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‘Tis the Season to Be Cautious: Orthopedic Injuries Rise During the Holidays

By the Center for Bone & Joint Disease

The holidays are a time of joyous family gatherings, festive decorations and elaborate dinners. But it’s important to be extra careful while enjoying the most wonderful time of the year. While there is an increase in holiday cheer, there is also a sharp rise in injuries during the holiday season.

“While the holidays are an exciting time, they are also a peak time for orthopedic-related injuries,” says Craig Bennett, MD of The Center for Bone and Joint Disease in Hudson, Fla. “People often get caught up in the hectic nature of the season and focus less on safety while engaging in holiday-related activities.”

While holiday celebrations would not be complete without twinkling lights and tinsel-covered trees, some of the most common injuries are broken bones from falling while hanging these holiday decorations. According to the Centers for Disease Control in the United States, research estimates that 5,800 people per year visit the emergency rooms due to decorating-related falls. Most of these falls occur while hanging lights on the house or attempting to put decorations on the Christmas tree.

Other injuries are a little more unusual. Dropped frozen turkeys have caused crushed toes. Overzealous shoppers, especially on Black Friday, (the day after Thanksgiving in the United States) cause broken bones due to crowd rushes and even careless control of shopping carts. And slips and falls related to snow and ice cause injuries ranging from sprained ankles to head trauma.

Orthopedic injuries are not the only kind sending people to the emergency room. Fire-related injuries also top the list. According to the U.S. Fire Administration, fires occurring during the holiday season injure approximately 1,650 people per year. Tree lights, space heaters, fireplaces and candles must all be used with care.

Staying Safe This Season
Injuries, however, do not have to take the joy out of your holidays.

“With the proper precautions, people can have a safe, happy holiday season,” says Bennett, who offers some suggestions in order to keep you and your family safe.
 
“Always use a sturdy ladder while hanging lights and decorating trees,” Bennett says. “The arms of sofas may be more accessible, but they are also less safe.” He also advises to make sure the ladder is set on a flat, even surface, and not to use the top two rungs of the ladder or attempt to stretch beyond reach.

To prevent falls on icy surfaces, Bennett recommends wearing shoes appropriate for winter weather, if you are in a winter climate in the world. Wearing footwear with rubber soles creates better traction and is one of the easiest ways to prevent slipping.

“Most importantly,” Bennett says, “take a moment to breathe and enjoy the holiday season. The less rushed you are, the more you will focus on safety. A safe holiday season is a joyful one.”

About The Center for Bone and Joint Disease:
The Center for Bone and Joint Disease has been serving the Tampa Bay community in the United States for over 30 years. Dr. Norman Higgins opened the practice in 1973 and is still in surgical practice. The Center for Bone and Joint Disease’s physicians are all Board-Certified/Eligible in Orthopedics and have received specialized fellowship training in areas such as hand and spinal injuries. Visit www.centerforboneandjoint.com or call 727.697.2200 to learn more.

Clues and Cues for Your Holiday Blues

By Carol Kivler, MS, CSP

Tis the season to be jolly!  Or is it?  For many people, the holidays are anything but jolly.  Depression, loneliness and overwhelm can turn what is supposed to be an upbeat, joyous time of year into a dreadful period that some would rather skip completely.  The blues brought on by the holidays are as varied as ornaments on a tree.  If you experience dread thinking about the upcoming holiday season, it may help you to determine the biggest culprit, so that you take steps to alleviate the blues, even a little.  Here are some of the most common clues (or indications) of the holiday blues followed by the cues (or problem solving stimulus) to minimize the blues:

Unrealistic expectations

Clues – Many people struggle to live up to the glorious images that bombard us from every direction, including television, movie theaters, store windows, magazines and billboards.   A mild brainwashing occurs and we hypnotically buy in to the fact that without the perfect decorations, holiday attire, latest recipes, and trendy gift ideas, that we just don’t measure up.  We set ourselves up for failure, because it is the rare person that can achieve that state of perfection!

Cues – Limit your exposure to these images and remember that most of them are used to sell products more than to paint a realistic picture.  Set up realistic holiday goals that fulfill your holiday needs but don’t overwhelm you.  Remember “less is more” and for those around you, they won’t remember how wonderful you looked, how great you decorated, or how much you spent…but they will remember how you made them feel.

Financial pressure

Clues – There’s no doubt that an economy like this one will fill more seats on the “holiday blues bus”.  If you have had a recent financial setback, it can be especially difficult facing the fact that there is less money to spend on the holiday season then there was before.

Cues – Keep in mind that you are not alone.  Many people are in the same boat and spending far less on the holidays then they did in years past.  But the gift of “time” is far more valuable to the average person than a gift of monetary value, meaning this could turn out to be the most heartfelt holiday you’ve ever experienced.  Consider homemade gifts, photographs, meals or poetry.  How about giving someone on your list a scalp massage or organizing their kitchen cabinets?  These types of gifts are treasured more than your retailers want you to know!

Physical and emotional fatigue

Clues – Shopping, wrapping, baking, visiting; not to mention all the other things we normally do in a given day, can absolutely turn holiday joy into dread.  Add to the mix all the high calorie, low energy calories we consume over the holidays and it’s no wonder we feel exhausted!

Cues – Don’t overdo it and repeat after me, “Focus, Delegate, and Let Go”.  Focus on a few of the most important aspects of the holiday season, things you just can’t do without.  Delegate tasks to family members and friends; it makes them feel valued!  Let go of the rest, especially the unrealistic expectations and the need to provide everyone with a picture perfect holiday.   Don’t get caught up in the mad rush.  Your good health is the greatest gift you can give anyone. 

Strained family dynamics

Clues – The holidays seem to focus on the family unit more than anything else.  And if the family unit has changed through death, divorce, discord or disease, it can be especially devastating around the holiday. 

Cues – Just as families change, holiday get-togethers can too.  If family tension begins to rise to the surface, have tension-diffusers ready; a funny video, an interesting game that captures everyone’s attention, an article of clothing for everyone to put on (like a goofy hat, or a boa).  Consider having everyone bring an instrument along (there are always pots and spoons for those who don’t have an instruments, or keep a couple kazoos around).  Or consider asking everyone to bring their sneakers so that once the meal is over and before the tension has a chance to begin, everyone can take a walk together. 

Outdated traditions

Clues:  Financial situations change, families dynamics change, and trends change.  But traditions are an inherited, established pattern, and the fact is, they can be as uncomfortable as an ill fitting shoe! 

Cues:  There is no law against letting go of outdated traditions!  It may be time for you to ditch traditions that augment your blues, and create new traditions that better suit your personality.  Be bold and consider some of these ideas:  Take the family to a movie.  Visit a nursing home.  Go out dancing.  Volunteer at a soup kitchen.  Round up some people who celebrate alone and bring them to your house to mingle.  Go to the beach and play football in the sand.  Go on a vacation.  Visit a city battered by a hurricane and hug people.  Leave your environment for a few days.  Whatever it takes to keep your spirits up and keep your blues at bay.  

My traditional family unit changed through my own divorce several years ago.  Therefore our traditional holiday celebrations needed an overhaul.  With three children, their spouses, and five grandchildren   one of my favorite new traditions is building gingerbread houses with five sets of little fingers.  The dining room is covered with icing and crumbs and gummy candy and lots of love and laughter and lifelong memories.  What are your favorite moments? 

Carol Kivler, MS, CSP, is a passionate consumer advocate, speaker, author and the founder of Courageous Recovery. She speaks to consumers, their loved ones and healthcare professionals to raise awareness instill hope and combat stigma surrounding mental health diagnoses and treatments.   Carol is also the founder and president of Kivler Communications which provides executive coaching and customized workforce development training.   For more on Carol, visit her website at www.CourageousRecovery.com

Kansha: The Japanese Tradition of Giving Thanks

Recipes from KANSHA: Celebrating Japan’s Vegan and Vegetarian Traditions
by Elizabeth Andoh

Celebrating Japan’s Vegan and Vegetarian Traditions, Elizabeth Andoh invites us to practice kansha – appreciation for nature’s edible gifts and the efforts of those who prepare wholesome, handsome meals from that bounty. Kansha – in any culinary culture – compels us to reduce waste, conserve energy, and sustain natural resources.

Heaven-and-Earth Tempura Pancakes (Ten Chi Kaki Age)

The name of this dish, Heaven and Earth, is a euphemism for kitchen scraps, namely the tops (heaven) and bottoms (earth) of produce: tender, leafy celery tops; tougher leek tops; mushroom stems; carrot and daikon peels; stubby ends of lotus and burdock root, parsnips, rutabagas, and bitter melon. All sorts of neglected or remaindered vegetable bits can be transformed into lovely, lacy-crisp, colorful tempura pancakes.

The key to making tasty pancakes from disparate ingredients is to select items that cook at approximately the same temperature and time. Cut your vegetables so that most of them are long and thin and a few are in crescents or rounds to make it easier to form a cohesive mass. Dusting ingredients with cornstarch before adding them to the batter will also help the pancakes hold together.

When you are ready to form the pancakes, use a large, flat stainless-steel spoon or ladle to help shape them. Dipping the spoon or ladle into hot oil first will ensure easy release of the pancake as you slip it into the oil.

Another bit of advice: gaman, which translates as “reticence” or “reluctance.” Refraining from taking action is often considered a virtue in both the Japanese kitchen and Japanese society at large. My recipe instructs you not to take certain actions, though you may find it tough to follow such advice.

I provide two assorted-vegetable examples below, one using wintertime produce, the other showcasing summer’s bounty. At any time of year, use this recipe to guide you in creating your own heavenly pancake with earthy flavors. Serve with lemon or lime wedges and the three-pepper salt.

Makes 8 pancakes

Winter pancakes
1/2 red onion, cut into thin slices through the stem end to make crescent shapes (about 1/3 cup)
1 tablespoon cornstarch
Scant 1/3 cup julienne-cut carrot peels (1-inch strips; about 3 ounces)
Scant 1/3 cup julienne-cut Satsuma imo, yam, or sweet potato peels (1-inch strips; about 2-1/2 ounces)

Summer pancakes
3-ounce chunk bitter melon, cut in half lengthwise, seeds removed, very thinly sliced, salted with 1/4 teaspoon salt, and drained about 1/4 cup
1 tablespoon cornstarch
2 small zucchini, about 4 ounces total weight, tops trimmed, cut in half lengthwise, and then cut on the diagonal into thin slices, about 2/3 cup
Scant 1/3 cup julienne-cut kabocha squash peels (3/4-inch strips; about 3 ounces)
2 tablespoons finely shredded summer herbs such as fresh shiso leaves
4 or 5 fresh chives, cut into 1/2-inch lengths

Batter                                                                                     Condiments

Several ice cubes                                                                     1/4 teaspoon kosher salt
a generous pinch of kona-zanshō                                            1/3 cup cold water
a generous pinch of tōgarashi                                                 ¼ cup self-rising cake flour    
a generous pinch of freshly ground black pepper                   Vegetable oil
Lemon or lime wedges                                                            1 to 2 teaspoons sesame oil

Condiments
a generous pinch of kona-zanshō
a generous pinch of tōgarashi
a generous pinch of freshly ground black pepper
Lemon or lime wedges

Depending upon seasonal availability, choose to make either the winter pancakes or the summer pancakes: To make the winter pancakes, place the red onion in a bowl.

With a pastry brush, dust the slices thoroughly with some of the cornstarch. Pull gently to separate the crescent shapes, dusting again with a bit more cornstarch. Add the carrot and sweet potato peels to the bowl and dust with the remaining cornstarch. Toss to distribute the vegetables evenly.

To make the summer pancakes, with a pastry brush, dust the bitter melon slices thoroughly with some of the cornstarch, then place them in a bowl. Dust the zucchini slices and kabocha peels in a similar manner and add them to the bowl; toss to distribute evenly. Dust the shredded shiso leaves and chives with cornstarch and add them to the bowl; toss again to distribute evenly.

Make the batter just before frying: Place the ice cubes in a small bowl with half of the water. Sift the cake flour over the water and stir to mix slightly; there should still be lumps. If needed, add water, a few drops at a time, until the batter is the consistency of a thin pancake batter.

Pour the vegetable oil to a depth of 1-1/2 inches into a small wok or small, deep skillet, add the sesame oil, and heat slowly. Check the temperature with an unvarnished long wooden chopstick (or a bamboo skewer). Small bubbles will form around the tip when the oil is about 350°F.

Wait for about 45 seconds longer to allow the temperature to rise a bit more—to about 370°F—and then test the oil temperature with a few drops of batter. If they sink slightly, then rise to the surface and puff quickly but do not color, the oil is ready. You may need to fry the pancakes in batches to avoid crowding them in the pan. Preheat the oven to 200°F for keeping the cooked pancakes warm.

Spoon a bit of the batter over the cornstarch-dusted vegetables and toss lightly to coat the vegetables with the batter. Dip a large spoon or ladle into the hot oil. Place one-eighth of the vegetable mixture in the bowl of the oil-dipped spoon. Carefully tilt the spoon to slide the pancake into the hot oil, aiming to make a disk about 2 inches in diameter. The batter and cornstarch act as “glue” to keep the vegetable slivers together. Repeat to make more pancakes, being careful not to crowd the pan.

Most importantly, refrain from touching the pancakes for a full 30 seconds after you place them in the oil. It will seem like an eternity, but gaman will yield the best results. If wayward bits are strewn at the edges of your pan, carefully pick them up and place them on top of the still-moist pancake batter in the center. (Skill with long chopsticks will be well rewarded, though a long-handled fine-mesh skimmer can scoop beneath as well.) If the center of the pancake is very dry, dip the wayward bits in some fresh batter before “gluing” them in place. When the batter in the center of the disk seems barely moist, carefully invert the pancake.

After flipping, allow the pancakes to fry undisturbed for about 1 minute, or until crisp. Using cooking chopsticks or a skimmer, remove the pancakes from the oil and place them on a rack set over a baking sheet to drain. If frying in batches, place the baking sheet in the oven to keep the fried pancakes warm. Use the skimmer to clear the oil of batter bits between batches. When all of the pancakes are fried, transfer them to paper towels to absorb any additional surface oil.

To serve, line a plate or shallow bamboo basket with folded paper (the Japanese use ones called shikigami or kaishi that are oil-absorbent on one side and oil-repellant on the other). Paper doilies make an attractive alternative. Mix together the salt and 3 peppers in a small bowl. Arrange the pancakes on the folded paper and put the lemon wedges and the pepper mixture on the side.

HOW TO KEEP GIRLS OUT OF THE SEX TRADE

Impoverished women and girls in the developing world are the main targets of labor and sex traffickers, who typically promise girls lucrative job opportunities overseas.  “I knew migrating was dangerous, but my family was desperate,” says 19 year-old Rina Long, a scholarship recipient of Lotus Outreach’s Girls’ Access to Education (GATE) program in Cambodia. The rural girl was on the verge of taking a job as a domestic servant in Korea last year before Lotus Outreach intervened with a rice stipend, averting her family’s need for an extra salary. “I don’t even speak the language - anything could have happened to me and I wouldn’t have known how to get help.”

Cambodia’s crushing poverty and proximity to Thailand, the seat of a thriving sex industry, make it a trafficking hotspot. A girls’ scholarship program, GATE is designed to keep vulnerable young women living in high-risk areas out of the clutches of traffickers by empowering them through education.

Labor recruitment agencies play a critical role in facilitating Cambodia’s human trade. The US State Department estimates that the number of workers who migrated to Malaysia in 2009 tripled from the previous year.

Lotus Outreach has found that educating the most susceptible populations about the common ruses of traffickers, the dangers of migrating for work, and the benefit of keeping children in school and out of the labor force can be highly effective. Its programs reach potential victims before they suffer severe psychological trauma. This was the case with Rina Long, who was recruited by a labor agency based in Phnom Penh.  Her affiliation with the GATE program averted a risky and potentially disastrous migration.

In August of 2010, the GATE program marked a milestone: its first class of 62 low-income graduates joined the 2 percent of Cambodian women who finish high school.  Lotus Outreach asserts that many of these young women could otherwise easily have been absorbed by the human trade that now rivals the global illegal drug market in reach. With as many as 27 million victims worldwide, there are more slaves today than in four centuries of the trans-Atlantic African slave trade - when a slave cost the equivalent of $40,000. Today, the average price for a human being is $90. 

Lotus Outreach: Lotus Outreach is a 501(c) (3) dedicated to ensuring the education, health and safety of at-risk women and children in the developing world.  For more information and photos visit www.lotusoutreach.org/press.php