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iStock/ThinkstockBY: DR. JOHANNA KREAFLE

(NEW YORK) -- Thanksgiving is only a week away, and with more than 46 million turkeys landing on 46 million dining room tables, there’s a lot of room for food preparation mistakes. If you have questions about preparing turkey, the U.S. Department of Agriculture has put together some handy tips for preventing your celebration from becoming a food poisoning disaster. Here they are.

How far in advance can I buy a turkey?

You can buy a frozen turkey anytime, even a year in advance. A turkey will keep its top quality for a full year in the freezer.

But be sure to thaw the turkey properly before you’re ready to cook it. Keep it in the fridge — one with a thermometer — at a safe temperature of 40 degrees Fahrenheit or slightly lower. Allow it to thaw one day for every five pounds of its weight, and then give it an extra day or two after that. So, if it’s a 15-pound turkey, allow four to five days for it to thaw. After it’s thawed, it’s safe for another two days.

If you prefer a fresh turkey, be sure to buy it no more than two days before you plan to cook it.

What are the most important steps before preparing the turkey and other dishes?

Hand washing and clean preparation and cooking spaces are two of the most important steps. A study from the USDA showed that people fail to properly clean their hands 97 percent of the time before and during meals.

The same study also found that more than 80 percent of people inadvertently contaminate other food they’re serving. This usually happens when germs from the raw turkey aren’t properly washed off a person’s hands and are able to reach other surfaces, such as soap dispensers, cutting boards and spice containers.

When you wash your hands, continuously scrub them with soap for at least 20 seconds, and remember to get between the fingers and under the nails. This will help you to avoid spreading bacteria that can increase the risk of foodborne illness.

How do I properly prepare the turkey for the oven?

After washing your hands, it’s time to prepare your turkey for cooking in the oven. Keep raw turkey separated from all other foods at all times and use separate cutting boards, plates, and utensils when handling the raw turkey.

Even if your mother did it this way, do not wash the turkey, since the splashing can get bacteria onto the aforementioned kitchen surfaces and prep materials.

Once you’re done prepping, place the turkey in the oven — recommendations from the USDA for safe cooking can be found here, but the main thing to remember is that bacteria that cause foodborne illnesses are completely killed by heat, so you should cook the turkey fully.

How do I know if my turkey is cooked properly before serving it?

Buy a food thermometer if you don’t already have one. Test the turkey in three spots to make sure the internal temperature is at least 165 degrees: the thickest part of the breast, the innermost part of the thigh and the innermost part of the wing.

How do I properly store the leftovers?

Place leftovers in the refrigerator within two hours of the meal; this will prevent bacteria from growing on the food. It’s best to place the leftovers in shallow containers — this reduces the cooling time and therefore the amount of time that the food spends at unsafe temperatures (between 40 and 140 degrees).

If you stuff your turkey, always remove the stuffing and store it separately from the meat. Leftovers are good for three to four days in the refrigerator, so if you don’t think you’ll eat them until the Tuesday after Thanksgiving or later, place them in the freezer.

Dr. Johanna Kreafle is an emergency medicine physician at the Carolinas Medical Center in Charlotte, North Carolina, and a member of the ABC News Medical Unit.


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ABC News(NEW YORK) -- Cameron Underwood was 24 years old when the course of his life changed forever, resulting in his undergoing a state-of-the-art face transplant procedure. Through this extensive surgery, Underwood's face is now connected to the face of another young adult who was able to give him a second chance at life.

Underwood, the son of a California pastor, told ABC News’ Amy Robach in an interview for "20/20" that he still has the face he was born with from the cheekbones up, but almost everything below that belongs to the donor -- a 23-year-old aspiring New York filmmaker and writer named Will Fisher.

But when he looks at himself now, "I see me," he said.

Underwood grew up in a close-knit family, grounded in its faith. His grandfather founded the United Pentecostal Church in the Northern California agricultural community of Yuba City.

"Faith is the essence of everything in our family," Underwood's older sister Julie Jones said. "Without that foundation, I think this journey would've been a lot more difficult."

Underwood’s mother, Bev Bailey-Potter said her greatest joy is her children – Julie, Aaron, Brad and her youngest, Cam.

"They were just so close and I always took pride in that." Bailey-Potter said, and Cam "was just easy. He was always quiet, a little on the shy side... but just a wonderful spirit about him... easy going."

She said he was "just a handsome boy," and "His smile would light up his face and it was so evident in his eyes."

Underwood had just started his career working in his stepfather’s business of heavy equipment repair. With that money, he was able to buy his own house at the age of 19. Hunting was also a family pastime.

“We’re really an outdoors family,” his father Randy Underwood said. “He [Cam] grew up on the lake… He was just a natural athlete, he was good, he enjoyed it.”

Even with everything going for him, his mom said the bright light that always shone in his eyes began to fade.

"You know, I have a clear memory in my mind," Bailey-Potter said. "I saw him walk across the parking lot... and he just looked so sad and empty. I just thought... what is he going through? Is he unhappy?"

The family says Underwood became a workaholic and was pushing himself too hard. He began struggling with depression, they said, but kept this to himself, rarely expressing his emotions. After Underwood went through a breakup, his brother Aaron Underwood remembered, "He started going out more... and you know, partying a little more at that time."

Over the next few years, Underwood’s family said he and his closest friend and brothers drifted apart – the friend started a family and his older brothers started new jobs and moved out-of-state. His struggle with alcohol was apparent, but less obvious to his family, they said, was Underwood’s underlying depression. It was a shock to them when Underwood not-so-subtly hinted one day that he was thinking of taking his own life.

"I thought well, you know, he’s just going through a rough time... we all do," his mother said.

His family decided to remove all of the guns in his home. But there was one they couldn’t get to: Underwood had put a shotgun in his safe.

On a Sunday night in June 2016, Underwood’s uncle Lonnie said he received a text from his nephew asking him to come over and stay the night.

"I got to his house and all the lights were on, which I expected," Lonnie said. "Door was unlocked, I walked in... nobody in the living room."

Lonnie walked into the bedroom and into a nightmare. He saw blood everywhere, and Underwood staggering against the wall.

"I think that is probably the point where I went into shock," Lonnie said.

Underwood had placed the shotgun under his chin and fired, in an attempt to take his own life. He was immediately rushed to a nearby hospital.

At the hospital, "They told us he had … no teeth, no chin, no cheekbones, no facial structure… nothing," Randy Underwood said.

"It really wasn’t a face... it was pretty horrific," Aaron Underwood added.

Underwood was transferred to University of California-Davis Medical Center, where renowned plastic surgeon Dr Lee L.Q. Pu implanted 12 titanium plates to keep what was left of his shattered skull intact.

Underwood survived the ordeal but underwent eight surgeries to restore the bare minimum function to his face. To cover his face, doctors used skin from his thigh and tissue from his shoulder. His nose was lost in the blast and he only had a tiny hole to breathe through. Even then, the results from his surgeries were difficult to endure.

"What kind of quality of life would he have?" Bailey-Potter wondered. "If he didn’t want to live with all that he had going for him, then why would he want to continue on now?"

"I cried every day for a year... every single day," she continued.

Randy Underwood said, "I would’ve changed places with him any day. I would’ve taken his pain any day, but I couldn’t."

It was six months before Underwood could leave the hospital – even then, he wore a mask wherever he went.

"I would see people stare at him and he would notice that," Randy Underwood said. "The worst part was the little kids... stare at him and hang onto mom and dad because he looked so pitiful."

But then Dr. Pu suggested that a face transplant might be possible and could give him a chance at a better life.

Coincidentally, Bailey-Potter found herself at the checkout counter of her local grocery, thumbing through a magazine that highlighted the story of firefighter Patrick Hardison.

Hardison was a fireman in Mississippi who was horribly burned trying to rescue a woman from her burning home. His face was so badly burned that his fellow firemen didn’t know it was him at first when they got to him.

Hardison survived -- but his scalp, ears, nose, eyelids and lips were gone.

Hardison underwent multiple surgeries to try to repair his face. He suffered years in isolation, hiding himself as much as possible from the outside world. Then he met Dr. Eduardo Rodriguez, a renown reconstructive surgeon who is the chair of NYU Langone Health's Hansjörg Wyss Department of Plastic Surgery in New York.

In 2015, Dr. Rodriguez agreed to perform what was at the time the most extensive face transplant ever done.

The operation took 26 hours and replaced Hardison’s entire face and scalp with skin, tissue and nerves of a donor. Since his surgery, Hardison, whose story was also profiled by ABC News' “Nightline,” has had a better quality of life.

So Underwood’s mother thought Dr. Rodriguez might be able to help her son as well.

"I decided I that I would go ahead and on my own, you know... send an email to Dr. Rodriguez," Bailey-Potter said.

"Cam’s mom sent me an email. Her story was very moving," Rodriguez said. "Looking at him with that injury, right away, I knew there was no way this kid, I could ever make him normal with conventional surgery."

Because Underwood’s brain wasn’t affected in the blast, Dr. Rodriguez’s thought he could be a potential candidate to be his third face transplant patient.

Each face transplant surgery is incredibly complicated and has its own particular, unique challenges in every case. The procedure costs over $1 million and though that’s usually paid for by a grant, Rodriguez said "everybody was worried" about the possibility that Underwood could try to end his life again after the transplant.

So, Rodriguez went up to Yuba City, California, to meet Underwood and his family in person and discuss the risks and concerns, including Underwood’s struggle with depression and his attempted suicide.

But according to Rodriguez, “I think these individuals all deserve a second chance … we shouldn’t give up on them.”

“I don’t think anybody knew it was a test per se,” Aaron Underwood said. “I think we did understand that… he had to be sure that their investment in Cameron was secure, that he was not the kind of patient that would take this amazing miraculous gift and throw it away.”

Rodriguez said this was something that they only offer to select individuals.

"And we have to be sure we have chosen the right person,” he continued. “I need to know that I have a fighter on my hands... and this person’s willing to do whatever it takes to have this operation be successful."

"We want to hear that we’re going to get this fixed and we’re moving on with our life, but it’s not that simple,” Rodriguez added “There could be serious complications from something like this. It’s very important that people understand the severity of undergoing this operation."

For starters, a face transplant means a lifetime of treatments with harsh side effects to prevent rejection – and doctors say they just don’t know enough yet to predict survival beyond 10 years.

Bailey-Potter said, "it did" give her pause, "but it was Cam’s decision to make."

"That was hard to swallow... but I would rather have 10 years of great life than 100 years of miserable life," Aaron Underwood said.

By the end of the visit, both doctor and patient were on board.

“Being accepted into this program is very much like winning the lottery,” Rodriguez said. “But instead of $500 million… Cameron wins a second chance at life.”

But "the most difficult part," Rodriguez said, was still ahead – the search for a perfect donor: "It’s like a needle in a haystack."

It was about seven months after Rodriguez accepted Underwood as a patient that a donor became available. It was a young man who had registered with New York state to be an organ donor, as well as signed up with the non-profit organ and tissue donation service, LiveOnNY.

But Dr. Rodriguez, who rushed from NYU Langone to another hospital in New York where the donor was, said the request for a face donation is a very special one – handled with the utmost sensitivity: "That’s asked at a separate time... a separate consent." After speaking with the donor’s mother, she consented to the request.

Miraculously, the donor had all the prerequisites to be a match for Underwood – skin tone, hair color, skull size plus a matching blood type. Rodriguez said the match felt "absolutely" fated to be.

A team of more than 100 medical staff worked in side-by-side operating rooms at NYU Langone to complete the transplant.

Doctors removed the lower portion of the donor’s face, preserving the muscles, tissues and blood vessels -- eventually taking his teeth, along with the bones that make up his cheeks, nose, chin and jaw.

The damaged portions of Underwood’s face were also surgically removed. This preparation alone took more than 12 hours – the actual facial reconstruction would take just as long.

"Often people think it’s just like putting on a mask... it’s not that simple," Rodriguez said. "The face needs to fit like a puzzle -- and that’s a tricky thing because we hit the point of no return."

Rodriguez started the actual transplantation by aligning the bones perfectly. Once they were connected, he moved on to the painstaking work of attaching muscles, nerves and blood vessels.

"We prayed for those doctors through the night," Bailey-Potter said. "They were pulling an all-nighter. None of them were leaving."

"I had prayed for that miracle every day for a year.... and my son had a nose, he had a mouth, he had teeth," Bailey-Potter said. "It was just a happy moment."

Underwood reflected on the first time he saw himself after the transplant: "Wow... that was breathtaking. And I was just blown away, relieved... and excited all at the same time."

Ten months later, he can breathe through his new mouth and nose – and smile.

"I can smile, I’m working on closing my lips all the way, they don’t close all the way... but they’re getting there," Underwood said. "They’re a lot better than they were."

Part of the recovery has been extensive dental work – and he says one of the biggest things he missed was "being able to actually eat."

"Just to let it sit in your mouth and taste it," he said. "All those little things that we take for granted that you know, you miss and you want back."

Underwood, now 26, said over the last year it’s been a lot of work to teach himself "how to talk again with a new mouth and new teeth and lips": "It’s just like a baby learning to talk."

"I have a strong son, and I’m grateful for that," Randy Underwood said. "He’s got a lot of tenacity, and he’s got a lot of determination... he’s going to come out of this."

Months after Underwood’s surgery, Dr. Rodriguez arranged for Underwood to meet his donor’s mother for the first time. “20/20” was there and captured the emotional meeting.

Back home, Underwood has been able to get other pieces of his old life back – playing golf, even skydiving. Though as great as getting back into his life is, he admits there are still tough days.

"Occasionally, it’s not a daily fight anymore... but yeah, there are still days when I am depressed," Underwood said.

His mother said they wanted to share his story to “give someone else hope” and show that “This ailment of depression it’s treatable.”

But he says he knows to ask for help now when he needs it – whether that means at church or at home.

“I just want people to know that it can happen, you know? That if you’re in the same kind of situation that I was in… there’s people out there that can help you and will. You just have to reach out,” Cam Underwood said.

He added that he was "very grateful" to have a full life ahead of him. His goal from here, he said, is "that I can get back to work... and you know, eventually I want a family and kids... you know, the American dream."

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iStock/Thinkstock(NEW YORK) -- Type 1 diabetes is one of the most common, chronic conditions in the U.S. -- the seventh leading cause of death and the top leading cause of kidney failure, lower limb amputation and adult-onset blindness.

Almost 30.3 million Americans suffer from diabetes and of those, 1.25 million have type 1 diabetes (T1DM).

The Egyptians discovered symptoms of diabetes in 1552 and life-saving insulin has been around in syringe form since 1949.

Type 1 diabetes is an autoimmune condition, where the pancreas is destroyed and can’t make any insulin to help process sugar and carbohydrates. In type 2 diabetes (T2DM), either the pancreas is not making enough insulin, or the body has become resistant and needs more insulin to process sugar.

Both types are still difficult disorders to control physically as well as emotionally, and there is no cure.

Yet in the past decades, there has been a rapid acceleration of new research and technology to help to make the lives of people with diabetes easier to manage.

Insulin pumps


Patients with type 1 or type 2 insulin-dependent diabetes need the medication insulin to regulate their blood sugar. It can only be administered with a needle, and needs to be delivered into the body throughout the day. This can mean an average of four to six injections a day in the thigh or abdomen, which can be difficult to manage in busy, everyday life.

But, insulin pumps are devices that can help provide continuous insulin without requiring multiple injections throughout the day. There is a small controller device that can clip on to clothing, connected with tubing to a thin plastic tube under the skin. It provides a constant rate of insulin -- called a basel rate -- over 24 hours, to keep blood sugars in range when a person is not eating or overnight.

When patients eat, they can enter into the pump how much they’re going to eat, what their blood sugar level is, and administer additional insulin to cover the meal.

Newer insulin pump algorithms can even calculate when the blood sugar is trending lower, and automatically reduce the amount of delivered basal insulin.

Using an insulin pump takes training. A person needs to check their finger stick glucose frequently, input any carbohydrates they are going to eat, and learn to understand the different alerts that can pop up on the device. The pump is not permanent, and the insertion site does need to be replaced every few days. The freedom from injections that an insulin pump offers is quite significant. Studies have shown that use of pumps results in improved average glucose values (called hemoglobin A1cs) over 3 months, as well as fewer episodes of dangerous hypoglycemia, or low blood sugar.

People can decide when they want to eat, and how much they want to eat, with tighter control of how much insulin they administer to themselves.

CGMs


The other half of diabetes technology focuses on monitoring blood sugars. Normally, a person would prick their finger and use a machine called a glucometer to measure the blood sugar.

For someone with T1DM, this could mean pricking themselves between 4 and 20 times a day -- including before each meal and before bedtime. Most people check more frequently: before snacks, after they eat, when they feel their blood sugar is off, and sometimes in the middle of the night.

Not only is this painful and disruptive, but finger sticks generally only provide a snapshot of glucose at a specific point in time. They do not provide glucose level trends (falling lower, climbing higher, or staying stable), or an accurate representation of how much time someone spends in a normal glucose range.

Enter continuous blood glucose monitors, CGMs for short. These are devices, first created in 2006, that can be attached to the body with a small sensor under the skin to measure glucose levels as frequently as every 5 minutes, 24 hours a day, for up to 10 days (depending on the device).

Some can notify the wearer if their glucose level is too high or too low, or even if it’s heading in that direction, allowing them more control over their diabetes management. Many devices connect to smartphones, and can be shared with loved ones, so that they can help keep an eye out of dangerous glucose situations.

The CGM sensor needs to be replaced every few days.

There’s another option called a flash glucose monitor that can be worn for up to 14 days, and provide a glucose reading when the wearer scans over it. It doesn’t provide a constant stream of data, which can more desirable and less stressful.

What about the “artificial pancreas”?


People suffering from T1DM have a pancreas that has completely stopped making insulin. A potential solution may be an artificial pancreas. This promising technology would take the need for carb-counting, finger-sticking and manual entry of data out of the hands of the user -- the device could do all of that.

Certain insulin pumps can communicate wirelessly with CGMs, and even have an algorithm that automatically adjusts the basal insulin rate depending on the trend of glucose from the CGM. We are still not yet at the point of

Still, a completely hands-off T1DM management remains elusive, at least for now.

These “hybrid closed-loop” systems still require user input for when and what they are going to eat, and do not have glucagon, which is a hormone made in the pancreas that helps to raise blood sugar if needed.

A Boston medical technology company called Beta Bionics is conducting research devoted to developing “the world’s first fully autonomous bionic pancreas”, according to a press release from earlier this year.

The firm has created the iLet Bionic Pancreas System, which is a “dual-chamber, autonomous, infusion pump that mimics a biological pancreas”, including both insulin and glucagon, and communicates with a CGM.

Utilizing a machine-learning algorithm, the system will autonomously calculate and dose insulin and/or glucagon as needed, without requiring blousing or input from the user. This summer, they received Food and Drug Administration (FDA) approval to begin clinical testing in a home setting of adults and children with T1DM. The company aims to finalize the design in 2019, and potentially launch their first product in 2020.

Can I get a new pancreas?


Technology is not for everyone, and sometimes people wonder if it would be easier to just get a new pancreas. Not everyone can qualify for a pancreas transplant: currently it is only considered in people with serious complications of diabetes, such as end stage renal disease, or frequent severe low or high blood sugars.

A full pancreas transplant is often done along with a kidney transplant in someone with both diabetes and end stage renal disease. It is a major abdominal surgery, and comes with the risks of such an extensive procedure.

After the transplant, they will need to be on lifelong medications to suppress their immune system to avoid rejection of the new organ. Even after a successful surgery, rejection can still occur days to years after the surgery in up to 30 percent of people.

The goal of transplant is to allow people with T1DM the opportunity to no longer be dependent on insulin, and decrease complications from having diabetes over their lifetime. For those who have been able to get a pancreas transplant, most were able to stay off of insulin, maintain normal glucose levels, and avoid hypoglycemia for many years. Some studies show improvement for up to 15 years!

A promising, less-invasive alternative is currently being developed: islet cell transplant.

What is an islet cell transplant?


Islet cell transplant is a minimally-invasive procedure that replaces specific cells of the pancreas that are destroyed by the autoimmune process in a person with T1DM.

With the gradual destruction over time, “it becomes more and more difficult to control the lability in glucose levels, [which] leads to unstable glycemic control”, according to Dr Michael Rickels, the medical director for Pancreatic Islet Cell Transplantation Program at the Hospital of the University of Pennsylvania.

They can develop hypoglycemia, or low blood sugar, “which can be severe, resulting in coma, seizure, [or] loss of consciousness that can be life threatening or even result in death.”

The program at the Hospital of the University of Pennsylvania started in 2000, with the goal that islet cell transplant “can provide both insulin and glucagon secretion to maintain near normal levels of glycemia, [in an] appropriately regulated manner.”

Insulin production should turn off when it’s supposed to, and glucagon can be made by the transplanted cells to prevent low blood sugars, or hypoglycemia.

The islet cells are collected from a deceased donor pancreas, purified, and delivered via a noninvasive procedure into the liver of the patient with T1DM.

After a few weeks, the islet cells grow a blood supply and can start to make their own insulin and glucagon hormones.

In 2004, Hospital of the University of Pennsylvania was named one of five NIH-sponsored centers to proceed with transplantation as part of an FDA registered clinical trial.

From 2008 to 2012, they successfully transplanted 11 individuals with T1DM and severe, frequent hypoglycemia. Of those, seven were able to stop insulin after the first transplant, and the remaining 4 were able to stop insulin after a second transplant.

More than half have remained off insulin for five or more years; the first transplant patient has been insulin-free for 10 years. One person did develop a recurrence of autoimmune diabetes, and three have required low doses of insulin, but not to the level of what they had previously required, and without hypoglycemia.

After transplant, the recipient does need to be on lifelong, low dose immunosuppression to prevent both rejection of the transplanted islet cells and potential autoimmune destruction from the T1DM antibodies.

Islet cell transplant has great potential for long term insulin independence, and Rickels’ team is currently pursuing the biologic licensure process with the FDA, in hopes of having this available for patients with T1DM and severe hypoglycemia.

“Patients tell us they feel like they’ve been cured,” he said.

“For patients having the hardest time with T1DM, and who have become extremely debilitated by glycemic lability and frequent, severe hypoglycemia, this therapy has been life-changing and really transformative. To hear ... what they’ve been able to accomplish in their lives, from what they never thought they could do before, has been the most incredible part of this.”

Type 1 and type 2 diabetes affect millions of people, and the science and technology required to make their lives better is making incremental improvements.

All medical devices and insulin requires prescriptions and since each person with diabetes is a unique case a discussion with medical professionals is appropriate.

But for those who suffer from diabetes, the potential to make their lives better and longer can’t come soon enough.

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iStock/Thinkstock(WASHINGTON) -- The Food and Drug Administration announced Thursday it will pursue a ban on menthol cigarettes and take new steps to keep youth from using flavored e-cigarette devices.

FDA Commissioner Scott Gottlieb has publically highlighted what he described as an “epidemic” of addiction.

“The actions #FDA announced today are a response to our deep concern over the epidemic growth in kids use of e-cigarettes,” Gottlieb said in a tweet.

THREAD: The actions #FDA announced today are a response to our deep concern over the epidemic growth in kids use of e-cigarettes. The data released by the #CDC shows a trend in use that simply cannot stand. We must reverse this trajectory of youth use and addiction....

— Scott Gottlieb, M.D. (@SGottliebFDA) November 15, 2018

The announcement comes with a new report which finds more than three million high school students use e-cigarettes. That’s up 20 percent since 2011.

At the same time, the number of middle school students using the nicotine products shot up by almost a factor of 10 to more than half a million using the devices in 2018, according to the Centers for Disease Control.

“The data released by the #CDC shows a trend in use that simply cannot stand,” Gottlieb tweeted. “We must reverse this trajectory of youth use and addiction.”

The U.S. Department of Health and Human Services identified the growing trend in 2016 and called e-cigarettes dangerous for young people.

Juul, a leading e-cigarette maker, tried to preempt additional regulation this week when the company announced it would rein in sales of flavored vaping devices popular with younger consumers, including mango, creme and cucumber.

The company rolled out what it calls an age verification system to help ensure only adults are purchasing the flavors online.

In the summer of 2018, the FDA used undercover investigators to crack down on more than 1,300 retailers illegally selling e-cigarettes like those made by Juul. It was the largest enforcement action of its kind in the agency’s history.

Last month, the FDA raided the San Francisco headquarters of Juul Labs, looking for documents related to the company's marketing practices. The federal regulator had been investigating whether Juul violated the law by targeting minors through its advertising and flavored products.

The new regulations come on the same day the FDA promotes its anti-smoking campaign which it calls the “Great American Smokeout.” The use of e-cigarettes has been left out of their primary list of tobacco-free alternatives promoted to help adults quit.

Gottlieb has continued to highlight the need for regulating e-cigs while acknowledging their use as a way of getting adult smokers to quit.

“I won’t allow policy accommodation we take to promote innovation to come at the expense of an epidemic of use of tobacco products by children,” Gottlieb said in a tweet. “We are now witnessing that epidemic.”

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Ramin Talaie/Getty Images(SAN FRANCISCO) -- The 5-year-old leukemia patient who captivated the world five years ago today with his wish to be Batkid for a day is now a 10-year-old cancer survivor who loves playing little league and helping on his family’s farm.

The Make-A-Wish Foundation, the non-profit organization that granted Miles Scott's dream by turning San Francisco into Gotham, posted an update on Miles on the fifth anniversary of his wish.

“Now 10 years old and in fifth grade, Miles loves science and robotics,” the organization said in the update on its website. “After fighting his own heroic battle with leukemia since he was a year old, Miles visits his oncologist once a year, and has been in remission from leukemia for the past five years.”

On Nov. 15, 2013, Miles was cheered on in San Francisco by thousands of people who turned out to support him as he helped solve a crime to save the city.

Miles' day as Batkid included rescuing a damsel in distress tied up across the Hyde Street cable car line and capturing the Riddler in the act of robbing a downtown vault.

As Batkid ate his lunch, he got a message from the police chief alerting him the villainous Penguin was kidnapping famous San Francisco Giants mascot Lou Seal and Batkid rushed to the rescue. His last stop was City Hall, where the mayor and police chief thanked him and presented him with a key to the city as thousands of supporters cheered him on.

The wish for Miles drew even the attention of then-President Barack Obama who issued his first ever Vine on Twitter congratulating Miles.

It also put a huge spotlight on the Make-a-Wish Foundation, a national organization that grants the wishes of children with progressive, life-limiting or life-threatening medical conditions.

“We saw an increase in offers of help across all areas, including donations, volunteers, referrals and other services,” Make-A-Wish said of the impact of Miles’ wish. “In fact, the volume of traffic on our servers caused our system-wide websites to go down for several hours on the day of his wish.”

Miles' wish was turned into a documentary, Batkid Begins, that took an inside look at the 2013 Make-A-Wish event. Proceeds from the documentary, which premiered at the 2015 Sundance Film Festival, went to the Batkid Fund, a charity started by Miles' parents, Natalie and Nick, after his Make-A-Wish day.

A recent study found that participation in the Make-A-Wish program may give children better quality of life and reduce hospital visits and health care costs.

Patients who received a wish were 2.5 times more likely to have fewer unplanned hospital admissions and 1.9 times more likely to have fewer unplanned emergency department visits compared to patients who would also quality for a wish but did not receive one, the study from the Nationwide Children’s Hospital in Columbus, Ohio, found.

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ABC News(NEW YORK) -- Winnie Harlow is making history as the first model with vitiligo to walk in the Victoria's Secret Fashion Show.

"[It] blows my mind," Harlow told ABC News' Good Morning America co-anchor Robin Roberts. "I can't even believe it...I'm a trailblazer."

The 24-year-old model sat down with Roberts for her new digital series, "Thriver Thursday," and shared how she's overcome challenges as a fashion model despite her skin condition.

Vitiligo is an autoimmune disorder that causes depigmentation of the skin, according to the Mayo Clinic.

Harlow recalled how some classmates avoided her because of her skin.

"One day they were running away from me during recess and I caught up with them -- I was like, 'Why are you running from me?' and they're like, 'Our parents say not to play with you because we're going to get your skin,'" Harlow said. "That was the first time I actually heard it and I was like, 'Whoa.'"

Now, for the first time ever, Harlow will be seen walking the runway at the high profile Victoria's Secret Fashion Show when it airs on ABC on Dec. 2.

But Harlow said her story and her mission are so much bigger than vitiligo.

"It's actually insane to me by just being yourself the things that you can achieve," she said. "I'm going to be the first model with vitiligo walking for Victoria's Secret. It's a door-opening for everyone. We are all the same because we're all different."

Harlow went on, "So people always ask me what would you like to say to little girls with vitiligo. It's bigger than that...it's those little girls with vitiligo, it's that little girl who didn't like her hair, it's that little girl who had freckles, it's that little boy who got teased because his lips were too big. It's everything."

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iStock/ThinkstockBY: BECKY WORLEY

Becky Worley, a technology correspondent for ABC News and "Good Morning America," has been covering technology since 1998. She's also a mom living in Oakland, California, and, in this article, tackles screen time limits and apps that help parents.

(NEW YORK) -- Parents, we have a dilemma: you want to be able to communicate with your kids but you don’t want to fight with your kids all the time about overusing a smartphone.

Manufacturers are realizing that some consumers actually want less from their phones and are coming out with new flip/feature phones with enhanced communication tools, long battery lives and durable designs.

Here are our top 10 reasons to get a flip phone instead of a smartphone for your child:

1. Communications and safety are the reasons most parents get a child their first phone. Flip phones are outstanding for making phone calls and while the numeric texting is laborious, simple logistics can be accomplished this way.

2. Your child will not get sucked into the vortex of games, social media and group-chat apps.

3. They are cheap -- many start at $25 for the phone. Manufacturers like Nokia, LG and Kyocera, are the predominate manufacturers of flip phones (technically they are called feature phones because many of them don’t flip).

4. You don’t need an expensive data plan. Basic phone plans can be as little as $15 a month for talk and texting. These plans can be found on alternate carriers like Republic Wireless or Tracfone or add a prepaid line from your existing carrier.

5. Battery life. Some of the phones can keep a battery charge for a week.

6. They are almost indestructible. Shattering a screen on a feature phone is a lot harder than on a smartphone.

7. Less texting pics. Because the screens are smaller and the cameras are lower resolution, texting pictures is less appealing.

8. Basic app access. Newer phones like the Nokia 8110 can work with basic apps from the KaiOS app store. The two apps that get my attention are the Google Voice speech-to-text-app that could help dictating texts and the Google Maps directions app. (Note: Even basic feature phones without these apps have browser access so in a pinch you could search for directions through the internet).

9. GPS-tracking. Flip phones can be GPS-tracked via add-on family mapping features from some carriers.

10. Peace of mind. You can communicate with your child but you don’t have to open the Pandora’s box of a device we adults are having trouble handling responsibly.

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iStock/ThinkstockBY: DR. JOHANNA KREAFLE

(NEW YORK) -- Public health and regulatory officials are under pressure to identify the turkey brands linked to the recent salmonella outbreak.

According to the Centers for Disease Control and Prevention, the outbreak started in November 2017. As of Nov. 5, 2018, 164 people in 35 states have been infected. Sixty-three people have been hospitalized and one person in California has died. The states most affected include Texas, Minnesota, Illinois and New York.

Consumer Reports on Wednesday called on the USDA to list the brands associated with the drug-resistant strain of salmonella with Thanksgiving about a week away.

“The USDA should immediately make public which turkey producers, suppliers, and brands are involved in this outbreak — especially with Thanksgiving right around the corner,” Jean Halloran, director of Food Policy Initiatives for Consumer Reports, said in a statement. “This information could save lives and help ensure consumers take the precautions needed to prevent anyone in their home from getting sick.”

Salmonella infection can cause symptoms of what is commonly referred to as “food poisoning.” Symptoms include fever, stomach aches and diarrhea which typically develop within 12 to 72 hours after being exposed to the bacteria. Most people recover within four to seven days without treatment. Sometimes the illness can be so severe that people need to be hospitalized; this could be for severe diarrhea leading to dehydration, or if the infection spreads from the intestines to the bloodstream and other places in the body. People at higher risk for severe illness are children under the age of 5, adults over the age of 65 and people with weakened immune systems.

The stain of salmonella causing the outbreak has been found in samples from live turkeys, raw turkey products and turkey pet food in Minnesota, the CDC said. It has also been identified in samples of raw turkey products from slaughterhouses and meat processors.

"The salmonella strain isolated from these samples is closely related genetically to the salmonella stain from ill people," the CDC said.

The CDC is not advising consumers to avoid eating properly cooked turkey products or that retailers stop selling raw turkey products. It recommends handling raw turkey carefully, including washing your hands before and after preparing or eating turkey. Counters, cutting boards and utensils should also be thoroughly washed to prevent the spreading of germs from raw turkey to food preparation areas. Cooking raw turkey thoroughly (to an internal temperature of 165°F, measured by placing a thermometer in the thickest part of the food) will help prevent food poisoning. Feeding raw meat to pets is also discouraged.

Johanna Kreafle, M.D. is an emergency medicine physician at the Carolinas Medical Center in Charlotte, North Carolina, and a member of the ABC News Medical Unit.

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iStock/Thinkstock(SAN FRANCISCO) -- Phil Powell was more than 163 miles from the massive blaze burning in Northern California and about 350 miles from one ravaging the southern part of the state, yet he and scores of other people walking around San Francisco this week were wearing masks to protect their lungs from smoky conditions.

"I can feel it in my throat and a lot of people have said they've had headaches," Powell told ABC station KGO-TV in San Francisco, adding that he had plenty of N95 industrial masks left over from the fires that ravaged Northern Californa's Wine County in Napa and Sonoma counties in October 2017.

Cities throughout California that are far from the flames of the Woolsey Fire in the south and the Camp Fire in the north, the deadliest and most destructive in state history, are feeling the effects of the smoke, officials said.

On Wednesday morning, Health and Human Services Secretary Alex Azar declared a public health emergency in California due to the wildfires.

"We are working closely with state health authorities and monitoring the needs of healthcare facilities to provide whatever they may need to save lives and protect health," Azar said in a statement. "This declaration will help ensure that Americans who are threatened by these dangerous wildfires and who rely on Medicare, Medicaid, and the Children's Health Insurance Program have continuous access to the care they need."

Azar noted that at least two hospitals and eight healthcare facilities close to the fire zones have been forced to evacuate. Azar also warned that smoke from the fires can present "a significant health threat" for people with asthma and other lung conditions.

Numerous school districts, some nearly 200 miles from the Camp Fire, including those in Santa Rosa, canceled classes for again on Wednesday due to bad air and smoke conditions.

The University of California Davis, which is about 100 miles from the Camp Fire, also called off classes on Tuesday "due to poor air quality as a result of the Butte County fires." University officials, according to a statement, decided to resume classes on Wednesday but canceled all outdoor activities after consulting with health and fire experts monitoring air quality.

The school was also handing out protective masks to students and staff.

"Unfortunately, smoke from the fire continues to blanket all nine counties of the Bay Area, which is why we have called the mandatory Winter Spare the Air Alert through Friday," Jack Broadbent, executive officer of the Bay Area Air District, said in a statement referring to the advisory for people not to use their fireplaces and to carpool or take public transportation to cut down on air pollution.

"Any additional smoke from Bay Area chimneys could push the region into an even higher unhealthy air quality level, which puts us all in jeopardy," Broadbent said.

The Woosley and Camp fires both started on Thursday and quickly spread, destroying more than 7,000 home and burning more than 345 square miles of land combined. The larger fire, Camp Fire, caused 42 deaths and is now ranked and the deadliest and most destructive in state history.

AirNow.gov, a state website that charts air quality throughout California, showed numerous cities far from the fires experiencing unhealthy air quality.

According to the AirNow chart, good air quality is anything under a reading of 50, meaning air pollution is causing little effect. Moderate air quality is a reading of 50 to 100, while bad air quality is any measurement of 100 to 200 and anything higher is considered very unhealthy or hazardous.

Oakland, which is more than 160 miles from the Camp Fire, had a reading of 164 on Tuesday, while San Francisco had a reading of 167.

Oxnard in Ventura County, which is about 30 miles of the epicenter of Woolsey Fire, had the worst air in the state outside the fire zone Tuesday with a hazardous reading of 392 while Gridley, about 30 miles from the Camp Fire, had a reading hazardous reading of 250.

"I've lived in the Bay Area for over 35 years and except for the Oakland Hills fires and Napa fires, I can't remember consistent smoke like this," Troy Blanchard of Oakland told KGO.

On Monday and Tuesday, the Golden Gate Bridge in San Franciso was clouded in smoke. Over Sunday, fans attending the Oakland Raiders football game not only sported the home team's silver and black colors, many also donned protective masks.

"It feels eerie and worrisome and the sun looks really funny and the moon as well," Beth Gorelick of San Francisco told KGO. "I feel really bad for the people in Paradise."

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iStock/Thinkstock(NEW YORK) -- Officials are now investigating 252 cases of possible acute flaccid myelitis (AFM), including 90 confirmed cases in 27 states, according to the Centers for Disease Control and Prevention.

The number of cases under investigation by the CDC is up 33 from last week, and the number of confirmed cases rose by 10, Dr. Nancy Messonnier, the director of CDC’s National Center for Immunization and Respiratory Diseases, told reporters Tuesday.

Acute flaccid myelitis is a condition that has polio-like symptoms such as partial paralysis. The virus mostly affects children and young adults.

The CDC said it does not know why the condition is impacting these individuals, but many believe it is caused by viruses. The CDC emphasized it remains a rare condition and said there have been no reported deaths from AFM so far in 2018.

The typical symptoms of AFM are similar to those of a severe respiratory illness, along with a fever, but then progress into neurological symptoms. Some patients with AFM feel weakness in their arms or legs, a loss of muscle tone or slower reflexes. Some patients may also exhibit facial droop or weakness, difficulty moving their eyes and drooping eyelids or difficulty with swallowing or slurred speech. The most severe symptom is respiratory failure.

Messonnier said the CDC doesn't yet have enough information to definitively say what causes AFM and are casting a wide net for information. Part of that is studying the long-term health of AFM patients. Scientists are also looking for a pathogen in AFM patients' spinal fluid, but haven't yet found a pathogen that's a clear cause, she said.

The CDC said it sees an uptick in AFM cases every two years, and so far, the curve of the cases being investigated this year looks very similar to that of 2014 and 2016. Officials don't expect many more cases in 2018 compared to 2016 and 2014, Messonnier said.

The best advice available is to wash your hands regularly, which lowers the chances of getting sick or spreading germs from many of the viruses linked to AFM, and protect against mosquito bites by using repellent, in addition to staying indoors at dusk and dawn.

The CDC said the vaccines your pediatrician suggests are very effective and children should continue to receive them on schedule even though there is no vaccine for AFM.

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iStock/Thinkstock(EL PASO, Texas) -- A woman who traveled to Mexico to receive plastic surgery suffered brain damage from the anesthesia used in the procedure, her family told ABC's El Paso, Texas affiliate KVIA-TV.

Dallas resident Laura Avila, 36, was supposed to go into surgery for a rhinoplasty on the morning of Oct. 30 in Juarez, Mexico, her sister, Angie Avila, told KVIA. But the surgery was pushed to noon because surgeons flying in from Guadalajara were running late, Angie Avila said.

Laura Avila's fiance, Enrique Cruz, was not permitted to see her when he returned to the facility around 4 p.m., although he'd been told the surgery would only take four hours, he told the station.

Once Cruz finally spoke to doctors, they told him that the director of a nearby hospital came in and saw her, saying, "We need an ambulance right away."

Her family later learned that she had suffered complications from the injection of anesthesia, Angie Avila said.

Although the anesthetic was injected into Laura Avila's spine, it traveled to her brain, and she suffered severe brain damage, Angie Avila said doctors told her. In addition, she suffered from a heart attack and deprivation of oxygen, Angie Avila said.

Laura Avila spent four days in a Mexican hospital before she was transferred to the University Medical Center in El Paso. Her condition has not improved much, her family said.

"She's been in a bed. She hasn't moved," Angie Avila said. "She's opened her eyes, and there have been small movements, but she has a glazed look in her eyes. Doctors don't believe she can see us. You know, she's physically here, but not mentally here."

Investigators for the Mexican state of Chihuahua have searched the facility where Laura Avila received the surgery, KVIA reported. Authorities are looking into whether medical negligence played a role in the complications she suffered.

Laura Avila's family is now juggling the difficult decision on whether to remove her from life support, as doctors said "there's really nothing else they can do for her," Angie Avila said.

"We cry every single day and I think, right now, we're just shocked and don't want to believe it's true, you know," Angie Avila said. "She is the person I love the most on this earth, she's a second mom to me."

Cruz, who has been with Laura Avila for more than 10 years, said the pair were "married by God."

"No matter what happens I want her to know I have a special place my heart (for her)," he said.

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Community Hospital North(INDIANAPOLIS) -- A pay it forward chain that began with two nurses in an Indianapolis neo-natal intensive care unit has allowed a mother of three battling breast cancer to feed her 10-month-old daughter breast milk.

The chain started when Katie Hanover, 29, a NICU nurse at Community Hospital North, gave birth last November nearly five weeks early.

Hanover’s daughter, Maggie, spent six days in the same NICU where she works.

Hanover’s coworker, Abby Black, who had her daughter Vivian just one month earlier, volunteered to donate her breast milk to Hanover.

"Just working in the NICU I’ve been educated on the importance and value of human breast milk," Black said. "It was something I had more than enough of, so it was an easy decision to make."

Once Hanover was able to breastfeed Maggie herself, she had a big enough supply that she too started donating her breast milk.

When a lactation consultant at the hospital told Hanover about Kata Carter, a mother who was facing breast cancer, Hanover jumped at the chance to donate her breast milk to Carter.

"I knew that feeling and knew I wanted to pay it forward," she said. "I was like, 'Absolutely. In a heartbeat.'"

Carter, 34, also of Indianapolis, was diagnosed in March with stage 3B inflammatory breast cancer, a rare subtype of the disease. She noticed a lump in one breast while breastfeeding her youngest daughter, Rosie, then just 3 months old.

"It was pure shock," she said of the diagnosis. "I had run through what seemed like every scenario of what [the lump] could have been in my mind and cancer was not one of them."

Carter said she was breastfeeding Rosie in her doctor’s office when she received the cancer diagnosis. She had to stop breastfeeding almost immediately and began the first of six rounds of chemotherapy just a week later.

"I got all of the information at once, the cancer, the type and that I had to stop breastfeeding," she recalled. "The thing that struck me immediately was the breastfeeding. I was devastated."

Carter, a dietitian, received support from a group of graduate school friends who knew how much she wanted to breastfeed Rosie. One of them, who lives out of the country, connected her to Hanover.

“We met in person the very first time she donated to me and she brought probably 600 or 800 ounces,” Carter said of Hanover. “Katie knew the feeling of not being able to breast feed her daughter so I think that connects us a lot.”

In the months since that first donation, Hanover has donated hundreds of more ounces of breast milk to Carter, including some from Black, her fellow NICU nurse.

Carter said the donations have been a "huge relief" as she has faced a mastectomy and radiation in addition to the six rounds of chemotherapy.

"They took that off my plate," Carter said of her concerns about not being able to breastfeed Rosie. "To take that worry away was enormous."

Hanover’s and Black's donations also started another chain reaction of breast milk donations to Carter from friends and strangers alike.

Carter estimates she has received thousands of ounces of donated breast milk over the past seven months. One group of friends got together to purchase and install a deep freezer in Carter’s home to store all of the milk.

“It’s not really anything I can express in words,” Carter said of her gratitude. “I know that if I were able to I would return the favor in a heartbeat. It’s one of the most precious gifts I’ve ever received.”

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iStock/ThinkstockBY: DR. JOHANNA KREAFLE

A recent study from the Nationwide Children’s Hospital in Columbus, Ohio shows that participation in the Make-A-Wish program may give children better quality of life and reduce hospital visits and healthcare costs.

Patients who received a wish were 2.5 times more likely to have fewer unplanned hospital admissions and 1.9 times more likely to have fewer unplanned emergency department visits compared to patients of similar age, gender, disease category, and disease complexity who would also quality for a wish but did not receive one.

What is the Make-A-Wish Foundation?

The Make-A-Wish Foundation is a non-profit organization whose goal is to provide children aged three to 17-years-old who have progressive, life-limiting, or life-threatening medical conditions, with experiences known as “wishes.” These wishes include “I wish to…” “go,” “be (someone for a day),” “meet,” and “have” (i.e. receive gifts.) The foundation is funded by contributions from individual donors, corporations, and other organizations.

What are the goals and mission of the Make-A-Wish Foundation?

The Make-A-Wish Foundation “serves a unique, and vital, role in helping strengthen and empower children battling illnesses.” And, “wishes make life better for kids with critical illnesses.”

How many “wishes” does the foundation grant?

The Make-A-Wish Foundation was founded in November 1980 and the first wish was granted in the spring of 1981 to Frank “Bopsy” Salazar, a 7-year-old who had leukemia. Bopsy had three wishes: to be a fireman, go to Disneyland, and ride in a hot air balloon -- all of which were granted to him. Since then, more than 285,000 children in the United States and its territories have benefited from experiencing their wishes. The foundation granted 15,300 wishes last year alone; which means on average, a wish is granted every 34 minutes.

There is a long-held belief that receiving a wish improves a child’s quality of life and potentially improves their family’s quality of life, enhances family bonding, reduces stress, increases hope and serves as a distraction from illness.

But recent research done at Nationwide Children’s Hospital shows it may do a lot more than that. This study showed that patients who received a wish were 2.5 times more likely to have fewer unplanned hospital admissions and 1.9 times more likely to have fewer unplanned emergency department visits compared to patients of similar age, gender, disease category, and disease complexity who would also quality for a wish but did not receive one. (The study's author, Dr. Anup Patel, is a member of the Medical Advisory Council for the non-profit Make-A-Wish Foundation. A list of all board members can be found here.)

And, a higher percentage of "wish kids" achieved a decrease in healthcare costs after their wish was granted, compared to those children who did not receive a wish over the same period of time -- this savings was even after the cost of the wish was factored in.

Johanna Kreafle, M.D. is an emergency medicine physician at the Carolinas Medical Center in Charlotte, North Carolina, and a member of the ABC News Medical Unit.

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iStock/Thinkstock(NEW YORK) -- It's happened to every parent on the planet at least once and perhaps many more times: your kid is in a stage 3, Defcon 1, the-wheels-have-completely-come-off meltdown.

They're screaming. You're sweating. You're looking for every. possible. way. to distract, distract, distract so they will calm. down.

It's not working. But what if you just . . . did nothing?

The Train Analogy


Katie McLaughlin, a blogger and mom of two, wrote about the train analogy in 2017 on her site Pick Any Two.

"The moment I published the post, the response was overwhelming," she told Good Morning America.

"I couldn't keep up with all the comments and shares. It obviously resonated with other parents who were struggling to help their children manage their big emotions."

It goes like this, according to McLaughlin: "Difficult feelings are tunnels, and we are trains traveling through them. We have to move all the way through the darkness to get to the -- you knew this was coming! -- calm, peaceful light at the end of the tunnel."

Now apply this to your child. That's what McLaughlin did when her four-year-old had temporarily lost his beloved tiger lovey blanket named Glenn. A broken heart and a full meltdown ensued.

"So often when our kids are struggling with a difficult feeling -- sadness, anger, fear, embarrassment, loneliness, guilt -- we try to logic them out of it," she wrote in her post. "We explain why they’re overreacting, or how WE know it will turn out just fine in the end."

"We’re trying to help our children, of course, but if we peel back the layers a bit, I think we’ll find that what we’re really doing is trying to make OURSELVES feel better," she said. "Because our children’s pain hurts US so deeply, makes US so acutely uncomfortable."

So instead of telling her son he would be fine, McLaughlin simply sat beside him and did nothing.

"I just sat next to him as the ripples of anger melted into shaking and sobbing," she wrote. "When I thought it was OK to do so, I started rubbing his back -- still without speaking. He kept crying and crying and crying. He cried and he cried and he cried."


"Until he wasn’t crying anymore."

"Until, from his vantage point -- splayed out on the floor -- he caught a glimpse of a nearby book about world-record-holding dogs, pulled it over, and started paging through it. As if nothing had happened at all."

"I peeked at the clock," she said. "It had been eight minutes."

"I decided speaking would be OK now, so I asked my son if he wanted to make a plan," she said. "I told him I knew that bedtime tonight would be extra tough, but maybe we could think of some ideas together to help him through it."

"Had I suggested such a thing two minutes prior, he would have EXPLODED," she said. "But because I waited until his train was through this tunnel, it was fine."

"Without any additional prompting from me, my 4-year-old chose two different stuffed animals to sleep with that night, then asked if we could read two extra books before bed to help make the evening more special," she said.

"Later, as I kissed him goodnight and he turned onto his side to fall asleep, he said peacefully, 'I’m going to be OK tonight.'”

Andrew D. Wittman, Ph.D., author of the book Seven Secrets of Resilience for Parents, told GMA that "because of how much we care about our child, we are tempted to immediately look for ways to solve their problem and shield them from any perceived suffering.

"This actually shields the child from learning how to process and deal with the situation," Wittman said. "We tend to fix the problem instead of teaching and coaching the child through the cognitive steps of finding a workable solution and learning how to channel his or her emotions in a productive direction."

He said the train analogy can be useful as a one-off, stop-gap measure and only as a short-term tactic.

That said, "it should not be utilized in a more public setting."

"Allowing your child to have a 'going through the tunnel' experience in the middle of the candy aisle at the grocery store is enabling, encouraging and rewarding the child to be controlled by their emotional reactions," he said.

McLaughlin told GMA that she has used the train analogy at home several times since the Glenn incident with great success.

"I've used it when my son was bawling over losing a soccer game. I've used it when my daughter was hysterical because her jacket zipper got stuck. Yes, our children need to learn how to handle these small disappointments and frustrations, but we also need to remember that in their world, these aren't small at all."

"So instead of telling them their emotions aren't valid or trying to logic them out of their tears, I choose to support and comfort them through the emotional tunnel. Nine times out of ten, it's only a few minutes before they're back on their feet," she said.

Wittman suggested the "first responder" technique as a long-term strategy.

"Teach the child how to perceive any situation in a way similar to a First Responder instead of an emotional reactor," he said. "Imagine a firefighter showing up to a house that is on fire and having to go through the tunnel before taking any life-saving actions."

Since McLaughlin first published her "train analogy" post, it's been shared more than 300,000 times on Facebook and almost 50,000 times on Pinterest.

"My recommendation to parents is to remember what your job is -- and what it isn't," she said.

"Your job is not to get your child to stop crying and be happy again as quickly as possible. Rather, your job is to provide comfort, show empathy, and be there with your child as they travel through the tunnel of their emotions. They will make it to the other side!"

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iStock/Thinkstock(NEW YORK) -- A group of physicians at Johns Hopkins Medicine and the American Heart Association have released updated guidelines on managing cholesterol to minimize the risk of heart attack, stroke, and death.

The new guidelines advocate for more aggressive treatment with statin therapy and getting LDL cholesterol counts, commonly referred to as “bad cholesterol” to your target level –- in general, less than 100mg/dL; for those with risk factors, less than 70mg/dL.

What is cholesterol?

Cholesterol is a type of fat found in blood and cells. It travels in bundles called lipoproteins. Cholesterol itself isn’t bad -- the body needs it to make hormones, vitamin D and digestive fluids, and it helps organs function properly. But having too much cholesterol can be a problem.

There are two forms of cholesterol:

- LDL (low-density lipoprotein): “bad,” unhealthy cholesterol. It builds up in arteries forming plaques, which can block the flow of oxygen-carrying blood to major organs including the heart, and has been shown to be associated with cardiovascular events including heart attacks and stroke. LDL levels are influenced by the food you eat, genetics, liver function and other factors.

- HDL (high-density lipoprotein): “good,” healthy cholesterol. It takes extra cholesterol out of arteries and delivers it to the liver, removing it from the body.

How do I know if I need to lower my cholesterol?

There are three tests to talk about with your doctor:

- Non-fasting blood test to measure LDL cholesterol

- Coronary artery calcium score

- Atherosclerotic Cardiovascular Disease (ASCVD) Risk Estimator -- an equation to calculate the 10-year future risk of a heart attack

Based on these tests, your doctor will decide if you should be on a statin.

What can I do to lower my cholesterol?

Lifestyle changes including exercise, a healthy diet, and quitting smoking can prevent 80 percent of heart disease, the leading cause of death in the U.S.

Diet has been shown to be vitally important and effective in preventing heart attacks and reducing the risk of subsequent cardiovascular events in those who have already had a heart attack. Plant-based and Mediterranean diets are effective but you must find a diet that works for you.

However, lifestyle changes may not be enough; you may need to take a statin to lower your LDL further.

What are statins?

Statins prevent heart attacks by lowering LDL and reducing inflammation, among other mechanisms. They can be used to prevent a heart attack or stroke before it occurs, or prevent a second heart attack or stroke.

What are the side effects of statins?

The risk of serious side effects range from one in 500 to one in 1,000, which is considered very low. Muscle aches are a possible side effect, but are not considered serious. An increase in the dose of statins is not associated with an increase in side effects.

What is the bottom line of the new recommendations?

Talk to your doctor about what LDL level is right for you, and use the highest dose of statin tolerated to get to that target LDL level. And, as always, continue with lifestyle modifications, including exercise, a healthy diet, and quitting smoking.

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