a text,” he said. “As a text, no one would attach to the characters as much.”

So the family chose to publish through Blooming Twig Books, which will release it as a story.

Having the book published helped Vicki deal with some of the uncertainties she faced during the crisis.

“I realize now that I did make the best choices I could have at the time,” she said. “Even if people don’t buy the book, it’s documented so people like Kevin’s kids and his grandkids can know who he is.”

Kevin still hopes the book will help parents, doctors and children listen to each other.

“I’d like it to helps a doctor be more compassionate with a patient or help with a parent navigate the medical system or have a kid deal with their own pains,” he said.

“In Pain we Trust” will be available Oct. 10 at amazon.com and by visiting vickiwhiting.com.

Yesterday, French newspaper Libération reported that the European Medicines Agency (EMA) in London has set its sights on Servier as well—initially for problems around strontium ranelate, an osteoporosis drug marketed by Servier in France under the name Protelos. an estimated 390,000 French women in France have taken the drug during the last 4 years.

Dominique Maraninchi, head of the French regulatory agency AFSSAPS, confirmed EMA’s worries in a telephone interview with ScienceInsider. in November 2007, EMA’s Pharmacovigilance Working Party issued a warning that Protelos could cause severe and potentially fatal skin rashes known as Drug Reaction with Eosinophilia and Systemic Symptoms, and ordered Servier to correct “flaws” in its system to keep track of such adverse events, Maraninchi says.

EMA asked AFSSAPS to carry out an inspection in December 2009 to ensure Servier had followed up. that inspection revealed other “critical and major findings,” this time with Servier’s manufacturing process, and raised concerns over all of the company’s drugs, says Maraninchi. as a result, Servier was ordered to submit information on all of its medicines to EMA, whether authorized for marketing by EMA itself or by national agencies.

EMA eventually concluded that the benefit-risk balance remained positive for Servier’s drugs, but it instructed the company to provide extra product information for some of them, an EMA spokesperson says. AFSSAPS carried out a second inspection in July of this year and will present its findings by the end of this month.

On Tuesday, reports in the newspapers Le Figaro and Libération also cast doubts on Servier’s integrity when it applied for regulatory approval for Mediator in 1973. the papers quoted from the court testimony of retired neurosurgeon Jean Charpentier, now 81, who prepared the regulatory file at the time. Charpentier, who started working for Servier in 1968, reportedly told the judges that clinical trials had shown Mediator to be a powerful appetite-suppressant, but that this was downplayed in his report to get Mediator approved as an antidiabetic drug. (Diabetes was “an infinitely more profitable choice” than weight loss for pharmaceutical companies, said Charpentier.)

the report also didn’t mention that Mediator is an amphetamine derivative, Charpentier said in his testimony. “The word amphetamine was to be avoided,” he said.

Jacques Duhault, 78, a pharmacist who headed the company’s diabetes and obesity lab in the 1960s, told the judges he regretted that Servier didn’t pull Mediator as a precautionary measure in 1999, Libération reported. his studies described the drug as a “powerful appetite suppressant.” in January 1969, he said that the drug, then known by its code name S992, “causes almost total anorexia from the first day.”

Servier has dismissed all of the allegations. in press statements, the company has condemned the breach of judicial secrecy over the Mediator testimonies, reaffirmed that it had “deceived neither the health authorities nor patients,” and denied that any of Charpentier’s studies had been tampered with.

Former Healdsburg star, no stranger to challenges, now overcoming cancer Published: Saturday, September 17, 2011 at 8:45 p.m. Last Modified: Saturday, September 17, 2011 at 8:45 p.m.

DAVIS — Cloverdale’s Sarah Sumpter never felt better, that was the thing. she was in the best shape of her life — toasty, rosy, ready to lead UC Davis’ women’s cross country team to a conference title. Repeat her 2009 honor as the Big West Conference Women’s Athlete of the Year? Yep, that was certainly possible. Fatten that resume, which included her winning the Division IV CIF state championship while at Healdsburg in 2007? that was there, too.

“I was on a roll,” Sumpter said.

OK, so she had missed her menstrual period. it happens with women runners. Might as well get it checked out anyway, she thought. it was Sept. 10, 2010, and Sumpter saw the upcoming doctor visit as eventful as going into a convenience store for a doughnut. It’ll just take a sec. Heck, Sumpter had a race the next day in Sacramento. it was like she was fitting this pesky thing in between classes.

The MRI was taken at Sutter Davis Hospital. Half-hour later, the doc emerged.

“I need for you to come into my office with me right now,” he said.

“You are not going to tell me anything good, are you?” said Sumpter, reading the body language.

“unfortunately not,” the physician said.

He showed Sumpter four X-ray panels. A growth was on the right side of her brain, and had advanced to the point that it was pushing against the left side. “Smashing” was the verb Sumpter used. “Huge” was the way it appeared to her.

“I don’t know what it is,” the doctor said, “but I am not comfortable letting you leave this hospital.”

“does this mean I will live,” Sumpter asked, “or die?”

“I don’t know” was the reply.

Her mind hit the throttle and in no particular order, but in rapid fashion, she was flying everywhere. I have no symptoms. I’ve got a race the next day. I am on a roll. never felt better. I came through anorexia. Now this? Nah. maybe the panels are inconclusive. maybe this. maybe that. maybe. maybe. maybe. one thought kept repeating itself.

“Is this it? Is my life over? I have way too much left to do.”

The solemnity of the moment was driven home by the reaction of the medical personnel. You are running, competing for Davis? Sarah, you shouldn’t even be walking! she remembers that, too.

Tumors never cross the radar in young athletes.

“You’re going to make the Stanford meet, aren’t you?” Sumpter remembers her teammates asking her of a competition that would take place in two weeks.

Ten days later Sumpter underwent surgery. Eighty percent of the mass was removed. the remaining 20 percent had wrapped itself around cords that affect motor functions. the surgery would have been too dicey. Weeks later, tissue examination revealed a Stage 3 malignancy in a small part of the mass.

Within days, if not hours later after the surgery, Sumpter knew what she must do. Go on the offensive. No pity party here. it was the same Sarah who decided to go public with the Press Democrat in 2008 about her battle with anorexia.

“I got a gerbil in my head,” she joked.

Sumpter had six weeks of radiation, five days a week. she began to take and still takes a chemotherapy pill, Temodar, twice a day, three weeks on, one week off.

But the exercise! What about the exercise, Sumpter wanted to know. I want to walk. Go ahead, but stop if you get dizzy or nauseous. within two weeks, Sumpter was walking three to four hours a day in Cloverdale. By mid-November Sumpter told her oncologist, Dr. Nora Wu, “I can’t stand walking this much!”

She was a runner! It’s my religion, she said. Sumpter begged, pleaded.

“I finally broke her down,” said the 5-foot-1, 104-pound academic junior. “she realized I was not a normal case. I’m an athlete.”

OK, OK, Sarah, do some aqua running. Sumpter went to the swimming pool at the Finley Center in Santa Rosa. In February she ran unattached in some meets. Last Saturday, for the first time in over a year, Sump-ter competed. In that same cross country Hornet Jamboree she missed a year ago, Sumpter placed third against a field that included runners from Sacramento State, Cal, St. Mary’s and Santa Clara. she was named Big West Athlete of the Week, an honor reflecting not only her high finish but her journey over the previous 12 months.

“I feel so blessed,” Sumpter said. “I found out how stubborn I am. I also found out how much I am loved. my family, my friends, my teammates have been incredible. and my coach … ”

Sumpter paused to catch her breath. Drew Wartenburg was the second person she called that day after she called her mother, Shawn. Wartenburg was at the emergency room in 10 minutes. he was there for every bit of news, development, reaction. he was there for the person, not so much for the athlete.

“I’m really glad you are here,” Wartenburg told her time after time, whether it be in the hospital, watching a meet, running with those shuffling baby-steps in those initial recovery days. Wartenburg was the parent, the uncle, the friend, the coach, the lamppost to lean on.

“I don’t have the words,” said Sumpter, when asked to explain his value.

When her cross country teammates all bought and wore pink backpacks last season that read “FOR STUMP,” she didn’t have the words for that, either. When the UC Davis men wore bracelets in last year’s conference meet that read “STUMP,” she went quiet again. some things reach so deep for her, it is as if the issuing of words would cheapen their impact.

“the dark night of the soul,” is what she said of those first nights after the MRI and then again after surgery. Sumpter is a little over a year from getting her degree in psychology and she has had a lot of on-the-job training forced upon her. Sumpter fought back, as is her nature, like she did to conquer her eating disorder, to rebound from the hip flexor injury that shelved her freshman year, and now the tumor.

She doesn’t know, no one does, if that chemo pill will perform its idealized function and disintegrate that remaining tumor mass. but she refuses to worry about what she can’t control. Rather, she concentrates on what she can speak of.

“Athletes think of themselves as tough, and we are,” said Sumpter, 21, “but we are so incredibly fragile, mortal. A year ago I was running my fastest times. I had even developed muscles, if you can believe that. I felt more confident than I ever have in my life. and then this happened. Drew and I call it the ‘new normal.’”

Appreciate what is. Don’t waste time on what could be or what was. her teammates have embraced that thought spectacularly.

“They want to paint the Aggie symbol and the Aggie colors on my scar,” said Sumpter of the 12-inch, crescent-shaped mark on the right side of her head.

Will she let them?

“oh, yeah,” Sumpter said with smile a lot bigger than that scar. “oh, yeah.”

For more North Bay sports go to padecky.blogs.pressdemocrat.com. You can reach Staff Columnist Bob Padecky at 521-5223 or bob.padecky@pressdemocrat.com.

HAPPINESS: ALL IN WHO YOU KNOW, GOALS

An Indiana University study that compared strategies used by extroverted college students and their less socially inclined peers found that happy people who are less outgoing relied less on partying and drinking to be happy and more on connections with family and friends or cognitive strategies, such as positive thinking.

“You don’t have to go out and party to be happy. That’s the thing students feel they need to do, particularly when they’re new to campus,” said Bernardo J. Carducci, director of the Shyness Research Institute at Indiana University Southeast. “But, it’s critical to maintain contacts with family, with friends and like-minded individuals with whom you feel some sort of meaningful connection. That could be other people in clubs that you belong to, like the accounting club, astronomy club . . . people you play intramural sports with.”

A second study, also conducted by Carducci, found that college students who are goal-oriented also tend to be happier than their less focused peers.

“When you look at what these people do differently, people who strive to reach personal goals, they engage in more purposeful leisure, rather than sitting around and watching television,” Carducci said. “They don’t go clubbing as much as the others. They spend more time on what we call spiritual reflection. They write in journals. these are the kinds of people who tend to be more happy. these also are the people who mostly graduate from college.”

* Carducci’s study “Self-Selected Strategies for Seeking Happiness by Individuals with High Happiness and Low Social Affiliation: a look at being HHIPe” was discussed in August at the American Psychological Association’s annual meeting. Co-author was Rebecca S. moody, an IU Southeast undergraduate psychology major. The study “Instrumental Goal Pursuit as an Individual-Difference Dimension in the Seeking of Subjective Well-Being” was discussed in June at the Biennial Meeting of the Association for Research in Personality. Co-author is Benjamin D. Traughber, an IU Southeast undergraduate psychology major. * Both studies involved 337 undergraduate students who completed an online survey that measured aspects of happiness, social affiliation, and drive to reach goals. The survey included the Satisfaction with Life Scale, Positive/Negative Affect Scale, and a 44-item Survey of Happiness Strategies.

Carducci said it would be useful for student advisers to know where students rate on Instrumental Goal Pursuit. “With this measure, you can look at people who are low and realize you need to keep an eye on them,” Carducci said. “They might need help learning how to develop goals. They might need help learning how to delay instant gratification.”

The studies are part of the IU Southeast Happiness Project, which is looking at the relationship between happiness and student achievement and retention. For more information about the Shyness Research Institute, visit ius.edu/shyness/.

SEXUAL HEALTH SHOULDN’T BE LEFT TO CHANCE

For college students, back to school readiness goes far beyond gearing up with laptops, school books, a map of campus, or dorm room furniture. College students from freshmen to seniors — even those who may not be planning to have sex any time soon — need to take care of their sexual health.

Debby Herbenick, associate director of the Center for Sexual Health Promotion at Indiana University and a sexual health educator at The Kinsey Institute, offers this tips:

* Wait until you’re ready. There’s a lot of advice out there about avoiding the pressures of sex. Equally important is to figure out what “ready” means for you. When you’re in love? Married? Engaged? With someone you trust? after you’ve learned all you can about birth control, preventing sexually transmissible infections (STI) and are in a relationship? People’s “ready point” varies from one individual to another. Once you understand what you need to feel safe and comfortable enough to open yourself to pleasurable sex, you’ll have a better sense of when to say “No” — and, ultimately, to say “Yes.” * Update your status. Your STI status, that is. if you’ve ever had oral sex, vaginal sex or anal sex, then it would be wise to get tested for STIs such as chlamydia (the most common bacterial STI in the U.S., and prevalent among those ages 15 to 24), gonorrhea, syphilis and HIV. Leaving certain STIs untreated can lead to various health problems, including infertility for both women and men. Condoms provide excellent protection against most STIs, so keep some around and make sure to use them if and when you have sex. Adding water-based lubricant to the condom can increase pleasure. * plan ahead. even though many college students abstain from sex for personal or religious reasons, it is true that most college students choose to have sex with a partner — or more than one partner — during their college career. Sex could be greatly improved, and be enormously safer, if more men and women thought ahead. if you’re already sexually active, or thinking about becoming sexually active in the next year, you should also seek out a wellness exam from your healthcare provider. Women: ask about a gyn exam. Men and women both: ask about the HPV vaccine, STI testing, and birth control options. also, keep a handful of condoms around your dorm room. even if you don’t end up using them any time soon, they tend to have long expiration dates — or your best friend or roommate may need one. * Party within reason. Going to parties is a common part of the college experience — and they can be a lot of fun. Make sure to follow common sense, though: Go with a group of friends and make sure to leave with that same group of friends. never walk home alone. never let your friends walk home alone (especially if they’ve been drinking or taking drugs). keep an eye on your drink (yes, that means taking it to the bathroom with you). also, load your phone with numbers of friends you can rely on as well as a reliable taxi service or “safe ride home” service provided by your fraternity, sorority, university, community and/or health center.

College is a great experience for many men and women. Herbenick said many people use this time to date, to better understand or explore their sexuality, to come out to family or friends, to learn how to communicate about sex with a partner and to generally make good memories.

“By having safer, smarter sex you’re also likely to have better sex — if and when you make that choice,” she said.

INDOOR AIR QUALITY: NOTHING TO SNEEZE AT

For college students, their dorm room or apartment might be “home, sweet home” — but the air they breathe inside their homey sanctum could be causing illness or breathing problems.

Cramped or shared living quarters can make questionable air quality even worse when poor cleaning habits, building features that serve as “sinks” for pollutants, and even modern “green” designs expose students to increased levels of unwanted airborne substances and common allergens. these can include mold, tobacco smoke, radon, pet dander, volatile organic compounds and other substances.

“When multiple residents share a house or apartment, they’re at risk for bacterial and viral infections caused by the close quarters,” said Larry Newton, a certified industrial hygienist and assistant director of the Industrial Hygiene Lab at Indiana University’s School of Health, Physical Education and Recreation. “Humans shed bacteria such as Staph, an opportunistic organism that can cause mild to severe illnesses including MRSA (methicillin-resistant Staphylococcus aureus). Breathing problems can be aggravated. Simple hygiene, like routine light cleaning, can make a big difference. you don’t need to be phobic about it, just pick up and clean up after yourself.”

Wallboard, said Newton, can act as a sink for pollutants because the wallboard can absorb odors and chemicals and re-emit them later when the conditions, such as temperature and humidity, are right. Allergens such as mold and pet dander can get stuck in cracks found in walls, carpeted floors and behind fixtures.

Weatherization and other environmentally friendly retrofitting can make it more difficult for fresh air to come into a house and for stale or polluted inside air to leak out. Newton compares it to trying to breathe with a plastic bag over one’s head.

Kevin Slates, clinical assistant professor and director of the Industrial Hygiene Lab, said the risks of poor indoor air quality in residential and commercial dwellings are often overlooked because the health symptoms are not acute.

“The EPA cites poor indoor air pollution as one of the Top 5 health risks,” Slates said. “As a result, we are seeing an increase in the diagnosis of adult onset asthma. according to the Centers for Disease Control and Prevention, almost 34.1 million Americans have been diagnosed with asthma. In addition, 9.6 percent of children have asthma.”

Slates and Newton provided the following tips for improving indoor air quality:

* put away or throw away things that attract rodents or bugs, such as food, dirty dishes and clothes that need to be washed. * Mold will show up where there is a water leak, so any water leaking into the residence or excessive moisture should be addressed right away. Cabinets, drawers and closets that are rarely used can accumulate moisture, stale air and other pollutants, so they should occasionally be aired out. too much humidity can encourage mold growth, so it should be reduced to acceptable levels (less than 60 percent). * Residents should open windows and doors at least once a year to air out their dwellings. * Contaminants in air ducts usually accumulate where the supply-air duct curves sharply up to the floor vent. Slates and Newton suggest removing the register and vacuuming the supply duct at that curve. * Vacuuming the supply-air ducts’ curves in newly built residences is particularly important before turning on furnaces or air-conditioners, Newton said, because builders often sweep debris, such as fiberglass, gypsum dust, general debris and sawdust, into these ducts. if they are not vacuumed out first, the debris will be blown into the living areas of the residences. * Leave shoes and boots by the door so that allergens and contaminants that could be hitchhiking on the footwear are not spread throughout the residence. * Purses and backpacks should be kept off of the ground as much as possible, particularly in restaurants, to avoid picking up “riders,” such as insects. * Kitchens and bathrooms should be cleaned at least once a week because roommates often share these spaces or items within these spaces. That red film that sometimes appears in toilets is bacteria, Newton said, and should be cleaned. Surfaces should be wiped with a cleanser to keep germs from spreading. * Air freshening sprays generally mask odors but do not eliminate the bacteria, mold or other substances causing the odor. * Change furnace filters according to manufacturers’ instructions. Consider using a HEPA filter in the furnace and purchasing a HEPA-filtering vacuum cleaner. Residents can check with the maintenance staff or supervisor of their apartment buildings to see how often filters are changed. * Carpeting can serve as a reservoir for allergens and other particulates, so residents should consider solid floor surfaces.

Slates and Newton said everyone should be concerned about inside air quality, but children, the elderly and people with compromised immune systems, asthma and serious allergies are more likely to feel the effect of poor inside air quality.

DRUNKOREXIA: STARVING FOR a DRINK

Binge drinking and eating disorders are rife on college campuses. The combination of disordered eating practices and binge drinking behavior, “starving all day to drink at night,” can cause a range of health problems.

Young women (and some men) beginning their college experience are concerned about body image and may worry about gaining the “freshmen 15.” They might engage in calorie-sparing eating or even go so far as to fast prior to weekend drinking parties with the hope of not gaining weight.

“They also might abuse caffeine, laxatives, diuretics, prescription stimulants or prescribed or over-the-counter medications to suppress appetite, to purge themselves or to increase their metabolism,” said Carole Nowicke, research associate at the Indiana Prevention Resource Center at Indiana University. “These young men and women in most cases have not been diagnosed as suffering from anorexia nervosa or bulimia nervosa but are engaging in extreme calorie restriction, and/or purging before drinking.”

Not eating or drinking non-alcoholic beverages prior to a night out, says Nowicke, can cause dehydration, which is further exacerbated by the diuretic properties of alcohol. Drinking on an empty stomach allows alcohol to enter the bloodstream much faster than it would if it were arriving on top of a full meal. Nowicke said extreme dietary restriction, bulimia or anorexia, may lead to weakness, dizziness, fainting, low blood pressure, constipation, bone thinning, hair loss, growth of fine body hair (“lanugo”), loss of tooth enamel and decay, sleeping problems, electrolyte imbalances, and problems with the heart, kidneys and liver.

Eating a meal before indulging, especially food containing proteins, fats, and carbohydrates, will slow the absorption of alcohol as it passes through the stomach and into the small intestine and then is metabolized by the liver.

Some facts about disordered eating, alcohol and binge drinking:

* a 2010 study of freshmen at a Southeastern University found that 14 percent were restricting calories prior to drinking. six percent of the freshmen were trying to avoid gaining weight and 10 percent were trying to accentuate the effects of alcohol. * a 2001 study by the National Center on Addiction and Substance Abuse (CASA) found that individuals with eating disorders were up to five times likelier to abuse alcohol or illicit drugs, and those who abuse alcohol or illicit drugs are up to 11 times likelier to have eating disorders. * There may be little gender difference in calorie restriction behavior prior to binge drinking, although some males indicate that they may spend less money on food to save funds for alcohol purchases, as well as wishing to feel the effects of alcohol more quickly. * Very thin celebrities who gain media attention by appearing inebriated in public may seem glamorous to young men and women and encourage similar behavior. Pro-anorexia websites publish photographs of these celebrities for “thinspiration.” * “Drinking games” encourage binge drinking by design; the objective is not to socialize with friends but to get quickly inebriated. * a “drink” is half an ounce of alcohol: one 12-ounce beer, one 5-ounce glass of wine, or one 1.5-ounce shot of distilled spirits. * a “binge is a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram percent or above. For the typical adult, this pattern corresponds to consuming five or more drinks (males), or four or more drinks (females) in about two hours. * a wine spritzer, reduced-calorie beer, or one ounce of liquor mixed with a zero calorie soft drink may be slightly under 100 calories, but margaritas, mudslides, Long Island iced teas, chocolate martinis, pina coladas, and “hard” lemonades can range from 200 to more than 600 calories per serving. Therefore, 4-6 mixed drinks can easily add up to more than 2,000 calories, the same amount as eating an extra-large cheeseburger or having a large milkshake. * as many as 40 percent of college students binge drink. * About 90 percent of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks. * Approximately 92 percent of U.S. adults who drink excessively report binge drinking in the last 30 days.

Nowicke said the combination of eating disorders and substance abuse is not a new phenomenon, but the shorthand term “drunkorexia,” which is not a recognized psychological term, describes a certain type of drinking behavior in connection with unhealthy dieting. It has obtained recognition in the media for encompassing the issues of binge drinking and anorexia/bulimia. She said the strategy of not eating in favor of consuming alcohol might fail to keep weight off because many popular mixed drinks are high in both fat and calories.

Nowicke can be reached at 812-855-1237 and