Health Matters: Sarasota 10.17.19 by The Observer Group Inc.

Health Matters Observer

OCTOBER 2019

GET TESTED Many maladies can now be treated if detected early. But how often do you need to get screened to catch them?

HARRY SAYER STAFF WRITER

outine preventative wellness visits should be just that: routine. Yet changing guidelines for screenings, such as

different opinions on when to start them or how often they should be done, and genetic history can make what should be a routine appointment a confusing and complicated task. For example, guidelines on cervical cancer screenings for women have changed from every year to once every three years to once every five years for some women. Or take mammograms, which screen for breast cancer. Although federal guidelines recommend women start having a mammogram at 50 years old, the American Cancer Society recommends starting at 45, and the American College of Radiology recommends 40. SEE PAGE 2

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HEALTH MATTERS

YourObserver.com

OCTOBER 2019

Prevention starts

with annual screenings CONTINUED FROM PAGE 1

If you have a history of breast cancer in your family, you might want to start even earlier or have a more complete scan, such as a 3D mammogram or an MRI. The dreaded colonoscopy to scan for colon and rectal cancer follows a similar pattern: Federal guidelines advise 50 years old; the ACS recommends starting at 45. So why are there different guidelines, and why do they keep changing? One theory, according to Dr. Steven Merandi, a breast imaging specialist at Sarasota Memorial Hospital, is the government guidelines, issued by the Centers for Disease Control and Prevention, might prioritize optimizing costs rather than outcomes. “Their recommendations are to start screenings at age 50, which is 10 years later, and then every other year,” Merandi said. “We believe it’s a movement to decrease the cost of Medicare providing some of these services. … When you cut the screenings in half, you cut the expenditures. We believe it may be influenced by politics and finances.” Changing guidelines means it’s important for patients to know the earliest recommended guidelines as well as their family history to ask for earlier screenings than the general population. Most preventative screenings have been

ASK ABOUT YOUR MENTAL HEALTH Biondolillo estimates around 20% of the visits to his emergency department are for mental health-related conditions. Florida is one of the worst states for mental health care and — though it seems obvious — it’s important to find treatment with a therapist or counselor when feeling low. It can help you in the long run.

developed because of a chance to change the outcome and allow patients to lead healthier lives. For example, although one in eight women get breast cancer, and 40,000 women die from it each year — it’s the No. 2 cause of death for women — it can be cured in most cases with early detection. “I like to think we’re in a 95-98% cure rate for breast cancer,” Merandi said. “But obviously, to get that cure rate, we have to find the cancer early, when it’s small and treatable.” Aside from cancer-specific screenings, routine wellness checks can help spot precursors, such as high body weight, diabetes, high cholesterol and high blood pressure, which lead to big-

ger problems long term. Dr. Frank Biondolillo, the medical director of the emergency department at Doctors Hospital of Sarasota ER, receives countless patients with pain and illness each week. He said high blood pressure is one of the biggest contributors to greater sickness, such as heart attacks, strokes and coronary artery disease. “A lot of these [problems] compound each other,” Biondolillo said. “[High blood pressure] runs in your family. Next thing you know, you have diabetes mellitus or high cholesterol.” It doesn’t help matters that patients sometimes don’t follow the instructions they’re given, by skipping medication, not following the right diet or failing to exercise and live healthy. The historical wisdom is that high blood pressure sets in around middle age — the blood vessels become more stiff, and pressure goes up — but Biondolillo said he has seen a worrying trend where much younger patients come in with blood pressure far worse than the desired 120 over 80. The best course of action — beyond living a healthy, active lifestyle — is to be aware of your family’s genetics and predisposition to high blood pressure and to come in for routine checkups. See the box (right) for basic screening guidelines.

PREVENTATIVE TESTS DEPENDING ON FAMILY HISTORY AND OTHER RISK FACTORS n Talk with your doctor annually about your alcohol and tobacco use, preventing Type 2 diabetes and testing for sexually transmitted infections. n Talk with your doctor at age 65+ about getting screened for lung cancer. n If you were born between 1945 and 1965, get tested at least once for Hepatitis C. REGULARLY n Get your cholesterol checked annually. n Get your blood pressure checked annually. n Get a seasonal flu vaccine. MALE 40 years old n Talk with your doctor about taking daily aspirin to help lower the risk of a heart attack. 50 years old n Get tested for colorectal cancer. 65 years old n Get a pneumonia vaccine. n If you have ever smoked tobacco, talk with your doctor about abdominal aortic

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FEMALE 40 years old n Get tested for cervical cancer with a Pap test every three years or an HPV test every five years. n Get a mammogram every two years. 50 years old n Get tested for colorectal cancer. n Ask your doctor if you need a bone density test. n Talk with your doctor about taking daily aspirin to help lower the risk of a heart attack. 65 years old n Get a pneumonia vaccine. n If you have ever smoked tobacco, talk with your doctor about abdominal aortic aneurysm. n Talk to your doctor about preventing falls with tactics like exercise, physical therapy and vitamin D supplements. n Get a bone density test. Source: CDC, ACS

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HEALTH MATTERS

YourObserver.com

OCTOBER 2019

Sarasota County Schools offers mobile mammography screenings More than 270 participated in the pilot program, which was at 18 district locations. BRYNN MECHEM STAFF WRITER

October is often the month that local teams roll out the pink uniforms in support of friends and family who are fighting or who have died from complications of breast cancer. Sarasota County Schools, however, is taking the fight off the gridiron and into the parking lot of every district building. After a successful pilot pro-

gram in the 2018-19 school year, the district is partnering with Tampa Bay Mobile Mammography to bring 3D screening to every female employee in the district. Tampa Bay Mobile Mammography is a traveling bus that provides mammographies. During the pilot program, the bus traveled to 18 school district sites, but this year, it will be at all districtowned properties. Sarasota County Schools’ wellness coordinator, Erin Singerman, said this service was important to bring to staff because one in every eight women in the U.S. will develop invasive breast cancer in her lifetime. By bringing the 3D tests to the parking lots, Singerman said the school district is eliminating a lot

Photo courtesy of Sarasota County Schools

Tampa Bay Mobile Mammography brings 3D screening straight to patients.

of barriers that would keep women from getting tested. “It allows teachers to not have to use as much of their own sick time, which is less time out of the classroom,” Singerman said. “It’s kind of a domino effect.” The school began the program because breast cancer is one of the district’s high-cost drivers, Risk Management Supervisor Lynn Peterson said. Annually, about 76% of the district’s employees get their annual mammogram, which is higher than the Florida Blue benchmark of 65%. “We gear a lot of our programs toward our high-cost drivers, so that we can help mitigate those claims,” Peterson said. “This program is really a win-win for everybody because if you can help someone detect something early, they can get it treated.” During the pilot year, 276 women were tested. This year, Singerman and Peterson hope to more than double that number. The program is free for all employees on the district’s health plan, and the results are sent directly to each person’s primary care doctor. Additionally, Tampa Bay Mobile Mammography offered to pay for a substitute teacher to move between classrooms while teachers are screened. Of the 13 schools in the pilot program, three utilized the substitute, so

Brynn Mechem

Sarasota County Schools Risk Management Supervisor Lynn Peterson and Wellness Coordinator Erin Singerman worked to bring mobile mammography to all district employees.

more teachers could be screened. “This program is just so convenient,” Peterson said. “We all get busy in our lives, and especially with teachers being in the classroom, it doesn’t always work for them to go during the week. So just to be able to get that done this way, it just adds that bit of convenience that will help encourage people to get it done.” Women can apply for the 10- to 15-minute appointments by visiting TampBayMobileMammography.com. If their results are clear, they receive a letter in the mail. If it was an abnormal screening, their doctor will follow up to set up a diagnostics test. Although Peterson and Singerman could not share the names of

employees who have participated in the program, they did say that they have had a great response so far. “I just had my mammogram done, and they were great,” read one email Singerman received. “It was my first one, and they made it quick and painless. I spoke with another teacher, and she said it was the best mammogram she’s ever had.” The district does not currently offer a comparable program for men, but Singerman said other screenings covered by district insurance, such as an annual physical or dermatology screening, check for issues in sugar levels, blood pressure or skin.

Hearing Aids: Myths & Facts Myth: Hearing aids are too noticeable. Fact: Miracle-Ear hearing aids are smaller and more

discreet than ever. Chances are, other people won’t know you’re wearing them. Untreated hearing loss is often more obvious than a hearing aid - especially if you frequently ask others to repeat themselves or you respond inappropriately in conversations.

Fact: Hearing aids are not a cure for hearing loss, but they can help you listen and talk with others. Wearing hearing aids improves quality of life by making everyday tasks more manageable, as well as by improving communication and increasing independence. Hearing aids can also help slow the progression of your hearing loss.

Myth: I can buy hearing aids online. Fact: You can find hearing aids online, but it is

hard to know if they are the right aids for you. It’s very important to work in person with a hearing professional during the purchase of your hearing aids. Only a qualified specialist will be able to make sure that your hearing is screened properly, that you choose the aid that is most appropriate for your needs, is fitted correctly and comfortably, and you receive the necessary follow-up care and support.

Myth: Hearing aids will sound too loud. Fact: Once upon a time, hearing aids amplified all

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HEALTH MATTERS

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OCTOBER 2019

SPLURGE VS. SAVE Organic produce can put a dent in your pocket and leave you wondering if the extra care is worth it. The Environmental Working Group, an activist group, did the work for you by looking at annual reports from the U.S. Department of Agriculture’s Pesticide Data Program and listed these 12 mustbuy-organic foods:

Eat seasonal in Sarasota Local restaurants and farms are trying to make seasonal eating easier. WHITNEY ELFSTROM STAFF WRITER

ommercial grocery stores are overflowing with yearround produce, which can create some confusion surrounding what fruits and vegetables are actually in season. Eating seasonally can be looked at in two ways, according to a 2013

study by Public Health Nutrition Research Group. Globally seasonal eating is when food purchased is in season elsewhere and shipped worldwide. Locally seasonal eating is when food is grown and purchased in the consumer’s region. Although globally seasonal eating can create diverse daily meals, it contributes to a higher environmental cost, the study stated. Whereas locally seasonal eating can aid in a more sustainable diet. Seasonality also affects how nutrients are absorbed by the body. Local produce is picked when it’s ripe, which leaves fruits

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and vegetables to reach maximum nutrients levels that would otherwise decrease significantly when shipped from farther locations. After produce is harvested, vitamin C decreases rapidly and continues during storage, according to a 2007 University of California study. Vegetables stored at 39 degrees for a week can lose up to 77% of their vitamin C, depending on the type of vegetable. A 2005 Penn State University study found that spinach, for example, left in a refrigerator, such as a refrigerated truck or

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produce box, for eight days at 39 degrees has the ability to lose 37% of its folate, a B vitamin needed to make DNA and other genetic material. Honeyside Farms, known for its strawberries, is in its ninth season and recently moved from the Sarasota area to Parrish. Honeyside President Tiffany Bailey said that compared to a commercial grocery store, the farm’s strawberries are always picked at peak ripeness. “You’re not ever going to see any white [on our straw-

berries],” Bailey said. “Not only is that the best-tasting [strawberry] but also the most nutrient-dense. That’s when it’s intended to eat, not when [a strawberry is] half white.” Honeyside Farms delivers fresh produce twice a week to the restaurants it partners with. Rather than calling its customers after crops are ready, Bailey said she sits down with chefs to inform them of what they plan to grow in the upcoming season. Unlike northern states, where the growing season is from late April to early October, Honeyside begins its field prep work in July and harvests through the first week of June. Steve Phelps, the owner and chef of Indigenous Sarasota, is no stranger to watching what foods are in season. A Florida transplant from Cleveland, Phelps said living “in a place where seasons truly change” taught him that when the temperature changes, it’s time for a new menu. Relying on a seasonal menu was a no-brainer for Phelps, who opened Indigenous Sarasota in 2011. Each season he sits down with local farmers to see what the crops look like, and from there he crafts his upcoming menu. “Everything that we put on these plates, we do it for it your body and for your knowledge,” he said. “Not only would we like you to know the name of the captain who caught your fish, but you can actually go meet the farmer who made your salad on Saturday if you go to the [Sarasota Farmers Market].”

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OCTOBER 2019

A PLACE TO STRENGTHEN YOUR PHYSICAL, EMOTIONAL AND FINANCIAL HEALTH.

Pam Eubanks

Adept Audiology’s Lyndsey Nalu said hearing occurs in the brain, which is why it is important to treat hearing loss early.

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Hearing: It’s in your brain

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efore Ed Ogiba went deaf, his hearing became garbled. He would be at an outing, such as a party or business meeting, with plenty of chatter and background noise. He may have nodded as if he’d heard the conversation, but his facial expressions gave him away. They’d asked if he’d heard them, and he’d respond, “I heard you, but I didn’t understand you.” “Most people think the solution is turning up the volume,” said Ogiba, a spokesman for the Hearing Loss Association of Sarasota. “That’s not what you need. You hear most of the words. All it takes is not understanding one word to throw off understanding.” He said hearing dulls with time.

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According to the Center for Hearing and Communication, a nonprofit that provides health care for people with hearing loss and auditory challenges, one in three people over the age of 65 have hearing loss, and two in three people over the age of 75 have hearing loss. When you hear a sound, that sound travels into the ear, begins to vibrate the eardrum and then travels into the cochlea (the inner ear), where tiny hair cells amplify the sound and send that information to the brain. “It’s in the brain [where] we actually hear,” said audiologist Dr. Lyndsey Nalu, of Adept Audiology in Sarasota. “It’s the brain that processes that information. Your brain atrophies, and that affects how clearly you process speech.”

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WHAT CAN I DO ABOUT IT?

Ogiba has learned to read lips and has taken advantage of other techniques to help improve his hearing and conversations. He said those soft skills have improved his hearing by 40%. He said navigating which hearing device or tools to use can be overwhelming, but audiologists and organizations including Hearing Loss Association are there to help. Nalu said there are plenty of options to help. The first step,

however, is getting your hearing checked by an audiologist each year. Such exams should start around age 60, or earlier if you suspect hearing loss. She said Medicare even covers the exam. “You’ve got to think of hearing loss as preventative,” Nalu said. The base test checks your reaction to low- and high-pitched sounds and checks how well you understand words. Typically, the high-frequency loss — sounds with “S,” “T” or “P” — comes first and makes sounds more garbled, Nalu said. If your hearing loss becomes significant enough, a hearing aid might be helpful. Nalu said hearing aids have advanced, and there are hundreds of styles available. Nalu said that although many people worry about looking “old” or the hearing aids being noticeable, most of the devices are now discreet. “What’s more noticeable, your hearing aid or your hearing loss?” Nalu said. The cost of hearing aids typically ranges from $2,000 to $6,000, but that does include service on the equipment for the life of the hearing aid. A cochlear implant, which is a replacement of the entire cochlea, works best when hearing aids become ineffective. Ogiba and Nalu said individuals can help preserve the hearing they have and help keep it longer simply by being aware of volume. If it’s at 85 decibels or more, you are at risk for damage to your ears. Nalu recommends wearing earplugs in loud situations and avoiding exposure to loud noise when possible. If you use headphones, ensure the volume is low enough to hear outside conversations, and limit loud noises to 30 minutes.

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Nalu said hearing loss is inevitable as you age because hair cells begin to deteriorate; that means some sounds no longer get to the brain, which is then no longer being stimulated. That’s why taking care of hearing loss early is so important, Nalu said. As hearing loss increases, the brain must work harder to interpret the sounds it receives and will begin creating neurological pathways to parts of the brain normally used for other functions, such as memory. The longer that atrophy occurs, the less likely it can be corrected. “Once it’s gone, it’s typically gone,” Nalu said. Hearing aids — not sound amplifiers — help the brain reroute those neurological connections, so the sound goes to the proper part of the brain again. Many people with hearing loss experience symptoms of fatigue and memory loss because other parts of the brain are strained. They also tend to become more isolated because understanding conversations is difficult. “It affects us emotionally,” Ogiba said. “Helen Keller (explained) it best — with blindness, you lose things. With hearing loss, you lose people.”

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HEALTH MATTERS

YourObserver.com

OCTOBER 2019

Taking care

For high school students, athletic trainers are more than medical professionals.

RYAN KOHN SPORTS REPORTER

ikayla Owen had no idea what she was walking into when she accepted an athletic training job with Manatee County this year. Fresh out of graduate school at the University of South Florida, which included training stints with USF Athletics and the Pittsburgh Pirates, the 24-year-old was assigned to Braden River High, where she is now the school’s athletic trainer. Things at this level are more hectic than she anticipated, but she said she wouldn’t trade it for anything. Turns out, she was walking into a family. “The relationship-building is the best part,” Owen said. “Communicating with the athletes and having them trust me with their injuries while being able to joke around with them.” Every day, Owen and her nine student helpers — who receive extracurricular credit for their time — take care of Pirates athletes. Afternoons are hectic. On average, upwards of 30 athletes from all sports fill the training room at the moment the endof-day bell rings and require anything from taped ankles to “cupping” therapy on their backs to relieve pain. Owen is qualified to do it all, even helping kids go through physical therapy for more long-term injuries. Her student trainers can’t do all that, legally, but they help with filling water containers and placing bandages

Photos by Ryan Kohn

Cardinal Mooney athletic trainer Steven Favia and student trainer Tiffany Thompson give senior Andres Linares assistance.

on kids who receive cuts. They also act as an extension of Owen’s eyes. Owen said she couldn’t do the job without them. Despite her expertise, the transition to high school hasn’t been the easiest thing for Owen. At first, she said, a handful of athletes didn’t show her respect because she is a woman; they would talk down to her and ignore her advice. The interactions caused her to report the action to the athlete’s coaches, and since doing so, the interactions between her and those athletes has been better. With everyone else, it has always been great. Owen has a speaker in the training room for students to play music. She wants them to be at ease, she said. When

everyone else is having fun, Owen is having fun. She never knows what will come through the training room door — or happen during a game — on any given day. That sense of the unknown keeps things fresh, she said. Over at Sarasota’s Cardinal Mooney High, athletic trainer Steven Favia, who works directly for the private school, has been doing this since 2012. For the first five years, it was more or less a solo gig. Last year he had the idea to add student trainers on a volunteer basis. It went so well that this year, Favia and the school turned it into a full-fledged class. There are levels to the class that act like security agencies’ clearance levels: The more you know,

the more you can do. Students gradually climb levels when they demonstrate mastery of the material, either on or off the field, Favia said. Cougars senior Tiffany Thomas has been with the program since 2018. Thomas said she has learned a lot since then, most recently how to take off a football player’s helmet without moving their head or neck — plus the importance of doing so. Favia said he didn’t know what to expect when he started the program, but it has turned into something he talks about with pride. Taking the bus to an away game with his 14 students singing Justin Bieber songs around him: It’s something he thought he would hate, he said, but he loves it, and his students love him. “Steve gives us his all every day,” Thomas said. “If you are having a bad day, this [program] will turn it into a good day.” Favia said he wants his students getting as much real-world experience as possible. The seniors in his class will soon take a trip to observe a surgery in progress and report back to the class on what the specific injury was, what the rehab process will be like and how to prevent those injuries in the future, among other things. It’s not the easiest class, and Favia is still learning how to be a teacher, but he made sure to instill the biggest lesson he learned himself early and often. “If [the athletes] know you love them, they will love you back,” Favia said.

COMMON SIGHTS Braden River athletic trainer Mikayla Owen said the Pirates have been plagued by concussions lately, but not just in football — volleyball, too. When that happens, Owen walks athletes through the six stages of return-to-field protocol: symptom limited activity, light aerobic exercise, sport-specific exercise, noncontact training, full-contact practice and then a return to full activity. Generally, each step should take at least 24 hours to complete. Through it all, the athletes must not show concussion symptoms. If they do, they have to start back at step one. At Cardinal Mooney, athletic trainer Steven Favia said his athletes have had a rash of meniscus injuries in 2019. Every year, a different injury becomes “popular,” he said. Sometimes there are things athletes can do to prevent such things — including modifying their technique in the weight rooms — and other times, they are simply random occurrences you deal with as best as you can when they happen. The meniscus injuries fall into the latter category.

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t’s sort of like baby food or fruit gummies: easy to eat and packed full of nutrients. Except this type of mushy and gooey food, known in brands Gu, Honey Stinger and Gatorade, is for athletes going the distance while carrying as little as possible. It’s another way to try to unlock a better performance, used by athletes who climb mountains, run ultramarathons or bike for miles. If you’ve ever tried to go for a run on a less-than-ideally full stomach and felt like trying super hard but not going as far as you’d like — congratulations! You bonked. This describes a wall you “bonk” against when undernourished during a hard workout. It’s different from being merely tired, and you know it when you feel it. “It’s where your glycogen stores have completely been depleted,” said Frankie Ruiz, the race director for the Sarasota First Watch Half Marathon. Energy gels and goos can give you a boost when you haven’t eaten much and need a quick jolt

to the system. When exercising, a lot of your blood is directed to your working muscles and not to your stomach or digestive system, according to Paul Kriegler, nutritional products development manager at Life Time Fitness. So although a banana has what an endurance athlete would need, the fibers and effort to eat solid food makes a soft goo or chew the more efficient fuel source. Enter the adult baby food. These energy goos and chews contain electrolytes, simple carbs and sugar and are easy to eat and digest for distance athletes to boost their bodies back to peak performance by depositing vital nutrients into the system. These products are typically for those going the distance, such as cyclists and runners, Ruiz said. Strength-based workouts, however, focus on intermittent bursts of strength. Just eat healthy, and you shouldn’t need to suck down a Gu during your session. Eating well before a long, sustained workout decreases the possibility of bonking significantly — and you might not even need to turn to energy gels, Kriegler wrote in an email. Generally, a well-fed person has enough nutrients stored up for activities shorter than 90 minutes. In a morning race, gels also help along the course (in addition to a

What you can safely consume before, during and after heavy exercise depends on your body and the number of calories you burn. Visit CaloriesBurnedHQ.com to find out what you’re burning.

nutritious, familiar breakfast). “If you know the activity will last more than 90 minutes and neglect to consume something to delay the bonk, you’ll end up feeling weak, fatigued and otherwise exhausted and hungry in the immediate time frame,” Kriegler wrote. “Later on, you may feel sore or broken down longer during the recovery phase.” If you’re concerned that the gooey stuff will mess with your stomach, just keep an eye out for ingredients you already know give you problems. The fewer ingredients in a gel, the better, Ruiz said. And let’s not forget hydration. Energy gels should be followed by a swig of water and definitely not a sports drink, Ruiz said. This way, you avoid bloating by capping the carbs you’re taking in at what the gel had to offer, and the water will help the gel dissolve and work into your system properly. “Small amounts of fluid every 15-20 minutes during intense activities of any type can help delay fatigue or help with temperature regulation and nutrient circulation to the working muscles,” Kriegler wrote. If you’re in an endurance race, don’t wait until the aid station to try your first gel. Introducing anything new could mess with your stomach — and your finish time.

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CYCLING n The average-weight woman over 60 will burn about 539 calories per hour of cycling. n She can consume 53-159 calories in an hour, or one to four GU gels. n The average-weight man over 60 will burn 628 calories in per hour. n He can consume 62-186 calories within that hour ride, or two to four GU gels.

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RUNNING n Women over 60 weigh an average 167 pounds. For an hour-long run, she will burn 779 calories. n She can consume 77-226 calories during that hour. One GU gel is 40 calories, so eat two to six. n Men over 60 weight an average 195 pounds. For an hour-long run, he will burn 910 calories. n He can safely consume 90-180 calories during his run, or two to seven GU gels.

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GENERAL n You can safely consume 1030% of what you burn while exercising. n Aim to drink half an ounce of water per pound of body weight, plus an additional 16-20 ounces per hour of exercise. n The main energy source during intense activity is glucose. The more sugar consumed during activity, the less fat burned. n Electrolytes including sodium, magnesium, potassium and calcium are also important during long, intense exercise.

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HEALTH MATTERS

YourObserver.com

OCTOBER 2019

LIFESTYLE RX

Helping you live the life you want, the way you want.

E-cigs: The newest fad is hurting teens school classes. Juul’s market share is somewhere in the 70% range, which demonstrates its popularity. Its other enticements include tooty-fruity flavors, such as creme brulee, along with an alarming amount of nicotine — one flavor cartridge contains as much nicotine as an entire pack of cigarettes.

“You have given us the true gift of

KRISTINE NICKEL

peace of mind,

aping is the act of inhaling and exhaling the vapor that is produced by an electronic cigarette or a similar device. The term is used because e-cigarettes do not produce tobacco smoke but rather an aerosol, which looks like a vapor but actually consists of fine particles, thus the term “vaping.”

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over her.”

WHAT ARE THESE DEVICES?

E-cigarettes were introduced in the U.S. about 10 years ago. They actually resemble a smoked cigarette. The evolution of the concept brought vaping pens — which look like a fountain pen — into the market, where were then follwed by “mods,” or modifications of vaping pens, customized by the user.

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WHAT ABOUT JUULS?

This device is small, is sleek and uncannily resembles a flash drive. That design makes it easy to hide and unquestionably alluring for teens who vape their way through middle and high

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Most devices have a mouthpiece and a heating device powered by a battery that heats the substance into the aerosol then inhaled into the lungs. The substance, known as the e-liquid, usually has a base of propylene glycol or a glycerin-based liquid with nicotine, flavorings and other chemicals, such as THC, the chemical that produces the high in marijuana. E-cigarettes and other vaping devices do not contain tobacco. ARE THEY ADDICTIVE?

Nicotine is the king of addictive substances — especially when delivered by inhaling it into the lungs, which releases it into the blood, thus allowing it to go to the brain, where it releases brain chemicals called neurotransmitters that regulate our moods and behaviors. One of those, dopamine, goes to our brain’s “reward center,” which makes us feel oh so good. Bingo, we want more and more. Ergo addiction.

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