Women's Wellness Blog

A celebration is often the result of an accomplishment, a special event , or honoring memories. These are good things, but do we really need the “special” to warrant a

celebration? Wouldn’t it be great to be able to delight in the relatively mundane? Some of the happiest folks I know are those who relish just being able to get out of bed in the morning. We can celebrate our health, good or bad, by reflecting on what a true miracle it is that all these billions of cells are working in concert to allow us to walk, run, think, eat, love, write, and even occasionally complain. In celebration of simply being alive, I have compiled a list of rambling recommendations collected over the years to promote, extend, repair and rekindle your health. Let the celebration begin!

People who rarely spend time outside (elderly, housebound) are at a greater risk for osteoporosis due to a lack of vitamin D, which is increased in sun exposure. 400 IU a day in supplement form can help prevent brittle bones.

Taking 400 micrograms of folic acid a day before getting pregnant can reduce the likelihood of neural tube defects in the baby (spina bifida, etc.)

Exercise 30 minutes every day. The more and bigger the muscles used, the less time needed to achieve fitness (cross country skiing best, walking is good, using the channel changer is bad.)

The more colorful your meals the better. Bright colored fruits and veggies contain greater anti oxidants and other protective substances.

Use herbs (Black Cohosh) and vitamins (E) to control mild menopausal symptoms. Many are scientifically valid and may work for you.

It’s not brain surgery; to eat healthy go low fat, low sugar, high fiber and balanced.

Eliminate soft drinks. An extra can of soda a day can add 15 pounds in a year.

Almost half of all doctor visits are stress related. A great tool for stress management is regular, aerobic exercise.

The solution to permanent weight loss is not dieting, it is getting fit. Only muscles burn fat, and only muscles that are used!

If you are pressed for time, three ten minute exercise sessions can be as helpful as a single thirty minute segment.

Most women over twenty need to take some extra calcium (500mg) The better the bones before menopause, the better they are afterwards.

Eating habits are formed at an early age. Teach children as early as two to be aware of good and bad food choices.

Don’t focus on weight. Your per cent body fat and/or your Body Mass Index (BMI) are better measures of health. Throw away the traditional scales and get a device that calculates body fat and BMI. They are reasonably priced and accurate.

A good doctor will always encourage and support getting a second opinion…so in important decisions, do just that.

Don’t limit yourself by thinking that health is strictly physical. Wellness is a balance of mind, body, and spirit.

Don’t skimp on preventive care. The Pap test and mammogram have saved millions of lives.

If you have a strong family history of ovarian cancer (in mother or sister) demand a yearly sonogram and CA-125 blood test to check your ovaries. It is far from a perfect screen, but it is the best available so far.

Young women (ages 9-26) who are not yet sexually active should strongly consider getting vaccinated against the Human Papilloma Virus (HPV). It is the single biggest cause of pre-cancer and cancerous changes in the cervix.

Acupressure has been effective for the nausea associated with early pregnancies. The most common device used is “Sea Bands”, an elastic band that applies pressure to a point on the wrist.

Caffeine consumption is one of the leading causes of bladder problems in women. Eliminating caffeine from the diet may reverse symptoms of incontinence, frequency, and urgency.

Some women in the menopause need testosterone supplementation along with estrogen and progesterone to help with a lagging sex drive.

Many herbal medicines and treatments can interact with prescription drugs. When getting your yearly checkup, don’t forget to tell your doctor about any supplements or herbs you take on a regular basis.

Before any surgery, always stop taking Ginkgo, Ginseng, Garlic, or vitamin E. They can increase bleeding and lead to problems with the surgery.

Always bring two things to every doctor’s visit: a written set of questions and a list of your current medications.

20 percent of cancer deaths are related to obesity. Maintaining a healthy weight may be your best guard against developing cancer.

Aerobic exercise might be better for your brain than your body. Early studies show that exercise can cause damaged brain cells to regenerate, possibly thwarting diseases like Alzheimer’s.

The average person makes about 250 decisions about food every day and most people don't have a clue as to what influences their choices. Consciously think about what you are eating and you will generally eat less.

A massage once a week can not only reduce muscle fatigue and soreness, but it can be just as good for stress management as a session with a counselor.

The quickest way to get fit with exercise is to WALC. Wind sprints (just periodically increase the intensity of the exercise) Aerobic (this type of exercise burns fat) Lift (lifting weights builds muscle, which in turn increases metabolism) Cross train (vary your exercise regimen and you will get fit faster).

Have you ever wondered why your wife doesn’t appreciate your love affair with the remote control? Are men really from Pluto and women from Jupiter?

We may not come from different planets, but scientists tell us that many of the differences between men and women may actually stem from differences in brain structure. This variance leads to gender- specific behavioral traits. In addition, female hormones (estrogen, progesterone, and testosterone) can cause microscopic changes in cells which may influence perceptions and thought patterns.

Brain researchers report that the two primary reasons for gender differences are brain structure and hormones. These differences can lead to behaviors that can either help or hinder relationships. God designed the sexes to be different so as to complement each other, yet these gender-specific attributes may also lead to conflict and confusion for many couples. The good news is that we can also discover ways to live in harmony with our mates.

For decades scientists have known that the right and left hemispheres of the brain have different functions. It is well established that the left hemisphere predominately controls analytical, concrete, goal-oriented behavior, whereas the right side manages more spontaneous, emotional, and artistic actions. Most individuals, independent of their sex, have a dominant lobe that influences their personality.

These two hemispheres are connected by a large network of nerves called the corpus callosum. This superhighway permits the free transfer of complex information between the two lobes. When the corpus callosum is absent (as in some rare birth defects) or severed (by accidental trauma or as medical treatment for otherwise untreatable seizure disorders) the individual’s behavior and personality may become disjointed and unpredictable.

A woman’s brain contains an average of 40% more of these interconnecting nerve fibers: a veritable superhighway for the two sides of the brain in comparison to a man’s two-lane road.

How is this significant? It means that a woman can literally use her whole brain in a task, whereas a man is much more likely to use just one hemisphere at a time. This results in a woman being able to process many tasks at once, whereas a man tends to focus on conquering one task at a time.

Men and women also use their brains differently (when we use them). Fascinating studies utilizing state-of-the-art technology show that during identical tasks, women tend to use the right and left sides of the brain equally whereas men use one hemisphere more intensively. This female “whole brain” thinking, supported by the corpus callosum interconnections but not dependent on them, gives a physiological basis for the enigma of women’s intuition. Being able to use the whole brain in processing information allows women to perceive things in a broader sense and make conclusions based on a vast array of input. This sixth sense is founded on the “whole brain” thinking that takes input from a multitude of sources to produce uncanny and often unexplainable insights.

A woman’s brain has more nerve cells than a man’s in an area called the hippocampus, the area of the brain that is intimately linked to processing and expressing emotions. The hippocampus is also the switchboard for regulating the response to stress. This area is also very sensitive to the effects of estrogen, which partly explains the emotional changes seen with fluctuations in female hormones, i.e., puberty, PMS and menopause. Because women have more neurons in this switchboard, emotions are more closely linked to other behaviors, and stress is perceived differently

Hormones are nature’s messengers. They are chemicals that transfer information from one cell to another, in some cases even altering the structure and function of the target cell. The development of female brain function and structure is especially dependent on estrogen. As the female fetus develops, estrogen works its magic by altering brain structure and sensitizing receptors for the important neurohormone serotonin. Serotonin is the critical “mood messenger” hormone that is responsible for the expression of various emotions, including depression. Any alteration in the workings of serotonin can present as a clinical depression or anxiety disorder. Estrogen is closely tied to the function of serotonin and that is why women are twice as likely to develop clinical depression as men. This connection with serotonin also partially explains why fluctuations in hormones (as in puberty, postpartum, and menopause) can cause changes in emotions. For years, the male-dominated medical fraternity downplayed this episodic mood shift as largely due to external stresses: the “it’s all in your head” approach. We now know that it is all in your head, just in the literal sense, because of the interaction of estrogen with brain cells and serotonin.

One of the most important steps a man can take in helping his wife who is suffering the emotional trials and tribulations of PMS or menopause is to understand that these changes are real and based on both physical and emotional factors in addition to the stresses of her life situation. Fortunately, clarification of the roles played by hormone fluctuations and brain functions had also led to parallel discoveries of how diet, exercise, and nutritional supplements can correct imbalances to restore health and wholeness.

“Hey doc, my face looks like a war zone. I wouldn’t mind having the complexion of a sixteen year old if I could have the body of one also, but this is ridiculous for a grown woman!” Gladys was a victim of adult onset acne, and she was not pleased. She is not alone. Some experts estimate that up to 50 % of women over 30 suffer from some type of acne or acne like complexion disorders.

It is not known what triggers adult onset acne. The development of hormonal irregularities in the menstrual cycle may be a factor, or ovarian cysts may cause hormonal abnormalities that increase androgen productivity, resulting in acne breakouts. The classic situation is one in which a woman experiences irregular cycles, setting up an over production of estrogens and testosterone. These hormones stimulate oil production in the skin glands which in turn become inflamed and irritated. Sometimes these sebaceous glands continue producing a higher amount of sebum well into adulthood and thus acne infection continues even at that age. Androgens have also been associated with acne flare-up in women before menstrual cycles or sometimes during pregnancy. Whatever the cause, it is not wanted or welcomed.

Most acne treatments require prolonged care, from months to years. These treatments include topical creams and gels and/or oral medicines. Once improvement is achieved, a maintenance dose is usually necessary. Women who develop adult acne typically have the problem for years, frequently through menopause. The suspected hormonal disruptions that trigger adult onset acne are often treated by attempting to regulate the hormonal imbalance. The modalities used most in hormonal acne treatment are oral contraceptives and antiandrogens. (medicines that counteract the effect of too much testosterone in a woman’s system).

There are several simple things to do to minimize adult onset acne. Washing with soap and water once or twice daily is a good way to keep debris and oils from the day accumulating on the skin surface. Salicylic acid and benzoyl peroxide are both common over-the-counter treatments for acne. Benzoyl peroxide exfoliates the skin and the anti-bacterial agents in it clear the excess debris from the skin to help prevent infections.

Retinoids are a class of molecules in the vitamin A family. The retinoids are potent against acne because they stabilize abnormal growth and death of cells in the sebaceous follicle. These abnormal growth cycles are believed to play a key role in the formation of blackheads, whiteheads, and other acne. The danger in retinoids is that they cannot be used by pregnant women or women who might be getting pregnant because of the high rate of serious birth defects in unborn children.

Topical and oral antibiotics are used together with other agents. Topically, antibiotics neutralize the skin-based bacteria and, when used with other agents, help deplete the excess sebum or oil secreted by the sebaceous glands, allowing acne spots to heal without infection.

Oral contraceptives prescribed for women are based on their ability to regulate hormones. A birth control pill stimulates the production of a protein that binds testosterone, thus reducing the androgen’s ability to affect oil glands.

Occasionally, adult onset acne can be confused with a condition known as rosacea. Although it is not exactly acne, its red-faced, acne like appearance can cause many physical, psychological and social problems if left untreated. In a recent survey by the National Rosacea Society, nearly 70% of rosacea patients said that this skin disorder lowered their self esteem, and 41% of patients said that they avoided social contact or functions because of their skin disease.

The cause of rosacea in unknown and there is no cure, but with available medical help this skin disorder can be controlled and minimized. Its typical symptoms are redness on the cheeks, nose, chin or forehead, small visible blood vessels on the face, bumps or pimples on the face, and watery or irritated eyes.

Whatever the cause, whatever the result, if adult onset acne is cramping your style, see your doctor because there is help.

“I’m sick and tired of being sick and tired!”

“I just have no energy.”

One of the most common problems of the 21^st century woman is fatigue. I am not exaggerating by stating that well over 40% of women I see in my office complain at some stage of their life of excessive tiredness. Lack of energy is not a local phenomenon either (in spite of the claims of one woman who was sure that SRS had something to do with her low energy level. Of course this was the same gal who had been nabbed by aliens and forced to watch reruns of “Geraldo”). National statistics are equally as impressive. One study even went as far to claim that 30.3 % of adolescents experienced excessive fatigue (PEDIATRICS Vol. 119 No. 3 March 2007, pp. e603-e609)

The classification of fatigue runs the gamut from a transient mild tiredness to a debilitating lack of energy. One of the inherent problems in studying a condition such as this is the subjectivity of the diagnosis. Those who suffer with chronic fatigue are often perceived as malingerers and patronizingly dismissed. There is still reluctance on the part of many medical practitioners to legitimize chronic fatigue syndrome, the most extreme form of tiredness, as a genuine entity; however, this appears to be an area where the science is finally catching up with the clinical observation. As with any medical problem that is poorly understood, the treatment of excessive fatigue is varied, sometimes unconventional, and often unsuccessful. It is important to distinguish chronic fatigue syndrome from “garden variety” tiredness as they differ in numbers of symptoms and degree of disability. For many sufferers it comes down to how much the lack of energy interferes with normal day to day activities. The Center for Disease Control in Atlanta has set down certain criteria for physicians and researchers to use in making the diagnosis of chronic fatigue syndrome. A CFS diagnosis should be considered in patients who present with six months or more of unexplained fatigue accompanied by other characteristic symptoms. These symptoms include:

cognitive dysfunction, including impaired memory or concentration
exhaustion and increased symptoms for more than 24 hours following physical or mental exercise
non-refreshing sleep
joint pain (without redness or swelling)
persistent muscle pain
headaches of a new type or severity
tender lymph nodes
sore throat

You can see from these symptoms that there is tremendous overlap with other common problems. We all may experience some of these problems some of the time. The key is the

persistence and intensity of the problem and, importantly, no other medical or emotional troubles that serve as a cause.

There is hope! Since becoming a more universally defined syndrome, additional research has been done on ways to thwart this bothersome illness. Many of these treatments and suggestions also apply to the woman who has only mild symptoms. So whether you are unable to get out of the bed or just collapse at the end of a busy day, these pointers may be worthwhile pursuing.

First and foremost, get a good checkup by your doctor. Many medical conditions such as hypothyroidism, menopause, Lupus, depression, anemia, and sleep apnea have fatigue as a primary symptom. If you check out well with your doc, consider the following:

1. Check your sleep habits. We are a culture of sleep deprivation. It makes logical sense that if we don’t sleep restfully we will be tired the next day. I am amazed at the number of folks that forget this simple connection. Improve your sleep and your energy will rebound.

2. Force yourself to get off the couch. Multiple studies show the positive effect of exercise on energy level. You may be saying, “I would exercise if I wasn’t so darn tired!” It is tough, but forcing yourself to do something, even a good walk, will, over time, improve your energy level.

3. Garbage in equals energy gone. We are what we eat, and this applies to energy level. In fact, energy derives from the body’s ability to metabolize food. If we put molasses in our car’s gas tank, it won’t go far. If we put junk in our gas tank, we won’t go far!

4. Reduce stress. Stress magnifies everything! The more stress, the more your lack of energy. It’s as if the body tries to shut down to save itself from the stress. The more you can minimize stress, the more energy you will have.

I realize this is a very superficial treatment of very complex solutions, but maybe it can stimulate you to investigate these approaches on your own.

Aileen blew into my office like a Summer storm. “Help me, I’m a poster child for Hormones from Hell!” After catching my breath, I assured her that there were many ways of dealing with the ravages of hot flashes, dry skin, mood changes and forgetfulness. I started by reinforcing that menopause is not a disease. Inaccurately and unfortunately there is a pervasive sense that menopause is the “ultimate and inevitable bad experience” for aging women. I jokingly explained that women were not designed to self-destruct at fifty!

Menopause is a normal, natural transition, and it is vital for women to view it with a positive perspective. That simple understanding is the cornerstone in building a plan to thwart the symptoms of “the change.” But it is equally important to realize that not everyone has a problem with menopause.

As a physician, my experience treating menopausal women is that there are some universal similarities in women’s experiences, but because of every person’s unique physiology and life journey, this time in a woman’s life is very individualized.

I am a “recovering traditionalist”. I was trained in the old school approach to menopause (which means drugs, and if that didn’t work, more drugs). In almost twenty years of practice I have found that many women are not satisfied with their options and many discover that their “treatments” are worse than their symptoms. Especially in this age of “estrogen panic” where the media (and many physicians) has touted misleading and confusing advice on hormones, many women are looking towards alternative treatments for their symptoms. One woman put it well. She said, “Physicians have a duty to give a woman the best care they can provide, especially their options. However each person is ultimately responsible for his or her own health. We, the patients, need help, guidance, and a listening ear.” Those were powerful and challenging words.

The general dissatisfaction among women is amplified by the observation that only 17% of eligible women in the US are taking some type of hormone replacement and up to 80% of women who start on hormones stop them after two years! The needs of women are not being met! This problem with compliance is due to poor communication and fear. After all, treatment of symptoms is not limited to simply taking a drug. Successfully navigating the potentially turbulent waters of menopause requires a more comprehensive approach. Herbs, complimentary teachings, diet, and exercise all should be discussed along with hormones. The main caveat surrounding these modalities is that they must be held to the same standard and scrutiny that safeguards traditional hormone replacement. The major problem in meshing the traditional and complimentary approaches to health is a mistaken perception of mutual exclusivity. These treatments can coexist and be complimentary.

I am saying that choice and personal responsibility are keys to unlock a joyous menopause.

This is an opportunity to live with passion and fulfill your life mission. This is a time to take stock of the past and choose your path for the future. The choice is yours. It is a choice that is difficult if not impossible to make wisely without sound information and guidance.

CLICK HERE for how to get my "everything menopause" book

THE 4 “A”s

Many of the lifestyle choices you make, such as diet and exercise, can dramatically affect your menopausal experience. It is not a time to be complacent or anxious. It is a time- a season- to rejoice and celebrate the joy of living.

Following the four “A”s, Attitude, Action, Aptitude and Apothecary, can be the prescription for menopausal merriment.

Attitude- what we believe is our reality, what we know is our truth. Belief plays a major role in the symptoms of menopause. Our thoughts become our actions, our actions become our deeds, our deeds become our habits, our habits become our character, and our character becomes our legacy. In many instances, if you anticipate a horrible experience, you will be right!

Action- this involves two levels. First, acting on your knowing. The key to any successful person, whether it’s in business, raising a family, or celebrating menopause is taking action. There is nothing more sad than a good idea that dies from loneliness or lack of attention. Whether that’s using hormones, herbs, massage therapy or exercise, you have to take action to achieve results.

The second part of action is exercise. It is the fountain of youth and can help in reducing both weight and hot flashes!

Aptitude- educate yourself, learn your options. Ask questions, talk to others, and take responsibility. Through knowledge about menopause, you eliminate fear and create opportunities. M.D. does not mean menopause director! Learn so you can be a partner in your health care.

Apothecary- We have a plethora of medicines and natural substances to treat the symptoms of menopause. These are merely tools; however, they cannot stand alone.

Explore your options and live joyously and healthy.

Men and women are different. I realize this may not be a ground breaking revelation but aside from certain anatomical variations, the differences are not always noticeable.

Women certainly have a different hormonal milieu than men, and some of the internal variations can be directly attributed to such; however, laying everything at the feet of the hormonal hooligans is both simplistic and unfounded. In other words, men and women are not solely their hormones, but a complex interaction of gender specific, unique physiology. Let’s look at some examples.

Women are at a greater risk of developing problems from alcohol use than men. This applies to simple health risks as well as severe consequences. The National Institutes of Health state that, based on current research, female alcoholics have death rates 50 to 100 percent higher than those of male alcoholics, including deaths from suicides, alcohol-related accidents, heart disease and stroke, and liver cirrhosis. Even though there are more male alcoholics than female, the women fare worse overall. This is related to how alcohol is metabolized in the female system. Women are more likely to develop liver damage from excessive alcohol consumption even when compared to similar intake for males. In addition, having more than 2 drinks a day can increase the risk for breast cancer for a woman. Why do these differences exist? In general women have less body water than men of similar body weight, so that women achieve higher concentrations of alcohol in the blood after drinking equivalent amounts of alcohol. In addition, women have smaller quantities of the enzyme dehydrogenase that breaks down alcohol in the stomach. A woman will absorb about 30% more alcohol into her bloodstream than a man of the same weight who has consumed an equal amount. There is a push by many organizations, especially on college campuses to educate women as to these differences. The consequences later in life can be substantial.

For years medical research on heart disease and risk factors was done exclusively on men. The vast majority of major work done in the earlier decades purposely excluded women for reasons ranging from potential pregnancy to volunteer recruitment. What resulted is a plethora of data that is extremely useful, but biased. Only with the advent of multiple studies including women have researchers realized that heart disease risk factors, occurrence, and prognosis are different for men and women. Heart disease has taken a back seat to breast cancer, for example, largely due to media attention and breast cancer awareness programs; however, heart disease is the leading cause of death in women over 50. A woman is more than ten times as likely to die of cardiovascular disease as she is to die of breast cancer. This is partly due to the fact that the survival rate for breast cancer is quite high, whereas over 40% of women do not survive their first heart attack. Women’s hearts are anatomically different from men, and they also function differently. A woman’s heart on average is smaller than a man’s, and it also tends to have smaller blood vessels supplying it. Researchers from Columbia University and New York Presbyterian Hospital believe that women also have a different rhythmicity to the pacemaker of their hearts, which causes them to beat faster. These same researchers believe that it may take a woman's heart longer to relax after each beat. Some surgeons also hypothesize that the fact that women have a 50 % greater chance of dying during heart surgery than men could be related to some fundamental difference in the way women's hearts work. These differences have led to a bias in how physicians viewed heart symptoms in women. Several studies indicated that if a woman and a man presented to an emergency room with identical symptoms, the man would be more likely to be evaluated for heart problems than the woman. Luckily with the new data, this trend is reversing and early disease is being suspected and detected in women, hopefully reducing both death and disability.

Most would agree that men and women think differently. This may have a physiologic basis as research indicates that men’s and women’s brains are structurally different. There are variations in grey and white matter, which leads to differences in things such as verbal abilities and connectivity between the two sides of the brain. These anatomical peculiarities can lead to a number of behavioral differences once thought to be social or environmental.

It’s important to understand there is no advantage or disadvantage with these variations, it’s just that being aware of the differences may help in promoting each individual's health.

“I’m not kidding; it’s Miracle-Gro for the brain!” The statement reminded me of some ridiculous infomercial infecting late night TV. In this case however, it was generated from the mouth of a world class neurobiologist, so I took notice. He was speaking of a substance called Brain Derived Neurotrophic Factor (BDNF). What immediately intrigued me was he claimed that BDNF was the link between exercise and improved brain function. For years I had read articles in both the medical and running journals touting the psychological benefits of fitness, yet here was proof that fit folks were happier folks. Dr.John Ratey, a clinical professor of psychiatry at Harvard, outlined in his amazing book “Spark: The Revolutionary New Science of Exercise and the Brain” how exercise increased the production of BDNF which in turn stimulated nerve cells to grow and connect in the Hippocampus, a tiny area in the brain responsible for a number of high level functions. This growth of new cells actually translated into better memory and quicker learning. He went on to claim that certain other chemicals were released by exercising muscles that improved functioning in the amygdala, the emotional center of the brain. The implications of this and other research are monumental.

Twenty-five years ago when I was in medical school we were taught that we were born with a set number of neurons (brain cells) and there were no more to be made…period. I remember joking in college about taking another late night excursion to the disco (yes, I am that old!) to “kill some brain cells” with Singapore Slings and Jack and Coke. We didn’t fret about the wholesale slaughter of brain cells as we all knew from biology class that we only used 20% of our brain anyway. In our way of thinking, that gave us a pretty good cushion! It was the unlucky folks born with fewer brain cells, and we all knew a few of those, who had the most to fear. We were wrong on all accounts. Now research is proving that new brain cells can be created, and formed in areas that have a major effect on cognition and emotions. Don’t take this as permission to guiltlessly get plastered; I don’t need to tell you of the disastrous effects of that, but it does open the door for medical miracles. The study of such alphabet soup as BDNF, IGF-1, and VGEF and other neuropeptides has given hope to developing successful treatments for senile dementia, Alzheimer’s and Parkinsonism. Medicine is not there yet, but we can conclude that getting fit by exercising regularly can reduce the incidence of these diseases as well as certain cancers and diabetes.

The great news is that you don’t have to train for a marathon to reap the benefits of fitness. The studies indicate that a brisk walk for 45 minutes three to four times a week can elicit these life enhancing outcomes.

One of the most exciting applications of this knowledge is illustrated by the Naperville school district. A middle class suburb south of Chicago, Naperville has been the focus of a real-life experiment documenting the benefits of fitness in kids. It is no surprise that kids who are active are more physically fit than their sedentary counterparts, but what has been found in Naperville is that these fit kids are also smarter! Over the past seventeen years the school district, consisting of 11 elementary schools, five junior high schools and two high schools, has made physical education an integral part of the school day (unlike the national average where only 6% of high schools have a daily PE program). Their gym class is not your typical dodge ball, basketball, softball curriculum (the average student in the typical hour long PE class spends 16 minutes actively moving). It is a program that promotes and measures fitness, not competition, and grades based on effort, not ability. They regularly run or ride bikes using donated treadmills and stationary bikes measuring effort by heart rate monitors. And they do it at a lower cost per student than comparable school systems! The results have been amazing. In 2002, 97% of entering freshmen were at a healthy body mass index (BMI) as compared to the national average of 65% and most striking was the impact that fitness had in the classroom. In that same year 96% of the eighth graders took the Trends in International Math and Science Test, an instrument designed to compare student’s knowledge level in different countries around the world. On the science part of the test the Naperville students scored the highest…in the world! Through a strict and comprehensive analysis it was shown that regular physical activity and fitness level correlated with the academic success of the Naperville students!

The message is clear. For adults and kids alike, regular aerobic exercise is not only good for the body, but it is great for the mind.

Norman Cousins, while struggling with a severe neuromuscular disease, said, “Laughter is like internal jogging. Ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep.” Those of you who regularly scan Reader’s Digest remember a column titled, “Laughter is the best medicine”. Indeed it is, and sometimes we forget that. So here is my prescription for surviving everyday stress…laugh three times a day! Some of the most effective laughter is that which we do at ourselves. The less serious we take ourselves, the less burdensome everyday stresses and strains. For example, I recently attended a local high school football game and quickly lapsed into a flashback when the bands took the field for the halftime entertainment. No, I wasn’t in the band in high school. The idea of walking backwards in circles while reading music was a bit overwhelming, but my mother was convinced that I had the potential to be the next John Philip Souza. She felt that one way to navigate the treacherous waters of a new high school was to join their celebrated band. I had just been uprooted from a comfortable middle school existence in Memphis to the mountains of East Tennessee , replete with orange painted outhouses, to begin my high school years. I was the size of a Hobbit, and about as good-looking, so my social integration options were vastly limited. I certainly was not a candidate for football (a religion in Knoxville) although; in retrospect, I would have made a wonderful tackling dummy. Track was not an option as I had the speed of an anemic sloth. Basket ball…well let’s just say dribbling at the level of other’s knees didn’t fare well for a stellar career. So maybe the band was a way that I could find my niche in an otherwise niche-less existence. At least my mother thought so. So the first day a school she set up an appointment with the band director to discuss my future musical career. Unfortunately, she made me come along. Once we arrived in the hallowed sanctuary known as the “band room” , Mr.Jenkins, the band teacher, granted us an audience.

“Now exactly what instrument does your boy play?”, he asked condescendingly. I felt this was a rather appropriate question and a reasonable place to start the discussion until it dawned on me that I didn’t play an instrument. I suspected that my mother also knew this as she had not seen or heard me with anything other than a kazoo since kindergarten, but she was not fazed by the inquiry.

“He doesn’t…yet”, she confidently replied. This obviously was not the response Mr. Jenkins was expecting as he stared at her with a look that said, “Well what in the name of Beethoven are you doing here then?” Mom, ever the perceptive sort, picked up on his incredulity and explained that before we invested in lessons or instruments, she wanted to get his impression as to which instrument I was best suited to play. At this point I was busily plotting both my escape and my plan for putting mom on medication. I had read of studies that looked at a person’s likelihood of being a criminal based on their physical traits, you know, beady eyes, big forehead etc, but I had yet to see any research correlating a person’s physical appearance and their ability to master a band instrument. I felt myself slowly sinking into “Music Man” hell. Mr. Jenkins composed himself, obviously trying to pacify the crazy woman sitting before him, and shot a glance at my face, as if to say, “Is she serious?” I cocked my head, subtly conveying the dual message that yes, she is serious and she may be armed, so do what she asks. He then proceeded to survey my mouth, fingers, eyes and anything else he could possibly think of that would indicate the ideal instrument for me. It was like being scrutinized for lice after being accused of infecting the whole school.

After what seemed like hours, he stopped, grunted, and said “trumpet…yes, trumpet”. A huge grin crossed mom’s face as this seemed to validate her quest. All I could think of was Dizzy Gillespie, that huge, old guy who puffed out his cheeks to the size of a steroid laced chipmunk whenever he played his horn. I didn’t want to walk around school with the cheeks of a bloated rodent, so I instantly expressed my apprehension. Of course, my protest fell on deaf ears as mom was already negotiating horn rentals and lesson fees.

How was I supposed to get the girls playing something you have to clear spit out of every few minutes? Neil Diamond never wooed a woman with his classic marching tunes! As I walked out of the room, visions of chapped lips and elastic cheeks dancing in my head, I realized that maybe I needed to find a better way to fit in. I wonder if girls dig science projects?

The one question we are asked in the office most often, other than how to improve libido, is how to eat healthy. Since 45 million people in this country are overweight, it is no wonder that this is on everyone’s mind. Simple is better, so here are some simple guidelines for eating healthy.

Rule number one: Eat balanced meals. What your mother always taught you is true. There is no one super food, in spite of what the algae lovers claim, and there is likewise no naturally evil food (well, maybe Spam qualifies as evil). We were created to survive on a variety of nutrients and no one food can provide everything you need, so mix it up to guarantee proper health. Balance proteins, carbohydrates, and fats by selecting a wide variety of foods. Spice up your life! Get crazy and try foods that are different from burgers, bacon, and barbecue! Travel the world by making one night a week “ethnic night” and sample various foreign cuisine. There are three sub rules in this category: eat whole foods whenever possible, mainly plants, and prepare them in as close to the natural state as you can. In other words don’t fry, fritter, and fracture your food! And one final caveat, don’t overdo it. One given in proper weight management is watching total calorie intake. How much you eat is just as important as the mix.

Rule number two: Eat low fat meals. This is not to demonize fat but to remind you that too much of some stuff is just not healthy. In spite of the cacophony of nutritional advice out there, there is not a reliable expert around who tells you to eat more lard. Some fat is necessary but we should all limit saturated and trans fats. These include margarine, salad dressings, processed cakes, chips,cookies, and gobs of other nasties. Become a label reader. It’s right there in black and white. If the serving size contains more than 5 grams of saturated fat, put the item down and run away screaming. Total fat in your diet shouldn’t exceed 25% of total calories. There are a number of fat counters available in Apps and online so it is relatively easy to calculate how much of the grease is sliding down your gullet. Don’t forget there are some good fats. For example, the omega 3 fatty acids found in abundance in some plants (flaxseed) and cold water fish (tuna, halibut) are critical in assuring good health and are essential for their anti-inflammatory actions.

Rule number three: Eat low sugar. The average person will consume 160 pounds of sugar a year! Most sodas will contain 40g of sugar in each can! Sugar, or glucose in fancy doctor talk, is necessary for energy, yet most of us eat enough sugar to power a high school soccer team. The low carb craze of recent vintage did make us aware of the evils of consuming to much sugar (carbohydrates=sugar); and the data supports that a low carb lifestyle is healthy. Keep in mind that your need for sugar and energy is directly proportional to your activity level. Marathoners need more carbohydrates than chess masters.

Rule number four: Eat more fiber. This rule may be a bit of a surprise because it doesn’t get the airplay that the other rules seem to enjoy; however, fiber, both soluble and insoluble, is a key component of a healthy diet. These are things that aren’t actually metabolized in the system put serve a variety of vital functions such as binding excess cholesterol, promoting bowel health, and regulating hormone levels. The American Heart Association has stated that consuming 28 grams of fiber a day can reduce your risk of heart disease, the number one killer of both men and women. Fiber is abundant in fruits and vegetables, grains, nuts, legumes, and tree bark. (Just seeing if you were paying attention). Choosing foods high in fiber not only fulfills the need for roughage, but these foods also tend to be low in calories and filling.

“The doctor who fails to have a placebo effect on his patients should become a pathologist”

J.N. Blau, M.D.

The lines between the art and science of medicine are often blurred. Many years ago, when the earth was cooling and I was a medical student, I was assigned to shadow an older Ob/Gyn in private practice. The goal was to gives us young medical pups a sense of real world medicine. Dr.Koronik was a gifted clinician as well as a crafty student of human behavior. One afternoon we were speaking with a patient, a recently married young female, who was completing her yearly exam when she reported her libido, or sex drive, had driven off and she didn’t have the map! Dr. K had done a thorough physical exam and knew anatomically everything was intact, and so he talked with her at length about her life situation and decided to get some baseline blood work. She was to return when the blood work was back and review the results and discuss any treatment options. After she left, Dr. K pulled me aside and said he felt her problem was more from the neck up and not the waist down. He was not patronizing or minimizing her problem, it was just an honest assessment of what he surmised was the source of her lack of desire. Upon her return, they reviewed the blood work which supported the idea that all was well physiologically, and Dr.K had a long discussion about stress, relationships, and other important factors in sexual well being. At the conclusion he presented her with a bottle of tablets and told her that taking one on a daily basis may increase her libido. I was taken aback and after she left I questioned his prescribing of a medication for what he seemed to think was an emotional issue. He explained, in what was to be the first of many lessons in healing as opposed to curing, that the “medicine” was nothing more than sugar pills, and that he felt they would aid in minimizing her psychological issues with intimacy. There are a number of ethical and legal issues involved with this “treatment” but remember this was almost 30 years ago and in a small town in East Tennessee.

I didn’t see the young lady in follow up, but a few days later Dr.K reported a Ford 350 pickup truck backed up to the rear of his office around closing time. A burly, six foot something cowboy straight off a movie set ambled out of the truck cab and sauntered to the back door of the clinic.

“Hey doc,” he offered as he thrust his hand in greeting. “My wife came to see ya a few days ago about this...eh...problem she been havin’ ”. No doubt, this was the husband of the libido challenged patient.

“I just wanted to come shake your hand for them pills you gave her cause, let me tell ya, I don’t ever want to run out of them things! I brought my truck here to load up a batch!”

Say what you may but the placebo effect is a real and powerful scientifically validated phenomenon. There are some amazing studies done with PET scanners, machines that “light up” areas of the brain that are functioning in thoughts and emotions, that confirm that feelings can be translated into physical changes in the brain. When we feel happy or sad, specific areas of the brain are activated and in turn set off a cascade of hormones, neurotransmitters, and a cavalcade of substances that elicit amazing physical effects. There is a branch of science called psychoneuroimmunology that studies how our thoughts and emotions effect our immune system. For example, if you get int an argument with your spouse or yell at your kids getting dressed for school, not only do you feel stressed, but you are more susceptible to catching a cold! There is even some evidence that chronically stressed or angry individuals are more at risk for certain cancers because their emotional state impairs their immune system’s natural ability to eradicate early abnormal cells.

The Mayo Clinic issued a series of findings on research done on the reasons the placebo effect is genuine:

“A patient whose doctor is supportive and positive may benefit more from any treatment, active or placebo.

A patient who believes a treatment will work is more likely to experience the placebo effect than one who doubts it.

Some patients respond well to frequent and intensive medical attention, whether or not a drug or treatment is potent.”

Indeed, the placebo effect is “all in your head” but it is just as real and often as therapeutic as a drug.

Now if I could just find some of those “libido” pills!

Boyfriends are like Ebola in Sierra Leone, just when you think they’re are gone forever, they come weaseling back in. Now I am talking about my daughter’s boyfriends of course. This is not going to be some coming out of the closet confessional reporting after 58 years I am switching teams. No, my ire in comparing young men to a blood-letting scourge is directed at those who would court my beautiful and innocent offspring. Let me say at the outset, mainly because I want to eventually be welcomed back into my house, that this rant is reserved for boyfriends past. I have been on the receiving end of the looks of death after writing about current beaus, so with aspirations of self preservation I will limit my remarks to those who have gone the way of the DoDo bird and are extinct, at least from my daughter’s lives. It also is a compilation of boyfriends and not one in particular, again for preservation purposes.

There are certain warning signs when observing suitors that should send shivers down the spine of any self respecting dad. Red flag number one is not coming to the door to pick up the young lady. This tells me either you look like a motorcycle gang poster boy, were raised by wolves, or had a “couple” of beers before coming over. Not only should you come to the door, but you should expect to come inside and attempt to carry on a semblance of a coherent conversation. A couple of pointers are warranted here. Try to make complete sentences without using “like” fifteen or twenty times and if you have a nose ring, either take it out or come up with a story about completing your graduate degree in Bushman anthropology and you are in an immersion semester. Do not show up late unless your grandmother just died, and only tell me your grandmother died once. Red flag number two is the boyfriend beginning the conversation with a pitch to join him in a multilevel marketing scheme. Yes, it shows initiative, but also a hefty load of stupidity with a side of arrogance.

I was pretty benign towards boyfriends until I saw one of my daughters actually shed a few tears over one’s actions. This was unacceptable as my daughters usually only cry when I embarrass them by my wearing short shorts to run in. I reserve the right to exclusive tears and will not tolerate any behavior leading to sadness in my babies. The first time one of them came home sobbing over “nothing” I had to be restrained by my wife or I would have committed a genocide of one. I dreamed of using my surgical skills to smash their nose then sew it back up and have it look like a vagina; would you expect anything less from a gynecologist? Only a dad can appreciate the rage elicited by seeing the fruits of his loins crying their eyes out because some scum monkey boyfriend forgot their 2 month anniversary. If the insensitive boob can’t even remember a simple, irrelevant fact like that, what good is he?

Boyfriends who try to hard are also annoying and destined to work the night shift at Target. Know from the start, I don’t want to talk to you, I simply want you to be sober and take care of my baby. I want to talk with you long enough to know if you have any felony convictions or are a fan of Justin Bieber, both of which are a game ender. I want to know if you made it past the fifth grade and you have a current non suspended drivers license. I must say at this point I don’t want to give the impression that these are the kind of folks my daughter’s elect to date, quite the contrary. They have amazing taste and generally pick with aplomb, but every now and then, much like a termite, someone sneaks in who will eat you out of house and home, literally and figuratively. I remember one massive hunka-hunka burnin’ love who ate so much at our house I thought I was going to have to take a second job to pay for the extra groceries. Then there was the Mensa member who ordered the biggest steak on the menu at a local restaurant as we treated my daughter and he to a dinner out. That was fine, expensive, but fine; however, he also ordered what ended up being the equivalent of a six pack of craft lager. I was underwhelmed by both his choice and lack of cash to chip in. I wrote if off as being nervous, but the eventual truth was he was a sot.

I have been blessed with two intelligent, beautiful daughters who, for the most part, pick judiciously who they date. They have finally warmed to the idea that no boy they bring home can ever or will ever meet my expectations. If they could only find a younger me. But, alas, I would never allow them to date someone like me. As Groucho once said,”I would never join a club who would allow someone like me as a member!”

Could I possibly be warm enough in my Elvis outfit?

This question does not plague me often, but prior to the Memphis Marathon it was paramount. I have always eschewed the wearing of costumes, tutu’s, face paint, or edible underwear in races, but Memphis screamed out for a running Hunka Hunka burning love. With the latest check of the weather, my intuition about shedding the white bejeweled jumpsuit for an Under Armor cold gear ensemble was verified. I donned my black tights and compression shirt as my wife giggled and said I looked like an aging ninja in tennis shoes. Not dissuaded, I self satisfyingly sat on the bed knowing I would be toasty and compact. I would put Elvis on hold until the Las Vegas Marathon later in the year.

I had grown up in Memphis, left after grade school, then returned for medical school. I began running in medical school, largely in response to coffee and an impossible biochemistry course, so I was returning to familiar running turf, so to speak. The medical school is about a mile from the Mississippi River, on which whose bluffs Memphis is perched, so after flunking another biochemistry test I would head out in my Adidas trainers and run to the river (after a particularly bad test even considering jumping in) and back. It was not particularly far, but cathartic none the less. Needless to say the downtown had changed over the past 30 years. No longer did I see the friendly homeless guy I had treated for DTs in the ER hanging out in the downtown park nor did I have to dodge the broken beer bottles and used needles. Now the downtown area was ripe with hipster bars and upscale bistros. They had even built a baseball stadium smack dab in the middle of the city, right across from the hallowed Peabody Hotel. The Peabody ducks now had to compete with quarter beer night and bad organ music. I won’t say I missed the needles, but it did have somewhat of a yuppie feel, for better or worse.

The St.Jude Memphis Marathon has grown over the years and now spawns about 20,000 runners traversing everything from a mile fun run up to the marathon. We were told to self segregate into waves based on our projected pace as to facilitate the start. Let me say asking a marathoner to predict his likely pace throughout the race is like asking Donald Trump to predict which way his hair will lay on any given day. I am as guilty as anyone as I often start a race as a Kenyan and end as a spastic jellyfish. I lined up with my fellow Ethiopian wannabes in wave 5, the 9 minute a mile pace group, and imagined my winged feet carrying me to a new PR, given what I had gleaned from the topography graph of the race course. What I learned is that those dreaded topographers are demon possessed liars whose sole mission in life is to make my quads scream for glycogen like a lawyer screams for billable hours. I mistakenly thought there were only three small hills, going as far as to memorize where they fell in the course, only to find that the map makers (those hounds from Hades) “smoothed out” the graph for “simplicity”. In other words there were a heck of a lot of small rolling hills in between the mountains (okay, I exaggerate). I don’t like hills. I like leprosy more than I like hills. As I get older my major criteria for choosing marathons are which ones have free beer at the end and which ones don’t have the damned hills!

As a young medical student running on the asphalt of downtown Memphis I was immune to much of my environment. Today I took in the various landmarks like Charlie Vargo’s Rendezvous, home of dry rub pig parts (some refer to it as barbecue), sixteen places where Elvis slept (it seems he had trouble finding Graceland at night), Rhodes College (It was Southwestern when I was there but they got all full of themselves and became a Yale wannabe, but it was a pretty campus), and Beale Street, home of the Blues, and black toenails by the time I made it to that point of the race.

Probably the most memorable moment, besides the beer at the finish, was running through the St.Jude Hospital campus. There were patients and employees lining the route making sounds that rivaled the girls of Wellesley at the Boston Marathon, and they were much better looking! Having those folks cheering us was surreal. They are the heroes every day.

The race concluded in the minor league baseball stadium in the middle of the downtown. It was a great finishing spot as it was literally steps from the hotel and a hot shower. I will never forget walking to my first marathon years ago. We were walking with a girl we had just met and she found out it was my first race. She told me that the shower after a marathon was better than sex. It does feel good, but all I can say is that poor girl has had a very disappointing sex life.

Two thirds of adults and one third of kids are either overweight or obese. This comes as no great revelation to most of us as it is a simple matter of looking around. I find it tedious and unproductive to badger someone about their weight. Let’s be honest. If you are overweight, you know it. You don’t need some self-righteous, “thinner than thou” doctor harping on you to lose weight. That accomplishes nothing, and I should know because I did that for 20 years. I would admonish a patient to lose weight at their yearly checkup only to have them return a year later twenty pounds heavier. I was shirking my responsibility as their physician, and possibly even worsening the problem because I really didn’t understand the problem to begin with. Gaining weight and losing weight is a very complex undertaking involving physical, emotional, and even spiritual aspects. I have come to realize that out thoughts and emotions play at least as much if not more a role than our DNA. There is no question that genetics, hormones, and physiology contribute to thickness or thinness, but happiness, stress, and depression also contribute mightily to the equation. To simply tell someone to eat less and exercise more to lose weight is akin to telling the Arabs and Israelis to just get along. It’s not that simple.

A good friend of mine who has been in the weight management field for many years says, “To change your weight, you have to first change your mind.” There is great wisdom in that simple statement because it summarizes a terribly complex effort. Changing one’s mind is like turning the Titanic for some of us. I can’t even begin to address the complexity of emotions, beliefs, unconscious imprints, desires, and needs that go into mind changing, but suffice it to say each of us has a roadmap to change that only we can navigate. In other words, no one can change your mind for you, or tell you exactly how it is done. What I can do is give you some tools and insights as to the process and maybe outline a path for you to begin your journey towards better health.

Psychologists tell us that we humans are motivated largely by two opposite drives. We want to avoid pain and we desire pleasure. What is fascinating is that often we will spend much more time and effort avoiding perceived pain than seeking pleasure. I realize this goes against the grain of a society that promotes things like “Hedonism” and “Naked Dating”, but the impact of emotional pain in particular is a very powerful agent for change. I have seen this play out in my own practice when working with folks on weight loss. I will never forget the middle aged lady who had come to me wanting to lose forty pounds. On her first visit she looked across the table at me and tearfully said, “If I don’t get healthy, I’m not going to be able to play with my grandkids.” She was ready, and by gosh, she has done it! I could have screamed at her incessantly about her risk of heart disease, diabetes, and stroke from being overweight, and it would have all been for naught. She wanted desperately to avoid the pain of missing time with her family, and that was monumental motivation.

Often, with our weight management folks, I will have them do a simple exercise that crystallizes their motivations. I have them make two simple lists. On the left side of the paper I have them write three things they will gain by losing weight and on the right side of the paper I have them write three things they will lose by not losing weight. The key is the things have to be very personal and real. Then I have them sit quietly and imagine how they would feel if each of the things came true. I insist that they visualize each thing, good and bad, as vividly as possible and try to truly experience the emotions that it elicits. The I have them post this list somewhere where they will see it daily. I ask them to feel the emotions when they think of the bad things, as well as the joy from the good things. These emotions become massive motivators. It works, as these feelings often become the key that unlocks the desire to make changes.

Changing your mind can change your weight.

About the Author

Ron Eaker

Popular Posts

Blog Archive

Label Cloud

Contact Us

Search This Blog

Subscribe

Popular Posts

Popular Posts