Gonorrhea is the second most commonly reported infectious disease in the United States. Unfortunately, it has become resistant to most antibiotics. Antibiotics in the cephalosporin family are the antibiotics that have been effective. However, now there are some strains of gonorrhea that have become resistant to this group of antibiotics as well.

The age group that has more cases than any other are teen girls from ages 15 to 19. If gonorrhea is left untreated it can result in pelvic inflammatory disease, infertility and even arthritis and possible heart problems.

Since the advent of antibiotics gonorrhea has changed and developed resistance. The first drug that was tried was the class of sulfa drugs, then the penicillins and a wide variety of others. It is resistant to all but the cephalosporins now and soon we may be left with no options to treat this disease.

The key is to prevent gonorrhea in the first place. It is important that we talk to our children about the consequences of unprotected sex. Regardless of how you feel about abstinence, sexually transmitted infections and how you get them is one topic that must be discussed. Otherwise, the consequences could be deadly.

New research has found that for middle aged women to maintain their weight and not gain, they need to exercise an hour a day. I take care of many middle aged women who cannot understand why they continue to gain weight despite healthy eating and exercising two to three times a week. When I mention the need to exercise daily they groan. However, there is no easy fix for the problem. As we age our metabolism slows down. We cannot eat the same amount of calories we ate when we were younger. Life, children, jobs all make it harder to find time to exercise. That is why it is so important to incorporate exercise into our daily life. For some, cycling to work may be an option. For others, walking to work or walking from a distant parking spot may be a possibility. Women who work in a building with an elevator may want to use the stairs exclusively. The key is to look around and find a way to exercise daily. It is essential so become imaginative and just do it.

A newly released British study has found that for every women who gets unnecessary treatment as a result of something found on mammography, two women are found to have breast cancer who would not have known that they had it otherwise. The findings of this study are important considering the ongoing debate of whether women between 40 and 50 should have regular mammograms. Considering that breast cancer is generally a more aggressive disease in younger women, it is important to pay attention to these finding.

Many women do not like having mammograms. They are generally uncomfortable and the breasts are exposed to a small amount of radiation. However, in my opinion and the opinion of many experts, the risk is small compared to the benefits. In recent years, most of the breast cancers I have diagnosed in my patients have been found on mammogram. No mass was felt and the patients had no symptoms.

In addition to mammogram, I believe it is important to eat a healthy diet and remain thin, exercise regularly and drink alcohol in moderation or not at all. It is estimated that as many as 30% of breast cancer cases could be prevented if women follow these three simple behaviors.

The risk of breast cancer is one in eight over a woman’s lifetime. As we get older it is important that we do what we have to do to achieve optimal health. A healthy lifestyle and regular preventive tests and exams are not just essential but an absolute necessity.

As the importance of eating fish is stressed and many of us try to move towards being health conscious, sushi has become a favorite among many baby boomers. Isn’t it just amazing how when you finally start doing what you think is healthy, you find out that it may not be? A recent study by the Environmental and Occupational Health Sciences Institute tested tuna found in 20 restaurants in New York City and found that if you ate 6 pieces of tuna a week, you will have exceeded the acceptable limit of mercury exposure that was set by the EPA!

What is the problem with mercury? It can affect your nervous system. It can cause vision, balance, and memory problems (to name a few) not to mention what it can do to a fetus if a pregnant woman is over-exposed. I have a doctor colleague who was convinced he had multiple sclerosis. He had every test and every scan imaginable. Finally, some smart doctor checked the mercury level in his urine. It was sky high. He had mercury poisoning as a result of eating a ton of tuna to help him lose weight. Once he stopped doing that, his symptoms resolved.

What is a health-conscious person to do? I would suggest limiting the tuna to 12 oz a week. Keep eating fish, but go with the safer ones such as wild salmon, herring, sardines and you can also try shrimp.

If you like things raw, make sure you go to a reputable restaurant. If you want to play it safe, get cooked fish in your sushi rolls. There are many infections that you can get from raw fish that is contaminated (food for another article).

Eat healthy and be well!

When we think of eating disorders such as anorexia and bulimia, we usually assume it only happens in young people and especially young women. However, a recent study done at the Eating Disorder Center of Denver has found that it is not just an issue with younger people. They have found that women in midlife from 30 to 65 are also having problems with eating disorders. The majority of these women suffered from eating disorders when they were younger and life events threw them back into old behaviors. Many of these women had similar psychological profiles to younger patients including low self-esteem and a poor body image.

Anorexia and bulimia can lead to serious health problems including heart failure, abnormal heart rhythms and even rupture of the esophagus. It is really important that if you suspect that a friend or loved one is suffering from either of these diseases, that they get help as soon as possible. It is never too early to get help to prevent potentially deadly consequences. This is one of those throw backs to youth that we would like to avoid!

I am only 5’2” and always looking for ways to improve my height. A recent study done in Philadelphia has found a potential way to do that. They studied 24 women over 65 years of age and enrolled them in a nine-week yoga program. They did an hour and a half of yoga twice a week. After the women completed the program, they were more stable on their feet, walked faster, felt more confident and…..they gained an average of a centimeter of height!

I have taken many yoga classes and have to admit, there are other forms of exercise I prefer. However, if yoga can improve my health and become taller at the same time, I might reconsider!

There are approximately 220,000 cases of prostate cancer diagnosed each year. Men have a 1 in 6 chance of developing prostate cancer over a lifetime. When the cancer is localized to the prostate the five-year survival rate is 100%. Fortunately, due to early detection and new treatments the death rate is 1 in 35 and is going down. There are some things that men can do to decrease their chance of getting prostate cancer or decreasing the spread if they have it. The place to start is by eating cancer-fighting foods.
These include:

• Beans
• Berries
• Cruciferous vegetables such as broccoli, cabbage and kale
• Dark green leafy vegetables
• Ground flaxseed
• Garlic
• Grapes
• Soy
• Tomatoes
• Whole Grains and…

Green Tea

Green tea is packed with polyphenols. The one most commonly studied is Epigallocatechin gallate or EGCG. The catechins found in green tea such as EGCG have been found to stimulate the death of cancerous cells, act as an anti-inflammatory agent, and prevent the genetic expression of some of the more aggressive prostate cancers.

There have not been a lot of studies looking at the prevention of prostate cancer using green tea. However, there was a trial of 60 volunteers with a precancerous condition for prostate cancer. They were given 200 mgs of green tea extract capsules (the mgs refers to the polyphenols that were contained in the whole plant) three times a day. After one year only 3% of the treated group vs. 30% in the control group developed prostate cancer.

Three cups of green tea provides between 240 and 320 mgs of polyphenols and as much caffeine as one cup of coffee. It can be taken in tea or in supplements. If you want to use the extracts make sure they are standardized to contain at least 25% polyphenols and you take 600 mgs a day in divided doses. It can affect the liver over time, so it is important to let your doctor know what you are doing and have your liver enzymes checked periodically.

Eating healthy foods and drinking green tea are just couple of ways to keep your prostate healthy. So, eat your fruits and veggies and when it comes to green tea…drink up!

It is no surprise that as our generation is reaching retirement more studies are being done to see what improves longevity and function as we head toward landmark ages such as 100.

It also should be no surprise that there are a few behaviors that really make a difference. The biggest is not smoking. In a recent study of 2300 men reported in the Archives of Internal Medicine, smoking doubled the risk of dying between the ages of 72 and 90. Those who had diabetes had an 86% chance of dying before the age of 90; obesity increased the risk by 44% and high blood pressure by 28%.

So, you might be thinking, who cares, I don’t want to get to 90 and be disabled anyway. However, many of the people who lived to 90 and beyond had minimal disability and were living independently. What was their secret? They lived well. They did not smoke, ate fruits and vegetables, exercised and remained active (mentally as well as physically).

Even if you have a chronic disease such as diabetes, you can live to be100 if you are able to treat your disease aggressively. Studies have confirmed that if you can find a doctor who becomes your partner and treats your overall health it can happen and you can maintain your quality of life.

What is the take home lesson in all of this? Live well and take care of yourself, find a good doctor and find ways to incorporate healthy activities (like exercise) into your every day life. Simple? Maybe not, but essential!

There is a relatively new field in medicine known as Anti-aging. It is not recognized by mainstream organizations such as the AMA. However, patients (especially baby boomers) are flocking to it. The goal of anti-aging doctors is to help their patients feel and look younger. The treatments involve hormones and supplements.

The conventional side of medicine claims that this is just a way for doctors to make money. The anti-aging group claims they are in it to help their patients feel good.
What is a patient to think?

As a baby boomer myself, I noticed that when I started going through menopause, I needed help with my hormones. I continue to use them. I feel better when I can sleep, don’t have hot flashes in the middle of a conversation and have fewer body and joint aches. For me some simple hormone adjustments have made a big difference. Vitamin D has also made a huge difference. I was at the rickets level of vitamin D until I started supplementing with it. I noticed that my energy level, muscle strength and balance have improved 100%.

I am not trying to reverse aging, we all know that it is impossible. No matter what we do, time marches on. However, I think that aging as healthfully as we can is a reasonable goal. How one does that is very individual. Some women choose hormones others do not.

I think that for me as a physician (and a patient) that the middle ground works best. I aim to help my patients become as healthy as possible with diet, exercise, and supplements, for which there is evidence to show they help such as omega 3 fatty acids, vitamin D and B vitamins as well as foods such as ground flax seed. I also utilize mainstream approaches. So ultimately, I do not think there is a way to stop the clock or turn it back, but there is a way to help it to run more smoothly.

When many of us think about bathing suit weather we look at ourselves in the mirror, cringe and decide once again to lose weight. Most of us turn to “diets” for help. Of course, I believe that the one thing that really works over the long haul is a lifestyle change, however, diets can be a guide to what lifestyle changes work. There are the low carb diets, the no carb diets, the raw food diets, Weight Watchers….there are a zillion choices out there. I am going to pick a diet a week and describe them. Let’s start this week with the Good Carb/Bad Carb diet.

Many diets (such as Atkins and the early phase of the South Beach diet) restrict carbohydrates. This diet focuses mainly on not restricting carbohydrates, but rather on eating carbohydrates that have a low glycemic index (those that release sugar slowly into your system). Sugars that are from processed foods (candy, chips, cheese doodles) have a high glycemic index. They release sugar very quickly (these are a no-no). Whole grains, brown rice and beans are considered good carbs and release sugar slowly (these are a yes-yes).

This diet also focuses on the need to eat small meals throughout the day and on eating lean protein. It is basically focusing on a healthy diet. There is a book devoted to the topic: http://www.amazon.com/Good-Carbs-Bad-Indispensable-Optimum/dp/1569245371