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By Nada M. Elbuluk, MD, as told to Susan Bernstein

One of the most challenging aspects of generalized vitiligo is how much it will progress. This is different for each person. People who are newly diagnosed often ask: “How much will it spread or how stable will it be?” Some people may have stable disease for years. But others may have vitiligo that spreads at any point in their lifetime. If you’re on treatment, this can help your condition stay stable. If not, you can develop new patches.

[Choosing to camouflage vitiligo] is a very personal decision. Each person with vitiligo handles this differently. Some people want to conceal it. Other people are more comfortable with the way their skin looks and they don’t want to wear makeup. First, we will have a conversation about camouflage. I want to know how you feel emotionally about your skin’s appearance. I may also ask, “Do you want to begin treatment, or have your treatments not responded?” There are makeup products for vitiligo that you can acquire over the counter. Some people also use self-tanners that help to camouflage the areas of skin.

I also direct people to different support resources that are available, such as the Global Vitiligo Foundation. They have a section on their website about support resources for patients with vitiligo, as well as support groups across the nation. It may help you manage your feelings to meet with other people who also have vitiligo. Talking with others in a support group can be a very supportive, positive experience. There are online support groups for vitiligo, too. I try to suggest credible sources of information online.

Emotional Impact of Skin Color Changes

Research has conclusively shown that you can have a profound psychosocial and emotional impact from vitiligo. For one, you no longer feel that you have control over how you look — how your skin appears. Vitiligo changes your skin’s color, and you may develop white patches anywhere on your body, including your face. There is also a great deal of variability in vitiligo and how extensive it is on your body. People also feel uncertain about their vitiligo’s progress: Will I have a flare? Will these patches get bigger?

Vitiligo can affect people of all skin colors. I have patients of all colors. We see it in both

adults and children. It can first appear earlier in life, but it can develop when you’re an adult. For children, it can be difficult to understand what is happening to them, and it can also be difficult for other children they are around to understand it.

Therapy and support groups for people living with vitiligo can be very helpful. It depends on the degree to which you are affected, but seeing a psychologist or psychiatrist can be helpful, too. We encourage any individual who is feeling any negative emotions to seek medical care.

Famous Role Models Decrease Stigma

Winnie Harlow was one of the first people with vitiligo to be public about it in a proud way. She is beautiful and a successful model, and she often models without using makeup to cover her vitiligo. This has helped decrease the stigma of vitiligo. There has been a positive wave in recent years about self-acceptance in general. People are starting to accept beauty in all forms which is so important. CoverGirl also recently selected their first spokesmodel with vitiligo. Mattel released a Barbie doll with vitiligo. You are seeing retail stores and marketing campaigns using models with vitiligo.

Self-acceptance of your vitiligo doesn’t take away the need to have treatment options for those who want them. But everyone should know that they are beautiful and have self-worth. It’s important to educate our society about vitiligo. People may ask you if it is contagious — it is not. My patients also ask if it is hereditary. While there is a genetic and hereditary component to vitiligo, the chances of it occurring in the next generation is low. There is less than a 10% chance that you will pass it down to your children.

Protect Your Skin From Sun Exposure

If you are not treating it and just choose to live with your vitiligo as is, then you may not need to see your dermatologist regularly. If you are on treatment, or if you have vitiligo that is spreading quickly, then usually, you should see a board-certified dermatologist every couple of months just to monitor your condition and any changes.

My message to anyone who questions if they have vitiligo or if they’ve been diagnosed with vitiligo is to see a board-certified dermatologist, particularly one who specializes in vitiligo treatment. Again, it is completely up to each person if they want to seek treatment for it or not. Your dermatologist can guide you and talk you through all of your options.

If you have vitiligo, you should wear a sunscreen of 30 SPF or higher, just as we would recommend to anyone. We used to worry that people with vitiligo were at increased risk of skin cancer. However, with more research, we have found that this is not the case, and in fact, you’re at lower risk of melanoma. Still, we recommend sunscreen as a general precaution, and if you’re out in the sun all day, reapply it every 2 hours.

By Mark Braxton, as told to Kendall Morgan

In 1996, I discovered a small white spot on my thumb. It itched. I thought it was a scab or something. I didn’t think too much about it. Then, I started noticing other small white spots. They were spreading.

The first dermatologist I went to looked at me and walked right back out of the room. He came back in with a pamphlet and said, “This is what you have: vitiligo.” At that time, there wasn’t a lot of information. The doctor gave me a topical cream for it. I tried it for 6 months. It didn’t seem to me it was helping, so I stopped. I felt deflated.

Thankfully, when I went to another dermatologist, it was a different experience. He shook my hand. He knew immediately I wanted to know about the spots. He explained that I have vitiligo, which is a skin condition. It’s not contagious, which is important for people to know. There’s no cure or way to stop the loss of skin color. He told me that it could spread or maybe some of the pigment would come back. Then he asked me a question I didn’t expect, “How is your self-esteem?”

At that time, I felt good. It was just a couple of small spots. Over the years, as it started to spread and I could see changes, I started to feel more insecure. I have it around my mouth now and all over my body in spots. I stopped wearing shorts. I stopped going to the beach and the pool. I would avoid social settings where people could look at me. It was insecurity and sometimes slight depression and anxiety.

The mental aspect is probably the biggest challenge I’ve dealt with. Vitiligo changed my outlook on myself. I didn’t see myself how others saw me. I struggled socially with friendships and relationships. One of the worst things I’ve found that people can say is that it doesn’t bother them. I understand you may say it doesn’t bother you, but until you walk in my shoes, you don’t understand. You don’t have to look in the mirror watching your body or skin change over time. There’s this fear of the unknown.

I haven’t sought treatment, although it has been offered. The creams I tried at first didn’t seem to help. Light therapy is an option, but it’s time consuming and I didn’t want to risk getting burned. I thought I could do this all on my own. In 2019, I realized I’d been failing. Something a child said helped me start to shift my perspective. I was working at a camp and this little girl told me that I was a butterfly. She identified my spots as a butterfly, as something beautiful.

I decided it was time to open up. I joined the North Carolina Vitiligo Support Community after avoiding it for years. It was the best decision I ever made. For so long, my vitiligo was something that I never talked about. My family and friends didn’t know how I felt about it. I started sharing my journey with other people, and it helped so much.

I’m now one of two leaders for the North Carolina Vitiligo Support Community in Raleigh,. I’m also on the board of directors for VITFriends, which is a national organization that nurtures peer-to-peer relationships in the vitiligo community. I host a podcast called Living Life and Love, where others with vitiligo can share their journey. I found that sharing my own journey with such a large audience released me from a personal prison I’d been living in for too long.

Having this skin condition has opened my eyes in many ways. I’ve come to a place of acceptance. I’ve learned how to live with vitiligo and love myself. Some days are still hard if someone whispers or stares too hard. Kids are often curious and that’s OK. I try to educate people about what vitiligo is.

When it comes down to it, my skin looks different, but I still have interests, hobbies, and talents. I enjoy writing poetry and short stories. I like to paint and draw and be creative. I’m a big fan of science fiction and superheroes. We all have much more in common than we don’t. I’ve gone from being insecure to being secure in myself. I often say that it’s a process for all of us in the vitiligo community. Every journey is different. Everyone has a story to tell.

By Jackie McDonald, as told to Hallie Levine

About 25 years ago, I was at the beach with my two young children. It was just another lovely day together playing in the water and sand. We walked over to the concession stand to grab lunch. I noticed a man staring at me. At first, I thought nothing of it — I was used to guys and their admiring glances. But this time, I realized he wasn’t gazing at me with appreciation, but with horror. I grabbed my kids and got into my car. When I looked at myself in the side view mirror, I was in total shock. Who was this woman with patches of white circling her mouth, lips, and eyes?

It was my first real moment grappling with living with vitiligo. All of a sudden, I’d gone from being a lovely young woman to someone I didn’t recognize. Thankfully, today I accept and embrace my vitiligo, but it was a long, hard road getting there.

Grappling With the Diagnosis

I learned I had vitiligo when I was 31, right after the birth of my second child. I had already been diagnosed with Hashimoto’s disease, which is an autoimmune thyroid disease. (The two conditions sometimes occur together.) I had gone to see my dermatologist after I noticed a white, nickel-sized spot on the inside of my wrist. I’d spent the summer at the beach and was very tan. In contrast, the spot showed up as a glowing white orb. It unnerved me.

The dermatologist was very brusque: he spent 2 minutes explaining that I had vitiligo and the spots would most likely spread to other parts of my body. I was confused and kept asking questions, but he brushed me off. It was clear that he thought he couldn’t “fix” me and wanted to move on to his next patient. He wrote me a prescription for steroid cream and walked out.

At first, the vitiligo seemed manageable. I dressed strategically, in long sleeves and pants. Then it spread to cover more than a quarter of my skin — my hands, elbows, legs, and back. But it didn’t really start to bother me until the vitiligo appeared on my face and makeup wouldn’t cover it. At first, I tried eyebrow pencils and powders, but I gave up when they didn’t do anything. Self-tanners were also too messy and difficult to apply to only my spots.

My vitiligo didn’t seem to faze my husband or kids, but it upset me. I wanted to keep it private. I wanted to present myself to the world as the person I was before the spots — that’s who I felt I was. I hated the fact that almost every time that I went to the store, I’d pull out my wallet and the checker would automatically stare at their hands. Even though they never said anything, I could tell that they wondered what was going on. I hated being that woman with vitiligo.

How I Moved Forward

One day, I accidentally spilled furniture stain on my arm. I was amazed to see that the color matched my skin and hid a white vitiligo patch. I decided then and there to create a nontoxic stain for skin to camouflage vitiligo. Over the next few years, I tried everything from hair dyes and henna products to food coloring and eyebrow pigments. Nothing worked, but I didn’t give up. In my research, I’d read comments on YouTube videos from these young girls who were devastated by this condition. To see them write that they didn’t want to leave the house, and worry that they’d never get a boyfriend, broke my heart. I did youth ministry, and I knew how easily teens and young adults could spiral into crisis. I wanted to help them.

Then I noticed an advertisement for Fake Bake’s self-tanner. I reached out to the company with a pitch for a product designed specifically for those with vitiligo. They got back to me that same day. A year later, Vitiligo Vanquish by Fake Bake was on the market. It’s been a life changer for me: I apply it twice a week on my spots with more frequent touch ups on my hands.

For me, finding a way to cover my spots has given me the confidence to do things like go into stores or shake hands without worrying about awkward stares or conversations. But I also recognize that some people don’t want to cover their vitiligo, and that’s absolutely fine, too. I’m not ashamed of my spots.  I just enjoy going out into the world as one color.

What I Want Other People With Vitiligo to Know

I’ve spoken to so many young girls who worry that they’ll never go on a date because they have vitiligo. I make sure I take the time to explain to them that if a guy rejects you because of some spots, you don’t want anything to do with him anyway. I’m single now, and while I don’t bring up my vitiligo on my first date, I make sure that a man knows before we get too serious. If my vitiligo scares him off, that’s his problem. I want to be able to swim in the ocean or go a couple days without my Vitiligo Vanquish without worrying about what some guy thinks.

But there’s also nothing wrong with covering up your spots if you want to. I get notes from people with vitiligo every day who are embarrassed that they want to “hide” their vitiligo. But sometimes, you don’t want to keep having to discuss your condition at work or want people to get to know you without focusing on your spots. Every person with vitiligo needs to make their own choice.

Regardless, I encourage anyone with vitiligo to embrace their skin. Vitiligo is beautiful. Let’s celebrate it, whether you choose to occasionally camouflage your spots or proudly display them openly.

By Erika Page, as told to Hallie Levine

I’ve been living with vitiligo since I was 7 years old. It started as small spots on the back of my spine but quickly spread, first to my knees and elbows, then all over my body. By the time I reached my early 20s, I’d lost all of my skin pigment. I put on a brave face because I didn’t want anyone to know how much I was hurting, but I had moments where I’d lie in a crumpled heap, crying on the floor. The worst part was the feeling of lack of control.

When you have vitiligo, it’s easy to feel like you’re the only person in the world living with the disease. But you’re not. There’s a whole village of us out there. Thanks to the internet, there are a number of ways to find your vitiligo tribe, too. Whether it’s through social media platforms like Facebook or Instagram, personal blogs, or even through my own website, Living Dappled, there are ways to connect with others and feel less alone.

The Power of Connection

I’ll never forget the first time I connected with another person with vitiligo. I was 26. Up until then it had never occurred to me to try to speak to someone with my condition — it seemed so personal and it wasn’t something that I wanted to share. Then one day, I stumbled upon a vitiligo blog that really resonated with me. The woman was about my age and lived in New York City. I messaged her on LinkedIn, and we ended up talking on the phone for more than an hour. 

Talking to someone else with vitiligo made me feel normal. She knew my story before I even had a chance to tell her. She understood my pain and what I was going through. We talked about how it feels like no one gets it. Sure, a family member or friend might comfort you while you’re upset, but they can’t understand the ultimate reality of living with spots every day. When I hung up the phone, I cried, but I also felt a sense of peace: I had realized how much power there was in not feeling alone.

I decided then and there to launch a website. I’d been surprised at the lack of resources for people living with vitiligo. I also had loved to write since childhood. Why not combine my two passions to create a positive, uplifting platform? I wanted to capture the little moments of living with vitiligo: what’s it like to be stared at in the grocery store or to shake hands with someone when you first walk into a meeting. More importantly, I wanted to create a space where people could talk about how to live with vitiligo — especially in a positive, inspiring way.

Gaining Strength Through Social Media

When I was first diagnosed, there were no Instagram accounts I could turn to for inspiration or advice. Today, however, anyone who’s newly diagnosed can easily get

onto social media and follow other people who look just like them. That’s a beautiful gift. It’s very empowering to not only have your Instagram feed filled with these folks, but to realize that the condition doesn’t take over their entire lives. You learn that while you’re a person who has vitiligo, it doesn’t define who you are. It’s a small but fundamental shift when it comes to learning how to live with vitiligo.

It also inspires in other ways, too. A few years ago, another woman with vitiligo on Instagram dared me to take off my tanner, which I had been wearing head to toe for a few years to cover my vitiligo. The idea made me sick to my stomach at first. But the idea had been planted. A year later, I had the courage to dart into the grocery store without tanner for 5 minutes.  At first, I felt exposed, but once I got back into the car, I felt calm and confident. I had been seen by people without tanner and makeup — quite literally my worst fear — and nothing had happened.

How to Find Your Tribe

There are so many ways to reach out and get a virtual or in-person connection. The first are social media networks, such as a Facebook group or an Instagram account. These are safe spaces where you can get ideas, share thoughts, and get social support. (You can find a list of Instagram accounts to follow here.) There are also membership networks like the Dappled Darlings Community, which provides members with a private Facebook group, monthly virtual discussions, live community interviews and curated vitiligo news.

In-person support can also be important. Groups like the Global Vitiligo Foundation can point you to local events near you. There’s also the annual World Vitiligo Day conference, with allows you to connect with both medical experts and other patients.

One way I’ve personally connected with other women with vitiligo is through Living Dappled’s photo shoots. It’s been amazing to watch people’s confidence grow throughout the day as we photograph them. I remember once as we sat down for lunch, one of the women confided that she’d never worn a dress that showed off her legs before. She’d felt empowered to that day, as part of a larger community.

That’s the thing about vitiligo: you can see someone else with it and form a strong connection without even knowing each other’s name. We get each other the way partners, or parents, or children can’t. Just the act of opening up and talking about your skin helps you grow. The more you talk about it and own it, the more confident you become in who you are.

Jennifer Schmid had just learned she had pancreatic cancer and that she would need surgery to remove part of her pancreas, stomach, and intestines. Schmid’s oncologist recommended she have a CT scan to check for cancer anywhere else in her body.

That’s how doctors found the spot on her lung.

To 61-year-old Schmid, of Newhall, CA, this news sounded about as bad as it could get. The pancreas cancer must have been so advanced that it had already spread to her lungs, she thought. But that wasn’t the case.  

Schmid’s oncologist ordered genetic sequencing of both the lung tumor and the pancreas tumor. That’s a test to read the unique DNA of each tumor. It revealed that the two tumors were completely different from each other. Schmid didn’t have a single advanced cancer that had spread from her pancreas to her lungs. She had two separate early-stage cancers: lung cancer and pancreatic cancer. This made all the difference in Schmid’s treatment and long-term prognosis.

“It was a stroke of luck that they found that spot on my lung and that they figured out it was not a metastasis,” Schmid says.

Two separate primary cancers, as opposed to one that has spread to multiple parts of the body, require different treatment and, in many cases, can come with a far better outlook than a single metastatic cancer. And it happens more often than people might think. 

How Common Is It? 

While it may seem like a rare case of lightning striking twice, it’s not terribly uncommon for a person to get two primary cancers – even at the same time. 

Researchers estimate that about 1 in 20 people with cancer have another separate cancer at the same time. They define “at the same time” as two tumors occurring within less than 6 months of each other. It’s even more common to have two different cancers at separate times – that is, a second cancer more than 6 months after the first. This happens in up to 1 in 5 people who have had cancer. 

Lauren Stevens of Louisville, OH, was one of those 1 in 5. She had lived with a brain tumor from 2004 to 2019. Her doctor monitored it with routine scans and as long as it didn’t grow, they chose not to operate. A scan in 2019, however, showed that it had started to grow – and fast. 

Stevens, now 50, had surgery to remove most of the tumor followed by radiation and chemotherapy. Then she resumed routine scans to monitor the remaining tumor that the surgeon wasn’t able to remove. 

Continuing to live with an inoperable brain tumor, Stevens started seeing blood in her stool. A colonoscopy and biopsy revealed that she had colon cancer. Soon, Stevens was back in chemotherapy and radiation followed by surgery to treat this second cancer while still living with the first. 

Understandably, living with cancer since she was 32 years old has been daunting for Stevens. There were times when she wanted to give up and no longer pursue the recommended care. But 7 years ago, she got a new reason to live.

“I have a grandson now,” she says. “He just turned 7. I didn’t know my grandparents growing up. I want my grandson to remember me. We’re very close. I think the sun just rises and sets on him.”

Who Gets Cancer Twice?

Anyone who has had any type of cancer could get a second cancer of any type. But research shows that those who’ve had bladder cancer or non-Hodgkin’s lymphoma are at greatest risk for second cancers. Lung cancer appears to be the most common second primary cancer. 

There are a number of reasons why a person might develop two separate primary cancers in their lifetime. 

Chance. Anyone is at risk of developing cancer at any given time. You have a lifetime risk, for example, for lung cancer and a separate risk for, say, colorectal cancer. So while it’s less common than having just one of those cancers, it is possible that you could get both. 

Genetics. You can inherit genes from your parents that raise your risk for specific cancers. Mutations in the BRCA1 and BRCA2 genes, for example, that you inherit from a parent raise your risk for breast cancer (as well as ovarian and pancreatic cancers). You can also inherit a gene that raises your risk for colorectal cancer. This genetic predisposition is called Lynch syndrome. 

“This is why it’s important to have genetic testing to look for one of these syndromes if you have two primary cancers,” says Joleen Hubbard, MD, an oncologist at Mayo Clinic. “There are many that we can test for, but there are also probably many cancer syndromes that we aren’t aware of yet.” 

Common risk factors. Many factors that raise your risk for one cancer raise your risk for others as well. Smoking and tobacco use, for example, cause at least 14 different types of cancer. Obesity, alcohol use, and an unhealthy diet are other risk factors for several different kinds of cancer. Exposure to harmful substances in the environment can raise risk for more than one type of cancer, too. 

Previous cancer treatment. Radiation and chemotherapy for one cancer can raise the risk for another cancer down the line. But doctors don’t typically call these cancers second primary cancers. They are radiation-induced or chemotherapy-induced secondary cancers. 

How Do Doctors Diagnose Two Separate Cancers?

With many cancers, when you get a diagnosis, the doctor will order imaging of your chest, abdomen, and pelvis to see if the cancer has spread beyond where it started. For cancers that commonly spread to the brain, such as lung cancer, testing might include brain imaging, too. 

If additional tumors show up in these images, they might contain clues as to whether they arose from the same cancer or a different one. 

“If you have a patient that has two separate masses and they look different on a PET scan – one lights up more than the other – that raises our suspicion that they might not be the same malignancy, which would require us to sample both areas,” says Arsen Osipov, MD, the oncologist who managed Schmid’s care at Cedars-Sinai Cancer in Los Angeles. He runs the Pancreatic Cancer Multidisciplinary Clinic.

A biopsy and genetic sequencing of both tumors, like Schmid had, can tell doctors definitively whether they are looking at one cancer or two. 

“Finding out whether a person has two primary cancers versus a single cancer that has metastasized is critically important,” Osipov says. “It could have been assumed that she had metastatic pancreatic cancer, but actually she had two separate cancers that could each be treated definitively with the intention to cure. You take care of one, then the other, and those cancers are not as advanced as a single cancer with metastasis would have been.”

What’s the Treatment for Two Separate Cancers?

When two different cancers arise at the same time, doctors have to make a judgment call: Which cancer should they treat first? 

In unusual cases, the two cancers may share characteristics that would make them respond to the same targeted drug or chemotherapy regimen. 

“This would be an ideal scenario, but it’s very rare,” Osipov says. 

When two simultaneous primary cancers require two different treatments, Hubbard says, “You’ll either treat the most life-threatening cancer first or sometimes it may be best to treat the one that’s easiest to treat first.” 

Schmid had abdominal surgery first for the pancreatic cancer and then radiation and chemotherapy for her lung cancer. The chemotherapy is still in progress. 

What If It Happens to You?

If you get a diagnosis of metastatic cancer, make sure you get a biopsy of the metastases to make sure you don’t have two separate cancers.

“Most centers are already doing this,” Hubbard says, “and this is why your doctor needs to biopsy a metastatic site.”

Osipov recommends that people with two simultaneous primary cancers get care at a cancer center where they can work with a multidisciplinary team that includes oncologists, surgeons, radiologists, and pathologists who can all work together on your case. Keep in mind that oncologists tend to specialize in particular types of cancer, so if you have more than one type of cancer, you’d want a team of oncologists at a cancer center to determine which cancer to treat first.

At the least, Hubbard adds, patients with two cancers should get a second opinion on their diagnosis and care.

“This helps not only the patient but the primary treating oncologist have a better idea of what tumors they are dealing with, what treatment options are available, and the best order in which to treat the cancers.”

No matter what your scale says, being comfortable in your own skin is up to you. It can be tough, in a society that prizes unrealistic images. But it’s possible, and it starts with what you say when you look in the mirror.

One of the first rules of achieving a healthy and happy body image is to stop allowing “put-downs” in front of the mirror, says Lori Osachy, body image expert and lead therapist at The Body Image Counseling Center in Jacksonville, Fla.

“Even if in the beginning that means you have to jump in front of the mirror and shout, ‘You’re awesome,’ and then immediately jump back out, that’s OK,” she says. “The goal is to retrain your brain how to think positively about your reflection and your body.”

Over time, telling yourself that you’re beautiful, even if you don’t believe it at first, will improve your confidence, she says. The psychology behind this technique is called “cognitive behavioral therapy,” a method that psychologists and therapists use to stop negative thoughts and replace them with positive ones instead.

Robyn Silverman, PhD, body image expert and author, agrees that “faking” confidence will eventually turn bad body thoughts into good ones, though it takes time.

To speed up the process, Silverman suggests posting notes with positive messages on your mirror to remind yourself of your good qualities. Those notes don’t always have to be about your looks. Jotting down things about your character will help you develop a more positive attitude toward your reflection.

Be Your Own Body Image Advocate

You would never tell your friend she looks fat in a bathing suit, or tell your coworker his arms are scrawny, so why would you tell yourself that?

“Treat yourself as you would treat others, and you’ll find negative thoughts will lessen over time,” says Leslie Goldman, MPH, body image expert and author of Locker Room Diaries.

Ditch the things in your life that make you feel inferior, whether that is body-bashing friends, fashion magazines with supermodels, or TV shows that portray men and women in an unrealistic, sexist way, Silverman says. If a family member or roommate makes you feel bad about the way you look, talk to them directly and establish a “fat-talk-free policy,” she says.

If an advertisement or TV commercial makes you feel bad about yourself, examine it closer and look for the ways it’s trying to sell you something. “Remember, if we didn’t feel inferior to the models in the ads, we wouldn’t want to buy the product,” Silverman says.

Look Beyond the Scale

All too often, people get hung up on the number on the scale, rather than paying attention to how they feel, Silverman says. People of all sizes do that, and it doesn’t help.

Instead of focusing on one number — your weight — pay attention to how you feel when you wake up or after you hurry to catch the bus. Also check on all your other numbers, such as blood sugar, cholesterol, and blood pressure. Those may paint a better picture of your health than just your weight alone.

If you’re trying to lose weight, Silverman suggests swapping weight-loss oriented goals with fitness goals like keeping your cholesterol level down or training for your first 5K.

“Instead of running away from your old body on the treadmill or the StairMaster, work toward a goal that makes you feel accomplished,” she says.

Choose an exercise you love, and you’ll be more likely to stick with it, Osachy says. When you exercise for stress relief and fun, your weight and health may naturally start to fall into place, she says.

As an added bonus, doing something you love will make you see your body in a different light, Silverman says. For instance, instead of loathing your thighs, you’ll appreciate them because they enable you to do the things that you love, whether that is yoga or cycling.

Cut Yourself Some Slack

Forget perfection or rigid rules. It’s OK to splurge once in a while even if you’re trying to lose weight, Goldman says. Not letting yourself have a little cake at a party may make you more likely to overindulge later.

Focus on the bigger picture and praise yourself for the healthy choices you make, rather than the times you think you’ve “failed,” Silverman says.

Don’t label any food as “bad” or “good.” You’ll only feel worse about yourself and your body if you eat something that isn’t your definition of perfect, Goldman says.

Don’t Compare Yourself to Others

“Healthy comes in all shapes and sizes,” Goldman says.

Never resort to unhealthy measures, such as not eating or taking potentially dangerous supplements, to fit society’s idea of what looks healthy, Silverman says.

If you’re physically fit, and everything checks out with your doctor, you may want to redefine your weight-loss goals altogether. If negative thoughts about your body become overwhelming, or if you are finding it hard to give up perfectionistic habits about food, weight, or exercise, talk to your doctor or a counselor or therapist.

Oct. 4, 2022 — Paige E, a 76-year-old retired psychotherapist, had always enjoyed yoga, which she found relaxing, invigorating, and spiritually meaningful. As she grew older and faced increasing physical challenges, she began taking yoga classes for seniors.

When the COVID-19 lockdown began, Paige was concerned that she might need to give up yoga classes. She knew she could practice on her own but felt she needed the structure of a class and the support of an instructor. So she decided to take online classes with Howard Katz, a Teaneck, NJ-based yoga instructor, with whom she had taken in-person classes in the past.

At first, she was skeptical whether the online format would be useful. 

“I’m not very tech-savvy — in fact, I’m a tech dinosaur — and I worried that I wouldn’t be able to manage the technology or relate to a virtual format,” she says. 

She was also concerned because she has some brain challenges and wasn’t sure how they would impact her ability to participate in online learning.

“I don’t have classic dementia or Alzheimer’s, but I do have memory and organizational issues that are related to other health problems,” she says.

Fortunately, she was able to master the technology and benefit from the classes.

Feasible and Safe

 Online yoga became part of the “new normal” during the COVID-19 pandemic, and its use has remained since then. And although some people prefer in-person settings, many continue to prefer the convenience, affordability, and other benefits of online yoga. 

This is also true  for classes targeting seniors, including those with cognitive impairments. A recent study found that a remotely offered home-based chair yoga intervention was helpful for older adults with dementia. 

“The telehealth-based chair yoga intervention was found to be convenient to both participants and their caregivers in keeping them physically active, as it was easily accessible from home and did not require transportation or getting dressed, which reduced caregiver burden and stress,” says senior researcher JuYoung Park, PhD, a professor in the Phyllis and Harvey Sandler School of Social Work at Florida Atlantic University’s College of Social Work and Criminal Justice. 

Seniors with dementia “can focus on the chair yoga intervention more effectively in a comfortable home environment rather than in a community center, with its associated distractions,” she explains.

Notably, there were no injuries or other adverse events during the intervention, “indicating that online chair yoga with caregiver support is safe.”

Park stresses that some people might face technological challenges in accessing online sessions, so tech support should be provided if necessary. And “since the instructor cannot engage in direct action with the participant, it’s recommended that a caregiver attend sessions with the person with dementia, monitor the participant for safety, and assist in following the poses correctly.”

What Is Yoga for Seniors?

Katz teaches older adults in senior centers and also offers online and in-person group and private classes to seniors through his own yoga studio. 

“Senior yoga is regular yoga made accessible for older adults who might experience age-related physical challenges,” says Katz.

“With seniors, I usually start with gentle warm-ups, then guide them through basic standing forward bends, gentle back bends, and warrior poses,” says Katz.

Props such as blocks, straps, and chairs are offered, and postures are modified to accommodate the physical challenges of seniors. 

“Some seniors can’t sit on the floor because they have difficulty getting up, so I modify the postures so that they can sit on a chair. Some have difficulty with balance, so they hold onto the chair or wall,” Katz notes. In fact, half the postures in his Yoga for Seniors classes are seated, while the other half are standing. 

Katz’s yoga classes emphasize breathing techniques. In particular, he likes to teach alternate nostril breathing (Nadi Shodhana), ocean-sounding breath (Ujjayi), and bee-breath (Brahmerie) which are calming for people with anxiety and stress and have other benefits as well — like lowering blood pressure, for example. 

All of Katz’s classes include meditation, which, he says, can bring calm, peace, and spiritual opening to people of all ages and has also been shown to be helpful in improving cognition and quality of life in seniors.

“I regard yoga postures and breathing as preparation for the most important component of yoga, which is meditation,” he explains.

Addressing the Special Needs of Seniors With Cognitive Challenges

Katz offers private in-person and online classes to people with cognitive impairments.   

“Classes are highly individualized, and all the components are modified, depending on the student’s cognitive level and needs,” he says. 

For example, he simplifies the breathing techniques or postures and explains everything more slowly, repeating instructions and explanations as often as necessary.

Some individuals with mild cognitive impairment can take classes alone. But those with more severe impairments or with dementia benefit from having a caregiver present for safety and to reinforce the yoga lesson, according to Katz. 

“It also creates a shared bond and activity for the caregiver and the student to do yoga together,” he says. 

Paige’s cognitive impairments are mild. She lives independently, does not require a caregiver, and successfully takes online classes with Katz, who “is patient and supportive when I don’t remember some things,” she says. “He explains things well, so I understand what each posture is designed to accomplish, and he creates a safe atmosphere, so I never feel rushed or judged.”

Paige feels that yoga has helped her physical health, cognition, and mood. 

“Yoga is a gift in my life, and I encourage other seniors to try it,” she says. 

Oct. 4, 2022 – Brent called his dad, Jeb Teichman, MD, in November 2019 saying he had felt sick for the past 3 days. The otherwise healthy 29-year-old had a cough, sore throat, and was running a fever.

“It was what the CDC would call classic influenza-like illness,” Jeb Teichman said. “It was too late to start antivirals, so I gave him advice on symptomatic treatment. We texted the next day, and I was glad to hear that his fever was trending down and that he was feeling a little bit better.”

Two days later, his son called again. 

“He said he was having trouble breathing, and over the phone I could hear him hyperventilating.” The retired pediatrician and health care executive told his son to seek medical care. 

“Then I got the call that no parent wants to get.” 

Brent’s cousin Jake called saying he couldn’t wake Brent up.

“I called Jake back a few minutes later and asked him to hold up the phone,” Teichman said. “I listened to EMS working on my son, calling for round after round of many medications. He was in arrest and they couldn’t revive him.”

“To this day when I close my eyes at night, I still hear the beeping of those monitors.”

Brent had no health conditions to put him at higher risk for complications of the flu. “Brent was a wonderful son, brother, uncle, and friend. He had a passion for everything he did, and that included his chosen calling of the culinary arts but also included University of Kentucky sports,” Teichman says.

Brent planned to get a flu vaccine but had not done it yet. “In his obituary, we requested that in lieu of flowers or donations, people go get their flu shot,” his father said.

“I’m here today to put a face on influenza,” Teichman said at a news briefing Tuesday on preventing the flu and pneumococcal disease, sponsored by the National Foundation for Infectious Diseases (NFID). 

New Survey Numbers ‘Alarming’

The NFID commissioned a nation survey of more than 1,000 U.S. adults to better understand their knowledge and attitudes about the flu, pneumococcal disease, vaccines, and the impact of COVID-19.

“We were alarmed to learn that only 49% of U.S. adults plan to get their flu vaccine this season,” said Patricia A. “Patsy” Stinchfield, a registered nurse, NFID president, and moderator of the news briefing. “That is not good enough.”

In addition, 22% of people at higher risk for flu-related complications do not plan to get vaccinated this season. “That’s a dangerous risk to take,” Stinchfield said. 

An encouraging finding, she said, is that 69% of adults surveyed recognize that an annual flu vaccination is the best way to prevent flu-related hospitalizations and death. 

“So, most people know what to do. We just need to do it,” she said.

The top reason for not getting a flu shot this year, mentioned by 41% of people surveyed, is they do not think vaccines work very well. Another 39% are concerned about vaccine side effects, and 28% skip the vaccine because they “never get the flu.” 

The experts on the panel emphasized the recommendation that all Americans 6 months or older get the flu vaccine, preferably by the end of October. Vaccination is especially important for those at higher risk of complications from the flu, including children under 5, pregnant women, people with one or more health conditions, the immunocompromised, and Americans 65 years and older. 

Stinchfield acknowledges that the effectiveness of the flu vaccine varies season to season, but even if the vaccine does not completely match the circulating viruses, it can help prevent serious outcomes like hospitalization and death. One of the serious potential complications is pneumonia or “pneumococcal disease.” 

“Our survey shows that only 29% of those at risk have been advised to receive a pneumococcal vaccine,” Stinchfield says.

“The good news is that among those who were advised to get the vaccine, 74% did receive their pneumococcal vaccine,” she said. “This underscores a key point to you, my fellow clinicians: As health professionals, our recommendations matter.”

Higher Doses for 65+ Americans

The CDC updated recommendations this flu season for adults 65 and older to receive one of three preferentially recommended flu vaccines, said CDC Director Rochelle Walensky, MD. The CDC is recommending higher-dose, stronger vaccines for older Americans “based on a review of the available studies, which suggested that in this age group, these vaccines are potentially more effective than standard-dose … vaccines.”

During most seasons, people 65 and older bear the greatest burden of severe flu disease, accounting for most flu-related hospitalizations and deaths. 

“They are the largest vulnerable segment of our society,” Walensky said. 

What Will This Flu Season Be Like?

Health officials in the flu vaccine business also tend to be in the flu season prediction business. That includes Walensky.

“While we will never exactly know what each flu season will hold, we do know that every year, the best way you can protect yourself and those around you is to get your annual flu vaccine,” she said while taking part remotely in the briefing. 

How severe will the flu season be this year? William Schaffner, MD, said he gets that question a lot. “Don’t think about that. Just focus on the fact that flu will be with us each year.”

“We were a little bit spoiled. We’ve had two mild influenza seasons,” said Schaffner, medical director of NFID and a professor of infectious diseases and preventive medicine at Vanderbilt University. “I think with all the interest in COVID, people have rather forgotten about influenza. I’ve had to remind them that this is yet another serious winter respiratory virus.” 

“As I like to say, flu is fickle. It’s difficult to predict how serious this next outbreak of influenza this season is going to be. We could look at what happened in the Southern Hemisphere,” he said. 

For example, Australia had the worst influenza season in the past 5 years, Schaffner said. “If you want a hint of what might happen here and you want yet another reason to be vaccinated, there it is.”

What we do know, Walensky said, is that the timing and severity of the past two flu seasons in the U.S. have been different than typical flu seasons. “And this is likely due to the COVID mitigation measures and other changes in circulating respiratory viruses.” Also, although last flu season was “relatively mild,” there was more flu activity than in the prior, 2020-21 season. 

Also, Walensky said, last season’s flu cases began to increase in November and remained elevated until mid-June, “making it the latest season on record.”

The official cause of Brent Teichman’s death was multilobar pneumonia, cause undetermined. “But after 30-plus years as a pediatrician … I know influenza when I see it,” his dad said.

“There’s a hole in our hearts that will never heal. Loss of a child is devastating,” he said. The flu “can take the life of a healthy young person, as it did to my son.”

“And for all those listening to my story who are vaccine hesitant, do it for those who love you. So that they won’t walk the path that we and many other families in this country have walked.”

To prove their point, Teichman and Stinchfield raised the sleeves Tuesday and received flu shots during the news briefing. 

“This one is for Brent,” Teichman said. 

Oct. 5, 2022 — What if a baby’s developing brain at the critical time just before birth and in the early days afterward establishes the lifetime risk for obesity?

Previous research has suggested that human genes associated with obesity determine whether a person will have a hard time maintaining a healthy weight later in life. For decades, researchers have looked for links between genetic variants and body mass index (BMI), explains Robert Waterland, PhD, professor of pediatrics-nutrition at Baylor College of Medicine in Houston, TX.  But the problem is the genetic ties found so far don’t explain weight gain and who is most at risk, he says. 

So could there be more behind rising obesity rates than genetics and lifestyle?

In their new study published in Science Advances, Waterland and his team looked at the possibility that environmental influences – such as poor nutrition and stress – during a critical window of brain development might influence obesity risk.

The research team led by Harry MacKay, PhD, a postdoctoral associate in pediatrics-nutrition at Baylor, focused on a tiny section of the brain called the arcuate nucleus of the hypothalamus, which regulates the body’s energy balance between food intake, physical activity, and metabolism.

They studied mice in the first few weeks of life and found that the arcuate nucleus undergoes extensive growth in a critical window of time when brains are particularly sensitive to programming, which will later determine how well the body senses whether it is hungry and when the body has enough food.

The scientists focused on epigenetics and worked to bookmark which genes would and would not be used in different cells. A big surprise in the research came when the investigators compared their epigenetic data in mice to human data and found that the regions targeted for epigenetic maturation in the mouse arcuate nucleus overlapped strongly with human genomic regions associated with BMI.

Waterland says that even though the work did not address when the epigenetic changes happen in humans, previous research has shown it happens earlier in humans than in mice. 

“My hunch is that the same epigenetic development that we have documented in the early postnatal mouse actually occurs during late fetal development in humans,” he says. 

If that is the case, “a big, big concern is the very high prevalence of maternal obesity in the U.S. and many developed countries in the world,” which may be affecting the health of new babies.

If future weight problems begin before birth or in those first weeks of life, some might feel doomed to a fate of obesity. But Waterland says the focus on genetics in earlier research wasn’t particularly encouraging either since it’s very difficult to change your genetics. 

“At least if we understand how environment affects development, then at least we can look for ways to improve this in the future,” he says. 

It’s too early to say whether obesity is actually a neurodevelopment disorder, Waterland explains, but if early research like this continues to build evidence, public health interventions to curb the worldwide obesity epidemic could focus more on prenatal and early life nutrition, healthy weight gain, and stress reduction.

Oct. 5, 2022 – Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Joe Biden, said this week that he isn’t ready to say that we are nearing the end of COVID-19. But as a country, we seem to be on the right track, Fauci said during a virtual conversation for the University of Southern California’s Annenberg’s Center for Health Journalism. 

This comes just 2 weeks after Biden said that “the pandemic is over” on CBS’s 60 Minutes. Last month, the World Health Organization also said the end of COVID is in sight. 

“It’s obvious that [the president’s statement] could be problematic because people would interpret it as ‘it’s completely over and we’re done for good,’ which is not the case, no doubt about that,” Fauci said. 

Instead, he interpreted the comment as a reference to the country’s improvement in case numbers and death rates over the last several months — that the worst is likely behind us. 

Fauci, who has been the subject of harsh criticism for his public messaging, chooses his words carefully, even with the promise of a brighter future ahead.

“I think it would be cavalier to all of the sudden say we’re through with [COVID],” he said. “Because remember, we were going in the right direction in the summer of 2021, and along came Delta. Then in the winter, along came Omicron. And since then, we’ve had sublineages of Omicron.” 

Especially as the winter months approach, Fauci said, precautions still need to be taken to reduce the chances of yet another spike. When asked about the precautions that he himself takes, Fauci explained that he still doesn’t go to indoor, sit-down dinners. He continues to attend receptions — noting that most of them are outdoors — without a mask on, but if he’s in an indoor setting “for a considerable period of time,” he keeps a mask on. 

A large portion of the conversation also reflected on the lessons that can be learned from mixed messages delivered by public health experts, including Fauci, during both the COVID pandemic and the more recent developments in monkeypox. 

“I have tried always to give the hard truth, but very often the hard truth is not heard under the circumstance under which it’s given,” Fauci said. He blames social media for the misrepresentation of public comments and the spread of misinformation for the overall lack of clarity that many have attributed to his and the CDC’s statements regarding COVID. 

Fauci said that if he could go back and do certain things differently, he would. If he had the choice, he would have tried to be much more careful during the early months of the pandemic in underlining the uncertainty of the situation we were going through. 

The major shortcoming the U.S. continues to face regarding the pandemic is the resistance to getting vaccinated and ultimately boosted for COVID, Fauci added. And when it comes to vaccines, he doesn’t see the message as polarizing. 

“People say [I’m a] polarizing figure,” Fauci said. “Well, when I say we should get vaccinated because it saves lives, and someone says no, am I the polarizing figure? Or is the person who is saying something that’s completely untrue creating the polarization?”