Recently I was invited to attend a private horse experience that was designed to help women who are breast cancer survivors. I went, because I wanted to know how it could help my patients. What I found was something that would help all my patients and my colleagues as well.  Horses are intuitive beings that sense our emotions, our hearts and they are healers.

My experience started with an excellent orientation by Trish, the horse trainer and her assistants Jennie and Hannah. Then, I walked into the ring by myself with Mystic, the therapy horse.  She is small (for a horse), powerful and beautiful. She approached me and I allowed her to nuzzle my hand. Then for a brief moment she wrapped her powerful head around to the small of my back signaling that she wanted her back rubbed, which I did.  Then I was instructed on how to rock her hips ever so slightly and she became very calm.  After that I hugged her. I placed my hand on her back and pressed my body up against her side with my hand over her heart.

I felt like I could have stayed there forever.  I was overwhelmed by something that is hard to describe. My heart opened and I felt a sense of pure love and acceptance and then I started to cry. It was amazing.  What is really wonderful is that I remember the feeling.  I am able to recall it when I feel scared or sad or insecure, and it comforts me.

Horses have been used as therapy animals for centuries.  In more recent times, they have been used to help those with PTSD, children with autism and those with disabilities to name a few. They are highly intuitive, and their rhythmic movement is similar to the human walking pattern, which is soothing. Their reactions to touch, brushing, grooming and bathing can be very calming.

The Riding Beyond program has helped breast cancer survivors to feel accepted, strong and loved. For those that feel scarred and/or wounded, they feel whole. Mystic is quite a therapist along with her wonderful, caring trainers.

Therapy horses are amazing beings. They can help all of us ride beyond whatever obstacles we encounter in our lives. In my opinion, it would be a more peaceful world if we could all have a horse therapy session!

“Horse sense is the thing a horse has which keeps it from betting on people. ”
― W.C. Fields

I just returned from a trip to New York City. One of the things I enjoy doing when I visit is to walk.  It is often times the fastest way to get where you want to go unless you use the subway.  One of the things I noticed this trip was very disturbing.  Most people walking around the city are looking down at their cell phones or speaking on the phone and not paying attention.  I was rammed into so many times; I just wanted to stop the world and scream, “Look up!”

It is no wonder with the explosion of social media and smart phones that more people are getting injured while walking, talking and texting. A study done at Ohio State University found that the number of emergency room visits for pedestrian injuries related to cell phones tripled between 2004 and 2010.  They noted that those between the ages of 16 and 25 were at highest risk.

There did not seem to be that much of an age distinction this past week.  I saw men and women young and old looking down at their phones.  In a city where there are major pot- holes, uneven sidewalks and open cellar doors leading into bakeries and restaurants there are some serious injuries waiting to happen.

There are wonderful things to look at strolling around New York. It is a shame that many are missing out.  In addition to the enjoyment factor, it makes sense to pay attention to avoid not only danger from injury but also danger from crime.  Staying alert and aware is important for overall safety.

Last year police were stunned when security footage revealed that a man on the San Francisco light-rail had his gun in plain sight and was waving it around before he finally fired into the back of a college student. No one noticed because they were staring down at their phones.

How many other things are we missing while we are allowing ourselves to get sucked into the cyber-world?  I challenge all Americans young and old to get back into the real world to enjoy it and be safe.  It is time for all of us to look up!

There is no doubt that Ebola is a scary disease. The question is should you be scared? The answer in my opinion is, no. There are many health issues to worry about in this country.  Ebola is not at the top of the list.

First let’s get educated. What is Ebola?

Ebola is an infectious disease caused by a virus that is primarily seen in Africa. The symptoms include fever, severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain and unexplained bleeding.  Symptoms occur between 2 and 21 days after exposure.  The fatality rate is 50%.  If someone recovers they are immune for 10 years.

The disease is spread by direct contact with blood and body fluids that include urine, sweat, saliva, blood, vomit, breast milk and semen with someone who is infected with Ebola. Contaminated needles and medical equipment can also spread it.   Ebola is not spread by air or water.  Those most at risk for catching the disease are family and healthcare workers who live and/or care for Ebola patients.

If you are someone who flies or is flying to Africa  then take precautions as dictated by the Centers for Disease Control for those entering the countries at high risk for the virus.  If not….

It is time to get some perspective.  The media loves drama. Although the disease is spreading in Africa, there is one case thus far in the US and the patient is in Texas.  The risk of Ebola coming to a town near you is relatively small.  It makes far more sense, if you are concerned about your health to focus on what will really makes a difference.

Protect yourself from the flu that kills an average of 30,000 people in the US every year.  You can do that by washing your hands frequently, keeping them away from your face, exercising regularly, reducing your stress, getting plenty of rest, and eating healthy foods that boost immunity.  That would include plenty of garlic and onions and maitake and shitake mushrooms.  Most importantly don’t forget to get your flu shot this year.

Granted Ebola is a devastating disease, but it is a distraction from what is really important for those of us in the United States.  Let common sense prevail. It is time to focus on how each of us can become the healthiest people we can be.

As an adult you may think that you are done with immunizations, but guess what? You are not! One of the more common ailments I have been seeing with my patients is adult pertussis or whooping cough. This happens because the vaccine we were given as kids can wear off. For adults the disease is an incredible nuisance. It is what we call the 100-day cough, aptly named because that is how long the side-splitting, spasmodic cough usually lasts.

It is bothersome to us but can be deadly if passed on to infants who may not be immunized for it yet. That is why we all need a booster that is given along with the tetanus shot.  It is called the TDAP.  After you get your pertussis vaccine, you can get the tetanus booster alone every ten years (or sooner if you get attacked by a rusty nail).

The other vaccine I highly recommend is the shingles vaccine.  That can be given at age 60 and one shot is enough. It may not completely prevent shingles but can limit the severity of an outbreak. Shingles occurs in those who have had chicken pox.  At the time you get the disease, the virus hides in a nerve and then one day when you get good and stressed out or your immunity drops, you can get shingles.  This is a disease that results in painful sores.  It will occur on only one side of the body in the distribution of a particular nerve.  It can be any nerve so it can be located anywhere on the body.  If you have never had chicken pox, have your doctor check a blood test to make sure you are not immune and then make sure you get the chicken pox vaccine.  If you have never gotten chicken pox and you get the vaccine, you will never get shingles.

I never used to get the flu vaccine until many years ago when I was working in an urgent care and watched four healthy men in there forties (over the course of a winter) die from the disease.  That was enough for me.  Everyone is freaking out over Ebola, which has killed at least 2000 people this year.  Influenza on average kills 36,000 people in the US.  Should you get the flu vaccine? Yes.

Pneumonia is another potentially preventable disease. The pneumonia vaccine can help protect against multiple strains of pneumococcal pneumonia.  It can be given before the age of 65 to those who are at risk such as asthma and COPD patients, those with cancer, kidney disease, liver disease, etc.  After 65 it is recommended for everyone.  One shot is all you need.

For those who travel and those who work in the medical profession and work with people who may be ill, I recommend vaccines to protect against hepatitis A and B, Meningicoccus, and Hemophilus influenza type b.

I have encountered many young adults recently who have NEVER been vaccinated.  This is a very scary notion. Especially when world travel makes it easy for communicable diseases to be brought into areas where they never have been before.  Measles and mumps are on the rise, polio is still present in the world and I remember what it was like before we had vaccines for these diseases.  It was horrible.  If you or your children fall into this category, please catch up on these vaccines as well as the ones I have mentioned before it is too late.

It is important to have a discussion regarding which vaccines are best for you with your doctor.  He or she can look at your risk for various diseases and help you to decide which ones are best for you. Vaccines are relatively safe and can save lives.

As in life, in medicine there are rarely black and white answers to questions and treatments for medical conditions. Many of us have experienced different doctors with different personalities who either fit with us or did not.  When situations arise and you need treatment or diagnostic evaluation, and you feel things are not going in the right direction; it might be time for a second opinion.

This is especially important for those diagnosed with cancer. There are now a variety of approaches for acute and maintenance therapies.  Some doctors may prefer radiation to chemotherapy and others may have other types of treatments in mind.  This is especially apparent for those with prostate cancer. Some doctors may recommend conventional surgery vs. robotic surgery vs. cryosurgery.  For therapy there may be ultrasound vs. radiation pellets vs. hormone therapy vs. a variety of experimental therapies.

As you can see, it is important to find the approach that fits with what you may want and what will work best for you.  It is your body and you need to make an informed decision. It may take a couple of opinions for you to figure it out.  Patients are often afraid they will offend their doctors. However, most doctors welcome a second opinion.  If you have one that does not, perhaps it is time to find another doctor.

Who should you see for that second opinion? I will usually encourage patients to go to a university medical center such as Oregon Health Sciences University or Stanford.  However, there are often specialists that are highly regarded in our own communities. Speaking to people with similar diagnoses and your own physician can help you to find them. As a physician, I welcome another pair of eyes looking at my patients and possibly seeing something I may have missed or finding a treatment I might not have thought of or realized that was available.

Providers are always talking about how important it is for patients to take responsibility for their own health as regards to diet and exercise. Part of being accountable for your own health includes being an informed patient.  Seeking a second opinion is very often essential in order to do just that.

How lethal is Alzheimer’s disease?

According to the Centers for Disease Control (CDC), Alzheimer’s disease is the 6^th leading cause of death in the United States.  However, a recent study has found that it may be an even bigger killer than we thought. Researchers in Chicago followed over 2500 people who were 65 years or older and who underwent yearly testing for dementia. After eight years 1,090 participants died and 559 developed Alzheimer’s disease while being followed.

The death rate of those between 75 and 84 who were diagnosed during the study with Alzheimer’s disease was four times higher than those who were free of the disease.  It was three times higher in those over 85.  When the researchers took these numbers and applied them to American seniors with Alzheimer’s disease in 2010, it would mean that there were over 500,000 deaths in those over 75. That would be six times greater than the deaths reported by the CDC.

In other words, there are many more people dying of Alzheimer’s disease than we think. The reason for this is that death certificates report the immediate cause of death.  Often the chronic underlying cause is not reported.

Alzheimer’s disease results in memory loss from a progressive deterioration of the brain.  We still are not sure of the cause.  As people become more debilitated they have trouble with basic functions.  They may have difficulty swallowing, forget to drink and eat, and have trouble walking and balancing.  The common causes of death are aspiration pneumonia, which occurs from inhaling food as a result of trouble swallowing, dehydration due to lack of fluid intake and hip fractures as a result of falling.

Knowing the impact of Alzheimer’s disease on quantity of life as well as quality is extremely important. Not only does it take an emotional toll on family and loved ones, the cost to society is huge.  As the baby boomers continue to age, the numbers of those afflicted with this devastating disease will be skyrocketing.  The costs to care for these patients as well as loss of productivity will be enormous.

Recognizing the increase in the death rate hopefully will garner funding and accelerate new research projects.  We must find a cure for Alzheimer’s before it crushes our families and medical system and threatens our economy even more than it already has.

Certain strains of human papilloma virus or HPV are known to cause cervical cancer.  Treatment thus far has focused on a vaccine to prevent infection and if and when detected to follow women with pap smears. If pre-cancer or cancer develops there are a variety of procedures performed to remove abnormal cells.

What if there was a cure for HPV?

It looks like there is a cure. In fact there are two potential cures. One is natural and the other is a drug used to treat HIV.

The drug used to treat HIV is called Lopinavir. Two British physicians in Kenya treated 40 women with high-grade cancer and pre-cancerous disease of the cervix.  The drug was dispersed using a pessary. They were also treated with one capsule twice daily for two weeks.  Repeat pap smears at three months showed that 23 women diagnosed with cancer had returned to normal and two had low-grade disease resulting in a 91.2% response rate.  The women initially diagnosed with low-grade disease had a similar outcome.

The results of this study have many implications. A fair number of women especially in the US endure multiple procedures and exams every year along with a tremendous amount of anxiety related to having pre-cancer and the potential of it becoming cancerous. This medication may help these women as well as offering a cure for cervical cancer a disease that kills 290,000 women worldwide.  We also know that HPV can cause head and neck as well as rectal cancer.  It is possible that Lopinavir may be a reasonable treatment for these as well.

The Natural Treatment

Curcumin is a component of the spice turmeric.  It has both anti-inflammatory as well as anti-viral properties. Researchers have found that when it is used as a vaginal cream, it eradicates HPV.  The cream has no side effects but it may not affect abnormal cells that have spread to the uterus and ovaries.  However, the research team is working on an intravenous preparation that may work.

Here in Medford, Oregon we have started a small study using compounded curcumin vaginal suppositories to treat women who have HPV and abnormal pap smears.

How wonderful it would be to prevent cancer and eradicate HPV using a natural compound without side effects. Whether treated with a drug or natural remedy, it is becoming clear that HPV related disease could soon become a thing of the past.

“Let food be thy medicine and medicine be thy food”  ~Hippocrates

In honor of this, let me tell you some things you may not know about two popular fruits. They taste great and may even help you to lose weight. Let’s start with my favorite, grapefruit. Then we will move on to raspberries.

Grapefruit has many of the vitamins of the other citrus fruits but is has a lower Glycemic Index. That means that sugar is released slowly in the body rather than in one quick rush.

The results of a 12-week study linking grapefruit to weight loss done at the Scripps Clinic in 2004 put 100 men and women on a diet that included half a grapefruit or grapefruit juice three times a day with a meal. The average weight loss was 3.6 pounds for those who ate their grapefruit, 3.3 pounds for those who drank it. However, many reportedly lost more than 10 pounds. Grapefruit has chemicals that may lower insulin levels and expedite weight loss. The only problem with it is that it can interact with certain medications. It is important to check with your doctor or pharmacist to find out if you are on any of these medications. If so, you need to avoid it. (Sorry about that)

Raspberries are rich in antioxidants. Eating three or more servings per week have been found to lower the risk for age related macular degeneration. The anthocyanins (important antioxidants) in raspberries have been found to delay the effect of aging. Although raspberries contain sugar it does not seem to affect blood sugar in a significant way. Red raspberry ketones are currently being used in Japan as a weight loss supplement. Red raspberry seed oil has attracted the interest of the cosmetic and pharmaceutical industries because it is rich in Vitamin E, omega-3 fatty acid and has a sun protection factor (SPF) of 24-50.

Celebrate this month by eating your favorite fruit or vegetable and enjoy!

I have a friend who is amazing.  She is full of life, grace and light and she has been one of my most inspirational teachers.  She is dying of ovarian cancer. She was diagnosed five years ago at the age of 50 and was doing really well until about a month ago.   Knowing that she had a disease, which had spread at the time of diagnosis, she realized that she was living on borrowed time. She has tried every type of chemotherapy available to her, and she has lived life to the fullest and valued every moment that she has had.

She has given all those around her perspective about life. When my parents and grandparents used to say that our greatest gift is our health, I now know what they meant. My friend has shown me that.  She has taken great care of herself with healthy eating, exercise, meditation and lots and lots of love and laughter. And, she does not let little things bother her. She lives each day as if it were her last.

She is a reminder that we need to appreciate all that we have and not take our health for granted.  It is the most important thing for all of us. None of us know what is waiting around the corner.  What we can do is really listen when our practitioners provide suggestions on how to improve our health and lifestyle choices. It is important to take the advice instead of giving excuses for bad behavior.  Wellness is all about healthy eating and exercise. This is a concept that seems to elude many.   I am continually striving to help patients find the connection between their choices and behaviors and how they feel.  It isn’t easy but when it happens it is wonderful to watch.

Regardless of how much money you make, how old you are, what you think of your wrinkles or the state of your body, if you are healthy you are rich. Recently, someone was bemoaning the fact that she was turning 60 years of age; my friend told her that she would love to be able to get to 60. That would be an incredible gift.  Unfortunately she will not get there.

However, her legacy is the lesson on how to embrace life and not sweat the small stuff.  We are here and we are lucky to be able to enjoy life and make the most of it.  It is never too late to do what we need to do to be healthy.  Life is short. The time is now; just do it!

Protect and Check Yourself !

Melanoma is the deadliest form of skin cancer. There will be over 68,000 new cases in the US this year. The major risk factors for melanoma include a family history, exposure to UV rays of the sun especially early in life, light eyes and hair, and age greater than 20.

When melanoma is caught early it is very curable.The key is to recognize it and have it removed. The typical characteristics to look for are the A, B, C, D and E’s.

A is for asymmetry. If you look at a mole and it looks asymmetrical it is time to have it checked out.

B is for border. If the border is irregular and not smooth it needs to be evaluated.

C is for color. Moles that are purple, multiple colors, or black need to be checked out.

D is for diameter. If it is greater than the size of a pencil eraser top, it needs to be checked.

E is for elevation. If the mole is raised and bumpy it is abnormal.

If you have a skin mole that is oozing, scaling and/or growing it is important to have it evaluated. Sometimes moles are in places that you might not expect. They can be in the eye, scalp, and even on the bottom of the feet. In African Americans, melanoma can be mistaken for a wart on the hands or feet. That is why we recommend that you have a dermatology exam every year. A dermatologist will recognize those moles that are suspicious and remove those that need to be evaluated.

If you have anything that concerns you please go and get checked. Our motto: When in doubt check it out!