Remember Michael Moore’s movie “Sicko” ? It had quite a bit of notoriety several years ago  but I could never bring myself to watch it. Why you might ask? Although I agree that our medical system is tragically flawed and due to implode at any moment, there was a very important piece missing from that movie.You might want to call it the “elephant” in the room. Michael Moore himself appeared to be overweight and out of shape. Did he address that in his movie?

Where was personal accountability? Sometimes things happen. Cancer is one of those things. It is the result of many factors that are often out of our control (not smoking however which is in our control), but what about taking responsibility for one’s own health? Many diseases can be prevented with a healthy diet and exercise. We have the unhealthy habit in this country of blaming others when something goes wrong. What about looking within? We have great technology that can do amazing things such as opening arteries in the heart to prevent heart damage from a heart attack and removing plaque from the arteries that feed the brain to prevent damage from strokes. Even with all of this technology the true ability to prevent disease and keep things from getting to the point of needing it comes down to lifestyle choices. If you exercise, eat healthy, maintain a healthy weight, quit smoking or never start, have your blood sugar and blood pressure and cholesterol under control odds are you will not need it!

I see patients all of the time who are fatigued and achy and angry that despite optimizing their hormone levels and vitamin levels they are still tired. When I ask them whether they have incorporated exercise and healthy living into their life they say “no”. What more can be done? What will it take to turn on the light of understanding? I am still trying to find the answer to that question. Each person is different, but it is a beautiful thing to watch when a patient figures it out. I am sorry it doesn’t happen for everyone. It needs to, and I challenge Michael Moore to find that answer to that question for one of his next movies!

There have been many reported health benefits that have been discovered regarding the consumption of dark chocolate. One of those benefits is lowering blood pressure. When subjects with mildly elevated blood pressure were given a 100-gram dark chocolate bar daily their blood pressure significantly lowered. When milk was added to that chocolate, there was no benefit.

In another study, researchers divided a group of 470 elderly men into groups according to how much cocoa-containing food they ate and followed them over 15 years. The men who consumed the most cocoa-containing products were half as likely to die from heart disease as those who ate the least. In addition, they were half as likely to die earlier from any cause compared to those who ate foods containing the least among of cocoa or chocolate.

Finally, a recent study has found that 85% dark chocolate can decrease liver pressures after eating a meal in those with cirrhosis of the liver. After eating, abdominal pressures rise and chocolate can reduce that pressure.

Dark chocolate contains antioxidants called flavanols. Flavanols stimulate the production of nitric oxide in the artery walls. This causes the arteries to relax and pressures to reduce. That may be the mechanism for lowering blood pressure, preventing heart disease and lowering liver pressures.

Chocolate may be the new health food, but remember it has calories. So, if you are going to eat it make sure it is the good dark chocolate and that you reduce your other calories to compensate for the addition!

Spring is here and stress is in the air. There are worries over the economy, unemployment, and the state of healthcare (among other things). There are ways that each of us deals with stress -both consciously and unconsciously. Some people get sick (not a great solution);others overeat; still others drink too much alcohol. But many people have learned to work it out in a healthy way using things like exercise, meditation, yoga, and talk therapy such as cognitive behavioral therapy (CBT).

CBT is a process that looks at a person’s beliefs, and helps to change negative thought patterns.It is like teaching people to look at the cup as half full, rather than half empty.A recent study has found that ten sessions of CBT significantly improved worry in older individuals with generalized anxiety disorder.CBT has also recently been shown to have an impact on depression and health outcomes in those who have undergone cardiac bypass surgery.

If you are stressed out, you are not alone.We suggest that you look to healthy ways to deal with stress and worry.If you feel you need help and would benefit from talking to someone, you might want to find a therapist who does CBT.And of course, you can always exercise too! Are you sick of hearing that from us yet?!

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.

Just over a week ago we lost a family friend to a heroin overdose.   A drug that was rarely found in the mainstream when I was growing up is now extremely common in high schools, Middle American neighborhoods and even Wall Street. We have a major epidemic going on and it is out of control.  This one will eventually touch each and every one of us if we do not get a handle on it.

The use of heroin is being fueled by the exploding abuse of prescription pain medications such as Vicodan, Percocet and Oxycontin.   The medical establishment has gotten wise to this and has made it more difficult to get these medications by prescription. People who have become hooked on them are now finding they are expensive to buy on the street.  They turn to heroin, which is a much cheaper alternative.  Unfortunately, heroin is laced with many other things. Most recently a very powerful drug called Fentanyl has been added resulting in multiple deaths from accidental overdoses. 

We are losing our youth to this horrible epidemic.  It is frightening and incredibly tragic. What can we do to turn this around?

Awareness is the first step.  We need to recognize that this is a problem for all of us. Then we need to look at the bigger picture. Why are our children turning to drugs in the first place? There are many theories out there.  The one that seems most plausible to me is that our society has become very complicated. Perfection is being paraded across our media screens. We have instant critiques on social media and for many of us our lives seem to be moving fast and out of control.  This causes people to numb out and turn to things such as food, medication, alcohol and of course, drugs.

As a parent, what can you do?

·      I see parents out with their children more often than not, totally focused on their cell phones. It is disheartening. Get your children outside.  Step away from your phones. Step away from your computers and be there to have fun and speak with your children, and when they talk to you, listen.

·      Eat healthy.  It is essential for mental health that we eat a healthy diet.  Fruits, vegetables, lean protein and avoidance of processed foods are a must. Children follow by example.  It is important that we model good behavior for our kids. When they see you stress eating, they will stress eat. When they see you eating healthy, they will eat healthy.

·      Exercise. It boosts endorphins  (those feel good chemicals) and teaches children healthy habits. It also is an important tool for handling stress.

·      Most importantly, love your children and help them to understand that perfection is an illusion. It does not exist.   They do not need to be the star on the soccer team or a Harvard graduate to deserve your approval. They need to know that they are worthy of being loved regardless of what they achieve. The key is that they realize they are enough.

We all fall and we all fail. Be there to listen and nurture and console, but let them fail. This is how we learn. 

There is no guarantee in life.  And, drug abuse can occur in any family. Believe me, I know.  However, if we are able to have children who learn how to cope with anxiety and fear in healthy ways and who feel loved and secure, I think that we will see many of the problems start to diminish.  It is time as individuals that we take control and these simple steps can be very powerful. Start today. All of our children and the health of our society depend on it.

Spring is filled with flowers, green grass, and for some…sneezing, wheezing and runny eyes and noses! The most likely cause of spring allergies is tree pollen. However, mold and animal dander can also be contributing.

How can you know for sure? Get allergy tested. If your doctor can pinpoint the cause of your symptoms, the therapy can be tailored to what you need. Treatment could involve allergy shots or medications and help you to avoid a lot of grief.

How can you tell the difference between allergies and a cold? Both can cause a runny nose and eyes, but a cold usually has fever, aches and pains associated with it and it usually ends within about ten days. How can you avoid allergies? You might want to avoid the heavy pollen times, which are the early morning and late afternoons, by staying indoors. Use your air conditioner and keep the windows closed. Wash your clothes if you have been outside and use the dryer. That will help filter out the pollens from your clothes.

If you can’t avoid pollen, you may need to try medications. There are many over the counter antihistamines now that include Benedryl, Allegra, Claritan, and Zyrtec. They block the histamine reaction that is triggered by pollen. Decongestants such as Sudafed will dry up your nasal congestion. Steroid nasal sprays will reduce inflammation.

Often people with allergies will also have asthma. This may result in wheezing, shortness or breath and can have deadly consequences. That is why it is important to have your allergies assessed and treated.

It is that time again, National Heart Disease Awareness Month

Despite the fact that there has been a huge campaign to inform women about the different ways that heart attack can present, we (women) are still waiting too long to call for help. I believe that one of the reasons has to do with our nature. Most of us live in the land of denial. We do not think that something like heart attack can happen to us. In addition we are so busy taking care of others that we often ignore our own symptoms.

Research looking at heart disease in women done by the National Institutes of Health found that 95% of women studied noted symptoms that were unusual for them one month prior to having their heart attack. The most common being unusual fatigue; sleep problems, shortness of breath, indigestion and anxiety.

Despite all the research and push for public awareness, heart disease is still the number one cause of death in men AND women. Risk factors include: family history of heart disease, high blood pressure, high cholesterol, obesity, diabetes, lack of exercise, smoking, stress, and low magnesium.

Regardless of whether you have any of these risk factors or not, if you are a woman and you experience overwhelming fatigue like you do with a bad flu, (but you don’t have the flu), trouble sleeping, anxiety, a sense of dread, shortness of breath, vague chest or jaw discomfort; you may be having a heart attack or you are about to experience one.

If that is the case, do NOT drive yourself to the emergency room. Do NOT wait till a friend or family member can take you to the emergency room. Do NOT ignore the symptoms. Do call 911 and chew an aspirin while you wait (provided you are not allergic to aspirin).

The reason you call 911 is that you want to be cared for as soon as possible. As most cardiologists will tell you, time is muscle. If you take yourself to the emergency room, you may have to wait and that might have tragic consequences. I had a patient many years ago, who had her heart attack while she waited three hours in the waiting room of a hospital emergency room. Do not let that happen to you. The longer you wait the greater the chance you will sustain long-lasting heart damage. The sooner they can help you the better your chances of a full recovery.

Most of us may be self-sacrificing but we have really good gut instincts. Listen to your intuition. If you think that something is wrong with your heart then you are probably right. Take care of your heart so it can take care of you and keep you vital and healthy.

I recently went on the trip of a lifetime. I was able to go to Tanzania for a safari experience that was spectacular. Before I went on the trip, I researched what vaccines I needed and what medication to take in case of illness. According to the Centers for Disease Control (CDC), the one thing I really had to be aware of was the chance of getting travellers diarrhea, which is pretty high (where I was going) at somewhere between 40 to 70%.

I could just see myself on the jeep amidst all the wild animals (that included elephants, giraffes, wildebeests, and very hungry lions to name a few) trying to figure out where to go to the bathroom if diarrhea struck at the wrong moment. That would definitely have put a damper on things…to say the least.

Fortunately, a friend of mine who is an emergency room doctor had gone on a similar trip. She gave me the key to preventing a diarrheal illness. It came in the form of a pretty pink tablet that tastes like mint. The remedy is something that has been around since 1901. It is good old Pepto-Bismol. She suggested that I take two tablets prior to each meal. The CDC recommends 2 tablets four times a day.

I was religious about taking my Pepto and I remained healthy while many people around me were dropping like flies. The way it works is by coating the stomach and intestines protecting them from acid and killing potentially diarrhea-causing bacteria. Pepto-Bismol is a relatively safe treatment. However, it contains salicylate, which is found in aspirin. People who have aspirin allergies or who are allergic to nonsteroidal anti-inflammatories should not take it. In addition, it contains bismuth, which can turn your tongue and stool black and can cause constipation.

Fortunately, I had no problems with my newfound preventive treatment. From now on when I travel outside the country I will make sure I have a good supply. It is cheap, effective and it really did work like a charm. It kept me safely in the jeep and out of harms way. Asante sana (that is Swahili for thank you very much) Pepto-Bismol!

A good part of the country is in a deep freeze right now. We are seeing temperatures and wind chills many of us have never experienced. It is extremely important to know how to protect yourself when you need to venture outdoors. Here are our top 4 tips:

1. Bundle up in warm layers (it provides better insulation) and cover everything. Your fingers and toes are at risk for frostbite in extreme cold due to the shunting of body heat to your core to protect your main organs. It is very important to wear waterproof mittens (they keep your fingers warmer than gloves) and layered socks.
2. Wear waterproof boots to keep your feet warm and dry. Make sure you have room to wiggle your toes and keep the circulation moving in your feet. If you step in a pile of snow and it seeps into your boot, get inside and dry off as soon as possible. Remaining outside to, say, shovel snow and clear out your driveway can put you at risk for frostbite.
3. Wear a warm hat that covers your forehead and ears. We lose at least 10% of our body heat from our head and face. The tip of the nose and the ears are particularly vulnerable to frostbite. Wear a protective, warm facemask.
4. Stay hydrated and avoid overexertion. The body uses lots of energy to stay warm. Overexertion will cause the body to sweat and lose more heat.

People who are most vulnerable to the cold include the elderly and those with chronic diseases such as diabetes and heart disease. Those who abuse alcohol and drugs are less able to handle the cold and may show poor judgment when it comes to staying warm outside.

Frostbite, a freezing of the skin tissue, starts with stinging or tingling of the area affected. This is followed by numbness. Body parts that develop frostbite will turn white and appear waxy. Frostbite is not something to be ignored. It can lead to permanent damage to the blood vessels, muscles, tendons and nerves.

When the body temperature drops shivering occurs. If the body temperature continues to fall confusion will set in and is often accompanied by drowsiness.

If you think that you or someone you know may be suffering from problems related to cold such as frostbite or hypothermia (a dangerous drop in body temperature as a result of prolonged exposure to cold temperatures), seek medical help immediately. If you are unable to get to a medical facility get into a warm area as soon as possible. Avoid walking on frostbitten feet. Soak the affected areas in warm, not hot water. You can also use body heat such as an armpit to warm fingers. It is important not to massage or rub the frostbitten area since it will cause further damage.

Prevention is the key when it comes to avoiding illness caused by the cold. Stay safe in the cold by making sure you and your family stay warm and dry.

The holidays keep on happening and the urge to stuff ourselves along with the turkey is a temptation. What can we do to avoid the pitfalls?

Nutritionists and scientists have long tried to unlock the secrets of overeating. But some of the best information is coming from an unexpected source: marketing experts! It turns out that even the most self-aware individuals are subject to mindless eating.

Most of the research comes from a marketing professor, Dr Brian Wansink, from Stanford University. He wrote a book called Mindless Eating: Why We Eat More Than We Think.

Interesting things to know

* Package size counts
In one study, two groups of people were given free, but stale (five-days old) popcorn while watching a movie. Half of the group got a medium-sized tub; the other got a large tub. The people with the larger tubs ate 53 percent more than those with the medium tubs. They ate the popcorn regardless of taste (five-day-old movie popcorn? YUK!) because it was there and they were distracted by the movie.

* People use visual clues to stop eating
In another study, Dr. Wansink rigged a soup bowl to continuously fill with tomato soup essentially making it bottomless. The eaters with the rigged soup bowls ate on average six ounces more soup than those with a regular bowl. This means that most people ignore how full they feel and eat until they clean their plates.

• Our eating is influenced by color
People will eat more M&M’s when they are multicolored than when they are all one color. People also eat more in a yellow or red room (think about the colors at McDonald’s), and eat less in a blue room.

• We are influenced by those who eat around us
People are more likely to eat faster (and larger amounts) if those around them are shoveling food into their mouths.

• Sound and distraction matters
Playing fast music while eating will cause you to eat more. And every parent knows that kids (and adults) eat more when in front of a TV.

Some tips to help you avoid overeating:

* Eat slowly (or pick a slow eater to sit next to at the next dinner party). It takes ten to 20 minutes for your brain to register that your gut is full.

* Use smaller bowls and plates. Since we all have a tendency to clean our plates and bowls, start small and use smaller utensils as well.

* Never eat directly from the box or bag (think cookies and chips). You can’t see how much you’re eating, which means you won’t remember how many calories you’re consuming.

* Beware of buffets. Use a small plate and only put two items on the plate at a time.

* Be aware of your surroundings. Always sit down to eat and try not to eat in front of the TV. When you choose restaurants, gravitate toward the quiet ones that are painted blue!

Mindless eating contributes to the gradual weight gain that many of us experience as we age. By being aware of some of the cues that trigger overeating, you can turn gradual weight gain into weight loss!