Psoriasis is a common skin condition that affects 7.5 million people in the United States. It occurs when a person’s immune system goes on the fritz and it sends signals that tell skin cells to grow too fast. The new cells form in days instead of weeks. This causes them to pile up and creates patches of psoriasis.

Anyone can develop psoriasis but there is often a hereditary component to it. It occurs most often between the ages of 15 and 30 and between the ages of 50 and 60. It is often precipitated by certain triggers. These include: an infection such as strep throat, a stressful event, medications such as lithium or those that help prevent malaria, cold and dry weather and a cut, scratch or bad sunburn.

What you may not know is that there are many different types of psoriasis. The majority of people get plaque psoriasis. These are raised red plaques on the skin with silvery white patches. The fingernails develop pits.

The other types of psoriasis include:
Guttate psoriasis: small red dots scattered over the body
Pustular psoriasis: pus filled bumps that can cause the patient to feel sick
Inverse psoriasis: Raw red patches on the skin
Erythrodermic psoriasis: Red skin that looks burned and can be painful and intensely itchy.

Thirty percent of patients with psoriasis will develop psoriatic arthritis. As with psoriasis there are different types of arthritis. They can range from mild, moderate to severe.

Four things you may not know:

1. In 15% of patients, the joint problems may show up before the skin changes.

2. It is often difficult to diagnose psoriatic arthritis. It may occur in a joint after an injury,
and look more like a cartilage tear.

3. There may be pain without swelling

4. Often patients will develop swollen fingers that look like sausages.

What many people may not realize is that those with psoriasis are 58% more likely to have a heart attack and 43% more likely to have a stroke. They are also 46% more likely to develop type 2 diabetes and are at high risk for cancers, obesity and depression.

Treating psoriasis can reduce the inflammation and alter these risks.

For the skin, there is light therapy and steroid ointments. For psoriatic arthritis, non-steroidal anti-inflammatory medications are used initially. For severe disease drugs used to treat rheumatoid arthritis such as Enbrel and Remicade are often used.

There is no cure for psoriasis, but with combination therapies it can be controlled. More importantly the risks for other diseases can be reduced by seeking help early and getting the treatment that is best for the degree of disease you may have.

Or……..”Everyone has plans, until they get punched in the face.” Mike Tyson

I have spent a good part of my life thinking about and striving to balance work and my life. This year I was asked to give a talk at a professional women’s conference about how I was able to do that. Much to the chagrin of those in the audience, I told them that I had not found the magic bullet point to tell them all how they could achieve balance.

The truth is that the notion of balance assumes you have almost total control over your life. Control is an illusion. Things happen all the time, and we need to deal with them. A perfect example is one that most women can identify with.

You have your whole day planned out. You are gong to take your two young children to school, go to work, finish just in time to pick the kids up and you do your shopping, errands, etc. during your lunch hour. Then after you pick up the kids you can get dinner ready while they do their homework. Perfect right? That morning your older child starts throwing up, develops a fever and he needs to stay home from school. You have no childcare so you have to call in to work and stay home. You can’t leave the house, you can’t do your shopping and you can’t run your errands. You have to scramble to get your other child to school.

That is a small example. There is no way to find balance in this situation. However, you can be flexible. In my opinion, juggling work and life is not about balance at all. It is about learning to go with the flow.

In the above example, you can look at a day home with your child as a blessing to spend alone time with him or her, get your laundry done and get the house picked up while he or she takes a nap. Watch a video, read a book or phone a friend. There are many things that you can do instead of stressing about what you are unable to do because you were thrown a curve ball.

That is what I have realized in the last many years. Going with the flow and becoming more flexible is far more workable than striving for perfection in balance. It is never going to happen for me. I feel so much better having realized that. Is the world going to end if my house isn’t as clean as I like it? How horrible will it be if the laundry isn’t folded? Are these things that I will look back on and regret? No.

My advice; keep your to do list. But, if you cannot get to everything or you get sidetracked, appreciate it and enjoy the detour. Life without balance can be a life well lived depending on your attitude.

November is diabetes awareness month. Why is this important? Because, diabetes (specifically type 2 diabetes) is a HUGE problem. Here are some quick facts: Of those Americans over 65 years of age, close to a third (26.9%) had diabetes in 2010.

Between the years 2005 and 2008, more than a third of those over age 20 and half of those over 65 had prediabetes for a grand total of 79 million Americans over 20 who had prediabetes.

Why is it such a problem? Diabetes is a major cause of kidney failure, limb amputation and blindness. It is also a risk factor for stroke and heart attack. Overweight and obese individuals are most prone to developing type 2 diabetes. Weight gain decreases the body’s sensitivity to its own insulin. This causes the body to kick out more insulin but eventually insulin stores run down. This whole process results in inflammation, and that is how diabetes causes serious damage to the body.

Type 2 diabetes, also known as adult onset diabetes in the past, is no longer a disease of adults. As a result of our obesity epidemic it is becoming a disease of children. Unfortunately all the complications that follow as a result are being seen in children including stroke.

The symptoms of diabetes can be subtle. When it becomes more pronounced with increasing blood sugars the symptoms that occur include excessive thirst, urination and an increased appetite. Some people may lose weight. Others may also note fatigue and tingling of the hands and feet.

Fortunately, type 2 diabetes is preventable. A recent study found that small amounts of weight loss (5-10%) can delay or prevent diabetes in those who are at risk. In fact, it was pretty dramatic. Diabetes was reduced by 40 to 60% over the 3 to 6 years that the study was conducted.

The solution to this growing problem sounds easy. But, it is not, because achieving significant weight loss is tough. Obesity continues to grow as an epidemic that is threatening to kill our children, crush our medical system and ultimately our economy. We worry about terrorism and weapons of mass destruction or WMD, but perhaps what we should fear most are the ultimate WMD; the knife and the fork.

Global warming with crazy weather happenings, the recent government shutdown, people with economic problems, trying to help patients get well when they cannot afford the medications that will heal them, these are just a few things that have led me to write once again about ….STRESS!

Stress is one of those things that is a natural part of life. And one of those things that can show up physically with new, or worsening, symptoms. Some of us handle it better than others. There are various types of stress. There is acute stress that you feel when you are in danger and that provokes a “fight or flight” response, otherwise known as an adrenaline rush. There is intermittent acute stress that is a hallmark of those with the type A personality. These are people who are stress junkies and thrive on deadlines and rushing around. Finally, there is continuous or chronic stress. This can be seen in people who are oppressed either by a job, relationship or a government.

The most dangerous form is chronic stress. After time, those with this type of stress get so used to it they don’t even notice it. The continuous outpouring of stress hormones can lead to obesity, diabetes, heart disease, stroke and even cancer.

It is important that you recognize stress in your life and that you do something about it, especially since there are so many ways to relieve stress. I advise starting with a healthy diet (avoid the urge to devour carbs), exercise is key, and then find ways to relax: read a lighthearted book; listen to soothing music; lay on the sofa holding your dog, and pet her nonstop. There are also complementary medical therapies (CAM) such as massage and acupuncture that can help. Meditation and yoga are great ways to relax and manage the stress response. Some may need the help of a therapist. There are chapters in our book, which go into much greater detail about all of these stress-busters including diet, exercise, and CAM therapies

Regardless of which route you choose, it is important to pay attention to your body and if you are chronically or even intermittently stressed get help and stay healthy.

It is estimated that over our lifetime women in the US have a one in eight chance of developing breast cancer. There are many risk factors for this disease that include the following: a history of breast cancer in a family member, BRAC1 and 2 mutations, increasing age, early onset of menses, exposure to radiation and pesticides, excessive alcohol (two or more drinks a day), obesity, and lack of exercise.

Certain things such as family history and gene mutations we cannot change. However, there are a few simple things that we can do to decrease the chances that we will develop breast cancer. Here is what I have found.

Exercise. Just two and a half hours a week of vigorous walking can decrease the risk of breast cancer by almost 20%. Put on your shoes and get out there!

Eat a healthy diet that includes ground flax seed. A study done in Canada took 39 women with newly diagnosed breast cancer. For a month they were given either a regular muffin or a muffin made with 25 grams of ground flax. No other treatment was administered. At the end of the month they had another breast biopsy and the activity of the cancer cells was measured. Those who had eaten the daily flax seed muffin had a 31% decrease in the activity of their breast cancer cells. Those with HER-2 oncogenes (a more aggressive form of cancer) showed a 71% decrease in the activity of their cancer cells.

I suggest that you gradually add 2 tablespoons of ground flax into your diet. You can put it in smoothies, salads, and yogurt or in muffins. Make sure you keep it in the refrigerator if it is already ground. Caution: you need to increase the amount gradually or you will be spending a lot of time in the bathroom.

Eat mushrooms. Actually it is better if you get medicinal mushrooms in capsules. I recommend a blend of 17 mushrooms called Mycommunity that includes Reishi, Maitaki, Shiitaki, Turkey tail and Lion’s Mane. I also recommend capsules of Turkey Tail mushrooms in addition to the blend. Multiple scientific studies done around the world have found that mushrooms help to prevent breast cancer as well as improve treatment.

Certain types of mushrooms are able to boost the body’s ability to fight cancer cells. The beauty of these mushrooms is that they are food and have virtually no side effects unless of course you are allergic to mushrooms.

Drink green tea. Studies of Asian-American women found that those who drank green tea had significantly less breast cancer than those who did not drink it. How much to drink is unclear, but it is healthy and you might want to drink up many a cup.

Eat your veggies especially the cruciferous ones such as broccoli, brussel sprouts, and cauliflower. The indol-3-carbinol in the vegetables may reduce the negative effect of estrogen on the breast. Soy in the form of food can also help prevent breast cancer through a similar mechanism.

Take your vitamin D and calcium. A recent clinical trial found that supplementing women’s diet with daily calcium (1500 mgs) and vitamin D (1000 IU’s) reduced their overall cancer rate by 60%. Of course it is best to get calcium from the diet. New recommendations have reduced the amount needed to 800 mgs a day but vitamin D is most consistently obtained from a supplement.

Making just a few simple changes to your lifestyle and adding a couple of supplements can have a huge impact on preventing one of the most dreaded diseases for women. You can’t change your parents or your genetic code (yet), but you can be proactive about your health and do what you need to do to make a difference.

When was the last time you or your children had their cholesterol levels checked? Do you have a strong family history of heart attack in your family? Do you want to have a healthy heart?

If you and your family have not been checked and/or you have a first degree relative that has premature heart disease (heart attack in a man <45 years old or a woman<55 years old) then it is time to see your doctor.

One in 300 to 500 people will have one gene mutation for familial hyperlipidemia (FH). This results in total cholesterol levels between 350 and 550 mg/dl. The form of FH with two gene mutations only occurs in 1 in 1,000,000 resulting in cholesterol levels between 650 and 1000 mg/dl. Both forms of these mutations puts patients at high risk for premature heart disease.

If aggressively treated, heart disease can be avoided but the key is to discover it early in life. The easiest way to do that is to have an exam by your physician and have a simple cholesterol panel done.

FH may result in cholesterol deposits on the skin and in the eye. A physician can easily detect these on exam. With the cholesterol blood panel the following results indicate FH in 80% of those with the following:

LDL cholesterol >249 mg/dl in a patient 30 or older
Or
LDL cholesterol > 219 mg/dl for patients between 20 and 29
Or
LDL cholesterol >189 mg/dl in a patient under age 20

Although it is relatively easy to detect and treat this problem, many people are going undiagnosed. That is why it is so important to have your children screened between the ages of 9 and 11. If you have a family history of hyperlipidemia and heart disease the recommendation is to test children by the age of 2. All patients should be tested by the age of 20.

The treatment for FH is the same as that for high cholesterol that is not hereditary, however it is generally started earlier in life and more aggressively with the goal of reducing LDL cholesterol by 50%. A heart healthy diet such as the Mediterranean diet and (for those who want to be as aggressive as possible) a vegan diet along with exercise are the first lines of treatment. Statins, as tolerated are the medications that are generally recommended.

It is really important to be proactive about your health. For FH it is essential. The earlier it is detected and treated, the less likely disease will develop. Be smart and take care of your heart (and those of your children).

I love to walk, but now that the weather is starting to turn, it is getting harder. Fortunately, I have someone who will not let me do that. She is relentless and she pesters me until I get off the couch. Her name is Lucy. She is a German shepherd basset hound mix (I know it sounds impossible and a bit strange but it is true).

Her front legs are shorter than her back legs so she hops. At times walking for her is not easy, but nonetheless she gets me out there every day, twice or three times a day.
How can I beg off the walk when she needs it to keep her joints agile and it is such an obvious struggle for her at times? To top it off with all her doggy disabilities, she is always happy, and she makes me laugh. I have no excuse.

Lucy keeps me in shape. She also helps me to stay calm and control my stress. These benefits are among many reported by the CDC (Centers for Disease Control and Prevention) and the NIH (National Institutes for Health). Pets can lower blood pressure, cholesterol and triglyceride levels, reduce stress, help maintain social engagement and prevent loneliness.

Not too long ago, there was a national meeting hosted by the NIH where data was presented from large, well-designed studies of people and their pets. One of the studies found that of those people who suffered a heart attack, dog owners were more likely to be alive a year later regardless of the severity of their heart attack compared to those without dogs. Another study looking at married couples found that pet owners had lower heart rates and blood pressures than those without pets even in times of great stress.

Of more than 2000 dog owners, those who regularly walked their dogs were more physically active and less likely to be overweight than those who did not own or walk a dog. Older dog owners had better mobility in as well as outside their homes.

Dogs are great for helping people to be more social. They provide companionship, and people are always stopping dog owners to pet their animals and chat. Those who feel connected and engaged live longer.

If you are having trouble finding reasons to go outside when it is cold, wet or snowy and/or you are feeling a bit lonely and out of sorts then I suggest you go to your local humane society and find your Lucy. There are so many dogs that need a home. They can be a great comfort and motivation to become fit.

And if I haven’t given you enough good reasons to adopt a dog here is one more,

“You can say any fool thing to a dog and the dog will just give you this look that says, ‘My GOSH, you’re RIGHT! I NEVER would’ve thought of that!”
― Dave Barry

Over 25 years ago I completed a fellowship in the field of Preventive Cardiology, which was a relatively new concept at the time. The idea behind it was to find those at risk for heart disease and stroke and help them to modify their risk factors for disease. We started with family members of those who had a heart attack or stroke. We checked their cholesterol, blood pressure, blood sugar, weight, stress and activity level, and their smoking history.

Trying to change people’s behavior even when they have seen their close relatives suffer heart attacks and strokes is not easy especially if they cannot feel the problems (such as high blood pressure and high cholesterol). One would think treating the actual heart attack patient might be a bit easier. However, a recent study found that 26.4% of men make no lifestyle changes after a stroke, heart attack or major cardiac event, and although women were more likely to make changes (66% made two improvements in their lifestyle habits) only 7.4% made all the recommended changes.

WHY NOT?

I gave a talk to my physician colleagues many years ago about what I had learned in my fellowship concerning the best ways to help their patients prevent heart disease. After my talk, a Cardiologist got up to give his presentation. He started by saying that they could skip the steps that I mentioned for prevention, because he could take care of all those patients when they had their heart attacks with his balloons and stents.

He was joking (sort of), but the truth is that many people think that they will be cured by these procedures and that it is OK to eat what they want as long as they chase it with a statin drug and consume all the salt that they want as long as they take their blood pressure medicine. Some people don’t take any medication at all and think that if their unhealthy lifestyle choices lead to heart disease, they will be saved by the stents and bypass operations.

What is important to understand is that despite all these procedures and medications heart disease is still the number one killer of men and women. Unfortunately, all the pills and procedures in the world cannot help us if we don’t make healthy changes. But, it does not need to be that way if we are able to take responsibility for our own health and wellbeing.

For example, the Mediterranean diet is a heart healthy diet. It is a diet rich in lean protein, whole grains, vegetables, fruit and olive oil. We know it lowers cholesterol and helps to lower weight and blood sugars. For those with very high cholesterol, the vegetarian and especially the vegan diet can dramatically lower it. It may seem extreme, but it works and can actually reverse the process of coronary artery disease, and the food is good and good for our bodies. It can help people avoid taking medications and see the positive results (like more energy, normal body weight, better mood, etc.).

The best way to cure heart disease is to prevent it from happening in the first place. Prevention is not glamorous and it is not easy. However, it is essential. If you cannot get your blood pressure, cholesterol, weight and/or blood sugar down on your own, take your medications and make the lifestyle changes your doctor recommends. Quit smoking and start moving. If you are stressed, find an activity that helps to relieve that stress….like exercise! When you adopt a healthy lifestyle, you will be amazed how good you feel and how long you live.

You’ve seen the TV commercials promoting special yogurt to rid abdominal cramps, bloating, and make up for years of poor eating habits. And you must be wondering: What makes yogurt so therapeutic? Wonder no longer, yogurt contains probiotics.

What are probiotics?

Probiotics are live bacteria that are good for us — improving the balance of good and bad bacteria in our bodies. Yes, bacteria has become a “dirty” word, but truth be told, we all have lots and lots of bacteria living in our gut, mucus membranes and on our skin. When these bacteria are in balance they assist in digestion, release gas in our colon (and are the origin of all farts), and improve your immune system by, among other things, stimulating our body’s own production of antibodies to help fight infection. Probiotics also help your body turn certain foods – through fermentation – into important vitamins for you to absorb.

Why do we need probiotics?

1. Antibiotics – They kill off the bacteria that make us sick, but in the process, they can kill strains of natural bacteria that help your body absorb nutrients. This can cause diarrhea and other digestive upsets, such as gas and cramping. In women, antibiotics can also cause yeast infections.

2. Enzyme deficiencies – Lactase, for instance, is an enzyme that helps us digest milk products. As we age, many of us become lactase deficient, causing gas and bowel trouble. Drinking milk with acidophilus can help.

3. Irritable bowel syndrome – A common problem as we age, irritable bowel syndrome causes gas, bloating, and abdominal cramping. Many factors can cause the discomfort, however, many of the symptoms may actually be caused by a bacteria imbalance in our gut.

4. A recent study done in China has found that children given probiotics had 72% fewer fevers in the winter and used 84% fewer antibiotics.

And, even if you do not have any of these problems, probiotics are still worth trying. They can help relieve constipation, prevent yeast infections, lower cholesterol, and increase protection from certain cancers including colon and bladder cancer.

Where can you get probiotics?

You can find probiotics in cultured dairy products like yogurt and kefir, as well as fermented foods like sauerkraut. You can also take supplements, which are made up of a mix of bacteria. The most common types are acidophilus, lactobacillus species, and bifidobacteria species. Most probiotics need to be refrigerated and kept tightly sealed in an opaque container.

If you’re experiencing cramping or bloating, you should start feeling better soon after you begin taking the probiotics. If you’re healthy, you won’t notice much change. Although you might have a happier glow because you are preventing illness.

Have you tried any probiotic products? Did you notice any improvement in your health?

A couple of weeks ago, one of my patients came in for a visit with a bag full of 15 vitamins and supplements. She wanted me to review them and tell her which ones I thought were good and which ones were not.

It took about 20 minutes to go through all her stuff. Truthfully, she had some good quality supplements. There were antioxidants, fiber pills, an assortment of vitamins – I had to admit that they were excellent quality.

Then she asked me which ones she actually needed. I told her that she could do without most of them if she would eat a healthy diet. She looked at me incredulously – as if, I bought all these pills for nothing?! The secret: Most supplements are unnecessary. The key to ultimate health lies in what you choose to eat. The problem is that most people want to do everything but eat a super-clean and super-healthy diet.

When you take nutrients out of food and eat them as supplements they are not going to pack the same punch. There is tremendous value in consuming the whole food. Furthermore, some supplements may go right on through the gastrointestinal tract without being digested.

I will never forget the story a septic tank cleaner told me (it’s a little gross, but worth repeating). He said that one time he was cleaning someone’s septic system and the hose exploded all over the lawn. He said it looked like a bunch of shiny jewels were everywhere. It was all the vitamins that the owner of the system had consumed that had landed on the lawn undigested!

You might say that organic veggies and fruits are expensive. But when you think about it, if you stop buying all those expensive supplements you might be able to afford more of the healthy food. If you eat a diet rich in vegetables, lean protein and healthy grains and fiber, there are only a couple of things you might need in addition.

Those supplements include calcium, vitamin D and possibly fish oil. Vitamin D is hard to get if you wear sunscreen, which will block its absorption. Calcium may also be hard to get if you are unable to eat dairy products, and if you are unable to find fresh fish, fish oil may be needed as a supplement. That’s about it.

Your selenium for the day can be obtained by eating two (just two) Brazil nuts. If you need iron you can find it in clams, liver, pumpkin seeds, beans, lean red meat (no more than three 3-4 oz. servings per week) and even in chocolate. Spinach and almonds are rich in magnesium. Sunflower seeds and almonds contain vitamin E. Vitamin C is in citrus fruits. B12 is found in clams, salmon and rainbow trout. You get the idea. The bottom line is that it is always best (and a lot tastier!) to get vitamins the way nature intended.

I have quoted Hippocrates before and I will do it again because it makes so much sense. “Let food be thy medicine and medicine be thy food” ― Hippocrates

– See more at: http://blog.sharecare.com/2013/08/14/are-vitamins-and-supplements-a-waste-of-money/#sthash.5rfWYVbj.dpuf