Colon cancer is the third leading cause of cancer death in both men and women in the U.S. Of all women in the U.S., African American women have the greatest chance of developing it, followed by Caucasian women, then Native American and Asian American women. Hispanic women have the lowest incidence of colon cancer.

That’s the bad news. The good news is that this cancer can not only be detected early – increasing the chance of a cure – but also may be completely prevented in many cases. Why and how can that be done? Because nearly all colon cancers start as polyps, and most polyps can be detected by colonoscopy, a procedure that is done using a scope or tube that has a camera on one end and the doctor on the other end. When this tube, which is nearly 6 feet long, is pushed up into the colon while the patient is sedated or under anesthesia, the doctor is able to see the colon directly. If she/he sees a polyp or growth, it can be removed at that time. Removing polyps and growths before they become cancerous is the goal. Not all polyps are cancerous, but again, nearly all cancers of the colon start as polyps.

Who should get a colonoscopy? Since the odds of getting colon cancer is greatest in people who are 50 and older, and increases with age, a screening colonoscopy is recommended when you turn 50 years old or soon after. If you have a first degree relative who has had colon cancer, then you are greater risk of getting it, and colonoscopy should be done 10 years prior to the age that that first degree relative was diagnosed with colon cancer. For instance, if your father had a colon cancer diagnosed at age 45 then you would need your first colonoscopy done at age 35. After your first colonoscopy, you will need to have one every five to ten years thereafter as recommended by your doctor.

The “bottom” line is that if you haven’t had your colonoscopy yet, it is time to arrange it now. Think of it as the ultimate spring cleaning! It can save your life.

In our book, there is a lengthy discussion of colon cancer, all the risk factors – including diet, and how both of us prepare for our colonoscopies in the most “pleasant” way possible (if that is possible at all!) Also for more information, go to:
http://nihseniorhealth.gov/colorectalcancer/toc.html

A recent analysis of a study involving 60,000 women has found that those with hot flashes early on in menopause are 11% less likely to have a heart attack and 17% less likely to have a stroke. In contrast, those who develop hot flashes later in life after menopause are at a 29% increased risk of heart attack.

No one is quite sure why hot flashes may be protective. However, hot flashes occur as a response to dropping estrogen levels. Those with early responsiveness in menopause may have healthier vascular systems. Those who develop them later in life may have unhealthy vessels.

These findings are interesting when one looks at the results of the Womens Health Initiative Study (WHI) that looked at the health consequences of taking hormone replacement therapy. The study found that women on Premarin (estrogen from pregnant mare urine) and Provera (progestin) were at higher risk of having a heart attack or a stroke. However, women for this study were chosen specifically because they did not have hot flashes. They were also on average 63 years old. This potentially puts them at risk of stroke and heart attack regardless of hormone therapy.

Knowing that lack of hot flashes may increase the risk of heart disease, I think it is important to take another view of the results of the WHI study. In addition, we are in need of clinical trials looking at the use of bio-identical hormones and evaluating the treatments for women with hot flashes. Whether women choose to use hormone replacement therapy or not, it is important that we learn as much as possible on the true risks and benefits to help women make an educated decision for themselves.

During the same yoga class that I discovered the arthritis in my hands (see Part I – last week’s blog), I also made another discovery. And not a very pleasant one either.  No, this blog is not going to be about the yoga instructor giving me the cold shoulder because I hadn’t been there for awhile. Quite the opposite, in fact; she couldn’t have been more helpful. So what was my problem/discovery?

One of the yoga positions calls for the arms to be stretched up by the ears, then to rotate from the waist in the same position – first to one side, then to the other. Try that for a moment. Actually feels good to stretch, doesn’t it? I had always thought so too…until this class. As I stretched my left arm and shoulder up and then rotated to the left, an involuntary yelp escaped from my mouth, surprising even me. What was that pain? I asked myself. There couldn’t be something else wrong with one of my joints at the same time I had just discovered my hand arthritis, could there?

Sadly, there was. I had gotten not just a cold shoulder, but a frozen one. You’ve probably heard that term bandied around a lot. It actually means that there is limited motion and pain of the shoulder joint due to inflammation. The medical term for a frozen shoulder is “adhesive capsulitis.” This refers to the fact that inflammation has taken place in the capsule of the shoulder, leading to adhesions, or scar tissue.   

Adhesive capsulitis can occur after trauma – for instance with a partial or full tear of the rotator cuff (those tendons that connect the shoulder to the bones and allow it to move in all directions).  However, many times it occurs for no known reason. That’s right, just out of the blue.  And who does it affect most often out of the blue? Us. Women over the age of 50. There have been some studies showing that women who have thyroid disease have a greater chance of getting a frozen shoulder, but the actual reasons for its occurring spontaneously are unknown. It generally runs a course of approximately 18 months to 2 years, and then the pain usually subsides.

Back to me. The truth was that I had been having symptoms in that shoulder for the prior 6 months, including difficulty fastening my bra in the back, difficulty putting on my seatbelt, and pain when I tried to put on my coat from the back. But, these symptoms were not enough to make me take notice until that day in my yoga class. Wanting to give that shoulder every chance to regain the motion it had lost and to relieve myself of pain, I saw my orthopedic doctor, who prescribed an 8 week regimen of physical therapy to keep the shoulder moving. In addition, I had an injection of cortisone into the shoulder so that I could better do the exercises without pain.

It’s been about 18 months now since those symptoms first began, and my shoulder is better, but not completely normal. Despite the upset of discovering two age-related problems in that same yoga class, I’m actually grateful that I did. Because those particular joint problems – in my hands and in a certain aspect of my shoulder joint – didn’t show up in my day-to-day activities, I wasn’t aware of them until I stretched myself (literally!) and did movements that I didn’t usually do.  Now I know what to expect with various movements, and can even premedicate with aspirin or ibuprofen before one of my exercise classes.

So, I guess the moral to this story is that one must continually do things – mentally and physically – outside of one’s usual activities or comfort range in order to best take care of oneself. Or, a simpler message is: don’t ignore changes in your body!

It is fascinating in this day and age of tremendous technological advances that whether you have good overall health really depends on the choices that you make. Recent estimates by the American Institute for Cancer Research and the World Cancer Research Fund have found that the incidence of certain cancers such as breast, lung, colon, prostate and stomach could be significantly decreased by never smoking and make healthy lifestyle choices.

It is also estimated that decreased physical activity is responsible for as many as 25% of breast and colon cancers, 30% of heart disease and 27% of diabetes in the world. Unfortunately, knowing that healthy habits can have such an impact does not seem to be enough to inspire people to follow them.

I have wondered why this is the case and I think the answer is complicated. It is hard for many of us to follow healthy lifestyle choices because they require time and energy. We all tend to get caught up in our busy lives and neglect ourselves. In addition, many of us live in denial that anything bad will happen to us.

Hopefully, if we hear the message enough, the wisdom of making healthy choices will sink in. It is important for each of to take responsibility for our overall health and the health of our families.

The following is a past blog that I am reposting, not only because it’s a common malady in our age group, but also because my next (new) blog will be Part II. Since I am going to refer to Part I in the new one, I thought it might be useful to run it again first.

What I Learned From Yoga

I have been doing the “Move it and Lose it Challenge” with Dr Oz on Sharecare.com since the first week it started. It is a great program where I have been diligently writing down my food consumption and exercise. I thought I was doing pretty well with my calories and should be burning quite a bit every day. However, I haven’t been losing as much weight as I would expect. It caused me to ponder what I might be doing wrong. I must confess, as I noted my calorie consumption going down, my chocolate consumption started going up!

I felt so good about doing well with my dietary changes that I was rewarding myself with chocolate. I know that dark chocolate is the healthier form, but I really like milk chocolate. I realized that any type of chocolate is my problem and I am hooked.

A week ago I stopped eating it and I am going through withdrawal. I think about it several times a day and last night I even dreamed about it. Today was better. They say it takes 21 days to break a habit. I am going to stick with it and see what happens. I bought some wonderful vanilla flavored tea and I have been drinking that when I feel the urge to splurge. I have also been taking a lot of walks.

From now on I will be rewarding myself with things other than food. I am thinking that a facial or a shopping spree may work really well. Without the chocolate I am hoping I make my goal weight ahead of time!

If you’re old enough to remember Jerry Lee Lewis singing his hit song, or even to recall your older brother or sister dancing to it, then you’re old enough to be concerned about your balance and your bones. Even if neither is a problem now.

Why am I mentioning these two health issues together? Because there is one therapy that can help to prevent both of them, and in some cases, even help to reverse both diseases.  And that therapy is a form of exercise, or rather, a combination of two types of exercise: weight-bearing (also known as strengthening) – such as lifting weights – and those movements that work on the ability to balance – such as yoga, pilates, and Tai Chi. You can combine these by doing weight-bearing movements like squats or by lifting weights while you are challenging your balance – by standing on the unstable surface of a BOSU ball or on one leg. This combo of challenges to your body really works to improve your balance while putting pressure on your bones, and muscles for that matter. (See the chapter in our book on physical activity which discusses this combination of exercises.)

Now comes a new type of training that purports to challenge your balance  and strengthen your bones and muscles at the same time.  It’s called “whole body vibration” (WBV). This training works just as you would expect: you stand on an level platform which, when turned on, vibrates rapidly. You can either just stand there, and supposedly benefit your bone density, or you can add your other exercise while you are vibrating, which will help your balance and strength in addition. The vibrating machine upon which you stand is called a WBV platform.

There are a great many studies on this training, particularly in the physical and sports medicine literature since it was initially used for athletes and as therapy after injuries. Many positive effect have been seen with WBV, including enhancement of muscle strength and conditioning, improvement of blood flow, and especially rehabilitation of all types of injuries. Different frequencies and amplitudes of the vibration, and varying durations, are used for different purposes.* Therefore, one platform with its own specific vibratory frequencies and amplitudes is not good for all purposes or all people. In addition, many studies support the idea that to get the best results, training on the WBV platform should be done in a progressive manner.

Initially, the WBV platforms were huge, exorbitantly expensive, and available only in a professional setting. Recently – as happens with all types of exercise equipment that appears to have positive effects – the WBV platforms have become available in smaller, portable, and less expensive forms, especially for professional gyms and physical therapy offices. (And I’ve read that Madonna has her own, of course.)

Should you run out and buy one? I would do that only after asking a certified physical trainer their opinion about it, and then actually training on one at a gym or at a physical fitness store under a qualified person’s direction.  The portable  WBV platforms are not all alike, especially with regard to the speed of the vibrations. While some of the studies showing improvement in bodily functions, particularly in rehabbing injuries, are impressive, there should be further studies on the possibility of negative effects of vibration at that level. In addition, the WBV platforms for home use probably need to have some kinks worked out before you spend a lot of money on one.

On the other hand, do I think WBV is going to go the way of the hula hoop (which is actually good exercise!)? No. The idea and science of it makes sense. Just look at Pilates and the Reformer: previously thought by many to be a fad, both have withstood the test of time and are now a respected part of many exercise regimens.  

So, as with any new thing you are considering trying that may affect your health, research it and try it under supervision before doing it on your own.

*Albasini, A, Krause, M, and Rembitzki,I. Using Whole Body Vibration in Physical Therapyt and Sport. Elsevier, 2010.

I used to live in Portland, Oregon, which is one of the most beautiful cities in the world. That is, when the sun is shining. Unfortunately, the average rainfall in Portland is 37.5 inches a year and by the end of October until the end of May it can be very gray. I noticed that many of my patients would get the blues during these months.

It did not surprise me when Dr. Norman Rosenthal described the condition known as Seasonal Affective Disorder in 1987. It is a condition that most commonly starts in September when the light starts to change. It can continue until the light returns in the spring and summer. Those who suffer from SAD often complain of fatigue, loss of self-esteem, moodiness, and a craving for carbohydrates. Interestingly, SAD can occur for some people in the summer and seems to be related to heat.

Light therapy, exercise, and antidepressants can help alleviate these symptoms. If a light box is used, it should be done in the morning with a special light that mimics daylight outside. There is some suggestion that blue light may be preferable. Regardless, it is important to research the lights or ask your doctor for a suggestion.

If antidepressants work best for you, it is important to start them in late August before the light starts to change. Exercise is essential for general health and will help especially during the gray months. If you were able to get away and go somewhere sunny, that would be great.

SAD occurs in one in fifty people so it is very common. If you think that you may have seasonal effective disorder, talk to your doctor. He or she can help to give you a sunny disposition even when the sky is gray.

I started learning how to do ballroom dancing about a year ago. I found that it helped me to lose weight, walk taller, and it improved my balance. In addition, I noticed that my thinking was clearer and I had more energy. The observation caused me to look into the therapeutic benefits of dance.

Both the Mayo clinic and the National Institutes of Health have found that social dancing helps to reduce stress, improve energy and coordination, improve overall strength and it strengthens the bones of the hips and legs. In addition it lowers blood pressure and improves cardiovascular health.

A recent study of 75 year olds discovered that those who did activities such as dancing, playing music, board games and reading at least 11 days a month reduced their risk of dementia by 63%. Recent studies of Parkinson’s disease patients who were taught tango determined that when compared to regular exercise, tango-dancing patients had improved balance and functionality. When they were taught waltz and fox trot, locomotion and balance improved but the tango dancers showed the most improvements.

Many of us have a hard time exercising, because sometimes it just isn’t a lot of fun. However, dancing is great fun and is a wonderful form of exercise. The best thing about it is that it doesn’t feel like exercise it just feels great. If you are trying to figure out how to get more movement into your life, find a dance class and get started. It is good for your body and your brain!

If you’ve read our book, you know that we strongly believe in the maintenance of good health and the prevention of disease by regular screening exams. Of course, maintaining good health also depends on being aware of our bodies, noticing new symptoms, and seeking help for them. But, many people have no trouble doing the latter, but just can’t make themselves do the regular screening.

I never really understood that attitude until this past year.  In 2010, I managed to get every one of the recommended screening tests done.  How do I feel about having done that? Proud of myself, sure, but more than that – utterly exhausted. From my routine mammogram and physician-performed breast exam to my annual pelvic exam to my yearly full eye exam to my twice yearly dental cleanings and exams to a colonoscopy to my regular labwork to my first ever full skin exam. All throughout 2010, it felt like I was always either making a medical appointment or going to one.

Add to those, several acute problems – all orthopedic that necessitated not only several doctor visits but also 8 weeks of twice weekly physical therapy – and I had little to no time for anything else besides work, eating and sleeping! I can certainly see why some people would be reluctant to buy into the whole health maintenance idea from a time standpoint, if for no other reason. No wonder some of my patients’ eyes glaze over when I start talking about the yearly screening schedule.

The truth is though, that, in spite of my compaining, my strongest feeling about my health maintenance schedule in 2010, coming in far ahead of the fatigue, is appreciation. I’m very grateful and glad that 1) I have such easy access to all of these tests; 2) most are covered by my insurance; and 3) they all had good results. There are many people, here and in other countries, who cannot say even one of those things.