Category Archives: Health and Wellness

Watch out: the Norovirus is lurking!

Posted on by

Many people are coming down with rather similar symptoms lately: nausea, vomiting, diarrhea, & cramping.  There is a virus that is going around, which spreads quickly, and you could be at risk. I wanted to discuss what the Norovirus is, how to know you have it, treatments, and, most importantly, prevention!

What is the Norovirus?
It is actually the name for a group of viruses that all act similarly, if not the same, on the gastrointestinal (GI) tract and cause nausea/vomiting, diarrhea, abdominal cramping, etc. and are thought of as a gastroenteritis (an infection of the GI tract). They were once referred to as the “Norwalk Like” viruses after an outbreak of these viruses in Norwalk, Ohio in the early 1970’s. They also gained a lot of press after hundreds (if not thousands) of guests on cruise ships were getting infected, and ships had to go to port due to such high rates of illness (If I ever even ponder taking a cruise, I remember this fun time, and I’m all set; could you imagine how horrible that must have been? Gross!) The tough part of the Norovirus is that the virus strains are highly virulent, in that they spread from person to person quickly and easily, and infections from these viruses are usually at the highest during cold winter months. That is a true bummer for all of us living here in New England! Fun fact? Norovirus is the leading cause of food-related gastroenteritis in the United States.  Another fun fact: You will never forget how miserable you feel while infected!

What are the symptoms?
Nausea
Vomiting
Diarrhea
Stomach cramps
Low grade fever, chills
Headache
Muscle cramps
*the symptoms can occur very suddenly 12-24 hours after exposure to the virus, and normally last around 12 hours and people feel better within 48 hours (see below: you are still a carrier for much longer and can infect others)

How is it spread?
Most often it is spread from person to person through contaminated food and/or water, caring for an infected person, or through contact with contaminated surfaces. It can live on hard surfaces that are infected for around 12 hours and has been found in infected carpet fibers (i.e. an area that someone threw up on) for up to 12 days, plus it can withstand pretty high amounts of chlorine before being killed off. The viruses live in the stool (poop) and vomit from people with the virus, so when caring for children, elderly, or anyone who needs a lot of assistance with care/cleanup, there is a high rate of spreading the infection. You are contagious from the moment you are infected (even before you feel ill) until a full three days after your symptoms end! Which makes this virus so quick to spread especially in places where people live/work closely together, and it is hard to stop the spread once it starts.

My standard at home hydration "go to"

My standard at home hydration “go to”

What is the treatment?
There is no vaccine or antiviral for these viruses, unfortunately. And as we all know antibiotics only treat bacterial infections, so they are useless against the Norovirus. So you are really just trying to treat/prevent the dehydration that can occur after the diarrhea and vomiting; fluids such as gatorade and coconut water will help to replace fluids and nutrients lost, but really any fluids that you can get in and keep down will help to prevent severe dehydration. If your mouth and tongue are really dry and you cannot make saliva, you feel dizzy when changing positions, you aren’t urinating (or it is very dark), you are clinically dehydrated.  When dehydrated, if you are unable to take in fluids, you should go to the Emergency Department for intravenous (IV) fluids. With children, they often will become restless, cry without tears, and have dry oral cavities; they need treatment with IV fluids if they refuse, or cannot keep down, fluids. The best assessment of dehydration status is to watch your pee (frequency, amount, and color- if it appears on the darker side, drink more).

How do I prevent this from happening?
Wash your hands FREQUENTLY!!
Eat food that is thoroughly cooked if you are eating out (or unsure of food quality)
Wash fruits and veggies before eating them
Wash areas that have become contaminated with hot soapy water or bleach
Immediately wash all clothes, bed linens, etc that have become in contact with vomit or stool of an infected person
If you do get infected, avoid contact with others and preparing food until three days after symptoms are gone

Generally, the Norovirus is a nasty couple of days where you feel horrible (absolutely miserable), but it always ends and there are no long-term effects. But if you have chronic illnesses or other active diseases, it can be deadly because of the effects of dehydration and the electrolyte imbalances that can occur. In children, the elderly, and chronically ill, you need to make sure they are taking in fluids with nutrients (pedialyte, Gatorade, coconut water)and if they cannot, you need to seek medical assistance.  Even if you are vomiting, still try to push those fluids…even absorbing small amounts are better than nothing!

So wash your hands, cook that food, and steer clear of anyone with those symptoms and you will be Norovirus free this winter!

Yours in Good Health
B

Cold and Flu Prevention

Posted on by

Cold and flu season is now upon all of us; we are all at risk, we all know that we should be getting flu shots, especially if you are considered high risk, and ideally you should get the flu shot before December, when flu season starts to hit its hardest. The flu can be a very devastating illness and can lead to complications of other medical issues and cause death.  Colds?  You just don’t want to feel crappy, so we should really try our best to prevent both, right?  Prevent illness in yourself and others, and you will be a MUCH happier person this winter!

The Flu Virus

Who is considered High Risk?
Per the CDC (Center for Disease Control) it is:
Pregnant woman
Children 5 and under
People with chronic medical conditions
People older than 50 years old
Anyone living in a nursing home or long-term care facilities
People who care for those at high risk (healthcare workers, caregivers for elderly or very young)

What else can I do to prevent colds and flu?
Get adequate sleep: I have certain unnamed friends that claim exhaustion if they get less than 10-12 hours of sleep a night, I am really happy with the average person if they get 7-8 hours of sleep; because that will refresh your body and help to keep your immune system strong.  And, if you are sick, then try to get more like 10 hours of sleep, and relax as much as possible, your body is trying to tell you something, and you need to let it recharge.
Keep your hands off your face:  Try not to bite your fingernails, wipe your nose on your hands, touch your eyes, or anything of that nature; it can spread germs all over your face, and increase your risk of getting a cold or the flu.
Beware of others: Wash your hands (or use and antibacterial gel) after shaking hands, and clean others belongings before you use it yourself (like phones, clothes, etc)  You never know how well other people clean things, and even something as benign seeming as borrowing a pen, can end up in a cold later on!  Plus, if someone is sneezing or coughing (showing any sign of illness), I would keep away from a big bear hug and be a little more wary of spending time in an enclosed space with someone who seems under the weather.
Eat Fresh: Eating a healthy, well-balanced diet of fruits, veggies, proteins can support a strong immune system, and if you aren’t eating all that well, pop a multi-vitamin to keep your immune system working optimally, and try to prevent illness as best you can.
Get your sweat on: Working out regularly keeps your immune system strong, and your body working like a well oiled machine, not to mention that you look good and feel good too.  So, despite shorter days, and cooler weather, make time to exercise and get your body moving.
Quit smoking: Just another reason to ditch the butts, it creates changes in your respiratory tract, and decreases your immune system, leaving your lungs as prime target for viruses and bacteria to attack and cause illness.  Yuck! (Really, as if I needed yet another reason to get on my soap box about quitting smoking!!)

If you do get sick?
Keep it contained to yourself and try to sneeze or cough into your elbow area, as to prevent the spread to others. Use fresh tissues at all times; I mean I always thought it was a little creepy that my Nana would use a tissue, then shove it in the wristband of her sweater for later, but as an HCP, I now know how truly germ-y and gross that is, and you can actually reinfect yourself by using dirty or old tissues!  Drinks lots of water (and coconut water to replenish your electrolytes), and get plenty of rest and sleep. I know easier said than done, but don’t overstress yourself when you are ill….make some “me” time, for sure, and stay away from work!  And, if you start to get really high fevers, and the illness doesn’t start to get better after a couple of days, see your HCP to make sure that it isn’t something more serious.

There is always an excuse NOT to work out and eat healthy, but there is no reason to want to get sick. So be proactive about your health: live a healthy lifestyle, and you will be a healthier person.  You’ll thank me!

Yours in Good Health
B

Allergies? You may try want to try a Neti Pot!

Posted on by

So many people suffer from late season allergies, and there are some obvious ways to treat them: by taking over the counter antihistamines, such as Benadryl, Zyrtec, Claritin, etc OR by using some alternative treatments. There is one alternative treatment that people SWEAR by and claim to get rid of their allergies altogether.  The main one? Neti pots.  I really cannot go anywhere without hearing about them and how amazing they are, so I finally decided to look into the science behind it and the theories surrounding why they work so well.

How to they work?
It is a nasal irrigation, you mix lukewarm water with usually a mixture of sodium bicarbonate, so that the solution is pH balanced and doesn’t irritate your nasal canals, fill the pot, and bend your head to the side and pour the contents of the pot (using gravity as a guide) into one nasal passage, and it comes out the other!  The theory is that it clears out the nasal passages and decreases your allergic reactions.

Is there any science behind Neti pots?
There have actually been a few pretty decent studies around the use of neti pots. Most of them support the use of neti pots because they decrease antibiotic days overall for people who get frequent sinus infections. As well, patients report less discomfort from seasonal allergies and decreased amounts of hay fever reaction and sinus infections.  Many HCPs (Healthcare Practitioners) suggest the use of neti pots to patients that have severe hay fever or chronic sinus infections. One rather large study did find that chronic use of neti pots actually increased the rates of sinus infections, so they are suggested to be used to treat seasonal allergies or for use to treat symptoms of a sinus infection but you should not use them chronically, only when you have symptoms that you want to clear.

Despite the research being a little contradictory, the outcome is the same: neti pots do decrease symptoms related to sinus infections and nasal reactions to seasonal allergies.  Just like anything else, don’t overdo it, and only treat the symptoms you want to clear.  As well, make sure that you clean your neti pots, I can only imagine that if you are sticking something up your nose, that has allergens or bacteria on/in it, then putting it up your other nasal passage, and using the same pot later, there would be cross contamination. You can clean it using warm soapy water OR most are safe to throw in the dishwasher to get a good cleaning.

So, keep it clean, and for those of you who love to neti pot, keep on neti’ing but use some restraint!

Yours in Good Health
B

Jellyfish Stings: Should I Pee on that?

Posted on by

For years people have been under the impression that if you get stung by a jellyfish, you are supposed to urinate on the other person as an antidote.  I think as far as the US is concerned, TV shows and movies have made it a bit of a joke; there was a particular episode of Friends, in which it was depicted that the only way to treat a jellyfish sting was to pee on the person. Good news, for those of us who love ocean swimming but don’t like to get peed on, it isn’t the only treatment, and it actually has never been shown to work in studies.  I’ve got some other home remedies that will help to prevent the burn and relieve symptoms faster.

How do Jellyfish sting?
Jellyfish have tentacles that are long and hang off of the bulbous “jelly” part and the tentacles are covered with nematocysts, which are coiled stingers that can become activated and cause a sting/burn.  The nematocysts that are on the tentacles can continue to sting for hours and sometimes days after the tentacles are no longer attached to the jellyfish.  The stinging ability is the jellyfishes defense mechanism and to ward off predators….it certainly wards me off!

Jellyfish

What are the treatments?
– Firstly, you need to remove the tentacles (and nematocysts) from your skin.  DON’T use fresh water or your hands, that activates the nematocysts to activate and sting your skin.  Try to brush the skin with a towel to remove the stingers from your skin, and pour salt water on your skin where the sting is occurring, it can help to get the nematocysts off without activating them.
– Try placing a towel soaked in warm water and vinegar (5% acetic acid solution)
– Unseasoned meat tenderizer or baking soda caked onto the areas can neutralize the stings (only leave on for about 15 minutes)
-If the stingers are still on the skin, put shaving cream on the skin and the tentacles will adhere to the shaving cream, and gently scrape the cream off with something hard-edged, but not sharp!
– After the stingers are removed, you can take 50mg of benadryl (for children give a children’s dose- age and weight appropriate) and for adults taking Ibuprofen can also help ease the discomfort, along with a hydrocortisone cream to decrease the swelling
– Ice packs can help to ease the pain
– Time is the only true treatment that will heal the stings….

*If you get stings near your eyes, flush your eyes out with Artificial Tears (or other saline solutions)
**Any stings in your eyes, mouth, or that cause trouble breathing, extreme swelling, etc. you should seek immediate medical attention and call 911 (or the emergency number where you live)

Why doesn’t urine work as a treatment?
Urine, depending on the person, is a majority of water, along with waste products from the body.  If someone has diabetes, dehydrated, on certain medications, on a low carb diet, etc. what the waste products in their urine are will be different and can actually make a jellyfish sting feel worse.  Ideally, if the urine is high in uric acid, it was thought that it would neutralize the stings but that has never been shown as true in research.

These treatments have been studied, but unfortunately all people’s skin reacts differently, so you have to try them out and figure out what works best for you.  The good news is that I gave you a bunch of other treatments, the bad news is that if you’ve had a stung and someone peed on you, you got peed on for no reason!  But, be safe, especially with children, and really look for jellyfish when swimming in warmer waters and ask locals about the ocean before swimming, just so you know what you’re getting into (pun intended).  So be safe and stay away from those pesky jellyfish!

Yours in Good Health
B

Exercising in the heat: How to stay cool

Posted on by

It has been pretty to and humid out, making most people either exercise super early in the morning (like me) or later in the evening, avoiding the days heat, and if they can’t fit that in, they go to workout inside or just skip it.  With winter always a step away, you don’t want to skip your outdoors time; I wait all year for it to be warm enough to play outside!

How can we keep it cool?
A recent study from Roehampton University in London, looked at the response of athletes bodies in heat, and tried to find ways to help cool them and improve their physical performance in the heat.  They found a really simple solution, that didn’t actually affect their core temperatures (so their bodies weren’t actually any cooler) but they felt much cooler and were able to run longer in faster.  The simple solution was to put a soft flexible neck strap with reusable cool packs around the athletes necks while they ran on treadmills in humid 87 degree heat.

summer-runningIt is really all about perception; your body isn’t actually cooler, but you feel that it is, and you are able to push through and work out despite the heat.  Of course, there are risks associated with that, and you need to make sure to hydrate with water and electrolyte based fluids (coconut water, Gatorade, Pedialyte, etc.) and when you really feel hot, to prevent heat stroke, just take it easy and stay inside.  Also, I am not encouraging you to run at 12pm every day BUT I do think this is a good trick for those of us that want to run outside in the summer, and not be excessively effected by the heat…..and it may be helpful for those training for competitions.  Tricking your brain into feeling cooler, can help you out, just remember to listen to your body and if you are too overheated, take a break.

Try it out, stay cool, and get your exercise in the fresh air!!

Yours in Good Health
B

Is BV an STD?

Posted on by

Bacterial Vaginosis, more commonly referred to as BV, is the most common vaginal infection in women, and despite the fact that you can get it after having sex with a new partner, it is NOT a sexually transmitted disease; your new partner doesn’t infect you.  I can’t tell you how many times women have gone screeching into their GYN’s office freaking out that they got an STD because something smells funky down there (which is a good practice to have, btw) but BV isn’t an STD and you don’t need to trash your new partner all over town about it!  Here is an explanation of what it is, symptoms, diagnosis, and treatment options.  I want you all to be aware of what could be going on down there… especially since it is National BV Awareness Day!!

BV_Day_Campaign_Pic.jpg.pagespeed.ic.rGAMMGEpleWhat is BV?
Basically it is an overgrowth of one of the natural occurring bacteria in your vagina, and when the delicate balance that is your vagina gets an overgrowth of one bacteria, there can be foul smelling discharge, itchiness, odor, pain, and/or burning.  Most commonly it smells like a dead fish down there….not good, ladies.  And, if it takes someone saying something to you about it, even worse.  Pay attention to what’s going on in your vagina, and notice if something smells off or looks funky.

So, How do I get BV?
Well, unfortunately, it is not completely known why some people are more prone to these infections than others. But, new sexual partners and having multiple sexual partners can cause a BV infection; it may be due to the use of numerous condoms and your body is reacting, or due to the change in your natural flora from having everything disrupted frequently down there.  Some women know that after they have sex with a new person, they will get BV, so they preemptively have a plan with their HCP about it (which is some smart thinking!)  If you have unprotected sex, it can just be that mixing their bacteria with yours causes an upset, and your body reacts the way it knows how and can.  Also, women who douche tend to have a higher frequency of BV; although this is a little bit of the chicken/egg debate. Women who douche tend to think that their vagina smells, and they may already have an overgrowth of bacteria just because they do, so they douche, and flush that bacteria all over the place, and cause an even bigger disruption in their flora, causing a more widespread BV, so they link the douche to BV, whereas they probably had the infection anyway. Oh, and women who are NOT sexually active can get BV infections; some peoples vaginal floras are just more sensitive than others.  It is a bit of a medical quandary though….

What are the signs/symptoms?
Strong fishy odor, that increases after sex
White/gray thin discharge
Itchiness around the outside of the vagina
Stinging/burning with peeing
OR no symptoms at all!

How can BV affect me?
Having a BV infection can increase your risk of contracting HIV if you are exposed to the virus
It also increases the risk that you will pass along HIV to a partner (if you are infected)
Having BV (past infections) increases your post operative risk for infection (post hysterectomy, abortion, or other gynecological surgeries)
Having BV increases your risk of also contracting HSV (Herpes simplex virus), Chlamydia, and Gonorrhea (your vaginas natural defense mechanisms are down due to the BV infection)
A BV infection while pregnant can increase your rate of complications such as pre-term labor, lead to low birthweight babies (under 5.5lbs), and premature babies.
Also, undiagnosed BV can lead to PID (Pelvic Inflammatory Disease) and make getting pregnant a very difficult task.

Are there any tests to determine BV?
The main “test” of determining BV is based upon your complaints (i.e. grey discharge, smelly odor, etc) and with a pelvic exam and taking a small sample of discharge from your cervix and examining a smear by your HCP. Balance Activ has just created an OTC pH testing kit, so if you suspect BV, you can use a testing strip and actually diagnose your BV. There are no blood tests or anything fancy to diagnose the infection, but seeing as it is so common, if an HCP even suspects it, without you complaining of symptoms, they may treat you anyway.

Is there a treatment available?
Honestly, many times it will clear up without treatment on its own, as long as you abstain from sex and using douche; the vaginas natural flora will fight to get back to normal BUT due to possible complications that can occur with long term infections, most likely you should get treatment if it is suspected.  There is a company called Balance Activ, that has a full line of products to help normalize the pH balance of the vagina, which will essentially treat and prevent these infections. Also, of note, male sexual partners do not need to be treated, but women partners do to prevent to possible spread!  There are two different antibiotics used to treat BV (you only need one): metronidazole or clindamycin orally (and the same treatment is for HIV+/-).  All pregnant women with any signs should be treated, and most HCP’s require that all women post gynecological surgeries be preemptively treated.

How do I prevent BV infections?
The best way is to limit your sexual partners and don’t douche!  Honestly, I am not sure why douche is still on the market, there is nothing good that comes from douching….so please don’t! Douche changes the pH of your natural flora, and the lower the pH is, the higher the risk of BV infections. Also, if given antibiotics as treatment, use all of the medication given to you to treat your BV, for the ENTIRE prescription, so that you actually kill off the bacteria and allow for your flora to re-grow.

The Balance Activ products that can help to treat and prevent infections are: Fresh wipes (neutral pH), fertility gels and sprays (to help normalize the pH levels, prevent BV, and allow for a better chance of conception for those with BV), and screening kits so you can test your own pH levels to see if you have BV.

It is important to note that BV infections can come back, and some people think that using probiotics can help encourage the regrowth of the natural bacteria and get it to normalize, there is no literature to support that, but if you are a chronic BV’er, it might be worth a try.  And, all of the Balance Activ products are a BOGOF (buy one get one free) in honor of national BV awareness week) so they are worth more than a try! If you do get BV infections after sex, talk to your HCP about different things to might try, like different kinds of condoms (you may have a small allergy), if you are in a monogamous relationship an don’t use protection maybe you need to clean your partners penis with antibacterial soap and you shower before intercourse. This doesn’t have to be a horrible life affliction, but to those who don’t know about it, you need to be aware and get proper treatment because it can have longterm health effects!

To learn more about BV, and products available, please check out this site directed towards BV awareness and treatment!

Yours in Good Health

B

A little overhung??

Posted on by

Why do we get hangovers? I think people don’t really understand the metabolism of alcohol, because there are ways to prevent hangovers, and make that fun night that you may have imbibed too much, into a much softer morning wake up!

 How the body responds to alcohol metabolism:
Its how our bodies convert substances into other compounds that we can either use  or excrete . Oxidation is the process by which alcohol is metabolized in the blood. Obviously the alcohol is distributed throughout the body, including the brain, organs, and tissues after ingestion and during metabolization, and small amounts are excreted through your breath and urine in unmetabolized forms.
You have your favorite adult beverage, it goes into your intestines, then is absorbed into your blood stream, it is metabolized by various enzymes.  In the liver the enzyme that breaks down alcohol is called alcohol dehydrogenase (ADH) which turns alcohol into acetaldehyde, which is then broken down to carbon dioxide and water.  Alcohol is also broken down by an enzyme in the liver called P450IIE1, which can increase in number with chronic drinking (hence how people build up a “tolerance” for drinking….increase P450IIE1) and this is where most alcohol is metabolized.

The liver can only metabolize a certain amount of alcohol per hour, no matter if you are a virgin drinker or if you have your sea legs.  That being said, the ability to metabolize alcohol is dependent upon the number of metabolizing enzymes, which varies in each individual and can be genetic (i.e. over half of all east Asians have low numbers of ADH enzymes so they tend to get drunk easily, have wicked hangovers, and get flushed with drinking which is due to a fast heart rate which is how their bodies respond to metabolism of alcohol.) Usually, once you have a drink, your blood alcohol level peaks within 30-45 minutes.

Wilkinson et al., Journal of Pharmacokinetics and Biopharmaceutics5(3):207-224, 197
 
IMG_2336
What other factors influence alcohol Metabolism?
Food: The higher the dietary fat content in the stomach/GI tract increases the amount of time it takes for the alcohol to get absorbed into the blood stream.  One study showed that people who ate a meal of fat, carbs, and protein absorbed alcohol 3 times more quickly than those who drank on an empty stomach.
Gender: Unfortunately, women absorb alcohol differently than men.  Us ladies will have a higher Blood Alcohol Content (BAC) than men drinking the same amounts, and we are more susceptible to alcoholic liver disease, heart muscle damage, and brain damage.  It is presumed that the difference is due to women having a smaller amount of body water and we may have a lower amount of ADH (never been proven but highly likely based on numerous studies).
Effects of Alcohol:
Body Weight: interestingly, Women who drink (moderately) tend to have significantly lower body weights than those who don’t drink at all.  Men, there is no weight difference, but if non drinkers add alcohol to their diet, they don’t tend to gain any weight.  Chronic alcoholics tend to lose weight because they substitute alcohol for food….
Sex Hormones: Chronic alcohol intake causes significant hormonal imbalances; the liver metabolizes estrogen into testosterone, but when damaged, it is unable to do that, so you can have decreased sperm production.  In men who consume 220 grams of alcohol daily for 4 weeks, testosterone levels decreased after 5 days and kept dropping throughout the study period.  Also, chronic alcohol intake in men can lead to testicular atrophy (getting smaller) and the growth of male breast tissue. In women, we can create estradiol, which increases bone density and decreases the risk of cardiac disease (whoo hoo!!)
Medications: Tylenol (paracetamol, acetaminophen) can be toxic in the liver in large doses by itself, but add alcohol and it is a HUGE problem that can lead to immediate liver failure.  Like 4-5 extra strength pills in the course of the day with someone who is drinking can cause death. Other drugs such as pepcid (famotidine), ranitidine (zantac), and cimentidine (tagamet) can cause alcohol to be metabolized slower for reasons truly unknown at this point.
What can also cause increased rate of metabolism?  
The only thing known to increase the rate of metabolism of alcohol is fructose!! Consuming 100 grams of fructose has been shown to increase alcohol metabolism by 80%!  So, not helpful for people like me that drink vodka sodas, but great for the rum and coke (not diet coke) drinkers of the world!!  I guess I need to go back to my gin and Q-Tonic beverages OR maybe a handful of skittles after every drink???
So, the best way to prevent a hangover is to eat a meal with fat, protein and carbs (cheeseburger anyone?), increase your water (before bed chug a coconut water if you have one, or just regular water) because we all know the metabolism process dehydrates our bodies (because of the effects of alcohol), and increase your sugar intake….high fructose corn syrup does count!!  So seriously, a great idea for a bar is to hand each patron a bag of candy with each drink!!  Actually, one of the reasons why “fruity” drinks tend to make you less drunk 🙂 hmmmm…..  BUT I must say, carbonation supposedly increases your alcohol absorption, so maybe a Harvey Wallbanger is the way to go…and try to stick with the same kind of alcohol.  Really, I think we all knew these tips except for the sugar.
So, ladies apparently drinking is good for you?!?!  And men, if you are looking to be more manly, you may want to lay off the booze for a bit….
Yours in Good Health
B

This is a little hard to talk about: Erectile Dysfunction

Posted on by

Many people are unclear as to what Erectile Dysfunction (ED) actually is, despite those really ridiculous Cialis and Viagra commercials on TV (which can be horribly awkward to watch in mixed company at times!!) ED affects between 15 and 30 million men in the US and approximately 22.3% of all office visits to HCP’s are for ED.  It is something that many men are embarrassed about and feel unable to speak to their partner about, and it can cause huge rifts in relationships. It is important to know that signs and talk to your partner about it, it is a physical issue that is normal, and totally fixable, so go to the doctor together and make it a couple problem, and don’t let your partner suffer and feel badly alone!

What exactly is the definition of ED?

It’s the inability to maintain an erection that is firm enough to have sex, on an ongoing basis, along with trouble getting an erection, difficulty maintaining an erection, and/or a reduced sexual desire.  If you have any of these symptoms, especially if you have diabetes or heart disease, you should go see your HCP and talk to them about it, your options, and to find out what might be going on with your body. Don’t let it get too far that your partner might get upset or think that they are the one causing the problem…be open about it and go to see your HCP.

erectile-dysfunctionWhat are the causes?

There are SO MANY possible causes of ED, in which some are physical, mental, and a combination of the two.  Some physical causes are: heart disease, atherosclerosis, high blood pressure, diabetes, obesity, metabolic syndrome, Parkinson’s disease, Multiple sclerosis, low testosterone, Peyronies disease (a build up of scar tissue in the penis), tobacco use, alcohol (alcoholism), substance abuse, pelvic/spinal cord surgery, enlarged prostate, and prostate cancer.  So, obviously it goes from being something that is easily fixed, to things that are more serious. As far as psychological issues: stress, depression, anxiety, fatigue, and relationship issues can all cause ED. Another psychological reason that many men have a form of ED, in this current society, is due to the inability to get their partner pregnant; we have a society wrought with infertility and it can case serious relationship problems on many levels. As well, many medications that your HCP might put you on for various health issues, can also cause ED.

Before you go to your HCP appt:

Write down symptoms that you have had even including things that you might think unrelated to ED.  Also, write down any life changes going on, including anything that might be causing relationship stress.  An update list of current prescribed and over the counter medications are always important to bring to every appointment, but especially to an appointment regarding ED.  Try to bring your partner to your appt and both of you talk before you go and both write down list of questions both separately and together.

What might happen at/after your appt?

A physical exam, which is standard at all appointments, but your HCP will inspect your penis, testicles, and check for nerve feelings.  Most likely you will have blood drawn to assess your risk of heart disease, diabetes, cholesterol, and testosterone levels.  A urinalysis may be performed to also look at your risk of diabetes, etc.  An ultrasound may be done to look at blood flow to your penis, it uses a plastic probe on the outside of your penis to project a video of the current blood flow (a non invasive exam). They also might have you go home and perform an overnight erection tests; many men have erections at night during sleep, and have no idea that they had an erection, if the test is positive, then the reason you have ED is psychological.  What they will ask you to do is to put a piece of tape that they will give you (it is easily split) around your penis, and if you wake up in the morning and the tape it split open, you’ve had an erection.

How do we treat it?

You can take oral pills like Viagra, Cialis, and levitra which are medications that enhance your bodies natural nitric oxide levels which helps muscles relax and allows more blood flow to your penis, allowing for a stronger erection.  You may need to change doses and change times that you take before getting an erection.   You need to talk to your HCP to take these drugs if you also take any nitrate drugs like nitroglycerin, Imdur, or Isosorbide because you can have too much of a build up of nitrates in your blood.  Also be careful with blood thinners and alpha blockers (for enlarged prostate).  Your HCP will have to discuss using medications if you have had a stroke, have either low blood pressure or uncontrolled high blood pressure, heart disease or heart failure, and/or uncontrolled diabetes.
Other medication options:
Alprostadil injections: a small needle is inserted in the base or side of the penis and you inject the medication, due to the small size of the needle there is usually little to no pain, and you can get an erection within 5-20 minutes and the erection usually lasts around an hour.
Alprostadil penis suppository: Using a special applicator, you insert a small suppository 2 inches up the inside of the urethra. The side effects can be pain, bleeding from the urethra, dizziness, and can cause a fibrous build up inside your penis.
Testosterone replacement: if you have low testosterone levels, oral supplements can help to increase your levels and ability to maintain/obtain an erection.
Other options:
Penis pumps: a hallow tube with a hand or battery-powered pump, you put your penis inside, pump out the extra air, which causes blood to flow to the penis and cause an erection, you need to put a tension ring on the base of your penis, then remove the pump.  The erection usually lasts long enough to have sex, then remove the tension ring.
Penile implants: implants are surgically places on both sides of the penis, either inflatable or semi rigid rods.  The inflatable implants, are inflated before sexual intercourse to help obtain an erection and the semi rigid rods allow for a firm but flexible penis at all times. Due to it being surgical in nature, there is a risk of infection, and usually a later option for ED.
Blood vessel surgery: at times a leaking vessel can cause a decrease in blood flow to the penis, a simple surgical procedure may be able to fix that problem.
Psychological counseling: if the problems are psychological in nature, counseling can help to talk about the problems and may help to decrease ED issues.

How can you fix it with lifestyle changes?

If you use tobacco, quit. Lose weight to get to a healthy level, exercise regularly, get treatment for alcohol and drug abuse, and work through relationship issues with your partner and with the help of a professional.

Alternative medicine:
Acupuncture is said to help with ED and relieve stress and anxiety, so it can help with some psychological problems.

Due to all of the possible causes, it is not only the first sign that something serious might be going on, but it also is something that might be fixed simply and easily, so I really encourage seeing an HCP early to talk about it.  Be open and honest with yourself, your partner, and your HCP.  ED is not something to be embarrassed about or something that you should allow to ruin a relationship.  If you notice any of these problems with yourself or your partner, please talk about it and go see you HCP ASAP!!

Yours in Good Health
B

Kettlebells!!

Posted on by

I have recently been introduced to the world of kettle bells and my abs are thanking me for it!  I thought that it couldn’t really make that much of a difference in my workout, but it really has.  I have 5lb, 10lb, and 20lb kettle bells; the 5lbs for when I am learning a new workout so that I don’t hurt myself and the 10lb and 20lb for actual muscle-building purposes.  They are great because I have totally new workout routines and am working my muscles in different ways.  Also, you are combining cardio with strength training which is the best kind of workout; you increase your metabolic rate significantly, so it truly is a fat burning workout.  The bells are so different from  regular dumbbell weights because they are unstable and it requires extra concentration and muscle strength to stabilize the bells, allowing you to use more muscles with each workout AND most often you are using your core muscles to aid in the stabilization.  Many of the workouts are full head-to-toe workouts and utilize every muscle in your body, that focus on muscle movement and toning, so you don’t bulk up (you can if you want to and use higher weights, but I like to tone).

Kettlebells2

Also, its fun, new to your body (so you burn more calories), and you are supposed to supplement your workout twice a week with kettle bells so it changes your routine. Kettle bell routines are easy to learn (Turkish get-ups are about the most challenging and even I could get them down quickly!), also it is low impact on your joints, and what is better than high intensity cardio that is low stress on your joints??

Give it a try, and let me know what you think, they have changed my abs!!

Yours in Good Health

B

Boost your daily exercise

Posted on by

A couple of years ago, I was unable to run for a couple of months, and it was absolutely killing me.  My doctor told me that I was allowed to walk as much as I wanted, he just really didn’t want me running for a bit.  Well, I felt like I was constantly walking and seeing all the results of my running going down the drain (I am obsessed with noticing muscle formation in my legs and it makes me really sad when I notice that they aren’t as cut as they should be).  So, I decided to get ankle weights, just 3 lbs, and I thought that they were too light at first, but let me tell you, at the end of a few 4 mile walks with my dogs, I totally noticed a difference, and I saw the definition in my calves coming back! On average, you burn an extra 180 calories an hour using 3 lb ankle weights, which isn’t a huge amount BUT it is an extra calorie deficit, and you are building muscle, which helps you burn more calories during the day.

When I got back into running, I tried with the weights, but that was a touch too much for me…I was lucky to get three miles without dying!  But, I started wearing my ankle weights while doing housework (vacuuming, doing laundry, etc), while running errands (under pants, of course), and even at work.  It tires your legs out so much and puts a little extra boost of exercise in your every day movements that you wouldn’t normally have. Plus, it was hidden, so it was my own little secret that I was getting a workout while running to each Code Blue!

exercise boosters!

exercise boosters!

If I have a great run or workout, I don’t bother with the ankle weights, but if I have a day where I am running around doing errands, and I know that I won’t have time for a proper workout, it gives my body a little exercise that I know I wouldn’t be fitting in otherwise.  Also, you can get spicy and move up and down the weights to work best with your level of activity and comfort; they can be purchased for pretty cheap at Target or Amazon; there are super expensive versions, but really all you need is something to strap onto your ankles that isn’t huge and bulky!  The ones that you can change the weights in tend to be a bit more pricey…I just bought a 3lb and a 5lb version because it ended up being cheaper than the adjustable version.

Also, low weight stimulation to your muscles, while helping to tone the muscles, also helps to adhere them to your bones, thus making your bones stronger, so this is a good suggestion for those of us who don’t get enough calcium OR anyone over the age of 30 to prevent osteoporosis.  So, while helping burn a few extra calories, it also prevents the degradation of your bones!  And, notice what a difference walking, running, etc. feels like when you take the weights off- you feel like you are floating on air!!

Yours in Good Health

B