Heatstroke!!!

Now that it is summer, and the temperatures are rising, we all need to be aware of the signs, symptoms, and treatment of heatstroke. It can effect anyone, but most often it is infants, the elderly (with pre-existing conditions), athletes, and outdoor workers. When it is hot out, and you are overly exerting yourself, you can easily dehydrate, and it becomes difficult for your body to autoregulate your temperature. Normally your body regulates through shivering (when cold) and sweating (when hot). When your body is unable to do this, you are at a high risk or heat stroke.

What are some signs/symptoms?

It can mimic the signs of a heart attack, or have no symptoms at all until someone collapses. Initial signs can be : nausea, vomiting, fatigue, weakness, dizziness, and headache. At this point, the person has heat exhaustion, should be encouraged to get to cooler temperatures, and drink fluids (preferably with electrolytes). Heatstroke symtpoms can consist of: rapid pulse, high temperature without sweating and reddened skin, confusion, agitation, lethargy, and eventually coma.

What should I do?
As earlier stated, when you/someone else first has symptoms of heat exhaustion, you should get out of the sun/heat and into shade or air conditioning (if possible) and take off as many clothes as possible to allow the body to try and regulate itself. Encourage fluids (even if they are throwing up) encourage any sort of fluids- including popscicle, Gatorade, water, etc. If you see someone in full heatstroke, immediately get them out of the heat and call 911- it is a true medical emergency requiring IV fluids and heart/temperature monitoring, at the very least.

How can I prevent it?
Drink lots of fluids in the sun, limit exertion in the heat (if you do something outside, try for before 10am and after 2pm), limit caffiene (it can dehydrate), avoid alcohol in the sun (I know that boating/beaching in the sun with a cold beer is fun, but can be very dangerous). If you do drink alcohol out in the sun, try to get in ample water and sports drinks between beers, if possible. Try to limit extreme sun for children and elderly- never leave either of these populations in hot cars for extensive amounts of time, and keep them out of high exposure times (10am-2pm). (same advise for pooches too!! )

Basically, use common sense with the heat and don't overdo it outside on hot days, and listen to your body because it will tell you when to get out of the sun! And, FYI, these hot humid days are the ones to worry about losing too much sodium! So pleas hydrate and take some breaks from the heat :)

Yours in Good Health
B

A fresh yummy summer dish

In honor of the first day of summer, I wanted to give you guys one of my favorite quick, easy, summer favorites!   It is fast and you can make tons of substitutions based on your preferences (and what's fresh at your local farm/farmer's market):

1 bell pepper (I prefer red due to high vitamin C content) diced
3 scallions diced
1/4 red onion diced
2-3 carrots (either diced or shredded)
3 celery stalks diced
1/2 cucumber (skin on) diced
12 snap peas (snapped)
1/2 zucchini diced
1/2 yellow squash diced
1 box high protein high fiber pasta ( I like the Barilla penne)
Either organic grass-fed chicken or ahi tuna (marinate in a soy/olive oil marinade) then grill.

Dressing:
1/4 cup toasted sesame oil
1/4 cup red wine vinegar
a couple of tablespoons sesame seeds (I like to toast on the stove top stirring frequently until lightly browned)
1/2 teaspoon  granulated garlic (or a half clove fresh garlic diced finely)
salt and pepper to taste

Wash and dice all veggies, cook pasta as directed on the box (I leave out the salt and add a bit of olive oil to the water to prevent sticking), drain the pasta and rinse with cold water to prevent further cooking.  While pasta is cooking, grill tuna or chicken.  Once all is cooked/diced/ready to go ( I chop chicken into small bites and ahi tuna I usually slice and put atop the bed of pasta/veg).  Mix together the dressing ingredients, and toss into the protein/pasta/veg mixture.

This dish is soo easy, really healthy, and you can change it however you want...I usually make my own marinades and dressings and change them every time.  But, it is filled with vitamins, proteins, fiber, and low calorie too!  I serve it cold, so it is great on a hot day and it keeps for a couple of days so you can have healthy lunches/dinners pre-made!!

I hope that you all enjoy and make it your own :)

Yours in Good Health

B

Are you in a rut?

I was asked over the weekend what do I do to workout when I get tired of running.  At first, to be honest I was kind of at a loss.  I mean, I know that I do other things, but when I was asked spot on, I couldn't really answer.

I am all about the "prison" workout.  So, I usually do go running, mostly because now I have my dogs totally hooked on a daily run, and during my run I try to find an area where I can stop, give the pooches a break, and do 1 to 2 sets of pushups (1 set= 100 pushups), and if I can find a secluded street with a good curb, I do, what I like to call, curb work (sometimes I am rally imaginative!!)  I will alternate feet and lift one so that it lightly touches the top of the curb, while the other is on the street, quickly and in rapid succession; it is almost like running in place but with a higher step and I try to do a couple of sets (150= 1 set) it makes for great calf muscles.  And, if it is a grassy area, I will try to do usually 300 crunches (100 straight crunches and then 100 to the right/left working the external obliques).  I then continue on my run home.  But, if I find a bar or pole that I can do some pull-ups on, I am a happy girl (despite the fact that I stink at pull-ups; I can only do around 8 and then I just look like a fool attempting to pull myself up!!)  I usually do another 900 crunches when I get home (it sounds like a lot but it only takes like 10 minutes because I work all my ab muscles) and then usually lift low weights (10lbs) to tone my biceps and triceps with various different lifting techniques. That is my normal daily work-out; I can do it anywhere, I don't need a gym, and I can do it at any time- all I need is my sneakers, an ab ball, my 10lb weights,  and preferably with an ipod, my dogs, and a piece of peppermint gum (mint helps to open the bronchioles and allow for better air movement- as an asthmatic, I swear by it with every run and it cuts down on inhaler use.)

 On days that I don't feel like running, or I have achey legs, etc. I will do interval training.  I try to find either a semi empty parking lot, or a non-busy street and I pick out a set space that can be easily land-marked (approx 1/8th-1/4th of a mile between trees, or a driveway, house, etc...something that cannot move as I have been duped by cars before that get moved!) And I will alternate between wind sprints, forward lunges, and side lunges.  Again, I will do push-ups, curb work, crunches, and I can also do reverse push up to work my triceps (sit on the curb, put your arms directly next to you, push up to get your butt off the curb and lift yourself up and down without resting- it is a small triceps movement but in high reps it is great for toning.)  I try to mix in squats, I use weights to work my biceps (when I get home), I try to work my obliques/abs just a little everyday BUT it is important to focus more on one part of the body each workout and give the other muscles a break.

 Other times, I will ride my bike, go for long walks, find a nice hike, do hot power yoga, or (GASP) take a day off!!  Your body is really smart, and when you workout hard, and a lot, your body will tell you that it needs a break. I used to really push myself because I was fixated on these goals that I set for myself, and it is part of my competitive nature, but I found that I got a few injuries and that laid me up from running, and then I had to start all over.  It is best to do what your body wants....not to sit on the couch all day every day BUT give it a rest for a couple of days after a really hard workout.

Listen to your body and your workouts will be more enjoyable because you won't be forcing yourself to run/bike/etc through pain, and switch up your routine.  That is precisely why I like my prison workouts, I do different things depending on where I am running- it is really great not to feel tied to a gym. Granted, I do belong to one, I just never go outside of the winter when it is freezing- I am not the kind of girl who puts on 20 layers to go for a run outdoors :)

I hope this helps those of you who were looking for advise on switching up routines and interested in how I keep in shape.  So, keep up the good work, and remember to listen to your body!

Yours in Good Health

B

Jessica Simpson is in trouble....

Not that this is fresh news, but a large study was conducted in the UK ( Scotland, more specifically), and it looked at the specific risk factor of tooth brushing and cardiovascular disease (which can lead to strokes/heart attacks).  It was found that people who do not brush at least twice a day, have a much higher risk of cardiovascular disease than those who do not.  The study took into account family history of heart disease, lower socioeconomic status, age, sex, body mass index, diabetes, hypertension, smoking, and physical activity.  Despite all of those factors being taken into account, it still showed that less frequent trips to the dentist for proper cleanings (i.e. longer than 6 months between visits) and less than twice a day brushing can significantly increase the risk of cardiovascular disease by causing a state of chronic inflammation in the oral cavity and increasing the bodies inflammatory markers in the blood.  This can cause a build up of atherosclerosis, thus increasing the risk of cardiovascular disease.  This can also effect the breakdown of lipids (fats) in the body and lead to a build-up of lipids in the body.

This is not to say that, for example (because she came out a few weeks ago stating that she only brushes her teeth once or twice a week), Jessica Simpson will definitively get cardiovascular disease, BUT she is at a much higher risk.  Brushing less than twice a day is a risk factor just like smoking, sedentary lifestyle, eating a high fat diet, etc.

So, it is important to maintain your oral hygiene, and really encourage oral hygiene for your children too.  This is another way that children learn from examples of their parents, and if they earn it is part of their daily routine as a child, then they will continue on as adults.  You all may be happy to know that Jessica Simpson's mom told the press that she is going to reiterate with Jessica the importance of oral hygiene- I know I will sleep better at night now ;)

And, as a shout out for my dentist buddies out there, please floss too!!  I know that sometimes it can seem quite laborious, but it really only takes an extra minute or so, and it is crucial to oral hygiene. So, keep brushing and flossing your way to a long healthy life!

Yours in Good Health

B

That message can wait....

I wouldn't be a very responsible healthcare blogger if I didn't talk about something that just made the New England Journal of Medicine (kind of a big deal in the medical world), that I never really thought about bringing up with patients before: texting while driving.

PCP's are now giving information to their patients regarding the use of cell phones while driving ,as they would regarding smoking cessation, eating healthy, and exercising regularly.  Apparently, studies have shown that people who are texting are more impaired as drunk drivers, due to their lack of attention to the road, and are 20x more likely to crash than those who are paying attention to the road ahead.  Texting while driving is also on par with sleep deprivation.  It is totally scary to think that people who are not under the influence of drugs/alcohol, can basically drive like they are solely because they are texting.

I remember on my old school phone that I could text like a champ without looking at the phone because I could feel the keys and I really could take on any teenager and give them a run for their money...BUT with the touch screen phones, that isn't the case.  And, with the number of, specifically, Iphones out there, people actually need to look at their screens to type and that takes away from watching the road (approx 400% more time with eyes off the road per one recent study) and diminishes response times to other cars on the road; it can make a teenagers response time that of a 70 year old.

Creepy statistics?  In 2008, during daylight times over 800,000 Americans were texting whilst driving and over 6,000 people were killed in that same year from distracted drivers.  25% of annual car accidents are caused by people talking on their cell phones. People who are texting while driving a re 6 times more likely to get in a care crash than those who are intoxicated!!  And, while this is old data, I found it very interesting; in 2002 the Harvard Center for risk Analysis found that 2,600 people die each year as a result of using cell phones while driving and 330,000 are injured. Also, according to one survey, 85% of people surveyed agreed that texting/talking while driving was dangerous, yet of those people, 80% stated that they still did it anyway.  Hmmm, so we know it's dangerous, but we still do it.....

I must say, on a recent cross country road trip with a dear friend, we watched and saw so many people swerving in/out of lanes, and you would swear they were drunk, but as you passed them saw that they were chatting on their phones, texting, putting on makeup (my personal favorite at 80 MPH), and other drivers were literally speeding past at any chance just to get away from them.  Really watch the road and see who is texting and chatting; we blame teenagers all the time, but I think that I see more adults talking, texting, working on a COMPUTER, putting on makeup, etc than I do teenagers.  So, maybe we should all practice what we preach and use hands free devices or just do what we did in the old days and sit back, listen to some tunes, and get where we are going safely...make the phone calls when you get to your destination!

I know that I will encourage patients, family, friends to drop the phone and pay attention to driving, and I hope that these statistics encourage you all to do the same, it may save a life :)

Yours in Good Health

B

dispelling a rumor

I wanted to talk and clear up a rumor I have heard from a few people and received emails about recently related to cancer.  I have heard, from many different people, that you shouldn't get an operation for cancer because it makes it spread (i.e. once cancer is open to air to spreads.)  Mostly because they have heard about people going in for an operation to have a tumor removed but more is found, leading to subsequent operations, chemo, radiation, etc.

So, this is completely not true!  Cancer being exposed to air does not spread the cancer.  Cancer can be "seeded" if an encapsulated tumor sac is opened, as in during a biopsy, for example.  All that means is that the tumor is opened and the cancer cells can spread and possibly affect other areas of your body.  But, operations that are performed to remove a tumor, are for just that purpose.  Many are done laparoscopically (a few small port holes are placed and the surgeon operates using small tools and a camera inside of you) by skilled surgeons, so they aren't even exposed to the air until removed.  But, even if you have an open operation (area is completely exposed) it does not spread the tumor.

Now, during your work-up to find out if you have cancer, and when you are getting ready for surgery, you will have many different tests like x-rays, CT scans, possibly MRI's, which are all to help locate the tumor, its source, and possible metastases.  It may be thought that you have one tumor based on imaging, but when your surgeon goes in to operate, a whole new picture may arise for you...they may find metastases or that the tumor starts/ends somewhere else making subsequent operations, or a different treatment plan necessary.  Modern medicine and imaging is really advanced and amazing, but it is not always 100% accurate, and it doesn't take the place of human touch and interaction with your body.

The only ways we currently have scientific proof of, to remove cancer from your body is through surgical removal, chemotherapy, and radiation.  And, while radiation and chemo can cause various side effects during their treatment, surgical removal of a tumor does NOT spread the cancer.  So, if you are told you need an operation to remove a tumor, always get a second opinion, but don't fear that the operation will make it spread!

Yours in Good Health!

B

the skinny on antioxidants

I know that people talk about "superfoods" and antioxidants a lot, and how they can help to prevent certain diseases such as cancer, Alzheimer's, HIV, etc. but I don't think that many people know how they work or what they do.  They come in a bunch of forms such as vitamin A, C, E along with plant-derived polyphenols (found in bright/colorful fruits and veggies), and in selenium, which is found in nuts and broccoli. 

Basically, these compounds are able to neutralize the harmful molecules in our bodies, known as free radicals. Free radicals have unpaired electrons, which leave them highly reactive, and allow them to attack various components of our cells and these attacks can cause cancer.  Free radicals can be the by products if different cellular reactions on our bodies and also from cigarette smoke, air pollution, UV light, and exposure to radiation.

Antioxidants neutralize free radicals either by providing the extra electron needed to make the pair (because they only have one electron) or by breaking down the free radical molecule to render it harmless (essentially attacking the free radical to kill it off). Antioxidants can help stop the chain reaction of free radical formation and benefit our health by boosting our immune system. Because antioxidants are used up in the process of free radical neutralization, a diet rich in antioxidants is essential to ensure a constant supply.

Research has shown that antioxidants can have an important impact on serious diseases. In one recent study, the addition of a polyphenol-rich blueberry gel to the diet of oral cancer patients prevented recurrence of the cancer. Another experiment demonstrated that increased levels of selenium in the diets of a group of HIV-positive patients significantly delayed progression of the disease.

Do HCP's suggest you go run out and pop supplement antioxidant pills?  No!!  But, I do suggest to patients to eat diets high in antioxidants, i.e. eat healthy diets that have lots and lots of colors (from fruit an veg- not artificial colors) on each plate.  And, try and limit exposures to free radical causing activities, such as steering clear of cigarette smoke, limiting radiation exposure (or wear lead to protect yourself), and limit high UV light exposure (i.e. the middle of the day).

Yours in Good Health!

B