Category Archives: Wellness

Cold and Flu Prevention

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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!

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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?

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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

Asthma: Medications and Alternative Treatments

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As previously discussed, Asthma is a long-term disease that causes a narrowing of the airways due to an allergic or hypersensitive reaction.  The bronchus spasm, and make breathing very difficult.  There are numerous medications that can be taken either in pill form or inhaled, that are FDA  approved, or you can try some different alternative therapies: some include taking herbal supplements (which may or may not be helpful) and  some include diet, exercise, and breathing techniques.

Modern Medical Treatments:
Allergy medications– like Zyrtec or Claritin to prevent common allergies and possible flare-ups
Inhaled Corticosteroids- like Flovent or Pulmicort. These are inhaled medications that have low risks from long term use and take a few days to a week to build-up in your system and are used for long term prevention of symptoms.
Leukotriene Modifiers: Oral medications such as Singular that prevent asthma symptoms for 24 hours at a time. They can have some serious mental side effects like depression and hallucinations, so you need to be aware of any feelings of sadness that are new and unlike you.
Long Acting Beta Agonists (LABA): like Serevent are inhaled medications that open airways and prevent inflammation but they have been linked with severe asthma attacks if they are not taken along with an inhaled corticosteroid.
Combination Inhalers: a mixture of a LABA and corticosteroid, like Advair. They work well for long-term control of symptoms, but there is a risk of asthma attack because of the LABA involved.
Theophylline: a daily pill that helps to open the airways by relaxing the muscles around the airways. It is kind of a treatment of the past, and not used very frequently these days….it was a first line treatment years ago.

What are Alternative Treatments?
Breathing exercises: in which you stretch the volume of your lungs and learn to relax to take deep breaths, can help to decrease the amount you need medications. Yoga breathing techniques can help to learn to relax and the feelings involved with taking deep, relaxed breaths.
Diet: eating fresh fruits and veggies high in antioxidants can help improve lung functions and prevent asthma symptoms.  As well, Omega-3 Fatty Acids (found in fish, flax, etc) have been found to reduce inflammation throughout the body, including the lungs, so it can help to improve asthma symptoms as well.
Exercise: regular cardiovascular inducing workouts can hep to strengthen your lungs and improve their function.  Working out in cold weather can trigger asthma, or if outdoors during high allergy season, but in a gym with AC you can work out your lungs and body all at the same time!

Are there Herbal Supplements?
As always, they haven’t been extensively studied or FDA approved, so I can’t say I condone the use of herbal supplements but many people have reported decreased asthma symptoms when using these products, and they may benefit you: butterbur, dried Ivy, Ginko extract, Indian frankincence, reishi mushroom, and Choline.  It is best to take these under direction of your HCP or an herbal healer, so please discuss so they can talk to you about any interactions to look for and any reactions that may occur.

Does anything make Asthma worse?
Exposure to allergens: if you are allergic to something, and know it, it can make your asthma symptoms worse, or cause flare-ups so you should stay away from that allergen, or do your best to avoid it (like cigarette smoke, exhaust, or foods that cause allergic reactions.)
Cold weather: As stated above, it can cause constriction of the bronchioles and make asthma symptoms worse.
Foods:
– Anything high in saturated fats (meats, butters, etc) can make asthma symptoms worse
– Additives and preservatives can cause people to have reactions and common additives are artificial sweeteners and sulfites (found in cheeses, red wines, etc.)
– Milk products can cause an increase in mucus production and a thickening of the mucus, making asthma symptoms worse.

Asthma is different for everyone and the way we all react can be very different, so work with your HCP to see what best fits your lifestyle and your beliefs.  Work with your HCP on your Action Plan and take into account all aspects of alternative and medical therapies. You know your body best, so learn what your triggers are, and how to prevent them!

Yours in Good Health
B

Asthma: Action Plans

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There are more people with Asthma worldwide than is actually documented, because not everyone knows the signs and symptoms.  But for those of us with documented asthma, we should have an asthma action plan to prevent flare ups and hospitalization.

What exactly is asthma?
Asthma is a long-term disease that causes narrowing of the airways due to an allergic type reaction or hypersensitivity. The bronchus (airways) spasm, making breathing a very difficult task.

What are signs and symptoms?
Coughing: that is usually worse at night or early in the morning, making it difficult for you to sleep.
Wheezing: high-pitched whistling or squeaking that occurs when you breathe and coughing won’t make it go away.
Chest tightness: your chest just feels tight, like there is a vice on your upper body and you almost physically feel like you cannot take a deep breath.
Shortness of breath: no matter how much air you take in, it is not enough.

What can cause it to flare?
Since asthma can be caused by allergens, many of the “triggers” for asthmatics, are: Allergens: Dust, animal fur, bugs (such as cockroaches), mold and pollens
Irritants: cigarette smoke, chemicals, air sprays (hair, room scents), bug sprays
Medications: aspirin containing medications, beta blockers (for heart rate control)
Viruses: causing upper airway/respiratory infections
Physical activity: cardio exercise

Treatments:
There are tons of treatments, ranging from taking anti-allergy medication, to inhaled steroids to oral steroids, inhaled non-steroidal treatments, and emergency inhalers (which immediately open up the airway in an emergency).  I will talk more about Asthma treatments in my Asthma: Medical and Alternative treatments blog!

Action Plans: What are they?
Action plans are super important in the treatment of asthma.  Literally, they are plans that you, the patient, and your HCP come together and create; it’s a plan that works for YOU.  You create plans so that you know what the early signs and symptoms of a flare-up are, what your triggers are, and what you should do as soon as you realize you are going to have an asthma attack.  For some people, it is to take their rescue inhaler, some can stave off an attack by drinking ice-cold water, others just need some caffeine, and some people need to go immediately to the Emergency Department (ED) because they will have a major attack.  Action plans help to prevent those trips to the ED, and to prevent those major asthma attacks that can keep children out of school, and people out of work.

It is imperative that you are a part of the action plan, because it is your body and your life, if part of it is unfeasible, then you know you will not do it, so speak up and have open and honest conversations with your HCP, because we all want you to be successful and stay healthy.  So, if you are allergic to dogs, but have one, be honest and tell your HCP that you are not going to get rid of your dog, and work on a way that maybe your dog sleeps in another room, and you use a HEPA filter in your room to clear the air.  There are many different plans, and tons of different treatments, we need to create one that is good for you, and that you will stick to!

Read here for more treatments…….

Yours in Good Health
B

Exercising in the heat: How to stay cool

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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?

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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

Is too much exercise bad for your immune system?

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For years and years (healthcare providers) HCP’s have been telling you that “moderate” amounts of exercise are good for you, and your immune system, especially during the winter months to prevent colds, flu, respiratory infections, etc. And, I am not going to tell you any different, BUT I am going to give you an explanation as to why exercise can boost your immune system and how much exercise can actually put a strain on your immune system.  Actually, one study showed that people who didn’t exercise and started 12 weeks of moderate exercise had over a 50% drop in sick days over the next year!!

Who can benefit?
The best part is that everyone can!  Even with chronic diseases or autoimmune diseases, you can find YOUR level of moderate exercise and it will only benefit your body, your general health, and support a healthy immune system.  For example, if you are bed bound, there are arm exercises, rolling in bed, leg lifts…a form of exercise depends on what you are used to.  So, everyone should be getting some form of moderate exercise, there is NO excuse! There is always a way to find some small amount of time to add exercise to your day, even if it is taking stairs instead of the elevator running between meetings at work, parking far away from the place you need to be, or doing a fitness video at home; you can always shave a few minutes out of your day to fit it in!

How does it support your immune system?
So, the immune system is a whole network that has been created by our body to protect it from invasions from viruses and bacteria using various different hormones, chemicals, and cells to attack, as well as to remember the viruses in the future, to prevent further attacks and hone your body’s response.  In an effort to not get too deep into cellular anatomy and physiology, I just want to explain that some of the cells that respond are called cytokines (of which there are many different types).  Some of the cytokines release a signal to your white blood cells (the ones that increase in number to attack when there is an invader present in your system: your number will be elevated if you have a cold, for example, and get your blood drawn at your HCP, but it will drop back down to a “normal” level when you aren’t sick) that there is an invader (bacteria/virus), then there is an inflammatory response, and the white blood cells know to go in for the kill.  So, why am I telling you this?  Well, with a moderate amount of exercise, the cytokines are produced and released in moderate amounts, so your immune system is being challenged a little bit every time you exercise, and it strengthens your immune system because it is constantly working.

Why is too much bad?
If you overtrain, or exercise too much, you can cause damage to some of the muscles, or various different cells in your body, and it can stress your body.  When your body feels stressed, overexerted, or over taxed, your immune system is actually decreased because your body is working so hard to recover your muscles from training, that your immune responses can be lowered due to a release of higher cortisol levels.  Cortisol is a natural hormone that is released from the adrenal gland that helps to regulate metabolism, the immune system, inflammatory responses, as well as having other functions; it is basically your “stress” hormone and the one that jazzes you up during your “fight or flight” response.  The problem with is being constantly elevated, is that your body is never truly relaxed (which can occur in our modern way of living where everyone is running around, working tons, worried about everything, and constantly stressed even when we don’t realize it) and this can lead to slower immune system responses and slower healing by the body due to the way that cortisol makes your body react.  So, too much exercise can depress the cytokine release, and make your body slower to react to minor pathogens (viruses/bacteria) that may be trying to invade your body.

What is considered Moderate exercise?
Usually it is defined as 20-30 minutes of exercise 5 days a week.  For me, that is not enough because my baseline is much more than that, so that is a great guideline but it needs to be based on your level of exercise specifically.  So, I would tell you that “moderate” really means what you feel comfortable with in exercise, can get through without feeling tortured and on a scale of 1-10 (one being barely any effort and 10 being extreme effort), it would be a level 4-6; where you are comfortable and can even talk during the exercise (not a lot mind you, but you aren’t struggling for breath).  Moderate exercise can vary with days that are a 6-8 (a little harder) and days that are a 4-5 (a little easier) but try to stay around that range for cardio.  You can push harder twice a week, for better results, but if you are happy with how in shape you are, try to keep it relatively even.  As far as lifting, you definitely want to add some muscle strength on top of your cardio, but again, don’t stress yourself out (i.e. you can barely lift your arms afterwards), but push yourself daily to the point that you know you have worked out and feel stronger.

What is too much?
Pushing yourself to run at a super fast pace and for a long distance when every step you feel like to want to stop and your legs feel like lead…that is too much.  You need to listen to your body (and non-runners, will probably say, “my body says that every time I run”, so I’m talking to those who are runners baseline!) Or if you are working out on the scale of an 8-10 every day, that is too much!!  You can go 8-10 once or twice a week, but really no more than that. If you feel strains in your muscles or muscle tears, you need to take a break and your body will let you know.  I totally understand the feeling of wanting to push your body to the limits EVERY time you work out, I have done that in the past, and I looked fantastic, but it isn’t sustainable over time, because as you overtrain, your body loses interest in wanting to work out and it gets harder and harder to push yourself to do so. Not to mention, that it ends up decreasing your immune system.

For my avid exercising readers, just listen to your body; it will tell you when you are overtraining!  Sometimes every step feels so horrible you just can’t exercise- then STOP,  just lift weights, or take a break and catch up on some missed TV shows and DON’T FEEL GUILTY about it!! Just go back to your normal routine the next day, Nurses orders 🙂 You really need to look at exercise as everything else, do it in moderation, and it will be sustainable over your whole life, not something that you stop and start, which is the key to fitness; sustainability.

For those of you who don’t exercise, I hope this inspires you to park farther away from the store and get a walk, skip the elevator and take the stairs, and grab a friend (bundle up) and go for a wintry walk and a cup of coffee/tea!  Try to get out there and get that heart pumping to stimulate your immune system!!  It actually is good for you, gets you out, and can help you also beat the winter blues.

Yours in Good Health
B

A little overhung??

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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
 
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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

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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