Have a Statin Chaser With Your Burger

A recent study done in England has found that it would be cost effective to have statin drugs as condiments at fast food restaurants for those who choose to have cheeseburgers and milkshakes. I am speechless, which for me is quite unusual. I have often joked to my patients that it is not okay to eat their twinkies with their statin drugs. Personal responsibility for healthy eating and exercise is so important when it comes to wellness. This suggestion to me flies in the face of common sense and points out why we are having an obesity epidemic.

There are a lot of tempting foods in our world right now for some of us. Many are not healthy. There are 2000 calorie milkshakes, 700 calorie coffee drinks and 1700 calorie appetizers. As much as we may want to have them, it is time for us all to stand up and say “No!” We adults should know better. It’s one thing if you’re a child and you need to learn that you can’t have everything that you want. But, come on adult world. You cannot have fatty foods along with your statin and think that is okay!
Statins are great for those with high cholesterol and who are at risk for heart attack and stroke. For those who really don’t need it the risks may outweigh the benefits.

The secret to a long, healthy life is eating a healthy diet and exercising. Take a pass on the cheeseburgers and milkshakes with the statin chaser and just live well.

No matter where you live in the U.S., it’s been tough to escape the heat! It’s even been unusually hot in Alaska. When we talk about getting overheated, we’re talking about several different conditions. As our bodies heat up, the conditions progress.

Normally when we get hot, we sweat; that’s how our bodies cool down. We can avoid dehydration by drinking plenty of fluids. (If you’re dehydrated your skin begins to tent – you can pick it up and it stays that way – and you either stop urinating or it becomes very concentrated and dark in color.) When we continue to sweat without drinking water and/or sports drinks to replenish fluids and electrolytes like salt – that’s when heat-related illness occurs. The first sign of heat-related illness is heat cramps, which are muscle spasms. I have had these and they are very unpleasant! Some people may, in addition, get a rash from excessive sweating.

The next phase is heat exhaustion. Outside temperatures (from the high 80s and up), combined with humidity, can lead to heat exhaustion if the body doesn’t have a chance to cool down and fluids aren’t replenished. Symptoms include a rapid but weak pulse, fast breathing and excessive sweating.

The last phase is heat stroke. The elderly, small children and people on certain medications, such as diuretics, may be more prone to heat stroke. This is a potential killer. The body temperature can rise above 106 degrees and a person may become delirious. The skin will become dry due to the inability to continue sweating, and he or she will have a rapid pulse.

What To Do
For mild heat cramps, drink sports drinks and eat some salty foods to replace the salt that is lost from sweating. If muscle cramps become severe, you may need to head to the ER for intravenous fluids and relief.

What about heat exhaustion? Move to a shady spot or get into a place with air conditioning as soon as possible. Drink salty fluids (like a sports drink or tomato juice). If you’re with someone showing heat exhaustion symptoms, be watchful that they remain alert. If they seem confused you may need to hold off on the fluids. Seek immediate medical attention.

If someone is suffering from heat stroke, call 911. While help is on the way, cool them down as much as possible by wetting their clothes and sponging them down with cool water. Ice packs applied to the groin, neck and underarms can be helpful. Getting a person with heat stroke to an ER is urgent since it can cause permanent brain damage.

Prevention Is The Key
Avoiding situations where you could fall victim to overheating is the best course of action. Days when outside temperatures hit over 90 degrees are perfect for heading to the movies or working out at the gym – not sitting on the beach! If you do head outside for any period of time, think ahead. Wear a hat and light-colored clothing that won’t absorb the sun’s heat. Bring plenty of water and drink every 15 minutes, regardless of whether you’re thirsty or not. If you’re doing any kind of physical activity, rest often in the shade. Along with looking after yourself, take care to check on elderly neighbors or relatives. You’ll want to be sure their AC is running or, if they’re dependent on fans to stay cool, that they’re drinking plenty of fluids and haven’t become woozy.

Be smart this summer. Stay cool, stay healthy!
– See more at: http://blog.sharecare.com/2013/07/30/stay-safe-when-temperatures-rise/#sthash.1JtKuKOc.dpuf

As a physician with conventional medical training, I often used to look at home remedies with skepticism. I have had several patients who have sworn that apple cider vinegar was good for whatever ailed them. Apple cider vinegar has been around for ages.Hippocrates used it to treat wounds; soldiers in the civil war used it for digestive problems and to prevent pneumonia and scurvy. Apparently Cleopatra used it to dissolve her pearls to make a love potion for Mark Antony.

Studies Showing Benefit

There have been recent studies done at the University of Arizona that have caused me to take a second look at apple cider vinegar. One study looked at 29 patients with either insulin resistance (prediabetes) or type 2 diabetes. They were given either a drink of vinegar, water and saccharine or placebo followed by a meal with 87 grams of carbohydrate. Compared to placebo, blood sugar decreased by 64% in the prediabetes group and 19% in the diabetes group.

Another study looked at weight loss in healthy women.The women were given a morning drink of vinegar or placebo followed by a bagel breakfast. Not only did the vinegar group have a 54% lower blood sugar one hour later, but they also consumed 11-16% fewer calories throughout the day.

Yet, another study found that taking a drink containing two tablespoons of apple cider vinegar along with eating one ounce of cheese before bedtime significantly lowered fasting blood sugars in the morning.

Some Cautions

There are potential safety and side effect issues. Obviously those allergic to apples need to avoid apple cider vinegar. Raw apple cider vinegar can contain bacteria, so it would be better to use the pasteurized form. Apple cider vinegar capsules can cause burning in the esophagus if they get lodged there. Apple cider vinegar can also irritate the stomach. There are potential drug interactions if a patient is taking digoxin, insulin or diuretics. Vinegar can lower potassium levels.

And…..

Of course, as with everything, moderation is the key. Taking a mixture of apple cider vinegar in juice or water in the morning may help with both blood sugar and weight control. It is important to discuss this with your doctor before you do it.

When it comes to your health, you want to make smart decisions. So, like the smart patient you are, you go looking for information. Good for you! But there’s so much information these days – it’s everywhere you look, and so much of it is frightening, or contradictory. The result: You may over-react to what you read and wind up having trouble making rational decisions.

Just look at how hard it is to be informed – but not make yourself crazy — after breast cancer. The whole process of being diagnosed with breast cancer and then getting treated is, of course, traumatic. As a result, every one of my patients dealing with it have become avid readers, and they are trying to do whatever they can to prevent a recurrence.

But this can make a person a little crazy. As an example, the use of soy after a diagnosis of estrogen sensitive breast cancer is not recommended. However, there is no evidence that it is dangerous. The rationale is that soy contains plant estrogens that could potentially stimulate estrogen receptors in breast tissue and cause a recurrence. Many of my patients and friends avoid all soy, even if there is a tiny amount in medication capsules.

These same patients will drink two or three glasses of wine a night, which we know increases the risk for breast cancer. Multiple studies have confirmed that more than one glass of wine a day increases breast cancer risk by one and a half times when compared to non-drinkers. My patients also may eat high-fat cheeses and other dairy products. This also has been found to increase breast cancer risk, because of the concentration of animal estrogens in fat.

Other patients may never let a bit of tofu or soy milk pass their lips, but get lax about exercise, when we know that working out just 30 minutes a day can decrease breast cancer risk by at least 18%.

I am not saying that it is okay to go out and eat unlimited soy. What I would like to point out, however, is that a logical approach to maintaining wellness is important. Regardless of your medical issues, speak with your doctor about what types of behaviors and habits will help you to maintain your health, because your doctor can assist you in forming a rational plan that will work for you.

Since there is a boatload of medical information from so many different sources, we all need help in sorting it out. Knowledge is power, so access it (in a rational way)!

“One of the first duties of the physician is to educate the masses not to take medicine.”
Sir William Osler

When it comes to our medical care, we take a certain level of safety for granted. We figure our doctors and dentists take basic steps to avoid causing infections – like washing their hands and cleaning their equipment. But sometimes news stories remind us that healthcare professionals don’t always live up to those standards – and we start to wonder how we can protect ourselves.

I just heard about a colonoscopy center in Atlanta that failed to adequately sterilize its equipment. No infections have been reported so far, but the news comes on the heels of the shocking story of an oral surgeon in Tulsa, Oklahoma, who exposed his patients to hepatitis C and HIV because he inadequately sterilized his equipment. “Inadequately sterilized” barely covers it: W. Scott Harrington’s equipment was apparently visibly rusty, and he re-used old needles. He also used unlicensed employees to start IV’s to sedate patients. So far, 70 patients have tested positive for hepatitis C, five for hepatitis B and three for HIV.

These are frightening numbers, and the situation doesn’t get any more reassuring when you realize that random inspections of dental offices are not routine in every state. In Oklahoma, for instance, they’re not done unless there is a complaint; procedures vary by state.

Here’s what makes things even worse: Harrington’s office appeared clean, and apparently he is a likeable guy. So how should his patients have known that he was exposing them to other people’s blood and saliva? How do you know if you are safe in your dentist’s office?

The short answer is that you don’t! Not just by looking around. But the long answer is that you can find out by being observant and asking some questions.

Make a Call
Do your homework: Check out your dentist with your state Dental Association. They will tell you whether there have been any infractions or complaints.

Take a Look around Your Dentist’s Office
– Is it neat and free of clutter? A messy office with lots of papers lying around cannot be adequately sanitized.

– Are the floors carpeted? Carpet cannot be sterilized, but linoleum can be.

– Do the employees wash their hands in front of you before they put on gloves? This is essential. There should be a sink in each patient area with a soap dispenser.

– Are employees pulling the gloves from a package, or are the gloves just hanging loose? You want them coming from the box or package.

– Do they wipe down their equipment with disinfectant before using it? My dentist’s employees always disinfect the overhead lamp, chair and anything that is going to touch me (or them, for that matter). And they do this before I sit down, so that I know it has been done.

– Does every patient area have a sharps container for needles and sharp, disposable instruments? You’ll generally see these attached to the wall (they’re usually bright red).

– Do the instruments come out of a sterilized package or a wrapped tray? Do they have a sterilization strip on them? This is critical! If they don’t, you can’t count on them being sterile.

Then Ask Some Questions
Ask your dentist or his or her employees how they know things are actually sterile. Have them explain how the sterilization strip works (here’s a primer: The strip goes into the sterilization unit with the equipment, and changes color when it gets hot enough for long enough, signaling that everything is sterile). If they do not want to answer, or if they get squirrely on you, walk out.

Do they have a sterilization or autoclave record? There should be regular checks to make sure the process is working. You can ask to see the record.

The last question may be the most important of all: Ask your dentist what precautions he or she has taken to keep you safe. If you don’t get an adequate answer, or if your dentist gets defensive, find someone else.

Fortunately, Dr. Harrington is very much the exception among dentists, and infections like those in his practice are rare. However, his case reminds us that it never hurts to be cautious, and that it’s perfectly fine to ask questions. That’s true no matter what kind of health professional you’re seeing. Whether you’re getting a tooth filled, taking your child for a check-up, or having a colonoscopy, use your eyes and ears to protect yourself.

Are you one of those people with creaky joints? If you have them, then you know that they can make exercise challenging. Biking is something that you can do that is a great aerobic activity, good for maintaining a healthy weight and is just plain fun. And, it will make you feel like a kid again!

Riding a bike is good for an overall workout. It is good for your legs, core and balance. If you don’t want to go outside you can use a stationary bicycle. If you want a real workout, go to your local gym club and find out about spinning classes. There you can ride a bike to music and be led up and down virtual hills with a group. It is social, fun and you can work up quite a sweat.

If you want to burn calories, biking is a good way to do it. If a 130-pound woman rides ten miles, she burns 400 calories. It is a very efficient way to stay in shape and have fun at the same time. It is also a great stress reliever that boosts endorphins.

Bicycling outside can be made easy if you find level ground. Start out slowly, and of course wear a helmet. It will feel good to get out into the fresh air. If you want to make it more competitive or social, find local bicycle races that map out rides. You don’t actually have to race. The key to incorporating exercise into your life is finding something that is fun to do.

May is National Bike Month. Consider taking this opportunity to put on your bike helmet, hop on your bike and ride to work. You may have fun and notice that you feel good as well!

A couple of months ago a patient of mine came in wearing a pedometer known as the fitbit. I was intrigued. It calculated her steps; calories burned and could be used at night to see how well she was sleeping. I decided to try it out and experience it for myself.

What I found was something that has taught me quite a bit about my own health habits. First of all, I realize that there are some days when I feel that I have run myself ragged at work, and in reality I have taken half as many steps as I would have guessed.

In addition, I burn far fewer calories than I expect regardless of how many steps I take. I wondered why I was unable to lose weight recently. Now I know why. I am just not burning enough calories in spite of how much I am exercising. I eat a healthy diet but apparently my portion sizes need to be smaller.

As far as sleep goes, I now know that it takes me an average of 7 minutes to fall asleep and I move on average 10 times during the night. My fitbit program gave me a 95% sleep efficiency rating, and I am satisfied with that.

When the people at work saw my fitbit, they all decided to get one and before I knew it they were starting a competition. I have been trying to get them all fired up for fitness for the last couple of years. I have tried nutrition games, biggest loser competitions, and many other programs and finally I found a hook. They have all lost weight and they are looking really healthy.

There are many slick pedometer and sleep monitoring programs out there. In addition to the fitbit there are bracelets. One is Up by Jawbone and the other is the Nike fuel band. They all do the same thing. The bracelets are definitely more stylish. I like the fitbit because it clips to anything and has a firm fit. It is light and inconspicuous and it talks to me in the morning.

When I pick it up off the counter it flashes all kinds of words of encouragement to me. It tells me that I rock. No one recently has told me that! I love it. It encourages me to keep walking and burn calories. I look forward to what it has to tell me every morning.

If you need encouragement to keep walking, and you want to know how much exercise you are doing and what you are burning, I suggest any one of these devices to help you. It is amazing what you might find yourself doing to add to your steps for the day. What is even more wonderful is that these little devices will put a spring in your step and a healthy glow on your face.

Once upon a time, people used to think that hormone replacement therapy after menopause was a risk-free proposition. In fact, way back when, some doctors thought that every woman ought to go on hormones at menopause and stay on them for the rest of her life. Then came the Women’s Health Initiative, raising questions about the safety of these hormones, and women got scared. I have many patients who come to me terrified of taking hormones, and as a result they have suffered with severe hot flashes, insomnia, mood swings, and vaginal dryness.

But the truth is somewhere in the middle: These hormones are too big a risk for some women, but can be a big help for others. So it’s worth noting that a recent consensus statement, published on behalf of seven international menopause and women’s health societies, has deemed hormone replacement therapy (HRT) to be relatively safe in women who are under 60 years of age or within 10 years of menopause. Here are some of the highlights of the statement:

– HRT may prevent osteoporosis-related fractures in women who are at risk of these debilitating bone breaks.

– The use of estrogen-only hormone replacement can help in the prevention of heart disease.

– When these hormones are taken orally (as opposed to being used in skin patches, for instance), they can increase the risk for blood clots and stroke.

– Women who use a combination of estrogen and progesterone may have a slightly higher risk for breast cancer.

I am glad that the relative safety of HRT for women under 60 has been acknowledged. But even this consensus statement makes the therapy seem a little riskier than it is when it’s prescribed with care. Why do I say this? The societies’ statement expresses caution regarding the use of estrogen and progesterone in combination. However, the clinical studies on which they based their opinion actually used progestin, not progesterone—and there is a big difference between the two.

Progestin is a synthetic hormone. This type of hormone is known to increase the risk for blood clots, fluid retention and high blood pressure. Natural progesterone is the “feel good” hormone of pregnancy. It reduces inflammation, acts as a natural diuretic and helps to keep blood vessels dilated so that blood can flow smoothly. Women can get a bioidentical version of progesterone (not progestin) by prescription, and that is what I recommend to my patients who need it. I do not recommend progestin, which is also called Provera.

As for estrogen, I agree that the oral form increases a woman’s risk of blood clots and other problems. Because of that, I recommend using estrogen in a transdermal (through-the-skin) form—in a gel or patch. It can also be used under the tongue. Any of these routes will help to avoid blood clots.

Many women breeze through menopause. The rest of us have symptoms that can be debilitating (in addition to making us hard to live with). The key, if you are in the latter category, is to find a doctor who understands the benefits and risks of HRT and realizes the need for a good quality of life. Then, the two of you can find a treatment that works for you.

Today I was looking at a picture of my mother that she sent me last year when she was traveling in Cambodia. She looked fit and happy. It got me thinking about the fact that as we age we have many choices. The major one is to be or not to be fit. I saw what happens both ways in my family. Let me start with my father.

My dad was brilliant but stubborn. He smoked, ate a fat-filled, high sugar diet, and was totally opposed to exercise. He had to quit smoking when he developed bladder cancer and his urologist told him that if he continued to smoke he would not see him in his practice, because a cancer recurrence would be inevitable.

He started eating healthier when his brother developed type 2 diabetes and he realized that he might end up with the same thing. However, he refused to get regular check-ups until he was in his mid 60’s. He did not realize that for most of his adult life he had high blood pressure, because he did not feel it. But, it took its toll on his kidneys in a big way.

By the time he was being seen on a regular basis he was in renal failure. Despite treatment for his hypertension, his kidneys finally failed completely. He made it to 84. He was alert and with-it till the end. Had he been treated for his high blood pressure early on he would still be here. It was amazing that he made it into his 80’s, but his quality of life suffered, especially the last 10 years.

My mother on the other hand has always been a health nut. She was exercising and eating healthy before it was fashionable. She quit eating red meat when she was in her 40’s. She has been walking and going to exercise classes most of her adult life. She now does Pilates, yoga, and is an avid tennis player. She started playing doubles a couple of years ago because her knee was acting up and she couldn’t run as fast in her singles games. She plays bridge, goes to lectures at the local university, and is now traveling around the world.

I cannot say how old she is because she would kill me, but I am 58 and she was not a teen mom so you can kind of guess her age. To look at her you would think that she was in her 60’s. She is committed to keeping her brain and body healthy and has been for most of her life. Fortunately my siblings and I have followed her example.

We have no control over what goes on in the world, but we can control how we treat our bodies. Life can get crazy, but there are choices we can make. You can choose to ignore your health as my father did (and please say hello to him when you see him) or you can follow the path that my mother is on and be well!

“To resist the frigidity of old age, one must combine the body, the mind, and the heart. And to keep these in parallel vigor one must exercise, study, and love.”
Alan Bleasdale

If I told you there is something that could improve your mood, decrease blood pressure, keep your blood flowing, lower your heart rate, calm you down, boost your immunity, and enhance your ability to learn, would you be interested?

What if I told you that it is free and does not involve medication? Now I have your interest! There is something that will do all of the above and is also quite enjoyable.

It is music!

Studies in England have found that patients who were taught to play music as part of a study for the treatment of depression experienced a reduction in their symptoms by 25%. Research in Italy revealed that listening to Celtic, classical, or Indian (raga) music for 30 minutes a day can significantly lower blood pressure. Researchers in the US found that relaxing music can dilate blood vessels in the body and improve general blood flow. Music that was perceived as stressful (heavy metal as an example) caused the blood vessels to contract and decrease blood flow to the body.

When students were studied by having them listen to six types of music, researchers found their heart rate synced up to the speed of the music regardless of the style and their interest. If the music was lively, their hearts sped up. If the music slowed down, so did their heart rates. It produces an additional calming, immune, and mood boosting effect by lowering cortisol levels, increasing hormones that improve the immune response and raise endorphin levels.

Finally, you have probably heard about the Mozart effect, where listening to Mozart’s music enhances learning. Baroque music, with a 60 beat per minute pattern, particularly activates both the right and left side of the brain. This enables the brain to process information more easily. It also improves recall of information when a particular tune is used during studying and then replayed.

Music is the universal language appealing to all of us while enhancing learning and healing. As medical costs continue to skyrocket, it is nice to know that there is something enjoyable and therapeutic we can do (in addition to your regular preventive evaluation and treatments) to improve our health!

“I think music in itself is healing. It’s an explosive expression of humanity. It’s something we are all touched by. No matter what culture we’re from, everyone loves music.” ~ Billy Joel

What music helps you to feel better and heal?