The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

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CDC warns of increased dengue fever risk across the US

The alert came Friday after the PAHO, which is the main international health agency for the Americas, reported the first deaths associated with the virus — including fetal deaths associated with “possible instances of vertical transmission,” in which a virus is transmitted mother-to-child during pregnancy.

At least 8,078 confirmed Oropouche cases, including two fatal cases, have been reported in the Americas. The cases are concentrated in Bolivia, Colombia, Cuba, Peru and Brazil — the country with the most confirmed cases and where the two deaths were reported.

Two young women in Brazil, ages 21 and 24, are believed to have died because of the virus. According to PAHO, they both died a few days after having first experienced sudden symptoms such as fever, muscle aches, pain behind the eye sockets, headaches and vomiting, among other symptoms. A third case is being investigated in Brazil as a possible third death from Oropouche.

At least 7,284 cases have been confirmed in Brazil, according to PAHO. That’s 90% of all confirmed Oropouche cases in the Americas and a significant jump from the 832 cases Brazil reported last year.

Among other fatal cases still under investigation in Brazil are one case of fetal death, one miscarriage and four cases of newborns with microcephaly, a birth defect in which a baby’s head is smaller than expected. Microcephaly is also associated with the Zika virus, another mosquito-borne disease.

A mother in Brazil who experienced symptoms consistent with Oropouche sought medical attention on June 6 after she noticed lack of fetal mobility, PAHO said. Oropouche genetic material in umbilical cord blood and organ tissue was detected after the fetal death was confirmed. A similar case was reported soon after, involving a mother who miscarried after having experienced bleeding symptoms related to the virus. Brazilian health officials who were conducting a study on four newborns with microcephaly found the babies already had antibodies against Oropouche virus.

Based on those cases, PAHO had issued a previous alert on July 17 “about possible cases of pregnant mother-to-child transmission of Oropouche virus,” according to the U.S. Centers for Disease Control and Prevention, which emphasized that it is still “not clear if infection with Oropouche virus was the cause of negative health outcomes for the fetuses.”

The CDC said it’s working with PAHO and other international partners to learn more about the potential risks of Oropouche during pregnancy.

There are no to vaccines or specific antiviral drugs to prevent or treat Oropouche infections. Treatment is focused on relieving patients’ symptoms, according to PAHO.

Oropouche virus symptoms are similar to those of dengue, according to the CDC. They include headaches, fever, muscle aches, stiff joints, nausea, vomiting, chills and sensitivity to light. In severe cases, the virus can also cause the tissues surrounding the brain and the spinal cord to swell.

In certain patients, symptoms may also include rash, vomiting and bleeding — typically in the form of nosebleeds, bleeding gums or blood speckles under the skin, according to PAHO.

Symptoms typically start four to eight days after a person is bitten. Even though symptoms tend to last three to six days, the infection can last up to three weeks.

This story first appeared on NBCNews.com. More from NBC News:

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Young people, especially women, are increasingly talking on social media about gastrointestinal distress, such as irritable bowel syndrome or chronic bloating. Some experts say that’s mostly a good thing, because it may help others seek help for a topic that has been taboo.

But they stress it’s important to realize that many people are being paid to promote sometimes unproven products and there is rampant misinformation. Here’s what else medical professionals suggest you do if you’re experiencing digestive discomfort.

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Why are more young people talking about digestive problems online?

It’s not clear whether there’s a rise in digestive troubles overall. Some experts attribute the trend to an uptick in anxiety after the pandemic in an already-anxious generation.

Ample research and science shows that our brain and gut are connected through nervous systems. That means when your brain is anxious or you’re feeling depressed, it can relay those signals to your gut, which can make it harder for your gastrointestinal tract to function properly.

The causes of irritable bowel syndrome are unknown, but experts say the nervous system has a big effect on the condition and stress can make symptoms worse.

Dr. Nina Gupta, a gastroenterologist based in Chicago, said managing her patients’ conditions often includes managing their mental health.

When should you go to the doctor?

That depends on the level of your discomfort, said Dr. Uma Naidoo, Massachusetts General Hospital’s director of nutritional and lifestyle psychiatry. She studies the connection between food and the brain.

Abrupt changes in bowel habits are concerning, she said, and may require further evaluation.

“For example, someone that didn’t really have digestive issues as a child or throughout their life and then all of a sudden is finding a very severe and significant change in their bowel habits,” she said. “These are all things that we would want someone to talk to their doctor about.”

And if you see blood in your stool — no matter the quantity or degree of frequency — or have ongoing diarrhea for more than a couple of weeks, seek care immediately.

What can I do to relieve digestive pain?

Naidoo said some mindfulness practices like stress management, meditation and breathwork can help. Food sensitivities can trigger IBS symptoms, so adjusting your diet and exercising more also may make a difference.

“Simply doing something like finding a good probiotic that they take, or adding probiotics and fermented foods to their diet slowly and steadily can be good,” she said. “Stress management is a huge part of this. In combination with dietary adjustment, it can be very powerful.”

However, if symptoms worsen or are unmanageable at home, that should be a sign to seek professional help.

The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

health Jun 25

CDC warns of increased dengue fever risk across the US

Hospitals have identified at least 30 newborns with what has been identified as “fetal fentanyl syndrome,” NBC News has learned. The babies were born to mothers who said they’d used street drugs, particularly fentanyl, while pregnant.

“I have identified 20 patients,” said Dr. Miguel Del Campo, a medical geneticist at Rady Children’s Hospital in San Diego who specializes in children exposed to drugs and alcohol in utero. “I fear that this is not rare, and I fear kids are going unrecognized.”

The syndrome was first identified in 10 babies last fall by geneticists at Nemours Children’s Health in Wilmington, Delaware. The infants had specific physical birth defects: cleft palate, unusually small heads, drooping eyelids, webbed toes and joints that weren’t fully developed. Some had trouble feeding.

Published research about the babies caught Del Campo’s attention. He’d previously diagnosed some children with similar abnormalities with fetal alcohol syndrome, even though their mothers denied drinking while pregnant.

“After reading the paper and thinking about things,” he said, “I have recognized the potential for exposure to fentanyl.”

Dr. Karen Gripp, a geneticist at Nemours, and her team were the first to identify the 10 babies with fetal fentanyl syndrome last fall. “This is another huge piece of the puzzle” explaining the defects, she said.

The birth defects in the babies closely resemble a rare genetic condition called Smith-Lemli-Opitz. It’s a condition that affects how fetuses make cholesterol, which is critical for the brain to develop properly. But none of the babies had Smith-Lemli-Optiz.

The mothers’ reported drug use was a strong clue as to what was causing the defects, but there was no scientific evidence that fentanyl stopped cholesterol production in developing fetuses.

When Gripp and a team of researchers at the University of Nebraska Medical Center exposed human and mouse cells to fentanyl, they discovered that the drug directly disrupted their ability to make cholesterol.

“This is not something that people had known before, that fentanyl interferes so significantly with cholesterol metabolism,” Gripp said. “This is so important because cholesterol needs to be synthesized as the embryo develops.”

Their paper explaining the connection was published in Molecular Psychiatry in June.

Who is at risk

Illicit fentanyl use during pregnancy is a known risk factor for preterm birth and stillbirth. Babies born after significant fentanyl exposure in utero may have seizures, vomiting, diarrhea and be irritable, fatigued and have trouble feeding.

But despite a rise in fentanyl misuse, even during pregnancy, there is no indication of a concurrent rise in birth defects. And most babies exposed to fentanyl in utero aren’t born with the defects that are hallmarks of the fetal fentanyl syndrome.

The new research helps to explain that.

While two copies of the gene that causes Smith-Lemli-Optiz result in the syndrome, cells with just one copy of that gene were more likely to be affected by fentanyl exposure.

That is, a single copy of the gene may make some babies more vulnerable.

“Not everyone is equally susceptible,” Dr. Karoly Mirnics, one of the study authors and director of the University of Nebraska Medical Center’s Munroe-Meyer Institute, said in a press release announcing the results. “The potentially adverse effects of any medication or chemical compound might depend on your genes, lifestyle and environmental factors. One drug might not cause problems for me and might be catastrophic for you.”

Gripp expects the number of documented fetal fentanyl cases will rise with awareness and continued research.

“The group is growing,” she said. “We anticipate that there will be many more patients.” 

Del Campo, also an associate professor at the University of California San Diego, said it’s critical to diagnose babies appropriately with fetal fentanyl syndrome so doctors can follow them long term.

“We need to know how these kids are doing. I have some 2 year-olds that are very concerning,” he said. “They’re just not growing or developing.”

This story first appeared on NBCNews.com. More from NBC News:

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It’s the latest measles case confirmed in New England — health officials have been tracking a growing measles cluster in New Hampshire and Vermont, with three known cases as of July 9. People who’ve been in the Dartmouth College area were being urged to monitor for possible exposure, and on Thursday, the New Hampshire Department of Health and Human Services shared three new local locations that someone from out of state visited when infectious.

Massachusetts’ new measles case is in an adult from Worcester County who recently traveled internationally — officials didn’t say where, but noted that there are large outbreaks of measles in Europe and elsewhere, and that many of the recent U.S. cases are associated with travel.

All people who may have been exposed to the Massachusetts resident with measles have already been contacted, according to the Massachusetts Department of Public Health.

“Measles is a highly contagious, airborne disease, which has increased worldwide, including here in the United States and in neighboring states in New England,” Massachusetts Public Health Commissioner Dr. Robbie Goldstein, MD, PhD. “Cases of measles have been reported in 30 states since the beginning of last year, mostly in people and communities who are unvaccinated. Vaccination is the best way to protect against measles.”

Measles is highly contagious and potentially serious. It’s prevented by the safe, effective MMR vaccine schedule that’s recommended for almost all people in the U.S., except those with severe allergies or several other conditions.

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As of Thursday, five people diagnosed with measles were linked to the cluster involving New Hampshire, state health officials said.

The informed the public that the anyone who visited the following locations may have been exposed to measles by the out-of-state resident, who had previously been exposed to an international traveler who flew back to their home country through Boston’s Logan airport:

• July 6, 1:00-5:00pm: Texas Roadhouse, 317 Loudon Road, Concord
• July 7, 2:30-4:30pm: Baked and Brewed Café, 915 Suncook Valley Rd, Alton
• July 7, 3:00-6:00pm: Common Man, 314 Daniel Webster Highway, Merrimack

Health officials initially said the exposures occurred on July 5 and 6, but have since provided the updated timeline above.

Anyone who thinks they may have been in those locations at the specified times and either isn’t vaccinated against measles or isn’t sure about their level of protection was urged to call the state’s Division of Public Health Services at 603-271-4496.

That’s the pitch from a new cluster of companies selling high-tech scans to healthy people interested in learning more about their wellness.

These whole-body MRI scans aren’t cheap. Startup companies like Prenuvo charge between $1,000 to $2,500 for various scanning options, none of which are currently covered by insurance.

Proponents say consumer-driven medical scans are the next logical step in preventive medicine. The industry has received a big publicity push from celebrities and influencers like Kim Kardashian, who posted about her Prenuvo scan last year.

But many medical experts say the companies are selling expensive, unproven technology that may cause extra worries and unnecessary treatment, while driving up costs for the U.S. health system.

Here’s what to know before considering a scan:

What is an MRI?

MRI stands for magnetic resonance imaging. It’s a type of medical scan that uses magnetic fields to produce detailed images of organs, bones and other structures inside the body. Unlike many other types of scans, MRIs don’t use radiation.

Doctors will order an MRI to help diagnose cancer, brain injuries, damaged blood vessels and other medical conditions. Full-body scans can take an hour or more, with patients lying motionless inside a cylindrical tube.

Medical societies only recommend routine, full-body scans for certain high-risk groups, such as people who have a heightened genetic risk of cancer.

“MRIs are great for what they’re typically used for,” said Dr. Ernest Hawk, a vice president at the University of Texas MD Anderson Cancer Center. “But now you’re moving them much earlier into an average risk population and that’s where you can run into these questions that haven’t been answered.”

Why are people paying for them now?

Companies like Prenuvo say their scans can help identify more than 500 medical conditions that can go undetected at a typical doctor’s visit.

The company charges $999 to scan the torso, $1,799 for the head and torso or $2,499 for the entire body. Several other companies offer similar services and pricing.

Prenuvo’s chief medical officer, Dr. Daniel Durand, says customers can decide for themselves if the price is worth it.

“We’re trying to give people the opportunity to be more proactive about their health,” Durand said.

Along with the scans and a reader-friendly summary of the results, customers can consult with a nurse or physician employed by Prenuvo to talk about next steps.

The company says it doesn’t pay for endorsements but will sometimes “provide a complimentary scan for an unbiased review.”

What are the potential downsides of MRI screening services?

Many radiologists say the likelihood of finding a serious problem, such as a cancerous tumor or brain aneurysm, in someone with no symptoms is very low. Instead, scans are likely to flag growths that are usually harmless. Definitively ruling out a problem could require additional tests, appointments and even surgeries.

“You’re going to end up finding a lot of incidental things,” said Dr. Mina Makary, a radiologist at Ohio State Wexner Medical Center. “That’s going to create more psychological stress or trauma for the patient, including additional costs for tests and procedures that may have risks.”

Experts also worry that people who undergo MRI scans may start skipping other routine exams, such as mammograms.

“You’ve gone through a scan and it didn’t find anything so you say ‘Gee, I don’t need to do the other routine things my doctor recommends that have been proven to extend life,” said Hawk.

What do medical authorities say?

The American College of Radiology does not recommend MRI screening in people without symptoms, stating that there is “no documented evidence” the technique is “cost-efficient or effective in prolonging life.”

The Food and Drug Administration has not approved any MRI machines for preventive screening, but doctors are free to use the devices however they choose.

There are examples of imaging practices that were once considered experimental but have subsequently become standard practice. Prenuvo executives say their approach could follow a similar path.

“The evidence will evolve over time but patients don’t necessarily want to wait 30 years to be in a position to benefit from it,” said Prenuvo’s Durand.

When will we know if MRI screening helps people live longer?

The studies needed to show such a benefit would have to be very large and long, tracking a diverse population for years, according to experts.

Prenuvo recently announced plans to screen 100,000 people and study their health over time. The study isn’t expected to wrap up until 2034 or later.

Most people enrolling in Prenuvo’s study are expected to pay a $2,200 fee. But eventually academic or government studies could offer individuals a chance to participate in such research without paying out-of-pocket.

“This is a great area in which to participate in a research study that might provide the information you’re seeking, while also helping answer whether this is beneficial or not,” Hawk said. “But doing so outside of a study makes no sense.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Every day, about 9,500 people are diagnosed with skin cancer in the United States, adding up to nearly 3.5 million people every year, according to the American Academy of Dermatology Association. The AADA also says skin cancer is the most commonly diagnosed cancer in the country.

So how much sunscreen should you really use? And how often should you reapply it? Here’s what to know.

What does a sunscreen’s SPF rating mean?

According to Hopkins Medicine, a sunscreen’s sun protection factor or SPF is a measure that tells you how many harmful ultraviolet rays the cream absorbs or reflects away from your skin.

Contrary to popular belief, an SPF rating is not an indicator of how long you can stay out in the sun before protection wears off, rather it indicates how much longer it takes skin with sunscreen to start to redden compared to without it, the FDA notes.

For day-to-day use, Hopkins Medicine recommends using sunscreen with an SPF of 30 or higher. However, if you spend time outdoors, such as at the beach, an SPF of 60 or greater might be better for you.

What is the difference between UVA and UVB rays?

According to the FDA, UVA rays are one of the strongest types of ultraviolet radiation coming from the sun. UVA rays go deeper into the skin than UVB, and cause skin aging, age spots and wrinkles.

UVB rays meanwhile are the ones that produce sunburns. Most of these rays are absorbed by Earth’s atmosphere.

UVA rays have the longest wavelengths, followed by UVB, and UVC rays which have the shortest wavelengths. While UVA and UVB rays are transmitted through the atmosphere, all UVC and some UVB rays are absorbed by the Earth’s ozone layer. So, most of the UV rays you come in contact with are UVA with a small amount of UVB.

Who needs to wear sunscreen?

The FDA recommends anyone over the age of six months use sunscreen with an SPF of 30 or higher.

Due to the greater risk of developing rashes and side effects, the agency does not recommend children under 6 months old to use sunscreen. Instead, it recommends limiting their sunlight exposure between 10 a.m. and 2 p.m and using protective clothing in case of direct sun exposure.

How much sunscreen should I apply?

Probably more than what you’re currently applying.

According to Hopkins Medicine, about 1 ounce of sunscreen covering your palm is enough to protect your face, neck, arms and legs. To protect your face and neck, meanwhile, HM recommends about a half teaspoon.

How often should I reapply sunscreen?

According to the FDA, how often you should reapply boils down to the SPF rating of your sunscreen.

Since an SPF rating indicates how much longer it takes skin to begin to burn with sunscreen applied compared to how long it takes to start reddening without it, the lower the SPF is, the more often it’s recommended to reapply.

In general, the FDA recommends reapplying sunscreen every two hours or more often if you’re sweating or swimming.

Should I use sunscreen indoors?

Yes. Even if you are inside, dermatologists recommend applying sunscreen.

Because UVA rays do not get absorbed by glass, it is recommended to apply sunscreen if you’re next to a window, use a digital screen or are inside your car. However, you may not need to reapply sunscreen as frequently until you step outside, Hopkins Medicine writes.

Should I use sunscreen at night?

No. While sunscreen is effective at blocking UV light from the sun, its SPF molecules could create larger pores in your skin if worn at night so it is important you wash it off before bedtime and use night cream instead.

However, little research has investigated the potential contaminants in tampons and whether they pose a health risk. And a new, first-of-its kind study has many wondering: Are tampons safe?

The recent research out of UC Berkeley found that many tampons on the market, including organic and non-organic, may contain toxic metals, such as lead and arsenic. The researchers looked at tampons sold both in the United States and Europe.

“Some tampons had higher concentrations of one metal, lower concentrations of another,” Jenni A. Shearston, Ph.D., the lead author on the paper, tells TODAY.com. “There wasn’t a specific tampon that we tested that seemed to have … a lower concentration of all the metals.” 

Dr. Mitchell Kramer, chair of OB-GYN at Huntington Hospital Northwell Health, tells TODAY.com that the study is “groundbreaking” and indicates a need for tampon manufacturers to conduct more testing on their products.

“It certainly requires more evaluation. … I think it has potentially some significant impact moving forward in terms of how tampons are produced and the effect on the users,” Kramer says.

That said, it’s unclear what the potential health impact, if any, may be of using tampons containing these metals.

“We don’t know if any of these metals are absorbed vaginally, which is key when it comes to exposure,” Dr. Jennifer Lincoln, an OB-GYN and author of the book, “Let’s Talk about Down There: An OB-GYN Answers All of your Burning Questions … Without Making You Feel Embarrassed for Asking,” tells TODAY.com via email.

Shearston — a postdoctoral scholar at UC Berkeley School of Public Health and department of environmental science, policy and management — adds that one of the limitations of the study is that they do not know if the metal can even seep out of the tampons.

“We only tested whether or not these metals are present in tampons,” she says. “We don’t know whether they come out.”

Here’s what to know about the study:

Tampons and toxic metals

The paper published was in the journal “Environment International,” and researchers looked at 30 different tampons from 14 brands to determine the metal levels in the tampons. They found “measurable concentrations” of all 16 metals they looked for — including some toxic metals, such as lead and arsenic — in all the tampons tested.

However, the research does not conclude that the tested tampons and others on the market are not safe. Shearston hopes people don’t “panic” about the study.

“We just need more information,” she says. “What I would like to encourage people to do is support more research and ask more questions about this to try to make research on menstrual products and menstruation a priority.”

The levels of metals varied based on the type, where they were purchased and if they were generic or name brand.

“These metals were found in different amounts, with some higher in organic tampons (like arsenic) and others in conventional tampons (such as lead),” Lincoln explains. “We don’t know what brands were tested as this was blinded in the study, which I know is frustrating.”

Lincoln, who was not involved in the study, notes it’s somewhat surprising that this study is a first, but that the findings make sense.

“I was not surprised that metals were found in organic tampons as well, since they can be absorbed from the soil, and organic farming still uses pesticides,” she says.

Are tampons safe?

Yes, it is still safe to use tampons, the experts say.

“People do not need to panic,” Kramer says. “We haven’t established that these products are dangerous or causing people to get really sick. I don’t think that’s the case. I think these levels of these heavy metals are very low.”

A press release also notes that “it’s unclear if the metals detected by this study are contributing to any negative health effects.” Shearston says she and her colleagues are currently investigating “if metals can come out of the tampons.”

“We’re doing some leaching experiment,” she says. “We’re also testing tampons, these same products, for other chemicals.”  

Lincoln also stresses that it’s too soon to say what the findings mean for consumers looking for the safest tampons.

“Per this study, the average amount of lead found in tampons was actually very small, and far lower than what is considered concerning in our food or water,” she explains. “This doesn’t negate the study’s findings, but it’s an important perspective when people are deciding if they want to continue using tampons or not.”

Are non-toxic and organic tampons safer?

All tampons tested had some degree of toxic metals, including those claiming to be non-toxic and organic. In fact, these were higher in arsenic than conventional tampons.

“I do hope this demonstrates for people that organic is not always necessarily better, especially with period products,” Lincoln says.

An organic label on a tampon doesn’t have as much meaning as it might on food, for example.

“It doesn’t carry a lot of information to have a tampon that’s labeled as organic,” Catherine Roberts, an associate editor of health at Consumer Reports, who covered organic tampons, tells TODAY.com. “It can mean a lot of different things.” 

Lincoln adds that you should choose period products based on what works best for you.

“This study shouldn’t be the reason we all throw out our tampons ASAP, but it is important that people decide what feels right for them,” she says. “It’s important to realize what period products you use is a personal choice. Not everyone feels comfortable with pads or cups or period underwear, and for them, tampons are clutch.”

Using tampons safely

For tampon users worried about their exposure to metal, Kramer suggests wearing tampons less often and rely on other menstrual products.

“Instead of wearing tampons 24/7 during the period, maybe alternate between that and a sanitary pad,” he says. “There are certain things you can try to mitigate some of the exposure.”

There are other things consumers can consider when selecting tampons to avoid unknown ingredients.

“Unfortunately, it doesn’t seem like shopping for particular brands or looking at particular labels is necessarily going to help you avoid (heavy metals),” Roberts says. 

Roberts says people can:

• Buy fragrance-free tampons
• Select tampons with fewer components
• Skip tampons with polyester, polypropylene, polyethylene or other plastic materials

“Fragrances are a big black box regulatorily,” Roberts says. “You can add fragrance and you don’t have to disclose what’s in them.”  

Still, Kramer hopes people do not panic about the findings.

“Tampons have been around for a very long time. We haven’t seen people coming in with heavy metal toxicity, and this is very different than the toxic shock syndrome issue,” he says. “That was a bacteria that had nothing to do with heavy metals.”

Tampon alternatives

If you’re interested in trying other types of period products, look into these tampon alternatives:

Menstrual cups

One popular brand is the Diva Cup. These are cups that you insert into the vagina to collect the menstrual fluid.

Menstrual discs

Similar to a cup, these products use a bag with a rim to collect the period fluid.

Period underwear

These resemble normal underwear but they contain extra material to absorb the menstrual fluid.

Reusable pads

These are cloth pads that you can put in your underwear to absorb the fluid but can also be washed and reused, unlike standard pads, which you throw away.

This story first appeared on TODAY.com. More from TODAY:

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The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

health Jun 25

CDC warns of increased dengue fever risk across the US

Transplants of the so-called voice box are extremely rare, and normally aren’t an option for people with active cancer. Marty Kedian is only the third person in the U.S. ever to undergo a total larynx transplant – the others, years ago, because of injuries – and one of a handful reported worldwide.

Surgeons at the Mayo Clinic in Arizona offered Kedian the transplant as part of a new clinical trial aimed at opening the potentially lifechanging operation to more patients, including some with cancer, the most common way to lose a larynx.

“People need to keep their voice,” Kedian, 59, told The Associated Press four months after his transplant – still hoarse but able to keep up an hourlong conversation. “I want people to know this can be done.”

He became emotional recalling the first time he phoned his 82-year-old mother after the surgery “and she could hear me. … That was important to me, to talk to my mother.”

The study is small — just nine more people will be enrolled. But it may teach scientists best practices for these complex transplants so that one day they could be offered to more people who can’t breathe, swallow or speak on their own because of a damaged or surgically removed larynx.

“Patients become very reclusive, and very kind of walled off from the rest of the world,” said Dr. David Lott, Mayo’s chair of head and neck surgery in Phoenix. He started the study because “my patients tell me, ‘Yeah I may be alive but I’m not really living.’”

Lott’s team reported early results of the surgery Tuesday in the journal Mayo Clinic Proceedings.

The larynx may be best known as the voice box but it’s also vital for breathing and swallowing. Muscular tissue flaps called vocal cords open to let air into the lungs, close to prevent food or drink from going the wrong way – and vibrate when air pushes past them to produce speech.

The first two U.S. larynx transplant recipients – at the Cleveland Clinic in 1998 and the University of California, Davis, in 2010 – had lost their voices to injuries, one from a motorcycle accident and the other damaged by a hospital ventilator.

But cancer is the biggest reason. The American Cancer Society estimates more than 12,600 people will be diagnosed with some form of laryngeal cancer this year. While today many undergo voice-preserving treatment, thousands of people have had their larynx completely removed, breathing through what’s called a tracheostomy tube in their neck and struggling to communicate.

Although the earlier U.S. recipients achieved near normal speech, doctors haven’t embraced these transplants. Partly that’s because people can survive without a larynx – while antirejection drugs that suppress the immune system could spark new or recurring tumors.

“We want to be able to push those boundaries but do it as safely and ethically as we can,” Lott said.

Head-and-neck specialists say the Mayo trial is key to helping larynx transplants become a viable option.

“It isn’t a ‘one-off,’” but an opportunity to finally learn from one patient before operating on the next, said Dr. Marshall Strome, who led the 1998 transplant in Cleveland.

This first attempt in a cancer patient “is the next important step,” he said.

Other options are being studied, noted Dr. Peter Belafsky of UC Davis, who helped perform the 2010 transplant. His patients at high risk of larynx loss record their voice in anticipation of next-generation speech devices that sound like them.

But Belafsky said there’s “still a shot” for larynx transplants to become more common while cautioning it likely will take years more research. One hurdle has been achieving enough nerve regrowth to breathe without a trach tube.

Kedian was diagnosed with a rare laryngeal cartilage cancer about a decade ago. The Haverhill, Massachusetts, man underwent more than a dozen surgeries, eventually needing a trach tube to help him breathe and swallow — and struggled even to muster a raspy whisper through it. He had to retire on disability.

Still the once gregarious Kedian, known for long conversations with strangers, wouldn’t let doctors remove his entire larynx to cure the cancer. He desperately wanted to read bedtime stories to his granddaughter, with his own voice rather than what he called robotic-sounding speech devices.

Then Kedian’s wife Gina tracked down the Mayo study. Lott decided he was a good candidate because his cancer wasn’t fast-growing and — especially important — Kedian already was taking antirejection drugs for an earlier kidney transplant.

It took 10 months to find a deceased donor with a healthy enough larynx just the right size.

Then on Feb. 29, six surgeons operated for 21 hours. After removing Kedian’s cancerous larynx, they transplanted the donated one plus necessary adjoining tissues – thyroid and parathyroid glands, the pharynx and upper part of the trachea – and tiny blood vessels to supply them. Finally, using new microsurgical techniques, they connected nerves critical for Kedian to feel when he needs to swallow and to move the vocal cords.

About three weeks later, Kedian said “hello.” Soon he’d relearned to swallow, working up from applesauce to macaroni and cheese and hamburgers. He got to say hi to granddaughter Charlotte via video, part of his homework to just keep talking.

“Every day it’s getting better,” said Kedian, who moves back to Massachusetts soon. His tracheostomy remains in place at least a few more months but “I’m pushing myself to make it go faster because I want these tubes out of me, to go back to a normal life.”

And just as Lott had assured him, Kedian retained his beloved Boston accent.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Hartford Public Library has partnered with Vision to Learn, a nonprofit that provides free vision screenings, eye exams and glasses to low-income schools and communities.

In the past two years, Vision to Learn has visited 56 schools and community groups, providing more than 9,000 children with free vision screenings. Their partnerships with Connecticut’s Alliance Districts, Boys & Girls Clubs and libraries like Hartford’s have helped them supply 5,100 eye exams and 4,500 pairs of eyeglasses.

“Summer reading and free eye exams are not just about providing resources but empowering our children to succeed,” said Hartford Public Library President and CEO Bridget Quinn in a news release. “We are grateful for Vision To Learn’s free services so students receiving eye exams and eyeglasses will be better equipped to learn when they return to school this fall.”

The Hartford Public Library has partnered with Vision To Learn since its launch in 2022. This summer, the mobile Vision to Learn clinic will visit the following locations and dates in Hartford:

• Albany Library: Thursday-Friday, July 25-26
• Camp Field Library: Monday, July 29
• Barbour Library: Friday, Aug. 16
• Downtown Library: Monday, Aug. 13, and Monday, Aug. 19
• Dwight Library: Monday, Aug. 5, and Monday, Aug. 12
• Ropkins Library: Monday, Aug. 26
• Park Street Library @ the Lyric: Wednesday- Thursday, Aug. 14-15

Appointments can be scheduled for the above dates by filling out this form from Vision to Learn. No insurance is needed, but patients are asked to arrive five minutes early to complete their paperwork.

The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

health Jun 25

CDC warns of increased dengue fever risk across the US

The event, which took place at Aruba’s pristine Eagle Beach, drew from a pool of vacationers who applied after receiving a QR code while staying at hotels on the island.

Participants sat for more than an hour — disconnected from phones — during the beach’s sunset with a calming breeze.

However, the event was not a total paradise.

Contestants were given heart monitors to track their heart rate. The competition threw “curveballs” at contestants to see if they could remain on island time amid turmoil around them.

“We would like throw in these curveballs to try to get people to get their heart rate accelerated,” White said in an interview with NBC Local. “So we have like kids run through kicking sand or starting a squirt gun fight.”

White said he had a blast hosting the event, and that people kept asking him how he would prepare for such an event.

White just advised people to remain calm and focus on the beautiful Caribbean island around them.

“I mean, it’s pretty hard to get worked up while you’re down there. Everyone’s on island time it’s just like the most relaxing, incredible place,” White said.

The winner of the competition will be named the “World’s Greatest Relaxer” when the competition airs in August.

The top three winners will also get amazing prizes for their relaxing performance:

• Gold – “The Ultimate Aruba Vacation” includes a four-night stay at the iconic Ritz Carlton, Aruba, two round-trip flights to Aruba, and dinner for two at Infini, the hottest culinary ticket on the island.
• Silver – “The Ultimate Aruba Weekend”: a three night stay at the Renaissance Wind Creek Aruba, a full spa day at the world-famous Renaissance Island, and dinner for two at the buzz-worthy OLIVIA.
• Bronze –  “The Ultimate Rejuvenation Package”: a romantic cruise with Pelican Adventures, private island tour with Isla Aruba, and relaxing massage for two from Aruba Wellness Therapies, to be redeemed during the remainder of their stay.

This story uses functionality that may not work in our app. Click here to open the story in your web browser.

Annie Grace, best-selling author of This Naked Mind, went alcohol-free after her own struggles with the substance and is now sharing tips to talk to kids of all ages. She explains it’s not a lecture, but a conversation led by curiosity. Today she talks with Maria about:

• Why it’s so important to start conversations when kids get curious (just make it age appropriate!)
• “Show, don’t tell, but tell everything” — how to get vulnerable with kids even when it’s uncomfortable
• What Annie wishes she knew about alcohol before her first sip
• The deal she made with her kids when they were young to keep a relationship of mutual trust rather than complete control

To listen to Annie’s story to an alcohol-free life, listen to her first episode with Maria: Getting Curious About Sobriety with Annie Grace

Follow along with Annie for more tips: @thisnakedmind

More tips on talking with your kids about alcohol: talkwithyourkidsaboutalcohol.com 

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Backward walking — also called retro-walking — is exactly what it sounds like: the act of walking in reverse. It involves walking backward while maintaining proper posture and balance. The movement engages different muscles than forward walking, activating the glutes, hamstrings and calves and stretching the quads and hips.

Walking backward has benefits beyong toning, too. It can help improve coordination and is a great way to switch up your workout routine and challenge your mind and body in a new way. Here are even more reasons to add it to your routine.

Backward walking challenges your brain

Backward walking offers a nice change of pace to your regular walking routine, keeping things interesting and preventing boredom. By challenging your body to move in an unfamiliar way, you are training your brain and muscles to adapt quickly.

“Walking backwards is not a ‘secret’ or ‘miracle’ exercise, but, it definitely provides some benefits,” Dr. Rand McClain, sports medicine physician and owner of the Regenerative & Sports Medicine clinic in Santa Monica, California, tells TODAY.com. “The most obvious difference between walking backwards versus walking forward is that walking backwards requires more focus and coordination, challenging the body and brain.”

“Different muscles are used to walk backwards and some of the same are used, but in a different sequence and balance,” McClain adds. ”That not only affects the muscles — typically getting them to work harder than they are used to — but affects the brain and the nervous system in new ways that help activate direct pathways involved in the movement itself as well as indirect pathways that help the brain grow and develop new neurons and synapses (a concept often referred to as neuronal or simply brain ’plasticity’).”

Backward walking benefits

The primary muscles used to propel you forward are the quads, hamstrings and calf muscles. Walking backward, on the other hand, engages the glutes, hamstrings and even the shins, which help to maintain balance. When you walk backward, you also naturally engage your core muscles to maintain stability and balance. This can contribute to better posture and spinal alignment over time.

As you walk in reverse, you are challenging your joints and muscles to move in a different range of motion. The increased mobility gained from walking backward can make everyday movements more comfortable and effortless, whether it is reaching for something on a high shelf or bending down to tie your shoes.

According to one study, people who walked backward improved their balance, length of their steps and speed of their steps. The same study showed that backward walking can actually put less strain on the joints compared to walking forward. So, if your knees, ankles or feet are feeling store or stiff, try walking backward to loosen things up.

Another study found that walking backward on a treadmill helped stoke patients improve their cardiopulmonary fitness, increased their walking speed and improved their balance.

Walking backward can help in developing coordination, strength, flexibility, cardiovascular fitness and “extra” calorie burning (due to it being more difficult), says McClain. “Also, it can often provide an alternate source of exercise for someone with injury or degeneration (arthritis) because walking backwards can often avoid using those injured or degenerated muscles or joint components (ligaments, arthritic areas and menisci) that walking forward aggravate,” he adds.

3 easy ways to add backward walking to your routine

•  Start small: Ease into it by simply walking backward throughout your day. You can walk backward down a hallway in your house, from the kitchen to the family room, or down the driveway to get your mail.
• Try intervals: During your daily walk, walk forward for 5 minutes and then walk backward for 1 minute. Repeat this routine a few times. If you want to incorporate even more backward motion, make the interval lengths equal by walking for one block or one minute forward, and then one block or 1 minute backward, alternating every minute.
• Use the treadmill: If you walk indoors on a treadmill, it’s a great opportunity to incorporate some backward walking with assistance. Since treadmills have handrails, they provide more stability and will help with balance as you get used to the new movement. Step on the treadmill backward, start the belt at a low speed (slower than you typically walk forward), and rest your hands lightly on the handrails before stepping on the belt.

This story first appeared on TODAY.com. More from Today:

• Michael J. Fox plays guitar with Coldplay at Glastonbury: ‘Thank you to the main reason why we’re in a band’
• It took Lainey Wilson more than 10 years to get noticed in music. What kept her going
• ‘Inside Out 2’ hits major box office milestone last achieved by ‘Barbie’

The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

health Jun 25

CDC warns of increased dengue fever risk across the US

We’re talking 60-plus — women and men. And we’re talking about hitting the gym and weight training. Don’t be put off, Bamman says.

“Resistance training is in many ways the true fountain of youth,” Bamman said in an interview with The Associated Press. “I like to say the fountain of youth is the water cooler in the gym.”

Of course, there are biological limits. But Bamman says the bulk of age-related decline in strength, flexibility and endurance is behavioral — putting too few demands on the body, not too many.

“When I tell somebody that in four to six months your strength and muscle mass and overall muscle function is going to elevate to the levels of people 30 to 35 years younger, that hits home,” he said.

So you know you’re too sedentary and the birthdays keep piling up. You suspect resistance training would be beneficial. But perhaps you’re intimidated. Don’t be.

Getting started

Check with medical professionals to make sure there are no health problems that stand in your way.

Then find a gym. Larger gyms offer a social component with things to do on a day off from weight training. And Bamman suggests getting a trainer.

“It’s actually quite safe, but it does require proper progression,” Bamman said. “You have to have a good instructor who can teach the movements properly.”

Bamman, a research scientist at the Florida Institute for Human & Machine Cognition, said finding a fully qualified trainer can be tricky.

“We need more rigorous certification of trainers,” he said. “The problem is that you can go online tonight and pay $50 and get some certification as a trainer.”

Done and dusted in an hour

Bamman suggests resistance training twice a week. Three times is even better, and he recommends non-weight-training days in between. For instance, work out on Monday, Wednesday and Friday, and let Tuesday and Thursday be days of rest.

He suggests 10 different exercise movements — eight is sufficient. Do 10 repetitions of each movement. Do this three times, described as three sets. Then move on to the next movement.

When you reach the 10th repetition, you should feel you can’t do many more. If you could have done 10 more reps, you might want to increase the resistance.

Bamman says machines are better for beginners, but free weights — barbells or dumbbells — may be more effective as you gain confidence.

Before the weights, start with a 5-10 minute warmup — on the treadmill, stationary bike or elliptical machine — to get the blood flowing. You can add a few minutes on the mat for stretching and abdominal work.

Then come the weights.

“Sometimes you see people who sit on the machine, do a set and then play with their phone for three or four minutes. We like to keep them moving.”

Women may benefit even more than men

Women may benefit from resistance training even more than men because it’s a way to fight osteoporosis, the loss of bone density.

“Women are on a disadvantaged trajectory for bone loss, particularly in susceptible areas such as the hips and lower back,” said Bamman, who completed his doctorate at the University of Florida College of Medicine.

“But the strength-training benefits for both sexes are really important. There are no sex differences in the ability to respond. In gaining muscle mass and strength in untrained people, men and women track the same.

Yasuko Kuroi is 72 and started resistance training about 20 years ago.

“I saw the men in the gym and thought I could do that, too,” she said, speaking at a municipal recreation center in Tokyo.

The body demands work

In a few words: Use it or lose it.

Bamman cautions against pampering yourself and criticized even health care professionals “who baby seniors.” Of course, common sense is required.

“Our human body is a demand-based system,” he explained. “If you chronically impart a low demand on the body, we have adaptations to low demand. That’s why we lose muscle mass, that’s why we get weaker. We’re not demanding much.”

“But if you put high demands on the system — like resistance training — now the body has to adapt to these higher demands. The body says: ‘To adapt to these new demands I’ve got to make my bones stronger. I’ve got to make my muscles bigger.”

Bamman used the example of space flight, or extended bed rest, where people rapidly lose strength.

“Bed rest or space flight is essentially expedited aging,” he said. “All of our systems as we age are capable of responding and adapting. They just need the stimulus.” He said he’s seen positive effects for people in their 70s and 80s, and even for some in their 90s.

Bamman is 57 and joked he’s getting “closer in age to the people I study.” He also emphasized there are no shortcuts.

“These programs that roll out for older adults — seated exercises and the like. This is gimmicky and they don’t impart enough demands on the body,” he said.

An analysis of data from more than 500 children and teens with hypertension revealed an association between shorter-than-recommended sleep times and high blood pressure, according to the study, published in Pediatrics.

While hypertension in kids has been declining, the Centers for Disease Control and Prevention estimates that 1 in 7 young people ages 12 to 19 have hypertension.

The study doesn’t prove that shortened sleep times cause hypertension, but doctors don’t typically think of sleep when they counsel parents about high blood pressure, said the study’s lead author, Dr. Amy Kogon, an assistant professor at the University of Pennsylvania Perelman School of Medicine.

Data for the study came from children and teens seen at a clinic at the Children’s Hospital of Philadelphia, where Kogon is a pediatric kidney specialist.

“We usually target things like diet and exercise,” Kogon said. “This is another thing parents might want to think about, particularly if the child has high blood pressure.”

Major risk factors for hypertension in children and teens include being overweight, not getting enough physical activity and a poor diet, according to the American Heart Association.

The majority of middle and high school kids in the U.S. are sleep-deprived. In fact, according to the CDC, nearly 60% of middle school kids and more than 70% of high schoolers aren’t getting enough sleep.

As many as a third of elementary school kids get less than the recommended amount of sleep, Kogon said.

The number of hours of sleep children and teens should get depends on age. The American Academy of Sleep Medicine recommends:

• 10 to 13 hours per night for children under age 6.
• 9 to 12 hours per night for children ages 6-12.
• 8 to 10 hours per night for ages 13 to 18.
•  7 to 9 hours per night for ages 18 and older.

It’s important to control blood pressure early in life because the longer someone has hypertension, the higher the risk of developing heart disease, said Dr. Barry Love, director of the congenital cardiac catheterization program at Mount Sinai Kravis Children’s Heart Center.

“We know that high blood pressure is associated with the early onset of coronary disease and stroke,” said Love, who wasn’t involved in the new study. “We think that the damage to blood vessels happens over time.”

For the new study, researchers at Children’s Hospital of Philadelphia examined the medical records of 539 kids, average age 14.6 years, who were referred to pediatric kidney clinics because of high blood pressure readings. The kids were asked when they went to bed and when they got up in the morning. They were also asked to wear ambulatory blood pressure measuring devices, which took readings every 20 minutes while they were awake and every 30 minutes during sleep.

The further sleep duration was from recommended levels, the more likely it was for kids to experience high blood pressure during the day. Kids who went to bed late were also more likely to have hypertension. The findings were consistent regardless of the kids’ ages, sexes and BMI categories.

Too much sleep was also linked to blood pressure issues. Normally, blood pressure drops by around 10% during sleep, but that was less likely when kids slept longer than the recommended amount.  

Why can’t kids sleep?

Anxiety causes sleep problems for about 25% of children ages 1 to 6, according to a University of Michigan C.S. Mott Children’s Hospital National Poll. Those kids were less likely to have bedtime routines and more likely to leave on videos or TV shows, their parents reported in the poll, which was released Monday.

Another possible cause of sleep problems: An estimated 59% of kids weren’t turning off their electronic devices at night, the poll found.

It’s not so much the light from the devices that causes problems but rather what the kids are viewing on such devices. Apps like TikTok and Instagram can spoil sleep because they are “difficult to put down and are also stimulating,” Kogon said.

Reading a book on a device, for example, “is probably not the same as flipping through social media,” Kogon said.

Parents shouldn’t allow cellphones in kids’ bedrooms at night, Kogon said. She also suggests kids not have any kind of electronics or TVs in bedrooms.

Dr. Mariana Bedoya, an assistant professor of allergy, immunology, pulmonology and sleep medicine at Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nashville, Tennessee, said other ways to help improve sleep include:

• Quitting caffeine at least six hours before bed.
• Keeping to regular sleep schedules.
• Avoiding naps for older kids.

“I tell patients not to change their sleep schedule by more than an hour and a half to two hours over the weekend,” said Bedoya, who wasn’t involved in the new study.

Love said it’s tough for kids to get enough sleep these days. “Is it that kids are worrying or eating bad things?” he asked. “There are so many things distracting them from sleep.”

This story first appeared on NBCNews.com. More from NBC News:

• Surgeon general wants tobacco-style warning applied to social media platforms
• Abortion pill access could still face challenges after Supreme Court decision
• From ‘tent life’ to soccer matches, creators in Gaza share glimpses of daily life during war

• What maternal mental health is and why it’s so important to talk about it
• At-home strategies to cope (NOT a replacement for professional help)
• How to support friends navigating motherhood
• Tips for becoming a better listener
• How to take advantage of the gift of a full range of emotions

For more tips from Olivia you can follow her on social: @theinnerwork_witholivia & @maternaltraumasupport

You can also find her Trauma-Informed Maternal Health Directory here

If you or someone you know is struggling, please call the Behavioral Health Help Line: (833) 773-2445

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Choose the right type of chocolate and you also get a rare dessert that gets approval from dietitians.

June is National Candy Month, though chocolate really rules in October for Halloween, December for the holiday season, February for Valentine’s Day and spring for Easter.

But people love it year-round: the average American eats almost 10 pounds of chocolate per year, according to Forbes.

Many might not know chocolate comes from a fruit tree and is made from a seed — the cocoa bean, the National Confectioners Association notes.

What is the healthiest chocolate?

Of the three types of chocolate — dark, milk and white — dark chocolate is the healthiest, nutrition experts say.

“The health benefits of chocolate products are all thanks to the cocoa bean, which contains numerous phytochemicals shown to have anti-inflammatory, anticancer, and antihypertensive properties,” Whitney English, a registered dietitian at Whitney E. RD in Palo Alto, California, tells TODAY.com.

“The more cocoa solids a product contains, the more nutritious it is. Dark chocolate contains the most cocoa bean solids and therefore is the most nutrient-dense.”

Dark chocolate also has a higher content of flavonoids than milk or white chocolate, says Elisabetta Politi, a registered dietitian at the Duke Lifestyle and Weight Management Center in Durham, North Carolina.

Flavonoids function as antioxidants to block the damaging effects of free radicals, which have been linked to increased risk of heart disease and cancer, she notes.

“Additionally, flavonols, a type of flavonoids in dark chocolate, may affect the function of the immune system by reducing inflammation,” Politi tells TODAY.com.

Is 70% dark chocolate healthy?

Both experts recommend choosing chocolate with at least 70% cocoa content because it will have less added sugar and more phytochemicals than chocolate with less cocoa.

A 70% chocolate bar will list cocoa beans or one of its derivatives — cocoa solids or cocoa liquor — as the first ingredient, Politi says. If sugar is listed first, it means cocoa makes up less than 50% of the bar, she adds.

Dark chocolate benefits

Cocoa beans contain protein and are a great source of minerals like iron and magnesium, plus manganese, copper, zinc and phosphorus, TODAY.com previously reported. You get a bit of fiber, too — about 3 grams per 1 ounce of dark chocolate, according to the U.S. Department of Agriculture.

Chocolate is rich in polyphenols, beneficial compounds produced by plants.

Higher chocolate intake is associated with a lower risk of future heart problems, researchers reported in the journal Heart.

Reviews of studies have found chocolate consumption “significantly reduced” triglycerides — a type of fat in the blood — and can modestly lower blood pressure.

Cocoa flavanols protect against vascular disease and appear to improve blood flow to the brain, a study published in Scientific Reports noted.

Chocolate also has benefits for the mind.

Dark chocolate “contributes to producing the feel-good hormone serotonin and contains magnesium, which is linked to reducing anxiety” and relieving stress, Keri Glassman, a registered dietitian in New York, notes.

Eating 85% cocoa dark chocolate may also boost mood via the gut-brain connection, with dark chocolate having a prebiotic effect on healthy bacteria in the gut and possibly improving negative emotions that way, a study found.

Could it make you smarter? There’s a “surprisingly powerful” correlation between chocolate intake and the number of Nobel laureates in various countries — perhaps because chocolate “enhances cognitive function,” a study published in The New England Journal of Medicine found.

For example, Switzerland was the top performer when it came to both the number of Nobel laureates and the amount of chocolate its residents eat, the authors noted. (Other experts were very skeptical of the correlation.)

Dark chocolate side effects

When Consumer Reports tested 28 dark chocolate bars from a variety of brands in 2022, it found cadmium and lead in all of them — two heavy metals harmful to health. The levels weren’t extremely high, but they were detectable, the organization said when it released its test results.

The National Confectioners Association countered that chocolate is safe to eat and all the products tested were “in compliance with strict quality and safety requirements.”

Any harms from heavy metals seem to be outweighed by other positive compounds in dark chocolate, English notes.

If heavy metals are a concern, Politi suggests choosing milk chocolate, or varying both milk and dark.

Dark chocolate contains caffeine — about 23 milligrams in a 1-ounce square, according to the U.S. Department of Agriculture. If you eat four squares, that’s about the same amount of caffeine as drinking a cup of coffee.

And it’s still candy — it has fat and sugar, with 170 calories per ounce, so eating too much can lead to weight gain.

How much chocolate per day is OK to eat?

Politi recommends sticking to 1 ounce per day, or the size of a dental floss case.

English says a few squares of chocolate a day is a reasonable amount for most people.

How do you eat dark chocolate if you don’t like it?

If it’s too bitter, try putting two small pieces in your mouth and let them melt over your tongue, which helps discover the complexity of the dark chocolate flavor, Politi advises.

A dark chocolate bar that contains sea salt or dried fruit may also taste less bitter than plain dark chocolate, even if they contain the same amount of cocoa, she adds. Politi personally loves chocolate with orange flavor added.

Yogurt with fresh berries and some dark chocolate chips sprinkled on top is another option, English notes.

Both dietitians are fans of dipping fruit in melted chocolate.

Is chocolate unhealthy or healthy?

Dark chocolate contains nutritious components and its benefits likely outweigh any potential drawbacks as long as it’s consumed in moderation, English says.

If a person enjoys a sweet treat at night, choosing a few squares of dark chocolate over a bowl of ice cream is more beneficial, but it’s likely less healthful than a bowl of blueberries, she explains.

“If someone loves a treat at the end of a meal, I think a small amount of dark chocolate is a guiltless choice, which has been shown to provide health benefits,” Politi adds.

“(But) I wouldn’t say chocolate is a health food.”

This article first appeared on TODAY.com. Read more from TODAY here:

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“I didn’t think much of it,” Salvador, now 21 of New Orleans, tells TODAY.com. “It was just getting bigger.”

As it grew, he worried that the mass was a sign something was seriously wrong. In the fall, he asked his mom about it, and she examined it. Concerned, she took Salvador to a hospital, and he eventually learned that he had stage 1 testicular cancer. He’s sharing his story so other young people with cancer feel less alone.

“Maybe someone will relate to it,” Salvador says. “Maybe somebody will find hope in my story.” 

A lump that keeps growing

Over the summer of 2020, Salvador noticed the bump but thought his body had just changed.

“I thought it was normal,” he says. Then it began growing, and he became worried. In October, he mentioned it to his mom, who believed they should visit the hospital.

“They did some scans. They did some checks,” Salvador recalls. “They said, ‘Yes, this is cancerous.’”

The doctors recommended removing both testicles, but Salvador’s mother balked at this. She hoped to someday have grandchildren and thought that this plan was too aggressive for her teen son. The two visited a doctor at Children’s Hospital of New Orleans for a second opinion. Doctors there shared some welcome news.

“They were like, ‘OK, we’re going to do the best to save one (testicle),’” Salvador recalls. “But the other one definitely has to come out.”

The doctor removed the testicle and several lymph nodes during surgery and diagnosed Salvador with stage 1 rhabdomyosarcoma, a type of soft tissue cancer that can occur in connective tissue or muscle, according to the National Cancer Institute.

“The biggest surgery was the one where they took out my lymph nodes,” he says. “They opened up the whole chest area, stomach area.”

Following that surgery, Salvador underwent radiation for a month and then eight months of chemotherapy with infusions once a week. Treatment felt tough at times.

“I lost my hair. I was nauseous,” he says. “I was pretty weak.”

Following the completion of chemotherapy, Salvador was cancer free. He had another surgery where they gave him a prosthetic testicle. While going through cancer treatment as a teen felt difficult, he was able to enjoy his final year in high school.

“(My) hair grew back,” he says. “My late senior year, everything went back to normal.” 

Testicular cancer

While Salvador’s cancer grew in his testicle, it’s not the same type of cancer often associated with testicular cancer diagnosis, such as the type that Lance Armstrong had, Dr. Pinki Prasad, oncologist and hematologist at Children’s Hospital New Orleans and one of Salvador’s doctors, tells TODAY.com.

“Ronal actually had a type of sarcoma, rhabdomyosarcoma, that can be found very often in the … testicular region,” she explains, adding that it’s more common in children than adults.

This type of cancer doesn’t have many noticeable symptoms other than a lump on the testicles — “usually painless, but it’s a bump that gets bigger with time and doesn’t get better,” Prasad says. “Sometimes it will be painful, and that’s what brings this to (their) attention.”

She estimates that, in 90% of cases of testicular rhabdomyosarcoma, a lump is the only sign. Prasad adds that “very rarely do we see pain with urination, blood in the urine.”

While Prasad says all pediatric cancers are considered rare, including testicular rhabdomyosarcoma, she urges boys to be aware of their bodies and say something if they notice any changes.

“Once they hit puberty, they should be checking their testicles at least once a month,” she says. “No one is going to know outside of them if there’s any changes, and so it’s really important for them to get used to knowing what’s normal for them.”

Treatment for testicular rhabdomyosarcoma includes surgery to remove the testicle with the cancer and lymph nodes, which can be followed by radiation and chemotherapy.

Like any cancer, patients diagnosed with rhabdomyosarcoma in early stages have good outcomes with lower risk of recurrence. Still, Prasad says doctors closely monitor people for several years.

“They resume their normal lives pretty quickly. They go back to school. They do all the things they want to do,” she says. “We do follow them for a very indefinite amount of time, and most of these patients are survivors.”  

With testicular cancer, people often feel hesitant to share symptoms with their family or doctor.

“There is a stigma,” Prasad says. “Most of these patients who have some sort of a testicular tumor do end up having a testicle removed, which can lead to some body issues.”

Prasad notes that prosthetic testicles are available, and more than half of her patients opt to have one. 

College and beyond

For years, Salvador hoped to become a doctor. After graduating from high school, he started college and is studying pre-med.

“I want to be a cardiologist,” he says. “When I was younger, I used to have a lot of heart issues, and I used to always see cardiologists. They always looked so happy.”

This summer, Salvador plans to work at his family’s business and read for fun. He hopes his story encourages others to be aware of their health.

“It’s important for everybody to learn about their bodies, how to examine it on their own,” he says. “It’s important to know how to take care of yourself.” 

This article first appeared on TODAY.com. Read more from TODAY here:

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The workout is simple: Set the treadmill to an incline of 12 (or lower — choose a challenging incline for your fitness level!) at a speed of 3 miles per hour and walk for 30 minutes.

The routine doesn’t require a lot of time, but if done consistently it can improve endurance and aid in weight loss. One of the reasons why it is so popular is that it can deliver these results with absolutely no running required!

Walking is lower-impact and less likely to cause injury than running, and has many important benefits, such as lowering blood pressure and cholesterol, boosting metabolism, improving mental health by reducing anxiety and depression, and even lowering the risk of some cancers.

The 12-3-30 trend took off when health and beauty influencer Lauren Giraldo posted about it on YouTube in 2019 and then again on Tiktok in 2020, sharing that the workout helped her lose 30 pounds and keep it off.

“I used to be so intimidated by the gym. It wasn’t motivating, but now I go do this one thing and I can feel good about myself,” she said on TikTok. “I look forward to it. It’s my me-time.”

Giraldo’s emphasis on self-care and attainable fitness goals has resonated with a wide audience. Her initial post has over 2.8 million likes.

The influencer, who is not a fitness expert, chose the numbers 12, 3 and 30 because the highest incline on the treadmill at her gym was 12, she didn’t enjoy running and three miles per hour felt like a good, brisk walking pace to her, and her grandmother always advised to exercise at least 30 minutes each day.

Clearly, the incline and intensity in the workout are personal to her, so people should consider their own fitness level and goals when trying it, and make adjustments as needed.

Physical therapist Vijay A. Daryanani, a certified personal trainer at Spaulding Outpatient Center, a hospital that partners with Harvard Medical School, says the simplicity of walking for 30 minutes is an attainable goal that’s appropriate for most people.

“I think the 3 mph for speed is good for most people, but the incline is a critical piece,” Daryanani tells TODAY.com.

He recommends that people pay close attention to their posture while walking on an incline.

“When I’m training someone, I will adjust the incline safely and with guidance to maintain posture, balance and stride. Inclining a treadmill is similar to walking up hills, which places different stresses on the musculoskeletal system,” he says.

Here’s what to know about preventing injury and walking for weight loss if you’re ready to try the 12-3-30 workout yourself.

What is the “12-3-30” workout?

Giraldo’s workout is guided by three settings on the treadmill:

• Incline: 12
• Speed: 3 mph
• Time: 30 minutes

According to Giraldo’s TikTok video, she does the workout approximately five times per week and it helped her drop 30 pounds. “I obviously noticed the changes in my body, but I was most happy with the changes that I felt mentally,” she said. “I was proud of myself every day for getting on the treadmill and having my ‘me time’ for 30 minutes. I feel accomplished every time I do it.”

For Giraldo it served another important purpose: getting her comfortable stepping foot in the gym. “The thing about 12-3-30 is it made the gym so much less of a scary place. I feel confident in the gym now, and I sometimes incorporate weights and other exercises into my workout,” she said.

Benefits of the “12-3-30” workout

As previously reported by TODAY.com, walking comes with a myriad of health benefits including: Improving cardiovascular health and blood pressure, controlling blood sugar and reduce your risk of diabetes, increasing your metabolism, aiding in weight loss and maintenance and increasing your aerobic capacity.

The U.S. Department of Health and Human Services recommends moderate-intensity aerobic exercise for 150 to 300 minutes a week. Doing the 12-3-30 workout five times a week will get you into the low end of that range.

Walking is also a low-impact alternative to running, which is good for people with joint issues, but adding the incline to your walks increases the intensity and makes it a more challenging workout. It also has toning benefits for the lower body. “Walking on an incline will engage your leg muscles more than walking on level ground,” TODAY fitness contributor Stephanie Mansour previously wrote on TODAY.com. “This will make for a more intense workout for your glutes, hamstrings and quads, while also increasing your heart rate.”

Is the “12-3-30” workout safe?

At first, Giraldo couldn’t make it the full 30 minutes. “I definitely had to work up to the 30 minutes. I couldn’t get through it without losing my breath and started out by taking a break after the 10 or 15-minute mark,” she said.

Although 12-3-30 is a relatively straightforward treadmill workout, it isn’t something you should just jump right into, Dr. Dennis Cardone, osteopathic sports medicine specialist and chief of primary care sports medicine at NYU Langone Health, tells TODAY.com.

“If someone is working that hard with this workout and they are a 20-something, young and healthy, and they are struggling, you see it was a pretty significant workout,” Cardone says. “It’s just too much too soon and it should really have a recovery day as well.”

That’s not to say that there can’t be benefits to adding an incline to your workout. “It certainly adds more stress to a workout in the sense that people are getting more of a workout in a shorter period of time; the muscles are working harder,” says Cardone.

But, he adds, the risks may outweigh the benefit when it comes to adding a significant incline to your workout.

“The problem is people don’t think that walking is a stressor. They think ‘what’s the big deal using an incline? I’m only walking.’ But it really is a big stressor: low back, hamstring, Achilles tendon, knee, plantar fascia … these are the areas where we see some significant injury related to inclining a treadmill,” he says. “As a general observation, anytime anybody begins or changes a workout or adds something like an incline, they have to follow the rule to do it slowly, otherwise they are certainly at significant risk for an overuse injury.”

Can you lose weight with the “12-3-30” workout?

Giraldo says that she lost 30 pounds with the 12-3-30 workout and has kept it off for years.

Gradual, steady weight loss of about 1 to 2 pounds per week is optimal for keeping the weight off, according to the Centers for Disease Control and Prevention. “Generally to lose 1 to 2 pounds a week, you need to burn 500 to 1,000 calories more than you consume each day, through a lower calorie diet and regular physical activity,” the Mayo Clinic explains.

Walking for 30 minutes burns about 125 calories for a 150-pound person — and adding an incline will increase that calorie burn. So with healthy diet changes, the 12-3-30 workout has the potential to burn the calories needed for steady, gradual weight loss.

Want to give it a try? Follow these guidelines for a safe and effective workout

“(Giraldo) did well, but most people never make it there because they will get an overuse injury and will be taken out of the game. It’s a great goal, but it’s just not realistic for most of the population,” says Cardone. “If you just do one activity — we don’t have to bash just this one — but whatever activity, if you keep doing it day in and day out, it’s just a setup for injury.”

So instead of jacking that incline way up, here is the safe way to try Giraldo’s workout:

• Don’t be fooled by the treadmill: “People think the treadmill is so safe; it’s not outdoors, it’s a soft, forgiving surface. But it’s not that different from walking up a hill; you’re not protecting yourself that much more by being on a treadmill as opposed to being out on a road,” warns Cardone. “Thirty minutes walking up a mountain, it’s pretty tough when you think about it. People feel a little overconfident about the treadmill.”
• Adjust the numbers to meet you where you’re at. “Don’t incline so rapidly, maybe don’t even start at 30 minutes; 3 mph is reasonable, but maybe slow down your duration of workout and incline to work up to that,” suggests Cardone. “Start flat on a treadmill, and do 0-3-30. Once that is comfortable for you, then start inclining, don’t go to 12 right away. Over 3 weeks start slowly progressing your incline, maybe 10-20 percent per week.”
• If you’re new to fitness, start on flat ground. “If someone is outdoors and starting their workout program, whether it’s walking, jogging, interval training, don’t look for a hill,” says Cardone. “First, tolerate flat. Once you’re doing that, then if you want to add some hills into your workout, fine. But don’t go looking for hills at the start of a program.”
• Gradually increase incline: “Slowly progress your incline, start at the lowest setting and it’s a gradual increase, like any other workout in terms of increasing mileage or intensity,” says Cardone. “This workout starts at a 12-degree incline, so I’d say go at 4-degree intervals. So gradually increase it over a 3-week period to get to that 12 degrees.”
• Don’t do it every day. “Almost whatever the routine is, the general rule is there should be a recovery day or at least alternating with some other activity in order to try to avoid overuse injuries,” says Cardone. “I wouldn’t discourage people from doing some sort of activity most days of the week, just not the same activity. Have a recovery day where you are doing some sort of alternate activity, maybe that might be the elliptical trainer, a bicycle or in the swimming pool, whatever you have available.”
• Supplement with strength and stretching. The bent posture of walking uphill places stress on your low back, Achilles tendon, calf muscles, plantar fascia and hamstring muscles, says Cardone. “Those are stubborn problems and people don’t want those kind of injuries, once they kick in, they are tough to treat,” he says. He suggests doing core-strengthening exercises as well as stretching those areas specifically to help reduce your risk of injury while walking or running.
• Consider something lower impact. If you are just getting into fitness, Cardone advises starting with lower-impact workouts. “Bicycling, elliptical trainer, swimming, cross-training type activities, are even safer. Those are great activities to start a workout routine and build up your cardiovascular endurance; you’re not doing a lot of impact, it’s a little more forgiving on the joints and also on muscle tendons,” he says. “So maybe do the treadmill 2 or 3 days a week and the other days these other activities; that is going to keep people out of trouble.”

How many times a week should I do the “12-3-30” workout?

Even if you’re following these guidelines, the workout should still be done at most, every other day, alternating with other lower-impact activities.

In order to get the benefits you seek from any exercise — whether that be weight loss, toning or overall health — the key is to find a program you can stick with, said Cardone. That means the fitness routine you choose not only needs to be safe, so you’re not sidelined by an injury, but “it has to be something they enjoy, and if they are only doing one activity they are going to burn out, not just physically, but mentally,” he says.

More viral workout trends:

• The Taylor Swift treadmill strut
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• The stomach vacuum
• Cozy cardio

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This is one of the most common challenges leadership coach Kim Meninger hears. Fortunately, she has practical strategies to not only identify the feelings but create an action plan to build confidence, raise self-awareness, and find more joy. She talks with Maria about:

• What imposter syndrome is & how it can exist differently for men and women
• When & how to ask for help with “outing” yourself and your insecurities
• Perfectionism — why this stops us from reaching our full potential
• Motherhood juggle & tips to find your strengths

Sign up for Kim’s “7-Day Imposter Syndrome Challenge”: kimmeninger.com

Follow Kim on social for more tips & strategies: @kim.meninger

Follow along on social: @thehubtoday & @mariasansone

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Following years of public outcry about the high cost of inhalers, the two drugmakers — along with a third, GlaxoSmithKline —  have committed to capping the out-of-pocket cost at $35 a month. GSK’s cap is expected to take effect by Jan. 1.

The moves mirror similar steps taken by insulin manufacturers last year following the passage of the Inflation Reduction Act.

Like insulin, the cost of inhalers in the U.S. is significantly higher than in other wealthy countries. An investigation by the Democratic-led Senate Committee on Health, Education, Labor and Pensions noted AstraZeneca charges $645 in the U.S. for the same inhaler it charges $49 for in the U.K. Teva Pharmaceuticals, another major inhaler manufacturer, charges $286 in the U.S. for an inhaler that costs $9 in Germany.

Caycee Shapland, 29, from Omaha, Nebraska, spends at least $80 each month on her 4-year-old son Jackson’s Symbicort, an inhaler from AstraZeneca, to manage his asthma. He also takes albuterol, also from AstraZeneca, for his asthma.

Despite having health insurance, Shapland said the cost can balloon to $350 a month — a significant financial burden — depending on the severity of Jackson’s asthma.

“Going down from at least $80 a month to $35 a month is astronomical,” Shapland said. “I mean, feeding three young boys 5 and under is $300 a week on our groceries alone. So, it’s a lot of money.”

Dr. Alan Baptist, the division chief of allergy and immunology in the department of internal medicine at Henry Ford Health in Detroit, said the price caps for inhalers should provide significant financial relief for the 30% of his patients who can’t afford their medication.

“I applaud the companies for putting that out and I was surprised by it,” Baptist said.

High prices and lack of access to inhalers, he said, play a role in the racial disparities seen in asthma care, both in Detroit and nationwide.

While asthma rates are slightly higher in Black Americans than in white Americans, “when you look at the outcomes, the adverse events, it’s so much worse,” he said. Black children were 4.5 times more likely to be hospitalized for asthma than white children, and 7.6 times more likely to die from asthma, according to the federal Office of Minority Health.

‘Chaos for patients’

More than 27 million people in the U.S. have asthma, including 5 million children, according to the Asthma and Allergy Foundation of America.

Dr. Steven Stryk, an allergist-immunologist and associate professor of internal medicine at Oakland University William Beaumont School of Medicine, said that while the price caps are a big deal, he remains skeptical until he sees how they’re implemented.

“I think what you’ll find is most doctors saying I’ll believe it when it happens,” he said.

According to a spokesperson for AstraZeneca, both privately insured and uninsured patients will be eligible for the $35 price cap, which will apply to all of the inhalers the drugmaker sells in the U.S.

A spokesperson for Boehringer Ingelheim said the $35 cap will be automatically applied at the pharmacy counter for the majority of eligible patients with commercial insurance. For those without insurance or whose pharmacies aren’t participating, they’ll be able to visit the company’s website starting Saturday, where they can enroll in a copay card that will reduce the out-of-pocket cost to $35.

GSK’s price cap will go into effect later this year, a spokesperson said, and will be available to all patients, regardless of income.

People enrolled in government insurance programs, such as Medicare and Medicaid, won’t be eligible for any of the price caps due to federal restrictions.

Out-of-pocket costs for inhalers can vary widely, depending on the medication and insurance coverage, said Dr. Megan Conroy, a pulmonologist and critical care specialist at Ohio State University’s Wexner Medical Center. “It really creates a lot of chaos for patients.”

Kiowa Rix, 27, of Warren, Michigan, found herself with a $500 out-of-pocket price tag for her son Lucas’ inhaler — Flovent, from GSK — in February, when her insurance stopped covering the medication. The 6-year-old has severe asthma and needs to use an inhaler twice a day.

Lucas’ doctor switched him to a different inhaler, from Merck, which cost $80 a month. Rix is now switching him to Symbicort, which will be capped at $35.

“It makes me feel a little better that they’re realizing they’re overcharging,” Rix said of the price caps going into effect. “You shouldn’t have to go through all these hoops just to get something lowered that you or your child needs.”

While the price caps are significant, it’s unclear whether they’ll apply to the cost of all of a patient’s asthma drugs, or $35 per inhaler.

Patients, said Conroy of Ohio State, often require a rescue inhaler for quick relief, as well as a long-acting or maintenance inhaler to prevent symptoms.

“Patients have multiple medical comorbidities that they’re treating, and a longer list of medications beyond just inhalers for their respiratory disease, some of which carry similar stories of high copays,” she said.

Devastating consequences

The price caps should at least provide a sense of relief to families that qualify, said Dr. Ixsy Abigail Ramirez, a pediatric pulmonologist at University of Michigan Health. Some families, she said, have been forced to consider skipping, delaying or going without the medication because of the high cost, which can add up to thousands of dollars a month.

“Am I going to pay for food and the roof over my head this month? Or am I going to pay for an inhaler that my child requires to breathe so that we don’t end up in the hospital incurring other costs?” she said.

Cole Schmidtknecht typically spent around $5 for his inhaler. According to his father, Bil, one day when he tried to refill his prescription, he was told it would cost more than $500, which he couldn’t afford. Cole suffered a severe asthma attack days later, leading to a fatal cardiac arrest. He was 22.

“Had he had an affordable option in front of him, he’d have probably been here today,” said Bil.

Baptist, of Henry Ford Health, said that while the price caps are a step in the right direction, they don’t go far enough.

“In some ways, it’s just a Band-Aid on the bigger problem that we have,” Baptist said. “The real problem is the outrageous cost of pharmaceutical and drug prices in the United States.”

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The most common type of dementia, Alzheimer’s disease, affects nearly 6 million Americans and is expected to rise to 14 million by 2060 due to our aging population. Cognitive decline — an impairment of memory, decision-making and ability to learn — develops due to aging neurons and the slowing down of the speed at which the brain functions. It’s directly linked to the aging process and leads to worsening memory, attention and brain processing. 

Beyond the calories that are burned by running all the many functions of the brain, there are specific foods that help support our brain’s activity. Here’s what to know about so-called brain foods.

New research on foods and brain aging

A new study published in the journal Nature Aging points to specific nutrients that can contribute to slower aging in the brain. The 100 participants between 65 and 75 years old completed questionnaires, underwent various physical and cognitive tests, MRI scans and had their blood plasma drawn after fasting.

Researchers found that one group had signs of slower aging and also ate a specific nutrient profile. The nutrients in the blood that were prevalent in participants with slower aging were:

• Fatty acids, found in seafood and some healthy cooking oils
• Antioxidants, found in berries, garlic, tomatoes, nuts and plenty of other fruits and vegetables
• Carotenoids, found in spinach, kale, carrots, broccoli and some fruits
• Vitamin E, found in fruits, vegetables, seafood, seeds and nuts and more
• Choline, found in egg yolks, beef, dairy and some veggies

Many foods that make up the Mediterranean diet are high in these nutrients, the researchers noted. While most previous research on foods and brain health have relied on food questionnaires, this research is one of the first to use blood biomarkers, brain scans and cognitive testing.

What is the No. 1 best food for brain health?

As a registered dietitian, I would say this is the best food to boost your brain health:

Fatty fish

Studies have shown that eating just one seafood meal per week has been linked with a lowered risk of both Alzheimer’s and dementia. Our brains are mostly made up of omega-3 fatty acids called EPA and DHA, so it makes sense that foods that contain these fats would help support brain health.

Omega-3 has been shown to help protect the brain with its anti-inflammatory effects, ability to help create new neurons, and power to help clear the brain of plaques, one of the signs of Alzheimer’s. The best-known sources of EPA and DHA on the planet are high-quality seafood, like wild Alaskan salmon, sablefish and halibut. Sardines are another source of omega-3s. Wild-caught seafood is sustainably caught and also has lower contaminants than farm-raised seafood.

What foods help with brain health?

Eggs

The micronutrient choline is finally getting the attention it deserves for its role in brain health, including memory, thinking, mood and more. Higher levels of choline intake are thought to support brain function, which may decrease the risk of some types of dementia, including Alzheimer’s. One of the best dietary sources of choline is the egg. One large egg provides 150 milligrams, about 25% of the daily requirement for men and 35% for women.

You’ll find choline (plus nearly half of an egg’s protein and many other vitamins and minerals) in the yolk, so be sure to eat the whole egg. According to the American Heart Association, eggs can be included as part of a heart-smart diet for healthy adults. 

Walnuts

Research has found that eating walnuts may be linked with improved cognitive function and memory in groups at high risk for age-related cognitive impairment, and reduced risk of Alzheimer’s disease. The nut is also linked with a reduced risk of other diseases, such as cardiovascular disease or Type 2 diabetes, which are both risk factors for developing dementia. Whether you’re munching on walnuts for heart or brain health, you can feel good knowing that you’re covering both bases. 

Berries

Known for being rich in antioxidants and polyphenols, berries contain several disease-fighting compounds. Research has found that eating berries has a protective effect against cardiovascular disease, cancer and Alzheimer’s. A major contributor to Alzheimer’s and other chronic diseases is inflammation. Both strawberries and blueberries have anti-inflammatory benefits.

A study on strawberries found that when older adults, ages 60 to 75, were given the equivalent of 2 cups of strawberries daily for 90 days, they showed improvement in memory and learning tests. In a similar study, participants who ate the equivalent of 1 cup of blueberries daily were tested on verbal learning and task switching and had significantly fewer errors on both tests at 45 and 90 days. 

Prunes

Known for their gut health and bone benefits, prunes are also great for your brain. Prunes are high in potassium and a source of vitamin B6 and copper, all micronutrients that contribute to normal functioning of the nervous system. What’s more, studies on prunes show that the dried fruit has anti-inflammatory, antioxidant and memory-improving characteristics. The benefits are likely due to the high content of anthocyanin, a blue plant pigment. 

Citrus fruits

One of the markers of Alzheimer’sdDisease is neurodegeneration. The peel of a small citrus fruit from Okinawa, Japan called shikuwasa lime (also called citrus depressa) is rich in a plant compound called nobiletin. Nobiletin has been found to protect nerve cells and provide anti-inflammatory benefits and is looking promising as a potential treatment for Alzheimer’s. The good news is that this important compound can also be found in mandarins, oranges, tangerines and grapefruits. 

Cocoa powder and dark chocolate

Cocoa beans are rich in flavanols, which help fight inflammation in our body and can increase blood flow to the brain. Choosing dark chocolate over milk chocolate helps you get more of the protective polyphenols.

Extra virgin olive oil

As the staple of the Mediterranean diet, extra virgin olive oil is rich in polyphenols and vitamin E. A 2023 study done at the Harvard T.H. Chan School of Public Health found that daily consumption of more than half a tablespoon of EVOO had a 28% lower risk of dying from dementia compared to never or rarely consuming olive oil. The study also found that replacing just one teaspoon of margarine or mayo with the same amount of EVOO daily was associated with an 8 to 14% lower risk of dying from dementia. 

Tips to sharpen your memory 

In addition to what we eat, there are other habits to work on to support brain health, Dr. Andrew Budson, author of “Why We Forget and How to Remember Better,” tells TODAY.com.

Here are some strategies to remember things better:

• Focus your attention on whatever it is that you want to remember.
• Organize whatever it is that you want to remember, whether it is by reviewing the sights, sounds, smells, thoughts, and feelings of an experience or the material you need to memorize for a presentation or exam.
• Understand what you want to remember, such as the deeper meaning or implications of an episode of your life or the individual elements of your presentation or exam
• Relate what you are learning to things you already know or have experienced

In addition to the tips above, you may want to ditch some habits that can hinder memory over time, Budson says. These include:

• Not correcting bad habits immediately. Break bad habits right away or they will become part of your routine. For example, don’t leave your keys, wallet, cell phone where they are difficult to find— even once —or you may find yourself frequently hunting around the house looking for them.
• Not paying attention to where you are or what you are doing. This is the No. 1 reason people have trouble finding their car, keys, phone, etc. Stop and pay attention to where you parked and where you put down your keys, for example.
• Not engaging in aerobic exercise regularly. Aerobic exercise releases growth factors from the brain that help to grow new brain cells in the hippocampus, the part of the brain that forms new memories.
• Being sedentary and watching too much television. There are new studies that suggest that even when controlling for vigorous exercise, it is still important to not be sedentary and not to watch more than one hour of television per day.
• Eating too much unhealthy food. Everyone can get away with eating dessert, red meat, butter, soda, refined sugar and flour once in a while, but it is important that the majority of one’s diet be from the Mediterranean menu, including fish, olive oil, fruits, and vegetables, nuts and beans, and whole grains.
• While Budson doesn’t recommend any particular supplements for brain health, he does encourage people to have their vitamin D and B12 levels checked by your physician at least once every decade after age 40. Both vitamin D and B-12 are necessary for proper memory function.

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Americans under the age of 30 reported lower levels of happiness from 2021 to 2023 than those over the age of 60, according to this year’s World Happiness Report.

Jonathan Haidt, a social psychologist at New York University’s Stern School of Business, lays the blame squarely on our devices.

His new book, “The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness,” argues that the constant access to social media that phones have given us has led to social comparison, sleep deprivation and loneliness in Gen Z.

And it’s touched a nerve: his book is currently No. 3 on the New York Times nonfiction bestseller list.

Of course, as high-profile as the book has become, not everyone agrees with its thesis. Some critics argue blaming smartphones is an oversimplification and not fully supported by evidence

Zach Rausch, lead researcher to Haidt and an associate research scientist at NYU-Stern School of Business, says kids who had access to social media and iPhones in elementary and middle school are more anxious and less productive.

“The goal of technology is that it’s a tool that we use to meet our goals,” he says. “If it’s not doing that, it ends up using us at the cost of our goals.”

But, there are ways to curb these negative effects. Here are three things you can do today to increase your happiness and stay focused.

1. Buy an alarm clock.

Your phone being the last thing you interact with before bed and the first when you wake up can adversely affect your sleep and add to stress levels.

Purchasing an alarm clock and keeping your device outside your bedroom can create some physical and mental distance from social media.

2. Use your phone to meet with people in person.

Oftentimes, conversations on Instagram or text don’t cross over from digital to physical.

“We used flip phones to connect with each other in order to eventually meet in person,” Rausch says. “The online world is kind of the opposite. We connect in order to stay there. And our argument is that that’s not sufficient.”

Yale University happiness professor Laurie Santos echoes this sentiment.

“Every available study of happy people suggests that happy people are more social, they spend more time physically around other people, and they invest time in their friends and family members,” Santos, who teaches “The Science of Wellbeing” course at Yale told CNBC Make It.

3. Silence notifications.

Adolescents get 237 smartphone notifications a day, according to a 2023 study which surveyed 203 teens and tween between ages 11 and 17. Almost a quarter, 23%, arrived during school.

Silencing your notifications can help you stay present and productive during the hours it matters most.

Rausch emphasizes that getting rid of smartphones is not a panacea for depression. But, using your phone in a more thoughtful way can help you pursue activities that are proven to increase your happiness, like in-person social connection, and get more done.

“It’s not that we need to reject technology outright,” he says. “It’s that as technology is rapidly changing the way that we live our lives we need to press pause and think about how we want this to be in our lives. Is it fulfilling us? Is it helping us flourish? Is it helping us meet our goals? And, if not, what can we do to change it?”

Want to be a successful, confident communicator? Take CNBC’s new online course Become an Effective Communicator: Master Public Speaking. We’ll teach you how to speak clearly and confidently, calm your nerves, what to say and not say, and body language techniques to make a great first impression. Sign up today and use code EARLYBIRD for an introductory discount of 30% off through July 10, 2024.

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According to NBC News report published this week by the Centers for Disease Control and Prevention revealed new details of the outbreak, which occurred in July 2022 at a nine-person family reunion in South Dakota.

One family member brought meat to the reunion from a black bear hunted in northern Canada. The meat had been frozen in a household freezer for 45 days. Hunting black bears is legal in Canada and many U.S. states.

The family made kebabs with the thawed meat, alongside grilled vegetables. According to the CDC, the family had a hard time determining whether the kebabs were fully cooked, because the meat was dark in color. So it was unintentionally served and eaten rare.

A week later, one family member — a 29-year-old man in Minnesota — developed a fever, severe muscle pain and swelling around the eyes. He was hospitalized twice for his symptoms.

The man tested positive for antibodies to Trichinella, a type of roundworm. Five other family members also developed symptoms such as fevers, headache, stomach pain, diarrhea, muscle pain and swelling around the eyes.

Two others who’d been exposed did not develop symptoms, and the CDC could not confirm whether the ninth person had been exposed to Trichinella.

The CDC tested the remaining frozen meat and detected larvae from the same roundworm species.

The agency presumed that all six family members had trichinellosis, a disease caused by eating undercooked meat contaminated with Trichinella larvae.

Such infections are rare. From January 2016 to December 2022, the CDC identified seven trichinellosis outbreaks in the U.S. involving 35 probable or confirmed cases. Most were linked to bear meat.

Trichinellosis is not the same parasitic infection that presidential candidate Robert F. Kennedy Jr. recently revealed he once suffered from. Kennedy said the brain infection he got comes from pork tapeworm larvae.

Two of the infected people at the family reunion ate the vegetables without the meat, the CDC said. Trichinella-infected meat can result in cross-contamination, so meat and its juices should be separated from other foods during cooking.

Three of the family members were hospitalized, each of whom had consumed the bear meat. They received a treatment called albendazole, which kills parasitic worms and their larvae.

All six people recovered from the disease.

The CDC report warns that freezing meat won’t kill all species of Trichinella. The bear meat at the family reunion, for instance, was contaminated with a species found in Arctic bears that’s resistant to freezing.

“Persons who consume meat from wild game animals should be aware that that adequate cooking is the only reliable way to kill Trichinella parasites,” the report’s authors wrote.

The CDC recommends cooking wild game meat to an internal temperature of at least 165 degrees Fahrenheit, which should be verified with a meat thermometer — not by looking at the color of the meat.

This story first appeared on NBCNews.com. More from NBC News:

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Nutritionists highly recommend starting your morning with foods that will keep you energized throughout the day like protein shakes and whole grain oats, experts told CNBC Make It last January. And cereal doesn’t fit that category.

“I never recommend cereal to my patients to have for breakfast, simply because it’s processed. I don’t recommend anything that’s processed,” said Dr. Nancy Rahnama, an internist and clinical nutritionist.

But cereal is a convenient choice if you’re short on time, Rahnama acknowledged. If you have only enough time to grab a bowl of cereal, reach for ones that are high in fiber and low in sugar, she advised.

Here is a list of cereals that are high in nutrients like fiber and protein and low in added sugar, according to a recent report by Healthnews.com.

Cereals with the most nutrients, lowest added sugar

Healthnews.com worked with nutrition scientist Lauryna Nelkine to compare the ingredients of the 15 most popular cereals in America, “taking into account their sales volumes and ratings on major American retailing platforms,” the report states.

These are the cereals that had the most nutrients, vitamins and minerals to support health, and the lowest amounts of added sugar.

• Highest in dietary fiber: Post Raisin Bran — 9 grams of fiber per serving
• Highest in protein: Special K Protein — 7 grams of protein per serving
• Highest in calcium and vitamin D: Multi Grain Cheerios — 200 milligrams of calcium and 4 micrograms of vitamin D
• Lowest in added sugar: Corn Flakes, Corn Chex and Special K Protein — 4 grams of sugar per serving each

Cereals with high levels of added sugar

Here are the cereals that stood out as having the highest amounts of added sugar (with 12 grams of added sugar per serving each):

• Lucky Charms
• Frosted Flakes
• Cinnamon Toast Crunch
• Froot Loops
• Reese’s Puffs
• Fruity Pebbles

Want to be a successful, confident communicator? Take CNBC’s new online course Become an Effective Communicator: Master Public Speaking. We’ll teach you how to speak clearly and confidently, calm your nerves, what to say and not say, and body language techniques to make a great first impression. Sign up today and use code EARLYBIRD for an introductory discount of 30% off through July 10, 2024.

Plus, sign up for CNBC Make It’s newsletter to get tips and tricks for success at work, with money and in life.

“The last thing you want is for people to go home and remember the beach trip because they got sick,” Dr. John Torres, NBC News senior medical correspondent, said on TODAY.

Leaving food unrefrigerated for a prolonged period can cause certain bacteria, like E. coli and and salmonella, to grow and make those consuming the food sick with diarrhea and vomiting. Between 40 and 140 degrees Fahrenheit is known as the food “danger zone” for this reason, according to the U.S. Department of Agriculture.

Even if you use a cooler, you may not be able to completely prevent the temperature of your food from reaching above 40 degrees Fahrenheit. That’s why Torres recommends leaving certain items at home and choosing safer beach foods instead.

Foods not to bring to the beach

Cold cuts that require refrigeration

If you’re packing sandwiches made with deli meats or cold cuts — such as sliced turkey, ham, chicken, roast beef, salami, bacon or bologna — these need to be refrigerated until they are ready to eat, says Torres.

Although deli meats are often cured and processed to help prevent spoilage and contamination, they can still contain bacteria that can make you sick and multiple rapidly in warm temperatures, TODAY.com previously reported.

Keeping them in a cooler can make this food choice less risky, but once you take them out of the refrigerated environment, eat them right away.

Fresh salads

Fruits and vegetables contaminated with salmonella, E. coli, listeria and other bacteria are responsible for a large chunk of foodborne illness in the U.S., according to the U.S. Centers for Disease Control and Prevention.

Washing produce can reduce the amount but doesn’t entirely eliminate dangerous bacteria, which love to multiply in warm, most environments — like an airtight container holding salad on the beach.

Anything mayo-based

“Mayo-based potato salad is always one of those big things that cause a lot of issues,” says Torres.

Although it’s bought from a non-refrigerated shelf, mayonnaise does need to be refrigerated, and any salad or dish containing mayo can only be left out at temperatures above 40 degrees Fahrenheit for two hours before it should be discarded, according to the USDA.

Ideally, mayo-based foods should be refrigerated until they are served, says Torres. So it’s probably wise to avoid bringing these dishes to the beach entirely and enjoy them at home instead.

Raw meat

Grilling is a favorite beach activity for many. But bringing a bunch of raw hamburger meat or chicken that will sit around at various temperatures before it is barbecued is not the best idea due to the risk of bacteria growing. In general, Torres recommends against bringing raw or uncooked meats to the beach ever.

If you do decide to bring raw meat, store it properly in a cooler below 40 degrees Fahrenheit until it’s ready to be cooked, and keep it sealed and separate from any other foods that won’t get cooked in the cooler.

According to USDA guidelines, beef should be cooked to a minimum internal temperature of 145 degrees Fahrenheit, poultry to 165 degrees Fahrenheit and fish to 145 degrees Fahrenheit.

Precut fruits

Precut fruit is notorious for containing foodborne pathogens, such as salmonella. These include include papayas, peaches, and a major culprit, melon — including honeydew, cantaloupe and an all-time beach favorite, watermelon.

Cutting the fruit can transfer bacteria on the surface of the fruit into the flesh, where it can grow and multiply, especially in hot beach weather, TODAY.com previously reported.

Sliced fruit can also get warm faster and draw insects, says Torres. Instead of buying presliced fruit for your next beach trip, bring the whole thing and cut it up at the beach instead — just make sure you have clean hands and use a clean knife and cutting board.

Food safety tips for the beach

Many foods can be totally safe for the beach as long as you practice certain food safety precautions. Here’s some advice to keep in mind from Torres and the USDA:

• Perishable foods should never sit out of refrigeration for more than two hours, and if temperatures are 90 degrees are higher, no more than one hour.
• When packing, take food out of the fridge or freezer and put it immediately into the cooler. Aim to keep food refrigerated right up until you eat it.
• Try to avoid leftovers by only packing the amount you plan to consume.
• If you do choose to bring raw meat, season it at home, and keep it tightly wrapped in a place where any juices that may drip cannot get on to other foods, such as the bottom of the cooler.
• Pack drinks in a separate cooler from food so the food is exposed to warm temperatures less often.
• Try to fill your cooler all the way, packing extra ice if necessary, as this will keep its contents cool for longer.
• Bring a food thermometer if you are cooking at the beach.

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The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

health Jun 25

CDC warns of increased dengue fever risk across the US

More severe symptoms of seasonal allergies this spring are likely due to a warmer winter and an earlier start of allergy season, says Dr. Purvi Parikh, an allergist and immunologist with the Allergy & Asthma Network.

And the cause of this longer, more intense allergy season? Climate change.

“There’s higher amounts of pollen due to rising greenhouse gasses and more CO2 in the air, which plants thrive off of,” Parikh tells CNBC Make It.

Allergens like pollen, dust and mold can cause swelling in your nasal passages, Shelby Harris, a licensed clinical psychologist and director of sleep health at Sleepopolis, told CNBC Make It in April of 2023.

“Your body mistakes allergens as a threat to the body, so then you have histamine that is released and that essentially can make you have the nasal swelling, the congestion and the scratchy throat,” Harris said.

Here are some effective ways to alleviate your allergy symptoms and still enjoy the spring.

1. Optimize your home to reduce pollen spread

Peak pollen times are in the early morning, so it’s best to keep your windows closed during those hours. Having your windows shut can prevent allergens from entering and circulating in your living space.

“When coming home, change clothes, take off shoes and shower to avoid bringing pollen into [the] house with you,” Parikh says.

Harris also provided seven tips for keeping your home as pollen-free as possible:

• Avoid using ceiling fans in your bedroom to reduce dust circulation
• Vacuum often
• Change your sheets once a week
• Use an air purifier
• Keep your hamper with your clothes you’ve worn outside out of your bedroom
• Use hypoallergenic bedding
• Try not to dry clothes outdoors if you can

2. Use these recommended medications

If you’re experiencing allergy symptoms, Parikh suggests grabbing medications from your local pharmacy, noting that even generic brands can work if well-known brands are sold out.

Here are a few of the allergy medications that she recommends:

• Claritin
• Zyrtec
• Xyzal
• Allegra
• Flonase
• Astepro
• Alaway
• Pataday

“Any cough, wheezing, chest pain [or] shortness of breath should not be treated with over-the-counter medications and [you] should see a physician,” Parikh says.

“This could be asthma which is deadly, and allergies are the most common cause.”

3. Try local honey

There are only a small number of studies that have tested the effectiveness of local honey on alleviating allergy symptoms, and lack of funding may be the reason, Dr. Timothy Wong, board-certified family medicine doctor and medical expert for JustAnswer, told Make It last April.

“Unfortunately when you’re not using medications that have billions of dollars of funding for research and development, you don’t get as many clinical trials,” Wong said.

A small study with 40 participants in 2013 found that eating honey each day, in combination with allergy medication as needed, was associated with less allergy symptoms after eight weeks, compared to taking just allergy medication on its own.

The logic behind using local honey specifically for allergy symptoms is that “if you ingest the pollens that bring you discomfort, you build up an immunity against them,” Andew Cote, head beekeeper at Andrew’s Honey, told CNBC Make It.

“One spoon a day every morning is the recommended dosage,” Cote added.

It’s better to start eating local honey a few weeks before you began experiencing allergy symptoms the previous year, Wong said.

Children under the age of one should not be given honey, the American Academy of Pediatrics strongly warns. And people who are allergic to bees and wasps should also avoid trying local honey for their allergies, Wong said, because “there are some cases where people who have bee allergies can also get allergies from honey.”

Want to be a successful, confident communicator? Take CNBC’s new online course Become an Effective Communicator: Master Public Speaking. We’ll teach you how to speak clearly and confidently, calm your nerves, what to say and not say, and body language techniques to make a great first impression. Preregister today and use code EARLYBIRD for an introductory discount of 30% off through July 10, 2024.

Plus, sign up for CNBC Make It’s newsletter to get tips and tricks for success at work, with money and in life.

The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

health Jun 25

CDC warns of increased dengue fever risk across the US

The oldest living person of Japanese descent in the United States, according to the Gerontology Research Group, Miwa prefers to focus on the times when she was happiest. She’s lived through the Spanish flu, prohibition, Black Tuesday, World War II, and the losses of her parents, siblings and friends, and still the supercentenarian’s go-to piece of longevity advice is: Don’t dwell.

Miwa is part of the nisei — the second-generation Japanese Americans sent to internment camps during World War II — who often say “gaman,” which translates to “enduring the seemingly unbearable with patience and dignity,” Alan Miwa, her son, tells TODAY.com. It’s often loosely translated to “perseverance,” “patience,” or “tolerance.”

These feelings, Alan Miwa suspects, are born from the resilience of many from his mother’s generation — who had much to endure. Shikata ga nai (仕方がない), a Japanese phrase meaning, “It cannot be helped,” or, “Nothing can be done about it,” is a common saying among them, too, he adds.

Yoshiko Miwa was born Yoshiko Tanaka on Feb. 28, 1914, in Guadalupe, California, to Japanese immigrants. She was the fifth of seven children. When her mother and infant brother died in 1919, her father struggled to care for his family and tend to the farm he owned. So Yoshiko Miwa and her siblings were sent to live at the children’s home founded by their parish, Guadalupe Buddhist Church.

She went on to graduate from Santa Maria High School in 1932, and she studied business at the University of California, Berkeley, graduating in 1936. She married Henry Miwa in 1939.

During the Second World War, the pair and their families were sent to Poston Internment Camp in Arizona before relocating to Hawthorne, California, after the war. When they, along with many other Japanese people, had difficulty finding work upon their release in 1945, her husband founded a plant nursery business, and in 1963, Yoshiko Miwa got her nursing license.

Yoshiko Miwa has three sons, 10 grandchildren, 20 great-grand children and one great-great-grandchild.

These days, Alan Miwa says she’s in good health and lives in a care facility, where she gets her hair done weekly and attends church services on Sundays.

In addition to a positive spirit, keeping your mind and body active is the key to a long life, Yoshiko Miwa has said in the past. Ahead she shares a few other aspects of her life that she believes have led to her longevity.

She keeps an ever-expanding roster of hobbies

When Yoshiko Miwa retired, she’d walk 4 miles each morning. In 1990, at 76, she walked a 20K as part of the March of Dimes Walkathon. She’s an avid reader, she practices ikebana (flower arranging), sumi-e (Japanese ink art), sashiko (Japanese stitching), sewing, furniture refinishing and reupholstery.

These days, though, her favorite activity is sleeping, she tells TODAY.com via email.

She wrote an autobiography

After taking a writing course, Yoshiko Miwa penned an autobiography. In it, she recalls her travels to Rome, Japan, Paris and Niagara Falls. She describes life in the children’s home and the long walks to school, her siblings and her childhood with her parents.

“We had a big pasture for the horses and cows to graze on,” she wrote of her family’s farm her in autobiography. “Some days, my sister and I would wander around the pasture to pick wild violets that grew there.”

She loves to eat noodles

Yoshiko Miwa’s a fan of any kind of noodles, eating them every day. “When I was in the children’s home, the cook used to make noodles and I used to love them,” she says. “Today, I like spaghetti, udon, ramen, soba and any other kind of noodles.”

Her faith energizes her

Yoshiko Miwa is grateful to Rev. and Mrs. Issei Matsuura of the Guadalupe Buddhist Church, who took her in when her mother died of the Spanish flu.

Yoshiko Miwa was 4 years old when her father turned to the church for help. “The church then started a children’s home and taught us Buddhism, Japanese language, Japanese culture and responsibility,” she recalls. “I’ve always been indebted to Rev. and Mrs. Matsuura.”  

… And her family does, too

The Miwa family travels together and hosts reunions. “I’ve been fortunate that my sons, my grandchildren, my great grandchildren and relatives have always been there for me,” says Yoshiko Miwa.

“Because my mother died so young, I have never enjoyed the warmth and love of a family unit,” she wrote in her autobiography. “Later, when I had my children, I keenly felt the wholesomeness of a complete family.”

This story first appeared on TODAY.com. More from TODAY:

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The Department of Public Health said Tuesday that a man in his 40s was exposed to West Nile virus in Hampden County. A horse was diagnosed with EEE, which officials said the animal contracted in Plymouth.

Both viruses were detected in mosquitoes earlier this summer.

West Nile virus usually causes fever and flu-like symptoms, but in rare cases can cause severe illness. There were six human cases in Massachusetts last year.

EEE is rare, but poses a serious threat to infected people of all ages.

The last known human case of EEE in Massachusetts occurred in 2020, when five people were infected and one died. A year earlier, in 2019, there were six deaths among 12 human cases in the Bay State.

There were six human cases of West Nile in Massachusetts last year.

The DPH noted that August and September are months of particular concern for mosquito-borne illnesses in Massachusetts.

“We continue to recommend taking steps to prevent mosquito bites until the first hard frost,” Dr. Catherine Brown, the state epidemiologist, said in a statement shared by the department. “People should use mosquito repellent with an EPA-registered active ingredient, clothing to reduce exposed skin, and consider rescheduling outdoor activities that occur during the evening or early morning.”

Plymouth, where the horse was infected with EEE, is the third Massachusetts community to be categorized as high risk for that virus this year, joining Carver and Middleborough. The state lists 12 as having moderate EEE risk, including Amesbury, Groveland, Halifax, Haverhill, Kingston, Merrimac, Newburyport, Plymouth, Plympton, Salisbury, Wareham and West Newbury.

The state also noted that mosquito samples in Dedham have tested positive for EEE, and that town is now considered a low risk.

There are moderate risks of West Nile virus in parts of Suffolk County, Middlesex County, Norfolk County, Bristol County, Essex County, Plymouth County, Worcester County and Hampden County.

Officials expect the mosquito population to increase throughout the summer and recommend, among other prevention techniques, avoiding outdoor activities in dawn and dusk, when mosquitoes are most active.

The Department of Public Health says people can call its Division of Epidemiology at 617-983-6800 for more information about the mosquito-borne illnesses.

More mosquito news

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After being diagnosed with stage 4 cancer, the high school football coach and counselor started chemotherapy in 2023, but he had to stop abruptly when the drug he received, cisplatin, became harder to find as part of a nationwide shortage of chemotherapy drugs.

“I just keep wondering, ‘What if we had gotten the cisplatin? Could it have slowed his cancer down? she tells TODAY.com. “Would he have been able to coach even more? Would he have been stronger? Would he have felt better? … It’s always a second guess.” 

In 2022, Jeff Bolle, of Milwaukee, learned he had bile duct cancer, which has a dismal long-term survival rate. At the time, doctors hoped that surgery and chemotherapy could prolong his life. He was in good health prior to his diagnosis, which made everyone feel optimistic.

He underwent surgery and four rounds of chemotherapy before the chemotherapy shortage stopped his treatment in May 2023 — two rounds short.

As the months passed and his cancer progressed unchecked, Jeff Bolle became sicker. In late September 2023, doctors realized “there was really nothing else they could do, which was hard to hear,” Connie Bolle recalls. There was no immunotherapy. There was no other chemotherapy.”

Jeff Bolle died on Dec. 29, 2023, seven months after losing access to his chemo drugs.

Last summer, Jeff Bolle shared his story with TODAY.com to raise awareness of the chemotherapy shortage. He also shared his desire to coach at least one more football season. He achieved that — and it was even sweeter than he could have imagined.

“The Marquette University High School ended up winning the division one state championship football title, and they were not predicted to be the one (to win),” Connie Bolle says. “Jeff made it to every single one of the games.”

Stage 4 cancer diagnosis

When Jeff Bolle felt the twinge of back pain in October 2022, he thought he pulled a muscle while exercising. But later that year, he was diagnosed with stage 4 bile duct cancer.

He underwent surgery, where doctors removed most of the tumor, and then started immunotherapy and chemotherapy, even though he knew he would likely never be cured.

“My doctor said it was the type of cancerous growth you’ll never really get into remission,” Jeff Bolle told TODAY in 2023. “Their thoughts were that they could get most of the tumor out and they could use chemo … to hold it off.”

The Bolles understood this. Still, it felt devastating when Jeff Bolle stopped treatment because of the chemotherapy shortage.

“He was never able to get on cisplatin (again),” Connie Bolle says. “His cancer was just continuing to grow, and his bile ducts were getting compromised because the cancer was pushing on them even more. He was really getting so very sick. It was horrible.”

Although he felt too weak to work as a counselor, Jeff Bolle continued coaching football. Prior to becoming sick, he’d ride to practice on his motorcycle, wearing sleeveless shirts to show off his biceps. He often hit the weight room with the players and challenge them to bench presses. Even when sick, Jeff Bolle continued to show up for his players at least several times a week and at games.

Eventually, he needed a wheelchair to attend the games and sat on the sidelines, but he coached the defensive backs for as long as he could. No matter what, he always rated the game film after. In fact, Connie Bolls recalls that during one stay in the intensive care unit, he brought his laptop to grade a football game.

Connie Bolle says she believes he lived to finish this season.  

“He knew how important it was for these high school kids,” she says. “Some of the seniors had journeyed with Jeff for four years.”  

The team kept winning, ending up at the state championship in November.

“I don’t know how Jeff did it because he could barely stand honestly. At that point, he was probably down to about 140 pounds,” Connie Bolle says. “The cold was just intense, and he went up and down the sideline with his walker.”  

Chemotherapy shortage

Last year, cancer patients, like Jeff Bolle, and oncologists faced some grim news: Many chemotherapy drugs and agents used in oncological imaging had become increasingly difficult to find.

The most impactful shortages were of chemotherapeutic agents carboplatin and cisplatin, often used in cancers that can’t be cured, Dr. William Dahut, chief scientific officer of the American Cancer Society, told TODAY.com in 2023.

But shortages of cancer therapeutics are not new.

“What we’re experiencing right now is really the latest of multiple waves of shortages that have really gone back a decade,” Mark Fleury, Ph.D., who works in policy development and emerging science at the American Cancer Society Cancer Action Network, tells TODAY.com.

“We have many drugs that have never really left shortage and some that cycle in and cycle back out (of shortages).”

Last summer, NBC News reported that 14 drugs used in cancer treatment were hard to come by. In April 2024, the U.S. Food and Drug Administration website indicates that 15 oncology agents are currently in shortage.

Asked about the status of the chemo shortage, FDA spokesperson Chanapa Tantibanchachai shared an email statement with TODAY.com that says:

“The FDA recognizes the potential impact that lack of availability of certain products may have on health care providers and patients. While the agency does not manufacture drugs, and cannot require a pharmaceutical company to make a drug, make more of a drug, or mandate who a pharmaceutical company chooses to sell its product to (among lawful purchasers), the public should rest assured the FDA is working closely with numerous manufacturers and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or reduced availability of certain products.”

FDA Commissioner Dr. Robert Califf told NBC News in May 2023 that the main reason for the chemo shortage is there’s not enough profit in producing these drugs, many of which are generic and do not have a patent. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology,” Califf said.

While carboplatin and cisplatin are “still listed in shortage,” Fleury says last year the FDA allowed imports of cisplatin that helped assuage that shortfall, and the drugs are now being produced more widely in the U.S.

“We’re not seeing the type of shortage that we did,” Fleury says. “We qualify it as in shortage, but … patients are getting their drugs.”

How chemo drug shortages affect cancer patients

Cancer patients felt the shortages. A survey by the American Cancer Society Cancer Action Network published in December found that 10% of all cancer patients were impacted, but the “shortages were not felt equally,” Fleury says.

For example, people on Medicaid experienced a tougher time, with 22% reporting a cancer drug shortfall affected their treatment. Some reported struggling to find pain medications or other therapies not directly used to treat their cancer but still important, he notes.

“Folks just had no idea whether they were going to get their next treatment or not, whether the dose was going to be cut in half,” Fleury says. “These are drugs … have really formed the backbone (of cancer care) and in some case have pretty high efficacy. And if they’re not available, you’re entering uncharted territory.”

While patients grappled with a high “mental toll,” they also faced “logistical tolls,” too, with some patients driving around to find treatment, he says.

“There are patients today who need help,” Fleury adds. “We need to figure out how to better manage the crisis that we’re in, but we also need to address some of the underlying causes, which keep us in this constant state of crisis.”

Lawmakers have taken some steps to address this issue. While many bills often provide short-term solutions, the Senate Finance Committee has been “doing a deeper dive” to address constant shortages, Fleury explains.

“The government has an important role to solve this,” Fleury says. “(But) that’s not to say that the private sector can’t.”

A lasting impact

By Dec. 14, 2023, Jeff Bolle was in hospice at home. Connie Bolle knew he was nearing the end on Dec. 28, when he agreed to stay in a hospital bed on the first floor because he was too weak to get to their bedroom on the second floor. He died the next day.

“He only spent one night in it,” she says. “That was the sign of defeat.”

At his funeral, his players shared what Jeff Bolle meant to them.

“They said such amazing things about the strength and determination and perseverance (they learned) from Jeff and kindness and love and compassion,” she says.

Connie Bolle believes that her husband would be humbled hearing about the impact he had on his students. She also believes he would be proud that his story raised awareness of the shortage of cancer therapeutics.

“He really cared about other people not getting these chemotherapy drugs,” she says. “He would still be sad today that people are still dealing with this.”

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The proposal had come after wide-ranging studies found an association between some of the ingredients in hair-smoothing and hair-straightening products, which are used mostly by Black women, and cancer. 

It is unclear why the FDA has not released its proposed ban. The agency did not respond to requests for comment by NBC News. 

The FDA has previously told NBC News, “the Unified Agenda estimates the action date for the NPRM as April 2024. We are still developing the proposed rule and cannot comment further about questions of timing or content at this time.”

In 2022, a decadeslong study by the National Institutes of Health of more than 33,000 Black women showed an increase in uterine cancer among those who regularly used hair relaxers. 

Several women who had uterine cancer or other severe illnesses joined class-action lawsuits against major beauty product manufacturers, including L’Oreal and Revlon. Thousands of women allege that the hair products’ ingredients caused them to develop uterine cancer or other severe health problems. 

Revlon did not comment on this article. Previously, Revlon told Reuters that the company does not “believe the science supports a link between chemical hair straighteners or relaxers and cancer.”

A L’Oreal spokesperson told NBC News on Wednesday it doesn’t have formaldehyde in its products and that it would welcome the FDA ban.

“Our highest priority is the health and wellbeing of all our consumers,” the company said in a statement. “Our products are subject to a rigorous scientific evaluation of their safety by experts who also ensure that we strictly follow all regulations in every market in which we operate.”

Formaldehyde is used in many household products, including some topical medicines and cosmetics such as some nail polishes, hair gels, baby shampoos and others. Not all chemical hair-straighteners include it, but many do include components that, once heated, can release formaldehyde. It is highly toxic and linked to certain cancers, according to the National Cancer Institute.

“About 50% of products advertised to Black women contain these types of chemicals, compared to maybe only 7% that are advertised to white women,” Harvard T.H. Chan School of Public Health’s Tamarra James-Todd said in a radio interview in 2020. 

According to the FDA’s comments on the proposal, the use of products containing formaldehyde and other formaldehyde-releasing chemicals “is linked to short-term adverse health effects, such as sensitization reactions and breathing problems, and long-term adverse health effects, including an increased risk of certain cancers.”

Last year, Democratic Reps. Ayanna Pressley of Massachusetts and Shontel Brown of Ohio sent a joint letter to the FDA commissioner urging more regulation over hair relaxers marketed toward Black women. 

“As a result of anti-Black hair sentiment, Black women have been unfairly subjected to scrutiny and forced to navigate the extreme politicization of hair,” Brown and Pressley wrote. “Hence, generations of Black women have adapted by straightening hair in an attempt to achieve social and economic advancement.”

In an exclusive statement to NBC News, Pressley urged the FDA to finalize the ban. 

“The FDA’s proposal to ban harmful chemicals in hair relaxers is a win for public health — especially for the Black women whose health has been disproportionately put at risk due to systemic racism and anti-Black hair sentiment,” she said. “We have been pressing for this and the Administration should finalize this rule without delay.”

Melanie Benesh, the vice president of government affairs for the Environmental Working Group, a consumer product advocacy group, described the field of cosmetics as the “Wild, Wild West of regulation” since the FDA has historically had more limited authority over them, “compared to other items under their jurisdiction, like food and drugs,” Benesh said.

Her organization petitioned the FDA in 2011 and in 2021 to ban hair products with formaldehyde. Because the FDA has been long aware of the issue, she added, “this is one thing that they have clear authority to do. They can ban ingredients that are clearly adulterating products, that are clearly making that product unsafe for use.”

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The agency has been conducting tests on 297 pasteurized retail dairy products after findings last week showed that fragments of the virus had gotten into the commercial milk supply.

The tests showed that the products didn’t contain live virus that could make people sick, the FDA said Wednesday.

The new results, though still preliminary, “affirm the safety of the U.S. commercial milk supply,” Don Prater, acting director of the FDA’s Center for Food Safety and Applied Nutrition, said during the briefing. The samples come from 38 states.

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In addition, the FDA has tested powdered infant and toddler formulas and found no evidence of bird flu virus. It was unclear how many formula samples were tested.

Prater said the latest findings confirm that the pasteurization process inactivates the virus, making it unable to infect people. The FDA is also testing raw milk for live virus, though it strongly advises against drinking raw, unpasteurized milk.

Bird flu has now been detected in 36 dairy herds in nine states: Colorado, Idaho, Kansas, Michigan, New Mexico, North Carolina, South Dakota, Ohio and Texas.

Those cases appear to have all originated among herds in Texas, then spread as cattle were moved across state lines to other farms.

In affected herds, about 10% of the cows show symptoms, Dr. Rosemary Sifford, chief veterinary officer at the U.S. Department of Agriculture, said during the call. Most recover on their own within about two weeks, she said.

Sifford said that it appears the virus spreads between cows through affected raw milk, which contains high levels of the virus.

There is no evidence yet that this strain of the bird flu, called H5N1, spreads easily from person to person. But the concern is that the longer the virus spends in mammals, it could mutate into a form that does.

For now, Sifford said, that doesn’t seem to be happening.

“We are not seeing any changes in the virus that would indicate it is in a position to be more easily spread between people,” Sifford said.

The risk to the general public remains low, said Dr. Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases.

One person, a dairy worker in Texas, has been diagnosed with the virus since the outbreak was detected in dairy cows. The person’s case was mild and the only symptom was conjunctivitis, or pink eye.

The Centers for Disease Control and Prevention said Wednesday that more than 100 people have been asked to monitor themselves for symptoms for 10 days after coming into contact with an infected animal.

Around 25 have been tested for the virus, Daskalakis said.

He said there is no indication of “unusual flu activity in people, and that includes avian influenza.”

But there have been reports that other cases may have gone undetected.

Multiple dairy workers in Texas were sick with fevers, body aches, upset stomach and eye infections at the same time the bird flu was working its way through cows in Amarillo, Dr. Barb Petersen, the veterinarian who discovered what was making the animals sick, previously told NBC News.

No hospitalizations or deaths have been reported.

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Bird flu has been found in nearly three-dozen dairy herds across nine states. The new testing is the latest effort by the USDA to track and understand how the virus is spreading among livestock.

Two studies will test if particles of the bird flu virus, called Type A H5N1, is found in beef for sale in the states where dairy cows have tested positive or in the muscles of dairy cows sent to slaughter. A third will test how cooking meat at different temperatures affects the virus using a bird flu surrogate.

A week ago, the U.S. Food and Drug Administration confirmed it found non-infectious remnants of the bird flu virus in pasteurized milk. The particles are inactive and pose no threat to consumers, experts said.

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Scientists say there’s no evidence to suggest people can get bird flu by consuming food that’s been pasteurized or properly cooked.

The virus was first found in dairy cows this spring, and since then, H5N1 was detected in the lung tissue of a dairy cow culled and sent to slaughter.

So far, officials with the U.S. Centers for Disease Control and Prevention have not seen signs that the virus is changing to be more transmissible to people. Two farmworkers have been infected with bird flu since the outbreak began.

AP Health Writer JoNel Aleccia contributed to this report.

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

Previously, the task force had said women could choose to start breast cancer screening as young as 40, with a stronger recommendation that they get the exams every two years from age 50 through 74.

The announcement Tuesday from the U.S. Preventive Services Task Force makes official a draft recommendation announced last year. The recommendations were published in the Journal of the American Medical Association.

“It’s a win that they are now recognizing the benefits of screening women in their 40s,” said Dr. Therese Bevers of MD Anderson Cancer Center in Houston. She was not involved in the guidance.

Other medical groups, including the American College of Radiology and the American Cancer Society, suggest mammograms every year — instead of every other year — starting at age 40 or 45, which may cause confusion, Bevers said, but “now the starting age will align with what many other organizations are saying.”

Breast cancer death rates have fallen as treatment continues to improve. But breast cancer is still the second-most common cause of cancer death for U.S. women. About 240,000 cases are diagnosed annually and nearly 43,000 women die from breast cancer.

The nudge toward earlier screening is meant to address two vexing issues: the increasing incidence of breast cancer among women in their 40s — it’s risen 2% annually since 2015 — and the higher breast cancer death rate among Black women compared to white women, said task force vice chair Dr. John Wong of Tufts Medical Center in Boston.

“Sadly, we know all too well that Black women are 40% more likely to die from breast cancer than white women,” Wong said. Modeling studies predict that earlier screening may help all women, and have “even more benefit for women who are Black,” he said.

Here are more details on what’s changed, why it’s important and who should pay attention.

When should I get my first mammogram?

Age 40 is when mammograms should start for women, transgender men and nonbinary people at average risk. They should have the X-ray exam every other year, according to the new guidance. Other groups recommend annual mammograms, starting at 40 or 45.

The advice does not apply to women who’ve had breast cancer or those at very high risk of breast cancer because of genetic markers. It also does not apply to women who had high-dose radiation therapy to the chest when they were young, or to women who’ve had a lesion on previous biopsies.

What about women 75 and older?

It’s not clear whether older women should continue getting regular mammograms. Studies rarely include women 75 and older, so the task force is calling for more research.

Bevers suggests that older women talk with their doctors about the benefits of screening, as well as harms like false alarms and unnecessary biopsies.

What about women with dense breasts?

Mammograms don’t work as well for women with dense breasts, but they should still get the exams.

The task force would like to see more evidence about additional tests such as ultrasounds or MRIs for women with dense breasts. It’s not yet clear whether those types of tests would help detect cancer at an earlier, more treatable stage, Wong said.

Does this affect insurance coverage?

Congress already passed legislation requiring insurers to pay for mammograms for women 40 and older without copays or deductibles. In addition, the Affordable Care Act requires insurers to cover task force recommendations with an “A” or “B” letter grade. The mammography recommendation has a “B” grade, meaning it has moderate net benefit.

So far, the risk to humans remains low, officials said, but scientists are wary that the virus could change to spread more easily among people.

The virus, known as Type A H5N1, has been detected in nearly three dozen dairy herds in eight states. Inactive viral remnants have been found in grocery store milk. Tests also show the virus is spreading between cows, including those that don’t show symptoms, and between cows and birds, according to the U.S. Department of Agriculture.

Starting Monday, hundreds of thousands of lactating dairy cows in the U.S. will have to be tested — with negative results — before they can be moved between states, under terms of a new federal order.

Here’s what you need to know about the ongoing bird flu investigation:

Why is this outbreak so unusual?

This strain of what’s known as highly pathogenic avian influenza has been circulating in wild birds for decades. In recent years, it has been detected in scores of mammals around the world. Most have been wild animals, such as foxes and bears, that ate sick or dying birds. But it’s also appeared in farmed minks. It’s shown up in aquatic mammals, such as harbor seals and porpoises, too. The virus was even found in a polar bear in northern Alaska.

The virus was discovered in ruminants — goats and then dairy cows — in the U.S. this spring, surprising many scientists who have studied it for years.

“When we think of influenza A, cows are not typically in that conversation,” said Richard Webby, an influenza expert at St. Jude Children’s Research Hospital.

How long has bird flu been spreading in cows?

Flu viruses are notorious for adapting to spread among new species, so detection in dairy cows raises concerns it could spread to people, Webby said.

Scientists confirmed the virus in cows in March after weeks of reports from dairy farms that the animals were falling ill. Symptoms included lethargy, sharply reduced milk supply and changes to the milk, which became thick and yellow.

Finding remnants of the virus in milk on the market “suggests that this has been going on longer, and is more widespread, than we have previously recognized,” said Matthew Aliota, a veterinary medicine researcher at the University of Minnesota.

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Under pressure from scientists, USDA officials released new genetic data about the outbreak this week.

The data omitted some information about when and where samples were collected, but showed that the virus likely was spread by birds to cattle late last year, said Michael Worobey, an evolutionary biologist with the University of Arizona.

Since then, it has spread among cattle and among farms, likely through contact with physical objects such as workers' shoes, trucks or milking machines, Worobey said.

And then the cows spread the virus back to birds, he said.

“The genetic evidence is as clear as could be,” Worobey said. "Birds that are sampled on these farms have viruses with clear mammalian adaptations."

What do scientists say about efforts to track the outbreak?

Several experts said the USDA's plans to require testing in cows are a good start.

“We need to be able to do greater surveillance so that we know what's going on,” said Thomas Friedrich, a virology professor at the University of Wisconsin's veterinary school.

Worobey said the ideal would be to screen every herd. Besides looking for active infections, agriculture officials also should be looking at whether cows have antibodies to the virus, indicating past infections, he said.

"That is a really accessible and quick way to find out how widespread this is,” he said.

More testing of workers exposed to infected animals is also crucial, experts said. Some farm owners and some individual workers have been reluctant to work with public health officials during the outbreak, experts have said.

“Increased surveillance is essentially an early warning system,” Aliota said. “It helps to characterize the scope of the problem, but also to head off potentially adverse consequences."

How big a risk does bird flu pose for people?

Scientists are working to analyze more samples of retail milk to confirm that pasteurization, or heat-treating, kills the H5N1 virus, said Dr. Don Prater, acting director of the FDA's food safety center. Those results are expected soon.

While the general public doesn't need to worry about drinking pasteurized milk, experts said they should avoid raw or unpasteurized milk.

Also, dairy farm workers should consider extra precautions, such as masking, hand washing and changing work clothes, Aliota said.

So far, 23 people have been tested for the virus during the outbreak in dairy cows, with one person testing positive for a mild eye infection, CDC officials said. At least 44 people who were exposed to infected animals in the current outbreak are being monitored for symptoms.

What are scientists' concerns for the future?

David O’Connor, a virology expert at the University of Wisconsin-Madison, likened recent bird flu developments to a tornado watch versus a warning.

“There are some of the ingredients that would be necessary for there to be a threat, but we’re not there,” he said. As with a tornado watch, "you wouldn’t change anything about how you live your daily life, but you would maybe just have a bit of increased awareness that something is happening.”

Worobey said this is the kind of outbreak “that we were hoping, after COVID, would not go unnoticed. But it has."

He said ambitious screening is needed "to detect things like this very quickly, and potentially nip them in the bud.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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A London-based dentist has sparked an online debate after advising against three situations that many regard as good times to brush your teeth.

The video, posted by Dr. Shaadi Manouchehri, clinical director at Smart Dental and Aesthetics Clinic in the U.K., has garnered more than 12 million views on TikTok, leaving many incredulous that they were brushing wrong all this time.

She recommends not brushing your teeth directly after vomiting and eating breakfast or sweets.

“I’ve ALWAYS brushed after vomiting,” one shocked TikTok user exclaimed.

“So then why have we ALWAYS been taught to brush out teeth after meals?” one quipped.

“Ah, yes, the three times I want to brush my teeth more than any other time,” another lamented.

So, do other dentists agree with Manouchehri’s assessment? TODAY.com spoke with a few experts to find out.

Acid and brushing your teeth

The argument against not brushing your teeth in certain scenarios is “all about the acid,” Dr. Tien Jiang, assistant professor of oral health policy and epidemiology at Harvard School of Dental Medicine, tells TODAY.com via email.

Many people think cavities come from sugar, but it’s not the direct cause, she says. It’s acid, which can remove the minerals, a process called demineralization, from the tooth’s outer layer, also known as enamel.

“Acid can come from many places — vomit … carbonated drinks, sucking on lemons, etc.,” Jiang explains.

The bacteria that break down the food you eat also release acid. As a result, “it’s natural for the pH of our mouths to drop when we eat, while the bacteria get to work to break down our food.”

Brushing while there’s too much acid in the mouth can damage your teeth.

“People should never brush when your mouth has a very low pH because you don’t want to then scrub that acid into your teeth,” Dr. Beth Caunitz, a dentist in New York City, New York, tells TODAY.com.

Should you brush directly after vomiting?

Many of the experts TODAY.com interviewed recommend waiting to brush your teeth after vomiting.

“Vomit contains stomach acids, which can soften and dissolve the outer layer of your teeth,” says Dr. Diana Nguyen, chief of clinical general dentistry at UCSF School of Dentistry.

“If you brush after vomiting, you’d actually be spreading the acid around to more of your enamel and risk stripping layers of enamel off your teeth with your toothbrush, which can cause the teeth to appear more yellow over time.”

One easy hack that she recommends is a simple homemade rinse.

Add a teaspoon of baking soda to a cup of water, swish it around in the mouth and then spit it out, she says. “This can help buffer the acids and protect your teeth.”

Rinsing after vomiting also reduces how long your teeth will be exposed to acid. A fluoride mouthwash in particular can help re-mineralize the enamel, and then you can brush your teeth sooner, adds Dr. Carlos González-Cabezas, professor and associate dean for academic affairs at the University of Michigan School of Dentistry.

Should you brush after you eat breakfast?

“When we eat, the mouth becomes acidic, as the bacteria in our mouth also feed on the food we eat and metabolize this to an acid, therefore dropping the pH of the mouth,” Manouchehri tells TODAY.com.

“If we brush straight away, we are rubbing this acid onto the teeth, which … can be damaged,” she says.

Our saliva naturally buffers this acidic state over approximately 30 to 60 minutes, so she recommends waiting at least that long to brush.

Jiang agrees: “Waiting 30 (minutes) after eating anything (not just breakfast or sweets) to brush is a normal instruction.”

“In these conditions, tooth enamel is softened, so you could actually damage your teeth by brushing them right after eating,” she explains. “In the meantime, you can drink water and rinse with mouthwash to help clear food particles away from your teeth and gums.”

However, Gonzalez-Cabezas says the impact on the enamel of brushing right after eating is likely minimal. The most important thing is that you brush your teeth at some point every morning.

Should you brush immediately after eating sweets?

Some experts recommend waiting at least an hour after eating sweets to brush your teeth to give your mouth time to wash away the acid, according Mayo Clinic.

Anything with sugar can increase the amount of acid in your mouth, but examples include soft drinks, sports drinks, sour candies, and citrus juices and fruits.

People should also avoid brushing right after having carbonated beverages, as they’re acidic, Caunitz warns.

Instead of brushing your teeth after eating sweets, Caunitz recommends drinking a glass of water because the water will rinse off all the unwanted acid.

However, Gonzalez-Cabezas says that brushing your teeth after eating sweets helps remove potentially harmful sugars that can damage the enamel sooner. Thanks to the toothpaste, brushing right after will also provide fluoride to your teeth, which promotes remineralization.

For those who enjoy sweets or snacking on sugary foods, Nguyen recommends the following:

• Drinking plenty of water
• Using a toothpaste that contains a remineralizing agent like fluoride
• Visiting your dentist regularly to monitor for tooth decay and other dental conditions

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Ana Estrada fought for years in Peruvian courts for the right to die with dignity, and became a celebrity in the conservative country where euthanasia and assisted suicide are illegal.

In 2022 Estrada was granted an exception by the nation’s Supreme Court, which upheld a ruling by a lower court that gave Estrada the right to decide when to end her life, and said that those who helped her would not be punished. Estrada became the first person to obtain the right to die with medical assistance in Peru.

“Ana’s struggle for her right to die with dignity has helped to educate thousands of Peruvians about this right and the importance of defending it,” her lawyer, Josefina Miró Quesada, said in a statement. “Her struggle transcended our nation’s borders.”

Estrada, 47, suffered from polymyositis, a disease that wastes away muscles and has no cure.

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She began to present the first symptoms as a teenager and started to use a wheelchair at the age of 20 because she had lost the strength to walk.

Despite these obstacles Estrada obtained a psychology degree and became a therapist. She earned enough money to buy her own apartment and became independent from her parents.

By 2017 however, Estrada’s condition worsened and she could no longer get up from her bed.

She had difficulty breathing and survived pneumonia. And even though she could not type, Estrada used transcription software to produce a blog called “Ana for a death with dignity,” where she discussed her struggles and her decision to seek euthanasia.

“I am no longer free,” she said in an interview with the Associated Press in 2018. “I am not the same person I was before.”

With the help of Peru’s Human Rights Ombudsman, Estrada won a lawsuit that gave her the right to die with euthanasia. From her bed, she participated in court sessions through video conferences.

Estrada told judges in 2022 that she valued life, and did not want to die immediately, but wanted to have the freedom to decide when to end her life.

“I want to accede to euthanasia when I can no longer sustain suffering in life,” she said. “And when I decide to bid farewell to my loved ones in peace and with tranquility.”

Only a handful of countries have legalized euthanasia, including Canada, Belgium and Spain. Some U.S. states including Maine and Oregon allow physician-assisted suicide, where a doctor provides a terminally ill patient with the means to end life.

Euthanasia is illegal in most Latin American countries, except for Colombia, which legalized it in 2015 and Ecuador, which decriminalized the practice in February.

According to NBC News, in the study of people ages 65 and older, 8.15% of women treated by female physicians died within 30 days, compared with 8.38% of women treated by male physicians. 

Although the difference between the two groups seems small, the researchers say erasing the gap could save 5,000 women’s lives each year. 

The study included nearly 800,000 male and female patients hospitalized from 2016 through 2019. All patients were covered by Medicare. For male hospitalized patients, the gender of the doctor didn’t appear to have an effect on risk of death or hospital readmission.

The data alone doesn’t explain why women fare better when treated by other women. But other studies suggest that women are less likely to experience “miscommunication, misunderstanding and bias” when treated by female doctors, said lead study author Dr. Atsushi Miyawaki, a senior assistant professor of health services research at the University of Tokyo Graduate School of Medicine.

The new research is part of a growing field of study examining why women and minorities tend to receive worse medical care than men and white patients. For example, women and minority patients are up to 30% more likely to be misdiagnosed than white men.

“Our pain and our symptoms are often dismissed,” said Dr. Megan Ranney, dean of the Yale School of Public Health. “It may be that women physicians are more aware of that and are more empathetic.”

Research shows that women are less likely than men to receive intensive care but more likely to report having negative experiences with health care, having their concerns dismissed, and having their heart or pain symptoms ignored, the authors wrote in the new study. Male physicians are also more likely than female doctors to underestimate women’s risk of stroke.

Part of the problem, Miyawaki said, is that medical students get “limited training in women’s health issues.”

Dr. Ronald Wyatt, who is Black, said his 27-year-old daughter recently had trouble getting an accurate diagnosis for her shortness of breath. An emergency room physician told her the problem was caused by asthma. It took two more trips to the emergency room for his daughter to learn that she actually had a blood clot in her lungs, a potentially life-threatening situation.

“There is a tendency for doctors to harbor sexist stereotypes about women, regardless of age, such as the notion that women’s symptoms are more emotional or their pain is less severe or more psychological in origin,” said Wyatt, former chief science and chief medical officer at the Society to Improve Diagnosis in Medicine, a nonprofit research and advocacy group.

Women seem to experience fewer of these problems when treated by other women.

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For example, a study published JAMA Surgery in 2021 found that women patients developed fewer complications if their surgeon was female. Another JAMA Surgery study published in 2023 found all patients had fewer complications and shorter hospital stays if they were operated on by female surgeons, who worked more slowly than their male counterparts.

Women primary care doctors also tend to spend more time with their patients, Ranney said. Although that extra attention is great for patients, it also means that women see fewer patients per day and earn less, on average, than male doctors.

Dr. Ashish Jha, dean of the Brown University School of Public Health, said several studies suggest that female doctors follow medical evidence and guidelines, and that their patients have better outcomes. 

“There’s lots of variation between women and men physicians,” said Jha, who was not involved in the new study. Women “tend to be better at communication, listening to patients, speaking openly. Patients report that communication is better. You put these things together, and you can understand why there are small but important differences.”

The authors of the study said it’s also possible that women are more forthcoming about sensitive issues with female physicians, allowing them to make more informed diagnoses.

That doesn’t mean that women should switch doctors, said Dr. Preeti Malani, a professor of medicine at the University of Michigan. For an individual patient, the differences in mortality and readmission rates seen in the new study are tiny.

“It would be a mistake to suggest that people need to find physicians of the same gender or race as themselves,” Jha said. “The bigger issue is that we need to understand why these differences exist.”

Malani said she’s curious about what women doctors are doing to prevent patients from needing to be readmitted soon after discharge. “How much care and thought is going into that discharge plan?” Malani asked. “Is that where women are succeeding? What can we learn about cultural humility and asking the right questions?”

Others aren’t convinced that the new study proves a physician’s gender makes a big difference.

Few hospitalized patients are treated by a single doctor, said Dr. Hardeep Singh, a professor at Baylor College of Medicine in Houston and a patient safety researcher at the Michael E. DeBakey VA Medical Center.

Hospital patients are treated by teams of physicians, especially if they need specialist care, in addition to nurses and other professionals, Singh said.

“How often do you see the same doc every day in the hospital?” Singh asked. “The point is that it’s not a one-man or one-woman show. Outcomes are unlikely to depend on one individual, but rather on a clinical team and the local context of care. … One name may appear on your bill, but the care is team-based.”

However, Singh said his research on misdiagnoses shows that doctors in general need to do a better job listening to patients.

Jha said he’d like the health system to learn what women doctors are doing right when they treat other women, then teach all physicians to practice that way.

“We should train everyone to be better at generating trust and being worthy of trust,” Jha said.

Wyatt said the country needs to take several steps to better care for women patients, including “de-biasing training” to teach doctors to overcome stereotypes. The health care system also needs to increase the number of women physicians in leadership, recruit more female doctors and do a better job at retaining them. All physicians also need more understanding of how adverse childhood experiences affect patient health, particularly for women, he said.

“More than once I’ve had white female patients tell me they came to be because I listened and they trusted me,” Wyatt said.

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“He was telling me, ‘Oh my neck is really hurting me,’” wife Lauren Barchanowicz, 38, of Finleyville, Pennsylvania, tells TODAY.com. “I’m like, ‘I think you should probably get it checked out.’”

The couple visited the emergency room where doctors found an orange-sized mass in his chest. Len Barchanowicz had a thymoma, a type of cancer of the thymus.  

“I thought I was a dead guy, honestly. Even how she presented it to me because she said she couldn’t tell if it was attached to my aorta,” Len Barchanowicz tells TODAY.com. “I thought honestly I was going in for an emergency surgery.”

Neck pain reveals underlying problem

As a mailman in the Pittsburgh area, Len Barchanowicz spends a lot of his time walking. When he began experienced stinging pain in his neck he wondered if he somehow pinched a nerve. Then on a humid August day, he felt like he couldn’t breathe easily.   

“I started having almost like chest pains, but not heart related but above where your heart would be,” Len Barchanowicz says.

At first, he attributed that to the weather, but Lauren Barchanowicz, a nurse, worried something more serious was occurring. She examined him and didn’t think he was having a heart attack. Still, it felt concerning.

“He’s like, ‘Oh it’s getting better,’” Lauren Barchanowicz says. “I’m like, ‘I don’t know. I think you should probably get checked out.’”

At the emergency room, it soon became clear something serious was occurring as doctors ran a slew of tests on him.

“I thought maybe they found like a clog or something was going on heart related,” he says.

While an X-ray didn’t show anything, a doctor had a hunch that something else was occurring and ordered a CT scan with contrast. That test revealed an orange-sized mass nestled in his chest above the heart.

“It was a shock,” Lauren Barchanowicz says.

At first, the oncologists thought he had Hodgkin’s Lymphoma, a type of cancer that begins in the lymphatic system which works to protect the body from infection.

“(When) you read the report on the CT, it is very unclear,” Lauren Barchanowicz says. “The only thing that they could say is there is a big mass.”

The surgical team mentioned something called a thymoma, too, but the diagnosis remained mysterious. His blood test had markers for Hodgkin’s Lymphoma and he no other symptoms consistent with cancer.

“They give you the cancer checklist,” Len Barchanowicz says. “Like, is there is a sudden weight loss? Do you have night sweats? Do you feel nauseated? I wouldn’t be able to check any of them.”

Len Barchanowicz eventually underwent a PET scan, which can determine where cancer is in the body.

“The only thing that lit up with him was literally the little circle right around … the mass,” Lauren Barchanowicz. “We were like, ‘Oh thank God. It’s localized. It’s not spread throughout his body.’”

Soon after, he underwent a video-assisted thoracoscopic surgery (VATS) for doctors to obtain a sample of the tumor to better understand what he had. It was still unclear but doctors had a better idea.

“They said probable thymoma,” Lauren Barchanowicz says.

Thymoma

Cancer of the thymus gland remains “very rare,” Dr. Ranjita Pallavi, a medical oncologist and Len Barchanowicz’s doctor at Allegheny Health Network in Pittsburgh, tells TODAY.com.

“He turned out to have something called a thymoma, which is a tumor that arises from the front of the chest,” says Pallavi. “When we see a mass in that area we’re thinking of something arising from the thymus gland.”

Everyone has a thymus gland, which is part of the immune system, but it works the most during infancy and childhood before becoming dormant, according to past TODAY.com reporting.

Pallavi says these types of tumors tend to be encapsulated, meaning they do not easily spread, and don’t have many symptoms associated with them. Doctors tend to find them incidentally when someone come in with an other unrelated problem. And in some rare cases, there can be symptoms, Pallavi says.

“There’s a proportion of patients where the mass can really get big in size when it starts compressing on the surrounding organs,” she explains. “That’s the time when people actually present with chest pains or shortness of breath.”

In Len Barchanowicz’s case, his tumor remained mostly encapsulated but did spread a little bit, deeming it a stage 2 cancer.

“It was also invading into the surrounding fat,” Pallavi says.

A surgeon removed the 8.7 centimeter mass and 14 lymph nodes leaving clean margins on October 3, 2023.

“He was not given any radiation after surgery,” she says. “For the same reason, because of the very low risk of these tumors coming back, he did not get chemotherapy.”

Len Barchanowicz will need to undergo a chest CT scan every six months for the first two years then yearly for up to eight more years.

“Sometimes the tumors can come back seven, eight years down the line,” Pallavi says. “The surveillance does extend up to 10 years.”

Recovery

Recovering from surgery, which required doctors to crack open his sternum, felt difficult. Len Barchanowicz experienced intense pain.  

“It was a nightmare,” he says. “I was hitting that (pain medicine) button pretty regularly on the hour.”

After two days in the hospital, Len Barchanowicz went home.

“Having good lung capacity and having a good heart, I think that probably helped in my recovery early, too,” he says.

Good news came shortly after, he says. His tumor had not become attached to his aorta or his phrenic nerve, where the cancer sometimes grows, Lauren Barchanowicz notes.

“There was no involvement with the major arteries and he did not have any major bleeding because that was a big concern as well,” she says. “The (surgeon) said … ‘The tumor came out easily and beautifully.”

Len Barchanowicz is struck by how quickly neck pain turned into a serious diagnosis that he luckily overcame. 

“It’s so weird that one day everything’s going great and then you get hit with this,” he says. “I almost have survivor’s guilt.”

By January 2024, Len Barchanowicz was able to return to work and feels grateful for the great care he received from his doctors at Allegheny Health Network and the support of loved ones.

“When something like that happens it hits you like a ton of bricks,” he says. “I was always very blessed with my kids and my wife and I really do live this great life.”

The Barchanowicz family wanted to share his story to help others who might also experience a thymoma because they often felt alone in the experience.

“We just can’t believe that this happened and I don’t want anyone else to feel this way,” Lauren Barchanowicz says.

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“Our water has been cloudy and bubbly and looks milky,” said Barrett, who blames fluoride, a mineral that communities across the nation have for decades added to the water supply to help prevent cavities and improve dental health.

“I don’t want fluoride in my nothing!” said Barrett, echoing a growing number of people who not only doubt the mineral’s effectiveness but also believe it may be harmful despite decades of data pointing to public health and economic benefits.

In February, the Board of County Commissioners in Union County, whose seat is Monroe, voted 3-2 to stop adding fluoride to drinking water at the Yadkin River Water Treatment Plant, the only water source wholly owned and operated by the county. But the decision came after heated discussions among residents and county officials.

“My children had the blessing of growing up with fluoride in their water and … they have very little dental issues,” said Commissioner Richard Helms ahead of the vote. A fellow commissioner saw it differently: “Let’s stop putting something in the water that’s meant to treat us, and give people the freedom to choose,” said David Williams.

Barrett’s water comes from the city of Monroe, not the Yadkin facility. So, for now, she will continue to drink water enhanced with fluoride. “I’m suspicious as to why they add that to our water,” she told KFF Health News.

It is a scenario playing out nationwide. From Oregon to Pennsylvania, hundreds of communities have in recent years either stopped adding fluoride to their water supplies or voted to prevent its addition. Supporters of such bans argue that people should be given the freedom of choice. The broad availability of over-the-counter dental products containing the mineral makes it no longer necessary to add to public water supplies, they say. The Centers for Disease Control and Prevention says that while store-bought products reduce tooth decay, the greatest protection comes when they are used in combination with water fluoridation.

The outcome of an ongoing federal case in California could force the Environmental Protection Agency to create a rule regulating or banning the use of fluoride in drinking water nationwide. In the meantime, the trend is raising alarm bells for public health researchers who worry that, much like vaccines, fluoride may have become a victim of its own success.

The CDC maintains that community water fluoridation is not only safe and effective but also yields significant cost savings in dental treatment. Public health officials say removing fluoride could be particularly harmful to low-income families — for whom drinking water may be the only source of preventive dental care.

“If you have to go out and get care on your own, it’s a whole different ballgame,” said Myron Allukian Jr., a dentist and past president of the American Public Health Association. Millions of people have lived with fluoridated water for years, “and we’ve had no major health problems,” he said. “It’s much easier to prevent a disease than to treat it.”

According to the anti-fluoride group Fluoride Action Network, since 2010, over 240 communities around the world have removed fluoride from their drinking water or decided not to add it.

One needs only to look to Union County to see just how intense discussions can be. Usually when the commissioners meet on the first floor of the Government Center in downtown Monroe, there are more vacant seats than attendees. But sessions about the prohibition of fluoride in public water supplies were packed, and residents who signed up to speak were divided.

One person who came to the microphone on Feb. 5 compared water fluoridation to a seat belt. It does not “prevent the car crash, but it limits the harm done,” he said. Another argued that there is no proof fluoride is safe or effective. “It’s a significant potential milestone to reverse 60-plus years of poisoning the public,” he said, using an unproven claim often made by opponents of fluoridation.

Fluoride opponents claim the mineral is responsible for everything from acne to high blood pressure and thyroid dysfunction to bone cancer.

The National Institutes of Health acknowledges that, when ingested in extremely large amounts, fluoride from dental products or dietary supplements can cause nausea, vomiting, abdominal pain, diarrhea, bone pain, and even death in extremely rare cases.

Infants and children who receive too much fluoride can develop discoloration or small dents in their teeth. In adults, consumption of excessive fluoride for extended periods can lead to skeletal fluorosis, a very rare condition that causes joint pain and stiffness, weak bones, muscle loss, and nerve problems.

However, the recommended dosage in drinking water has always been small. In 2015, the Department of Health and Human Services lowered the optimal fluoride concentration from 1.2 milligrams per liter to 0.7 mg/L.

Juneau, Alaska, voted to remove fluoride from its drinking water in 2007. A study published in the journal BMC Oral Health in 2018 compared the dental records of children and adolescents who received dental care for decaying teeth four years before and five years after the city stopped adding fluoride to the water. Cavity-related procedures and treatment costs were significantly higher in the latter group, the study found.

Portland, Oregon, is the largest city in the nation that has consistently refused to fluoridate its drinking water. Voters have repeatedly rejected measures to add it, first in 1956 and the latest time in 2013.

Despite the strong recommendation of local doctors and dentists, voters in Wichita, Kansas, have rejected adding fluoride to the water several times, most recently in 2012.

The Brushy Creek Municipal Utility District in Williamson County, Texas, had been adding fluoride to its water system since 2007 but ended the practice in December.

In 2016, Collier County, Florida, commissioners opted not to remove fluoride from the water system. But they unanimously reversed that decision following a 2023 Health Freedom Bill of Rights county ordinance in response to covid-19 “to safeguard the healthcare rights and freedoms of Collier County residents.”

The State College Borough Water Authority in Pennsylvania stopped adding fluoride to the water of its 75,000 customers in March 2023. Officials used claims often cited by fluoride opponents, such as potential environmental contamination, concerns about medical freedom, and possible adverse health effects, like the potential for the appearance of faint white lines on the teeth and lowered IQ for babies.

A study published in JAMA Pediatrics in 2019, conducted in six Canadian cities, associated fluoride exposure during pregnancy with lower IQ scores in children. But the study was based on self-reporting and has been criticized for its perceived methodological shortcomings.

In 2016, several consumer advocacy groups, including the Fluoride Action Network, Food & Water Watch, and Moms Against Fluoridation, petitioned the EPA to end water fluoridation under the Toxic Substances Control Act, alleging that significant research showed fluoride was neurotoxic at the doses now used. The same group filed a federal lawsuit against the EPA the following year, after the agency denied their citizen petition.

During a 10-day bench trial in San Francisco that concluded in mid-February, the two sides debated the risks and areas of uncertainty. If Senior U.S. District Judge Edward Chen determines water fluoridation presents an “unreasonable risk” to human health, the EPA will be forced to create a rule regulating or banning water fluoridation in the U.S. A decision is expected soon.

For the time being, decisions about whether to fluoridate community water systems are still made primarily at the local level, which Barrett hopes will change.

“Of all things, they want our teeth healthy when basic needs of housing and food are lacking.”

But besides adding flavor, condiments can also add salt, fat and sugar to healthy food if people pour or spread them on too enthusiastically, dietitians say.

There are countless condiments, classic and new, and the list keeps growing. Some Americans now use a half-dozen sauces at a meal, amounting to a “condiment invasion,” The Wall Street Journal recently reported.

“In general, I’m pro-condiment if it helps you eat healthier foods,” says registered dietitian Natalie Rizzo, nutrition editor for TODAY.

“For example, if you only like tofu with soy sauce on it, then add the condiment to entice you to eat more of this healthy plant-based protein. Or if you like to make spicy cauliflower with hot sauce, go ahead and use it to eat more of this cruciferous veggie.”

But if you love mayonnaise and add a few tablespoons of it to a meal, it can drastically increase the calories and saturated fat, she warns.

“Condiments change the nutrition equation. Of course, how much you use is going to be the biggest game changer,” Lisa Young, a registered dietitian in New York and author of “Finally Full, Finally Slim,” tells TODAY.com.

“A little bit goes a long way.”

What are basic condiments?

A condiment is “something used to enhance the flavor of food,” especially a pungent seasoning, according to Merriam-Webster’s definition.

Popular choices in the U.S. include:

• Mustard
• Ketchup
• Mayonnaise
• Relish
• Barbecue sauce
• Salsa
• Hot sauce
• Soy sauce
• Vinegar
• Wasabi or horseradish

Some people consider guacamole and hummus condiments, but foods that can be eaten on their own generally don’t count as a condiment, chefs told The Kitchn.

Condiment nutrition

Every condiment is different, so it’s important to read the label to check the serving size and nutrition facts, both dietitians advise.

Soy sauce and salsa are higher in salt, while mayonnaise is higher in calories, Rizzo says. Ketchup, barbecue sauce and relish all have added sugar.

You can taste the sweetness, but people don’t realize one tablespoon of ketchup has a teaspoon of sugar, Young notes. “Ketchup is something we put on so many foods. It becomes a quantity thing that you want to make sure that you watch,” she adds.

What are the benefits of condiments?

Besides being an easy way to boost taste, condiments can also make a meal more satisfying — potentially helping people to make better choices and eat less in the long run, Young notes.

“If you eat something you like, you’re satisfied and you stop. The thought is psychologically, you’re satisfied,” she says.

Steamed chicken is healthy but bland, so a bit of barbecue sauce will give it that flavor someone might need to choose it over a less nutritious option, Young points out.

Some condiments can add a little bit of nutrition: Salsa, for example, is made with tomatoes and onions — two vegetables that are beneficial to health, Rizzo points out.

What is the healthiest condiment?

Vinegar was the top pick of both dietitians. Drizzling it over beef, poultry or vegetables can boost taste without adding many calories.

“It doesn’t have any added salt, sugar or fat, and you don’t need a lot of it to get a really strong flavor,” Rizzo says.

Vinegar is fermented, good for the gut and adds a pungent taste, Young adds. Fruit vinegars made from wine or apple cider are rich in polyphenols — beneficial compounds found in plants — and organic acids, and can be a good source of antioxidants, studies have found.

Salsa was another top choice since it’s made from mostly tomatoes and plant-based ingredients, which means it has lycopene — a powerful antioxidant — and other health benefits, the dietitians say.

Mustard can also be a healthy pick, adding lots of flavor without many calories or sugar, Young says. But it can be salty, so people with high blood pressure should be careful about eating too much.

What is the least healthy condiment?

Mayonnaise, because it has a good amount of saturated fat, Rizzo says.

Since it’s high in fat and calories, mayonnaise would be the least healthy condiment to choose if you’re watching weight, Young adds. But if you’re a mayo fan, it’s OK to have it; just watch how much you eat.

“If you love mayo, have mayo, but then limit your guacamole” and other high-fat additions to a meal, she advises. “It’s not in the category of butter or cream.”

If sugar is a concern, ketchup and barbecue sauce are the worst condiments, both dietitians say. “The first ingredient on a lot of BBQ sauces is sugar,” Rizzo notes.

The main message is to use condiments wisely: Pick the one you like the best, add a bit to your meal and don’t go overboard. If you’re drowning your roasted veggies in condiments, you’re probably going way over the daily recommendation for salt, sugar and saturated fat, Rizzo cautions.

“It’s always best to look at the recommended serving size on the label. Sometimes you may want a little bit more than the recommendation and that’s fine, but don’t do it every time,” she says.

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CVS Health on Thursday said its drug plans will cover the first over-the-counter birth control pill in the U.S. at no cost for many health plan sponsors, a decision that could open the door for more people to prevent unintended pregnancies without a prescription. 

The company’s pharmacy benefit manager, CVS Caremark, said the pill will be added to its preventive services oral contraceptives list and will be covered at zero cost for many sponsors. The drug, known as Opill from Perrigo, was available at pharmacies starting April 1, according to a pharmacy update from CVS Caremark dated last week and viewed by CNBC.

Pharmacy benefit managers, or PBMs, maintain lists of drugs covered by health insurance plans and negotiate drug discounts with manufacturers. At most stores, Opill has a retail price of $19.99 for a one-month supply and $49.99 for a three-month supply. 

The Food and Drug Administration approved Perrigo’s medication in July. It marks the first time that many U.S. residents are able to buy birth control pills over the counter, the same way they would purchase common pills like Tylenol or Advil. 

The drug could significantly expand availability of contraception, especially for younger women and those in rural and underserved communities who often have trouble getting access to birth control methods. 

Medical organizations have estimated that 45% of the 6 million annual pregnancies in the U.S. are unintended.

The pill’s entrance into the market is a win for the Biden administration, which has tried to shore up reproductive rights as abortion restrictions rise in many states. 

The Supreme Court’s decision to overturn the landmark Roe v. Wade ruling more than a year ago, which ended 50 years of federal abortion rights, has led to shrinking availability of the procedure nationwide and renewed calls for expanded access to birth control.

In all, five women who lived in different parts of southwest Michigan suddenly sought help for serious eye problems within weeks of each other.

The medical mystery led to a startling diagnosis: All of the patients had ocular syphilis, a complication of the sexually transmitted disease.

The cluster of cases shared a common link. It turned out the five women had sex with the same man who had syphilis, according to a case report published by the Centers for Disease Control and Prevention in November 2023. His illness was mostly asymptomatic and never affected his eyes.

Few people know syphilis can endanger vision, doctors say.

“Patients are very surprised, and most of the lay public doesn’t think of syphilis involving the eye,” Dr. Rahul Khurana, a spokesperson for the American Academy of Ophthalmology, tells TODAY.com.

“Untreated syphilis in the eye is devastating because it can lead to blindness.”

‘Syphilis crisis’

It’s especially concerning as syphilis cases surge in the U.S.

More than 207,000 Americans were diagnosed with the disease in 2022, an 80% increase since 2018 and the highest levels since the 1950s, the CDC reported in January 2024.

Cases were up in most every region and demographic group, including older people.

The U.S. Department of Health and Human Services called it a “syphilis crisis” and an “epidemic.”

Possible reasons why it’s happening include a rise in substance use, with alcohol and marijuana linked to more risky sexual behavior, Dr. Akshay Syal, a medical fellow with the NBC News Health and Medical Unit, told NBC News Now.

There’s also been a decrease in condom use and less funding for clinics where people can get tested for STDs, he added.

As the crisis unfolds, doctors are seeing more people in the U.S. hospitalized for syphilitic uveitis, or inflammation inside the eye and the most common ocular manifestation of syphilis, according to an investigation published in JAMA Ophthalmology in November 2023.

What causes ocular syphilis?

Syphilis is a sexually transmitted disease caused by a bacterium that invades blood vessels and could involve the central nervous system — when that happens, it can go into the brain and the eye, Khurana says.

The illness can lie hidden in the body only to cause symptoms later in time, so it’s often not caught early and people don’t realize that they have it, he adds. Some of his patients had no idea they were infected until they sought help for eye problems.

“We often call syphilis the great imitator because it looks like many other things,” says Khurana, who is ophthalmologist at Northern California Retina Vitreous Associates.

“Because it’s non-specific, it’s often missed by many ophthalmologists, and many people don’t even think about it.”

Besides causing blindness, untreated syphilis can seriously damage the heart and brain, and cause deafness and paralysis, the CDC warns.

What are the symptoms of ocular syphilis?

When syphilis affects the eyes, it usually causes inflammation inside them known as uveitis, Khurana says.

Eyes may be red, light sensitive or painful, he notes.

“Whenever I have a patient with uveitis, I always rule out everybody for syphilis just because it can present in so many different ways that you don’t want to miss it,” Khurana notes.

Syphilis accounts for 1% to 5% of cases of eye inflammation, according to the American Academy of Ophthalmology notes.

Other possible symptoms of ocular syphilis include floaters, blurry vision or even blindness, the CDC warns.

A blood test can confirm if a patient has syphilis.

What is the treatment?

If there’s a positive test, it’s important for the patient to see an infectious disease doctor because when syphilis involves the eyes, it’s also potentially involved in the brain, Khurana says.

Patients are treated with an intravenous antibiotic for 10 to 14 days and usually respond well, he notes. They may also get anti-inflammatory medicine to take care of the eye inflammation.

“If these things are caught early and treated early, patients could do very well,” Khurana says. “The challenge with syphilis is that often (doctors) don’t think about it, and so the diagnosis is often delayed.”

He urges eye doctors to have a “high index of suspicion” and rule out syphilis when patients show up with eye inflammation.

Treatment may not undo any damage caused by the infection, the CDC warns.

Using condoms every time you have sex can reduce the risk of getting syphilis, the agency notes.

Always get checked for any vision problems to rule out eye syphilis or other sexually transmitted diseases. STDs such as herpes and gonorrhea can also harm the eyes, according to the American Academy of Ophthalmology.

“With the incidence of STDs and syphilis on the rise in the community, I think everyone should be aware of it,” Khurana says.

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Gutke, of Joliet, Illinois, has polycystic ovary syndrome, or PCOS, and the medications and supplements help the 45-year-old cope with migraines, high blood pressure, diabetes, high cholesterol, anxiety and depression that come with the complex hormonal condition. 

Not one of  Gutke’s medications are technically “PCOS drugs.” 

The Food and Drug Administration has not approved a medication specifically for PCOS, which is often linked to infertility, irregular or missed periods, weight problems, and other debilitating symptoms. Gutke’s array of medications is typical of how many of the estimated 5 million women in the U.S. diagnosed with PCOS deal with it.

“It’s such a vast syndrome that affects everything from your head to your toes,” she said. She was diagnosed with endometrial cancer — another risk linked to PCOS — at age 37. 

After nearly a century of disagreements over what, exactly, defines the condition, as well as a lack of research, PCOS is still poorly understood. The symptoms vary so widely that any single drug would be unlikely to help all patients, said Dr. Heather Huddleston, a reproductive endocrinologist at the University of California, San Francisco and director of UCSF’s PCOS Clinic. 

Women with PCOS and the doctors who care for them say they want better options — treatments for the condition’s root causes rather than bandages for individual symptoms. Even as calls for better treatments grow, the lack of investment in PCOS research has limited doctors’ ability to help their patients. 

“It gets very messy to try to identify one treatment that’s going to work for everybody,” Huddleston said. 

Many women with the condition end up taking off-label prescriptions — meaning drugs technically approved for other conditions, like diabetes or obesity — to help PCOS-related symptoms. Navigating insurance coverage for off-label prescriptions can be challenging.

“There’s no magic pill,” said Tallene Hacatoryan, 31, a registered dietician from Orange County, California. “There are too many components for there to be a one-size-fits-all treatment.”

Hacatoryan was diagnosed with PCOS at age 18 and now works as a diet and lifestyle coach for women with PCOS.  

Although research is murky when it comes to the best diet for women with PCOS, the most up-to-date international guidelines recommend exercise and a healthy diet. There’s no evidence that any particular diet improves symptoms, although some women have found lifestyle coaching helpful.

Insufficient funding for research

Among the reported 315 medical conditions that receive federal support from the National Institutes of Health, PCOS ranks near the bottom, with an estimated $10 million earmarked for research in 2024. Until 2022, PCOS was so underfunded that it wasn’t included as a line item in the NIH list.  And the condition is not explicitly included in the $100 million the Department of Health and Human Services announced recently to research neglected areas of women’s health. Neither is PCOS mentioned in President Joe Biden’s recent executive order to advance women’s health, which includes $200 million for NIH research grants, or the White House’s calls for Congress to allocate $12 billion to fund women’s health research.

A spokesperson at the NIH said that it’s too early to know which women’s health conditions will receive funding under the new initiative. 

“Given how common PCOS is, the amount of funding it’s gotten is proportionately extremely small,” Huddleston said. 

Government funding is just one part of the total research budget for a given disease. While it’s tough to pin down a dollar figure for private industry spending, experts say the lack of FDA-approved PCOS treatments reflects a lack of investment from drugmakers, too. 

Developing PCOS treatments requires a better understanding of the condition. This, in turn, requires far more research tracking thousands of women over many years, which can be extremely expensive, experts say. 

However, there are some promising signs.

Although research is early and only in a few dozen women, there are a handful of small drug companies studying possible PCOS treatments. A Menlo Park, California-based company called May Health, for instance, is developing a one-time surgical procedure it thinks could help with PCOS. Spruce Bio, a San Francisco biotech firm, is running a small clinical trial with a drug called tildacerfont for PCOS. It is not clear yet if the oral drug works. President and CFO Samir Gharib said larger clinical trials will depend on the company’s ability to “secure additional financing” or partner with another drug company. 

The FDA recently attended a meeting with advocacy group PCOS Challenge where women shared their experiences with the agency’s scientists and drug companies. No PCOS drug trials were announced after the meeting, but the FDA’s interest shows a growing push for improved treatment, said William Patterson, a spokesperson for PCOS Challenge.

No known cure for PCOS

Doctors recommend hormonal contraceptives — most commonly the birth control pill — to regulate heavy, irregular periods;, acne;, and unwanted hair growth. Others say taking the pill just masks, rather than treats, their PCOS symptoms and the symptoms return as soon as they stop taking it. 

“PCOS is unfortunately not curable, so treatment is about managing its symptoms,” said Dr. Jessica Chan, a reproductive endocrinologist at Cedars-Sinai. Chan said birth control can be a good option for some, but not all, of her PCOS patients. 

For women with PCOS whose main concerns are insulin resistance or stubborn weight gain, Chan often prescribes off-label diabetes medications like metformin. 

Some doctors who treat PCOS, including OB-GYNs or endocrinologists, have also begun prescribing GLP-1 agonists like Ozempic and Wegovy, which have shown promise for some women with PCOS,  although studies have been small and early -stage.

Novo Nordisk, the company that makes Ozempic and Wegovy, said it has no plans as of now to seek FDA approval for PCOS. Still, the company mentions PCOS on its Truth About Weight website, part of its marketing campaign for Wegovy

Causes and symptoms of PCOS

“We don’t know the initial spark leading to PCOS or where it arises from,” Chan said.

PCOS affects an estimated 6% to 12% of reproductive-age women in the U.S. The real prevalence is likely higher since an estimated 70% of cases go undetected. 

Experts generally agree that PCOS, at its core, is a hormone-related condition. Women with PCOS have higher levels of androgen hormones, which can cause a range of symptoms, including:

•  Missing, irregular, or heavy periods
• Acne
• Excess hair growth on the face or body
• Thinning or balding scalp hair

According to endocrinologist Dr. Andrea Dunaif, some doctors have been pushing to separate PCOS into two different diagnoses: one having more to do with the reproductive cycle and fertility issues and another having more to do with metabolism, high body weight, and diabetes. 

“PCOS looks to be at least two or three different conditions we’re lumping together, but they’re genetically distinct,” said Dunaif, the chief of the endocrinology, diabetes and bone disease division of Mount Sinai Health System and the Icahn School of Medicine.

The confusion surrounding PCOS diagnosis is partly why it’s been hard to get large pharmaceutical companies to invest in PCOS treatment, she said.

In Dunaif’s view, it’s not accurate to call the condition “PCOS” at all, because it has more to do with excess hormones than it does with actual cysts on the ovaries. PCOS got its name from the bumps on the ovaries appearing like cysts on an ultrasound image. These are not cysts, but instead egg follicles that are, as Dunaif described them, “arrested in development.” 

As it is, many doctors diagnose the condition based on two of three factors:

• Irregular periods
• High androgen levels
• Multiple follicles on the patient’s ovaries

But these three factors don’t account for some of the most challenging symptoms of PCOS: insulin resistance and stubborn weight gain. Excess androgen hormones can spike insulin levels, which interferes with how the body processes sugar. Doctors aren’t sure whether the hormonal dysregulation causes insulin resistance, or whether insulin resistance causes excess androgen hormones. 

Either way, women with PCOS have a higher risk of diabetes, excess weight gain, high cholesterol, and high blood pressure. Yet these metabolic conditions aren’t included in the criteria many doctors use to diagnose PCOS. The result? A missed diagnosis. 

This was initially the case for Candice Bolden, 35, who started noticing acne and excess facial and body hair several years before she was diagnosed with PCOS in 2021. Bolden, a lifelong dancer, also had unusually low energy.  

“The final straw was excess weight gain that I could not take off no matter what I did,” said Bolden, who lives in Los Angeles. “All the other things I had kind of just stuffed under the rug. I’d just chalked it up to being a hairy, Haitian woman.”

After gaining 35 pounds, the 5-foot-2-inch Bolden, who exercised twice a day and followed strict diets, saw multiple doctors who she said ignored her symptoms. 

“Doctors kept telling me I was fine, and to go home, work out, and eat clean,” she said. “It was the most frustrating thing ever.”

‘We don’t have to live underneath this dark cloud’

Women living with PCOS say the rise of online communities, including on social media apps like TikTok and Instagram, has given them a place to speak out, share the treatment approaches working for them, and meet other women with PCOS. 

When Bolden finally got a diagnosis, she wasn’t sure what to do next. Gutke and Hacatoryan had similar experiences. 

“I was like, ‘Wait, I have so many questions,’ and the doctor just told me, ‘It is what it is,’” Hacatoryan said. 

Hacatoryan calls women in her online community her “cysters.”

Bolden said she’s noticed more women turning to social media to learn how others manage their PCOS and share their own stories.

On her own social media accounts, she’s been trying to change the narrative about PCOS being primarily a fertility problem, which she sees as an outdated perception.

“When I was diagnosed, my doctor mentioned PCOS being the No. 1 reason for infertility, and that shattered me,” said Bolden, who was newly engaged at the time and eager to start a family. “I was happy I was diagnosed, because it showed me something was actually happening and I wasn’t just crazy. But I was heartbroken.”

Things changed after Bolden moved; found a new doctor; and worked closely with her husband and the  online PCOS community to find a system that worked to manage her PCOS symptoms.  

Bolden is now pregnant and expecting a baby girl. 

“I want people diagnosed with PCOS to know there’s hope, and we don’t have to live underneath this dark cloud all the time,” she said.

This story first appeared on NBCNews.com. More from NBC News:

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