Experts advise not watching the clock when you're trying to fall asleep.

By Jillia Fongheiser

A good night’s sleep plays an important role in immunity, memory, mood and even weight maintenance. But what happens when you simply can’t sleep? Insomnia is a nightmare for about 10 percent of the U.S. population — 30 million people. An additional 30 percent of the population reports sleep disturbances.

Do you have insomnia?
If you have difficulty falling asleep or staying asleep and often lie in bed trying to stop your mind from dwelling on what happened the previous day, then you most likely have insomnia.

Acute insomnia is short-lived and is characterized by identifiable stressors such as a change in relationship, the loss of a loved one and occupational stress. This form of insomnia typically lasts about a week and disappears once the stressor is gone or you’ve adapted to the situation.

Chronic insomnia is characterized by difficulty falling asleep or staying asleep for at least one month. During the day, this can result in inability to focus on work, driving impairment and becoming agitated or frustrated easily. Persistent insomnia often occurs with depression and anxiety disorders, possible evidence that there is a link between sleep and regulation of emotions.

While the physical causes of insomnia are unclear, signs point to the chemical cortisol, which is related to stress response. A study published in The Journal of Clinical Endocrinology & Metabolism showed that insomniacs have significantly higher levels of cortisol than people without sleep issues, especially during the onset of sleep and the early morning.

Treating Insomnia
Two types of medication are used to treat chronic insomnia. The first are drugs that activate GABA receptors. GABA is the primary neurotransmitter that slows activity in the brain to allow for relaxation and sleep. While doctors previously prescribed benzodiazepines (such as Valium) for this purpose, they now opt for non-benzodiazepine drugs (i.e. Ambien, Sonata) for decreased memory disturbances and hangover-like side effects.

The U.S. Food and Drug Administration just approved Intermezzo, which can be taken by insomniacs who wake in the middle of the night. The label specifies that the drug should be taken only when people have at least four hours of sleep time remaining and when it’s possible to wait an hour before driving.

Both benzodiazepines and non-benzodiazepines reduce non-REM slow-wave sleep associated with solidifying memories, which results in an unfortunate side effect: amnesia. In fact, a much-publicized side effect of the latter drug type is engaging in activities such as driving or eating and having no recollection of doing so the next day.

The second drug option is melatonin-receptor-activating drugs which affect the body’s circadian rhythm and initiate the onset of “night,” signaling the brain to slow for sleep. Ramelteon (prescribed as Rozerem) is the newest melatonin-mimicking drug.

Those with long-term insomnia may also seek psychological and behavioral treatments, including relaxation-based interventions, such as meditation, muscle relaxation and imagery; cognitive behavioral therapy, which aims to change thinking patterns, and sleep restriction, meaning that the patient is exhausted to the point he or she can’t help falling asleep, thus establishing new patterns. There’s also sleep education to create good sleeping habits.

Getting Your Z’s
Before resorting to medication, you might want to try these tips to improve your chances of getting a good night’s sleep.

1) Make sure you are in a cool room and a comfortable bed.

2) Stop watching the clock. This only produces more anxiety as the minutes tick by.

3) If you can’t fall asleep after 30 minutes, get up and do a light activity, such as journaling or reading.

4) Have a curfew for your electronics. Put the computer and smartphone away. (If the phone is your alarm clock, let it rest until morning.)

5) This is easier said than done, but do not use the time before bed to think about events that happened during the day.

6) Set a bedtime. One of the most important ways to minimize sleep disturbance is to go to bed and wake up at the same time every day.

Photo credit: Yin Yang

Getting a good night's sleep may be more important to your psychological and physical well-being than you think.

By Jillia Fongheiser

Too often, a little shut-eye is sacrificed here and there to accommodate our busy lifestyles. But can missing out on sleep really take a toll on immunity, learning ability, mood — and even looks? Read on for answers to your most important sleep questions.

Can sleep loss make you sick?

YES. Adequate sleeps bolsters your immune system, making it easier for your body to fight off illness and infection. Several studies have shown sleep deprivation decreases antibody response when the body is exposed to illness.

In fact, a study from the University of California, San Diego showed that just one night of inadequate sleep reduced immune function by 72 percent. However, after only one night of recovery sleep, immunity was back to normal.

Is pulling an all-nighter really a bad idea?

YES. Declarative memories, aka facts, are best remembered when someone gets deep slow-wave sleep during the night. Sleep is made up one stage of REM (rapid eye movement) and four stages of non-REM sleep; of these, the deeper stages are characterized as slow-wave sleep. Memories are consolidated during this period as the brain reprocesses and reactivates recently learned facts.

In an experiment conducted at Harvard Medical School, participants learned a visual task, and were subsequently tested on what they learned the four following days. One group of participants was sleep-deprived on the first night after learning the task, but received adequate sleep on subsequent nights. Those who got a full night’s sleep after learning the task improved their performances each day, but the sleep-deprived group never performed as well — suggesting a lack of sleep in the first 24 hours after learning something severely reduces the chance of forming necessary memories.

Staying up all night isn’t just a bad way to prepare for a big presentation or meet a deadline, either — it could be deadly. A study published in Nature showed that automotive driving performance starts to degrade after about 16 hours of continuous wakefulness; by 22 hours of wakefulness, driving skills are impaired as much as if you had a blood-alcohol level of .08, which is considered legally drunk in the United States.

Can sleep loss cause diabetic symptoms?

POSSIBLY. The body’s response to sleep loss can mimic insulin resistance. A precursor to diabetes, this condition is marked by the body’s inability to recognize the hormone insulin properly and to use glucose efficiently. A University of Chicago study showed that after five consecutive nights of four hours of sleep, previously healthy adults’ glucose tolerance was decreased by more than 40 percent, putting them in a pre-diabetic state. Some even argue that sleep is as important as diet to controlling blood-sugar levels and fending off diabetes.

Can sleep loss cause weight gain?

YES. Another University of Chicago study found that after getting only four hours of sleep for two nights in a row, participants had an 18 percent reduction in the hormone leptin, which controls satiety, the signal to the brain to stop eating. In addition, ghrelin, the hormone that triggers hunger, increased by 28 percent, and appetite for carbohydrates increased by 30 percent.

If you still aren’t convinced, the Nurses’ Health Study — a longitudinal study that followed 70,000 women for 16 years — found that women who slept five hours or less per night had significantly increased body weight compared to those who slept seven to eight hours.

Is crankiness due to sleep deprivation just a myth?

NO. Even minor annoyances seem magnified after a sleepless night, and the reason is more than just sleepiness. After a day with little sleep, we remember significantly more negative than positive events from the previous hours and we are more likely to respond to negative aspects during our day. Researchers believe that lack of sleep somehow affects the connection between the prefrontal lobe of our brain (where reasoning occurs) and the amygdala (the part of our brain key in generating emotions), resulting in an overactive, emotionally reactive brain.

Is there any truth to the need for “beauty sleep?”

YES. In a Swedish study, researchers took photos of participants after eight hours of sleep and again after an average of five hours’ sleep. The photos were then rated by another group, who ranked the sleep-deprived people in the images as less healthy and less attractive than the photos depicting the same people well-rested.

Photo credit: Dmitriy Shironosov

Medication — along with proper diet and exercise — can slow the progress of diabetes.

By Winnie Yu

About 25.8 million people in the United States — 8.3 percent of the population — have diabetes, and of these, 7 million are undiagnosed. Following are four facts you should know about this metabolic disease.

Nearly 27 percent of people over the age of 65 have diabetes.
Getting older raises your risk of diabetes, as does family history of the disease, being overweight or obese and belonging to certain ethnic groups, namely African-American, Hispanic and Native American.

While you can’t do much about aging or ethnicity, you can slow the onset or prevent diabetes by losing 5–7 percent of your body weight if you’re overweight; exercising 30 minutes five days a week; and cutting back on unhealthy foods. To gauge your personal risk, check out this calculator.

Nutrition recommendations for people with diabetes are based on those for the general public.
“People think if you develop diabetes, you have to [go] on a horrible diet, but that’s just not true,” says Ann Albright, Ph.D., R.D., director of the Centers for Disease Control and Prevention’s Division of Diabetes Translation. People with diabetes simply need to eat a healthful diet rich in fruits and vegetables, lean protein, whole grains and lowfat dairy products — and to practice moderation. The trick is to balance the amount you consume and the timing so your blood-sugar levels don’t become elevated.

The right lifestyle strategies can overcome a strong family history of diabetes.
Those with a genetic predisposition to diabetes need to put in extra effort to exercise daily and eat healthy foods, says Francine R. Kaufman, M.D., director and former head of the Center for Endocrinology, Diabetes and Metabolism at Children’s Hospital Los Angeles. “They need to be extra vigilant about any weight they gain and change their habits to improve their weight.”

The progress of type II diabetes can be slowed with diet, exercise and medication.
“Type II diabetes is a progressive disease,” says Albright, “so it is important to do everything you can — adopt healthy eating [habits], get regular moderate activity, take medications as prescribed and learn coping skills — to slow down the progression of this serious disease.”

Drastic consequences of diabetes include heart disease, stroke and kidney failure. Those with the disease also are more likely to suffer from foot pain and numbness, blindness and gum disease, so proper blood-glucose management is key.

To learn more about diabetes, go to diabetes.org.

Illustration: Dung Hoang

Survivor Eloise Caggiano, program director of Avon Walk for Breast Cancer, was told initially that the lump in her breast was nothing to worry about.

By Nicole Gregory

The Avon Walk for Breast Cancer events take place in nine cities around the United States and raise millions of dollars a year for cancer research and support for women who are diagnosed with disease. (One participant, Deb Wills, of Frederick, MD, has personally raised $300,000 over the last decade and is profiled in the current issue of VIVMag — to read the story, click here.)

The events raise money for breast-cancer programs in the areas in which they are held. Upcoming walks in October will take place in New York City Oct. 15-16, and Charlotte, NC, Oct. 22-23.

Want to participate? Each walk is 39 miles over two days, but no one is forced to finish the course. If you do want to go the distance, Eloise Caggiano, program director for the Avon Walk for Breast Cancer and six-year breast-cancer survivor, recommends you invest some time beforehand get in distance-walking shape — and prepare yourself for a moving, uplifting experience. Here she shares her personal story:

VIV: How old were you when you were first diagnosed?

ELOISE CAGGIANO: I was 33 years old. I was single, living in New York City and leading an active, fairly healthy lifestyle. I had no family history of the disease, so the diagnosis was an incredible shock. Hearing the words, “You have breast cancer” is truly life-changing, in so many ways.

VIV: Did you have any risk factors?

EC: I did not have any risk factors, which just added to the shock of the diagnosis. There was no family history, I was not overweight, I was always exercising — I had even run two marathons! The one thing I did have was a lump. I found it myself and showed it to my gynecologist. She dismissed it as nothing to worry about but told me to get a sonogram so she could tell if it was filled with fluid, in which case she could simply drain it and it would go away. When I called for a sonogram appointment I learned that I needed my doctor to schedule the appointment for me if I wanted it to happen soon, otherwise the earliest appointment they could offer was not for six months! I left three messages for my doctor, but she never made the appointment for me, so I took the one that was six months down the road. I had the sonogram, as well as a needle biopsy and a mammogram that same day — just to be sure — which resulted in more people telling me that it was nothing to worry about.

But over the six months I had waited, the lump had gotten bigger so it was recommended that I get the lump removed, which was fine with me because I wanted it out! I had never had surgery before so I was nervous, but the lumpectomy went smoothly and I recovered in a few days. It wasn’t until a week or so later when the pathology report came back that everything changed. I’ll never forget being in the doctor’s office and hearing her say, “We thought it was nothing, but you have breast cancer.”

VIV: What did your course of treatment include?

EC: I had a total of five surgeries: two lumpectomies, a mastectomy, and two reconstructive surgeries, plus a sentinel node biopsy where they remove a bunch of lymph nodes to determine if the cancer had spread— thankfully it hadn’t! I also had four months of aggressive chemotherapy. Thankfully, I tolerated the chemo better than I expected —  I had visions of spending a lot of time on my bathroom floor. But it was still no walk in the park.

The side effects from the drugs seemed endless, and were truly exhausting, painful, inconvenient and sometimes just downright weird. But I was so lucky to have great health insurance and access to amazing doctors. Not everyone is so fortunate and that is why I am so proud to be part of the Avon Walk for Breast Cancer because a good portion of the money raised helps people get the breast cancer care they need, regardless of their ability to pay for it.

VIV: How many walks have you participated in?

EC: Since I joined the Avon Foundation in 2008, I have been to every Avon Walk for Breast Cancer event except one! So that means I’ve been to 32 Avon Walks so far. By the end of 2011, it will be 35 walks!

VIV: What do you enjoy most about the walks?

EC: There are so many things I love about being at the Avon Walk events. First and foremost, it’s all about the people — there is an incredible sense of community and camaraderie among these people who come from all walks of life, from all over the country and are anywhere from 16-85 years old. They might not have much in common in their everyday lives, but for one weekend they are all part of something special. They are all making a difference together, inspiring each other, supporting each other, and definitely having fun together!

As a breast cancer survivor, it is so meaningful for me to meet other survivors, especially those who are 10-, 15- or 25-year survivors! It is so inspiring to meet them and they give me so much hope. And to think that as a six-year survivor myself, I might give some hope and comfort to someone who is newly diagnosed, or a 1- or 2- year survivor — well, that just makes it all worthwhile.

It is also particularly rewarding to meet people who have directly benefited from the programs we fund. I’ve met women who were diagnosed early (and now call themselves survivors!) because they were able to get a mammogram at one of our beneficiary organizations even though they didn’t have health insurance. It’s quite remarkable!

VIV: Should first-timers train for the walk, and if so, can you offer some tips?

EC: Anyone walking in an Avon Walk for Breast Cancer should definitely do some training! Trust me, you’ll be glad you did. Even our faithful Avon Walk Alumni who have done our walks many times in the past will train before each event.

You might think, “Oh, it’s just walking!” but if you are planning to walk the entire 39.3 mile route, that is a lot of time on your feet. We have training programs you can follow on our website and we conduct training walks leading up to each event (the training walks are also a great way to meet fellow walkers). If you are concerned that you can’t walk that far, don’t worry! The Avon Walk is not a competition and you do not have to walk every single mile; you can walk the distance that is comfortable for you. We provide lots of support along the way, including rest stops and buses for those who are not walking the full distance.

When choosing a doctor, studies indicate it may be beneficial to consider age, gender and practice location.

By Alice Lesch Kelly

Your physician’s gender, age and practice location can have a surprising impact on your diagnosis and treatment.

You probably think primary-care doctors’ training and experience determine their ability to diagnose and treat illness. To a large extent that’s true. But surprisingly, some other factors come into play as well.

Studies show that doctors’ age and gender can influence the quality of care they provide. Even the kind of hospital in which they practice can affect how you are treated. “Patients get different diagnoses and treatment from different doctors, even though they have exactly the same signs and symptoms of disease,” says John B. McKinlay, Ph.D., senior vice president and director at the New England Research Institutes in Watertown, MA.

Here are five ways your doctor’s dossier can affect your treatment:

1. Male and female doctors differ in how they relate to heart-disease patients, according to a 2007 study published in Sociology of Health & Illness. Researchers found that female doctors are more likely than their male peers to notice and recall details about a patient’s health history and psychological state.

2. A study by the Mayo Clinic found that women physicians are more likely than male doctors to order high-tech tests, make referrals to specialists and adhere to generally accepted treatment guidelines.

3. Older doctors have more experience; however, they are less likely than recent med-school grads to deliver cutting-edge treatments, according to a study published in the Annals of Internal Medicine in 2005.

4. The longer doctors have been in practice, the more likely they are to prescribe antibiotics inappropriately, according to a 2007 study in the Canadian Medical Association Journal.

5. Large and small hospitals offer different advantages, according to Jerome Groopman, M.D., author of How Doctors Think (Houghton Mifflin, 2007). “The major advantage at a teaching hospital is the presence of additional physicians, albeit ones in training,” he says. “They may sometimes challenge the attending physician to rethink a diagnosis or treatment plan.” On the other hand, doctors at a local hospital may provide more personalized care. “They may have a better sense of the personal and cultural aspects of the patient’s problems,” Groopman says.

Photo credit: Joshua Hodge

When exploring the great outdoors, don't forget to pack a few necessities to ensure happy trails.

By Linda Shelton

With summer at its peak, it’s time to trek up those winding trails into the woods for some hiking, campfires and maybe even some lakeside basking in the sun. Though camping means being one with nature, the great outdoors also means harsh ultraviolet rays, pesky bugs and dirt under your fingernails. Here are a few items to pack that will make that scenic hike a little more comfortable.

1. Insect repellent. Wearing insect-repellent clothing is the best way to protect yourself from bothersome bugs. However, you may want to arm yourself with a secondary line of defense by carrying either an organic, DEET-free bug spray or a sunscreen that includes bug-repellent agents.

At the top of the repellent line with these properties is EcoBlends Superior Insect Repellent, made with natural oils. A great sunscreen/insect repellent combo is SPF 30+ California Baby Natural Bug Blend, made with titanium dioxide and infused with herbal bug deterrents citronella, lemongrass and cedarwood.

2. Sunscreen. Even if you’re wearing UPF (Ultraviolet Protection Factor) clothing, don’t leave the sunscreen behind. Soleo Organics, Goddess Garden and California Baby are top rated by the Environmental Working Group, and all contain the minerals zinc or titanium for the best UVA protection — at least SPF 30+ — without the hazard of absorbable chemical ingredients like oxybenzone.

3. On the Trail Wash-up. Use a multipurpose product as a body or hair wash, or for washing dishes, clothes or gear. Citronella Wilderness Wash is biodegradable and paraben-free, and contains citronella and sandalwood essential oils that not only smell good, but also keep bugs at bay.

To become an expert adventurer, check out other hiking essentials in “Be Prepared!” in the July/August 2011 issue of VIVmag!

Photo credit: Courtesy Red Mountain Resort

Learn your Lyme disease facts so you can prevent the disease or spot it in its early stages.

By Winnie Yu

You’re feverish, achy and exhausted. Is it the flu? Arthritis? Advancing age? Consider Lyme disease, a tick-borne illness with vague and varying symptoms that make it tough to diagnose and treat. “Lyme disease is the great imitator,” says Jeffrey Morrison, M.D., a New York City physician who treats the illness. “It develops slowly over time, and you may think it’s just a cold that won’t quit.” Left untreated, Lyme disease has serious health ramifications, including arthritis, numbness, nerve paralysis and problems with cognitive functions.

Better protect yourself with this need-to-know information about the disease.

1. Lyme disease has been reported in almost every U.S. state.

There were 35,198 new cases of Lyme disease reported in the United States in 2008, according to the U.S. Centers for Disease Control and Prevention (CDC). When Lyme disease first emerged, it occurred primarily in northeastern states. But in the last decade, cases have been reported in every U.S. state except Hawaii, according to the CDC. To find out if Lyme is a problem in your area, check your county health department and the CDC websites.

2. You might not feel or see a bite.

Black-legged ticks (aka deer ticks) are the tiny insects that spread the bacterium that causes Lyme disease. Most infections are caused by ticks in the nymph stage, when they are less than 2 millimeters in size, and you don’t notice a thing. It typically takes 36 hours for the bacteria to be transmitted, which is why routine checks of your skin — scalp, armpits and groin are common hiding places — are important if you spend time outdoors. Ticks are especially active in the spring in wooded, brushy or grassy areas. They can also latch onto small animals.

3. Lyme disease doesn’t have any universal symptoms.

Only about half of patients have the telltale bull’s eye rash around the site of the bite, Morrison says. Instead, most patients develop a red patch around the bite, which often grows larger and multiplies elsewhere. Some sufferers develop flu-like symptoms such as a low-grade fever, chills, swollen lymph nodes, fatigue and muscle aches, which is why it’s easy to mistake Lyme disease for a viral infection.

4. Blood tests for Lyme disease are unreliable.

Both tests for Lyme disease — the ELISA and the Western blot — are prone to produce false results. Neither test can detect an infection until you begin producing a certain amount of antibodies, which usually takes two to four weeks. Even the two tests done together can miss up to 44 percent of infections. “A negative blood test doesn’t mean you don’t have an infection,” Morrison says.

5. If treated quickly, antibiotics usually eliminate the infection.

Treatment for Lyme disease usually involves three weeks of an antibiotic. If symptoms persist after you finish three weeks of medication, it’s possible that you’ve been infected longer than you thought. You may require a longer course of treatment or stronger antibiotics. It’s also possible you have a co-infection since ticks also carry other disease-causing bugs.

Photo credit: Toko Ohmori

Cindy Crawford joined dozens of celebrities working the phone lines at Stand Up To Cancer.

By Gerri Miller

It’s no surprise that celebrities turned out en masse for the recent multi-network Stand Up To Cancer telethon to raise funds for research. Like most of us, they either know someone who’s battled the disease or have survived it themselves.

“My mom’s a survivor. My father had colon cancer. I was diagnosed with breast cancer about three years ago,” says ice skater Dorothy Hamill. “I feel an obligation to help raise awareness. It’s really important because cancer doesn’t care who you are or how much money you have. It affects all of us.”

Hamill stressed the importance of early detection. “I was really lucky to be the beneficiary of all the research and studies so my treatment wasn’t as radical as it could have been. So don’t let those little lumps and bumps go.”

Marissa Jaret Winokur of the upcoming daytime talk show The Talk, a 10-year cervical cancer survivor, echoed that advice. “Go to your doctor. Get your mammogram and colonoscopy. Get your checkup. Get your Pap smear. Early detection is the only cure,” says Winokur, who had her son, Zev, via surrogate two years ago.

Mehmet Oz, M.D., who revealed his close call with colon cancer on the season two premiere of The Dr. Oz Show, is living proof that even healthy people aren’t immune. “Someone like me with no family history, I’ve stayed thin my whole life, I eat the right things, I don’t smoke. I don’t drink. If I can have a colon polyp you can too,” he warns.

“It used to be you couldn’t mention the word ‘cancer.’ People would keep it a secret. I think that’s pretty much changed,” notes supermodel Cindy Crawford, who lost her brother to leukemia 34 years ago when she was 10. “The type of lymphoma he died from is now 90 percent curable, but there are costs to that cure. A lot of the kids are sterile. It’s a great step but the next step is cure with no cost,” she says.

Like most attendees, My Big Fat Greek Wedding actor Nia Vardalos wore a Stand Up To Cancer T-shirt, but hers had the names Christina and Maria added. “They did not make it,” Vardalos said of her friend and aunt, whose deaths have made her even more vigilant. “You have to screen yourself. You have to wear sunscreen. I do it all. And I’m always looking at my friends: ‘That mole, get that checked.’ ”

Similarly, CSI: Miami’s Eva LaRue, whose mother and good friend had cancer, believes “you have to be your own personal health-care advocate. We all know when something is not quite right with us and yet we’re so busy we put it off. But if you don’t make time and get it checked out it can mean the difference between stage 1 and stage 4.”

If you missed any of the telethon or want to watch it again, you can see it online and donate at www.su2c.org/2010show.

For more ways to get involved, check out “The Media Have the Message: Fight Breast Cancer” in VIVmag‘s September/October issue.

Has cancer touched your life? Tell us your story.

Photo credit: Jon Kopaloff/FilmMagic

Use these tips to take care of your feet year-round.

By Stacey Colino

Whether you’re vacationing at the beach or relaxing by the pool, bare feet are almost an inevitable part of summer. Here’s some expert advice for dealing with five common foot problems so you can enjoy sandal season.

BUNIONS

• The fault: A bunion is a bony protrusion at the base of the big toe that can become painful, red and swollen.
• The fix: Apply ice and wear special bunion pads (available at drugstores). Custom shoe inserts called orthotics ($200 or more a pair) can help prevent worsening of the bunion, says Rock Positano, D.P.M., director of the non-surgical foot and ankle service at the Hospital for Special Surgery in New York City. Drugstore shoe inserts, such as Dr. Scholl’s Custom Fit Orthotics ($50), are considerably less expensive and may also provide relief. If these measures don’t help, you may be a candidate for joint injections. A last option is corrective surgery.

CORNS

• The fault: A hard corn is a red or thickened plug of skin on the tops of the knuckles of the toes; a soft one develops between the toes. Corns can become inflamed, painful and even infected with repeated friction.
• The fix: Cover the area with a corn pad (available at drugstores). Use a pumice stone to shave down a corn, says Carol Frey, M.D., a foot and ankle specialist in Manhattan Beach, CA, and assistant clinical professor of orthopedic surgery at the University of California, Los Angeles. But “avoid chemicals that burn off corns or ‘bathroom surgery’” in which you try to cut them off yourself, she says. If the corn continues to bother you, have it removed by a doctor.

HAMMERTOES

• The fault: Hammertoes are chronically bent at the first knuckle. The condition can be very painful, and the toes can develop blisters, corns and calluses on the tops of the knuckles.
• The fix: Wearing shoes with a deep toe box and a hammertoe pad can decrease pressure on the protruding bone. Wearing orthotics can prevent worsening of the deformed toe. If you’re in serious pain, toe-straightening surgery may be an option.

FUNGUS

• The fault: A fungal infection (aka athlete’s foot) can cause a red, itchy, scaly rash between the toes or on the soles. Nail fungus causes a patchy white or yellowish discoloration of the nail.
• The fix: For foot fungus, apply an over-the-counter (OTC) antifungal powder or cream twice a day and keep your feet as dry as possible. To treat nail fungus, first trim and clean out the debris beneath the nail, says Jane Denton, D.P.M., a podiatrist at the Center for Sports Medicine at Saint Francis Hospital in San Francisco. Next try an OTC topical medication such as Mycocide Antifungal Treatment NS ($18). If this doesn’t help, you may need a prescription.

INGROWN TOENAILS

• The fault: With an ingrown toenail, the corner of the nail grows down into the skin, causing irritation that can set you up for a bacterial infection.
• The fix: Soak the area in warm water for at least 20 minutes, several times a day, advises podiatrist Jane Denton, D.P.M. Afterward, put a small piece of cotton underneath the edge of the nail to retrain it to grow upward and apply an antibiotic ointment. If you suspect the area is infected, see a podiatrist or dermatologist.

Do you have any other tricks for dealing with foot problems?

Colds account for more doctor visits in the United States than any other condition, according to the American Lung Association. Adults get two to four colds per year, mostly between September and May. If you’re an optimist who sees the glass of orange juice as half-full, that means we’re more than halfway through cold season. Here, four tips for making your cold more bearable.

1. Break out the (eye) glasses. Colds affect production of outer-eye fluids, causing dry eyes, says William Benjamin, O.D., Ph.D., professor of optometry at the University of Alabama at Birmingham. He recommends reducing contact-lens wear while you’re sick to reduce irritation, and swapping daily-wear contacts for extended-wear. But you might as well don your specs for ultimate comfort — you don’t really want a crystal-clear view of yourself when you have a cold anyway, do you?

2. Skip the hot toddy. The alcohol in this traditional cold remedy can cause dehydration. Instead, opt for broths, tea and water, says Winnie Yu, author of What to Eat for What Ails You (Fair Winds Press, 2007): “The extra hydration will help minimize congestion and keep the mucus from becoming too thick.” Recent research from Cardiff University’s Common Cold Centre in Wales found that hot drinks provide immediate relief for runny nose, cough, sneezing, sore throat, chilliness and fatigue. The study involved warm fruit juice, so try heating up some apple cider or make some noncaffeinated tea.

3. Tickle your funny bone. Laughing hurts when your nose is raw and sore, but according to a study from Oak Crest Health Research Institute, the anticipation of laughter reduces stress hormones that are potentially detrimental to the immune system by up to 70 percent. Keep that immune system in check with The Little Cold Book (Quirk Books, 2005), which promises to keep you entertained for the duration of your cold, with home remedies, movie suggestions and how to figure out who to blame for your current misery.

4. Veg out with veggies. “Feeding a cold isn’t a free pass to eat whatever you want,” Yu says. She recommends fruits and steamed vegetables rich in vitamin C, such as citrus fruits, strawberries, broccoli and red peppers. Though dairy products increase mucus production in some, yogurt that contains probiotics has been shown to reduce the duration and severity of colds. The antioxidant minerals selenium and zinc, which help immunity, can be found in eggs, chicken and whole grains, Yu says.