ADJUVANT THERAPY FOR BREAST CANCER

You've just had, or soon will have, an operation to remove one or more invasive tumors from your breast. Your doctor wants you to consider an additional form of breast cancer treatment called adjuvant therapy.
The term "adjuvant" means something that helps or contributes. Adjuvant therapy uses chemotherapy drugs, radiation, hormone therapy, targeted therapy or a combination of these to help destroy any cancer cells that were not removed during your breast cancer operation. Its goal is to decrease the risk of your breast cancer coming back.
Your decision about adjuvant therapy for breast cancer is a complex oneYour decision about adjuvant therapy for breast cancer is a complex one. There's no one right answer for all women. Potential benefits vary depending on your situation, and there are costs, including potential side effects and problems caused by the therapy itself. You have to weigh both short-term and long-term effects and outcomes.

Health alerts and trusted answers on your mobile phone

Get topical news and health information from the world's first and largest integrated not-for-profit group medical practice and the source you can trust for reliable health information. Get First Aid tips and timely Health Alerts. See what your symptoms mean, and find a nearby Emergency Room or urgent care facility if you need care right away.*In some cases, a molded helmet may be used to help shape a baby's head. The helmet is worn continuously during the treatment period — often up to 12 weeks — with time off only to clean the device and the skin underneath.

BABY'S HEALTH in Baby's Health Center

Baby's head shape: What's normal?
A baby's head is easily molded, and not necessarily symmetrical. Here's how to prevent flat spots — and detect more serious problems.
Many newborns have slightly lopsided heads. Sometimes a baby's head is molded unevenly while passing through the birth canal. In other cases, head shape changes after birth as a result of spending too much time in one position. Although your baby's head shape will probably even out on its own, you can help prevent flat spots — and detect more serious problems.
How position affects head shape
You'll notice two soft areas at the top of your baby's head where the skull bones haven't yet grown together. These spots, called fontanels, are designed to allow a baby's relatively large head to move through the narrow birth canal. They also accommodate your baby's rapidly growing brain

Heart-healthy diet: 7 steps to prevent heart disease

Changing your eating habits can be tough. Start with these seven strategies to kick-start your way toward a heart-healthy diet.
Although you might know eating certain foods can increase your heart disease risk, it's often tough to change your eating habits. Whether you have years of unhealthy eating under your belt or you simply want to fine-tune your diet, here are seven heart-healthy diet tips. Once you know which foods to eat more of and which foods to limit, you'll be on your way toward a heart-healthy diet.
1. Limit unhealthy fats and cholesterol.
Of the possible changes, limiting how much saturated and trans fat you eat is the most important step you can take to reduce your blood cholesterol and lower your risk of coronary artery disease. A high blood cholesterol level can lead to a buildup of plaques in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke.
The American Heart Association offers these guidelines for how much fat and cholesterol to include in a heart-healthy diet:
Type of fat
Recommendation
Saturated fat
Less than 7 percent of your total daily calories
Trans fat
Less than 1 percent of your total daily calories
Cholesterol
Less than 300 milligrams a day for healthy adults; less than 200 milligrams a day for adults with high levels of low-density lipoprotein (LDL), or "bad," cholesterol or those who are taking cholesterol-lowering medication
The best way to reduce saturated and trans fats in your diet is to limit the amount of solid fats — butter, margarine and shortening — you add to food when cooking and serving. Use low-fat substitutions when possible for a heart-healthy diet. For example, top your baked potato with salsa or low-fat yogurt rather than butter, or use low-sugar fruit spread on your toast instead of margarine. You may also want to check the food labels of some cookies, crackers and chips. Many of these snacks — even those labeled "reduced fat" — may be made with oils containing trans fats. One clue that a food has some trans fat in it is the phrase "partially hydrogenated" in the ingredient list.
When you do use fats, choose monounsaturated fats, such as olive oil or canola oil. Polyunsaturated fats, found in nuts and seeds, also are good choices for a heart-healthy diet. When used in place of saturated fat, monounsaturated and polyunsaturated fats may help lower your total blood cholesterol. But moderation is essential. All types of fat are high in calories.
If you're not sure which fats or oils to use when cooking or baking, use this guide:
Choose
Avoid
Olive oil
Canola oil
Margarine labeled "trans fat-free"
Cholesterol-lowering margarine, such as Benecol, Promise activ or Smart Balance
Butter
Lard
Bacon
Gravy
Cream sauce
Nondairy creamers
Hydrogenated margarine and shortening
Cocoa butter, found in chocolate
Coconut, palm, cottonseed and palm-kernel oils
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2. Choose low-fat protein sources.
Lean meat, poultry and fish, low-fat dairy products and egg whites or egg substitutes are some of your best sources of protein. But be careful to choose lower fat options, such as skim milk rather than whole milk and skinless chicken breasts rather than fried chicken patties.
Fish is another good alternative to high-fat meats. Some types of fish — such as cod, tuna and halibut generally have less total fat, saturated fat and cholesterol than do meat and poultry. And certain types of fish are heart healthy because they're rich in omega-3 fatty acids, which can lower blood fats called triglycerides and may reduce your risk of sudden cardiac death. You'll find the highest amounts of omega-3 fatty acids in cold-water fish, such as salmon, mackerel and herring. Other sources are flaxseed, walnuts, soybeans and canola oil.
Legumes — beans, peas and lentils — also are good sources of protein and contain less fat and no cholesterol, making them good substitutes for meat. Substituting soy protein for animal protein — for example, a soy burger for a hamburger — will reduce your fat and cholesterol intake.
To help you decide which high-protein foods are best, use this guide:
Choose
Avoid
Skim or low-fat (1 percent) milk
Fat-free or low-fat dairy products, such as yogurt and cheese
Egg whites or egg substitutes
Fish, especially fatty, cold-water fish, such as salmon
Skinless poultry
Legumes
Soybeans and soy products, for example, soy burgers
Lean ground meats
Full-fat milk and other dairy products
Organ meats, such as liver
Egg yolks
Fatty and marbled meats
Spareribs
Cold cuts
Frankfurters, hot dogs and sausages
Bacon
Fried, breaded or canned meats
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3. Eat more vegetables and fruits.
Vegetables and fruits are good sources of vitamins and minerals; they are low in calories and rich in dietary fiber. A diet high in soluble fiber, the kind found in fruits and vegetables, can help lower your cholesterol and reduce your risk of heart disease. Vegetables and fruits also contain substances found in plants that may help prevent cardiovascular disease. Eating more fruits and vegetables may help you eat less high-fat foods, such as meat, cheese and snack foods.
Featuring vegetables and fruits in your diet may not be as difficult as you might think. Keep carrots, cauliflower and broccoli washed and cut in your refrigerator for quick snacks. Keep apples, bananas, grapes or peaches in a bowl in your kitchen so that you'll remember to eat them. Choose recipes that have vegetables or fruits as the main ingredient, such as vegetable stir-fry or fresh fruit mixed into salads. Even frozen or canned fruits and vegetables are good choices, provided they don't have lots of added sodium or sugar. Don't smother vegetables in butter, dressings, creamy sauces or other high-fat garnishes.
This guide can help you sort out which fruits and vegetables offer the most health benefits:
Choose
Avoid
Fresh or frozen vegetables and fruits
Low-sodium canned vegetables
Canned fruit packed in juice or water
Coconut
Vegetables with creamy sauces
Fried or breaded vegetables
Canned fruit packed in heavy syrup
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4. Select whole grains.
Whole grains are good sources of fiber and other nutrients. Whole grains are also a source of vitamins and minerals, such as thiamin, riboflavin, niacin, vitamin E, magnesium, phosphorus, selenium, zinc and iron. Various nutrients found in whole grains play a role in regulating blood pressure and heart health.
You can increase the amount of whole grains in a heart-healthy diet by making simple substitutions. For example, choose breads made from 100 percent whole grain instead of those with refined white flour, whole-wheat pasta over regular pasta and brown rice instead of white rice. Select high-fiber cereals for breakfast, such as bran flakes, oats, or shredded wheat, instead of sugar-sweetened cereals, muffins or doughnuts. And select whole-wheat flour rather than white flour for baking at home.
Another easy way to add whole grains to your diet is ground flaxseed. Flaxseeds are small brown seeds that are high in fiber and omega-3 fatty acids, which can lower your total blood cholesterol. You can easily grind the seeds in a coffee grinder or food processor and add them to your diet by stirring a teaspoon of them into yogurt, applesauce or hot cereal.
Use this guide to help you choose cereals, breads, rice or pasta:
Choose
Avoid
Whole-wheat flour
Whole-grain bread, preferably 100 percent whole-wheat or 100 percent whole-grain bread
High-fiber cereal with 5 or more grams of fiber per serving
Brown rice
Whole-grain pasta
Oatmeal (steel-cut or regular)
Ground flaxseed
Muffins
Frozen waffles
Corn bread
Doughnuts
Biscuits
Quick breads
Granola bars
Cakes
Pies
Egg noodles
Buttered popcorn
High-fat snack crackers
Potato chips
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5. Reduce the salt in your food.
Eating a lot of salt can contribute to high blood pressure, a risk factor for cardiovascular disease. Reducing the salt in your food is an important part of a heart-healthy diet. The American Heart Association recommends that healthy adults eat less than 2,300 milligrams of sodium a day (about a teaspoon).
You might think the best way to cut back on salt is to stop reaching for the shaker. True, but don't forget about the processed foods. Although reducing the amount of salt you add to food at the table or while cooking is a good first step, much of the salt you eat comes from canned or processed foods, like soups and frozen dinners. Eating fresh foods and making your own soups and stews can reduce the amount of salt you eat. If you like the convenience of canned soups and prepared meals, look for ones with reduced sodium. Some brands offer the same soups or meals you already eat with as much as 40 percent less sodium.
Another way to reduce the amount of salt you eat is to choose your condiments carefully. Reduced-sodium ketchups and soy sauces are available. Instead of regular table salt, reach for a salt substitute or other herbs and spices that can flavor your food. If using a salt substitute or reduced-sodium condiment, it is still important to use it sparingly. The amount of salt, although reduced, adds up quickly.
Use this guide to help you choose lower salt alternatives:
Choose
Avoid
Herbs and spices
Salt substitutes
Reduced-salt canned soups or prepared meals
Reduced-salt versions of condiments, such as reduced-salt soy sauce
Table salt
Canned soups and prepared foods, like frozen dinners
Soy sauce
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6. Practice moderation.
In addition to knowing which foods to eat, you'll also need to know how much you should eat. Overloading your plate, taking seconds and eating until you feel stuffed can lead to eating more calories, fat and cholesterol than you should. Portions served in restaurants are often more than anyone needs. Keep track of the number of servings you eat — and use proper serving sizes — to help control your portions.
A serving size is a specific amount of food, defined by common measurements such as cups, ounces or pieces. For example, one serving of pasta is 1/2 cup, or about the size of an ice cream scoop. A serving of meat, fish or chicken is 2 to 3 ounces, or about the size and thickness of a deck of cards. Judging serving size is a learned skill. You may need to use measuring cups and spoons or a scale until you're comfortable with your judgment.
A heart-healthy diet is also about balance. A simple rule of thumb is to remember to keep your portion size for meat, poultry and fish about the size of a deck of cards. This makes room on your plate for servings of vegetables, fruits and whole grains.
Allow yourself an indulgence every now and then. Don't let it turn into an excuse for giving up on your healthy-eating plan. If overindulgence is the exception, rather than the rule, you'll balance things out over the long term. What's important is that you eat healthy foods most of the time.
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Slide show: Portion control for weight loss
7. Plan ahead: Creating daily menus.
You know what foods to feature in your heart-healthy diet and which ones to limit. Now it's time to put your plans into action.
Create daily menus using the six strategies listed above. When selecting foods for each meal and snack, emphasize vegetables, fruits and whole grains. Choose lean protein sources and limit high-fat and salty foods. Watch your portion sizes and add variety to your menu choices. For example, if you have grilled salmon one evening, try a black bean burger the next night. This helps ensure that you'll get all of the nutrients your body needs. Variety also makes your meals and snacks more interesting.
Incorporate these seven tips into your life, and you'll continue to find that heart-healthy eating is both doable and enjoyable. With planning and a few simple substitutions, you can eat with your heart in mind.
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Decrease your mass by taking mass transit

There was an intriguing item in USA Today last week noting that metropolitan public transit agencies are promoting the use of their transportation systems as a handy way to get exercise and the resulting health benefits. Evidently the “beat the commute traffic” argument has hit a wall, so the providers of mass transit are going to the “beat the reaper” argument.
The pitch is that walking — from your house to your bus stop or rail station, and from another bus stop or station to your job or the store or other destination — is good for you. That’s the explicit approach of the “Metro Fit” campaign in Los Angeles, which also urges patrons to use the subway stations’ stairs rather than the escalators.
In Arlington, Virginia, they call it the “Car-Free Diet,” (see “The Car-Obesity Connection“) with the use of the muni system instead of your automobile extolled as a boon to your heart, circulation, and general well being

Nibbles: More young adults have heart problems, but can still live to 100

A study looking at autopsies of people who died of unnatural causes in one county in Minnesota found that among people aged 16 to 64, 8.2 percent had high-grade coronary artery disease, but 83 percent had the beginnings of the disease. Researchers say this shows that the recent decline in reports of coronary artery disease will soon be over. They blame the increase on sedentary behavior, more fast food consumption and larger portion sizes, the removal of physical education from the schools and the increase in high fructose corn syrup…Don’t worry if you’re one of those people with clogged arteries or other health problems: research in the Archives of Internal Medicine says even people with diabetes and heart disease can live to be 100 if their doctors treat their health problems aggressively. About 700 people over the age of 100 were interviewed, and while two thirds of them had avoided age-related disease, the other third had problems like high blood pressure, diabetes and heart disease. Men who lived to be 100 were in better physical shape than the women, suggesting that men have to be in really good health in order to live that long…

Diabetes can cause serious problems in your mouth. You can do something about it.

If you have diabetes, make sure you take care of your mouth. People with diabetes are at risk for mouth infections, especially periodontal (gum) disease. Periodontal disease can damage the gum and bone that hold your teeth in place and may lead to painful chewing problems. Some people with serious gum disease lose their teeth. Periodontal disease may also make it hard to control your blood glucose (blood sugar).
Other problems diabetes can cause are dry mouth and a fungal infection called thrush. Dry mouth happens when you do not have enough saliva—the fluid that keeps your mouth wet. Diabetes may also cause the glucose level in your saliva to increase. Together, these problems may lead to thrush, which causes painful white patches in your mouth.
You can keep your teeth and gums healthy. By controlling your blood glucose, brushing and flossing everyday, and visiting a dentist regularly, you can help prevent periodontal disease. If your diabetes is not under control, you are more likely to develop problems in your mouth.