What's the skinny with Alli?

I have received a lot of questions from readers about this drug recently, and I am not completely sure why, but it maybe because warm weather is right around the corner and that means bathing suit season???  So many people think that they can just take this pill, shed unwanted pounds, there are no side effects; a magic pill!  Well, I hate to be the bearer of bad news, but there are no magic pills, but this can be a really useful diet aid for those struggling with weight loss, and one of the major side effects helps you to eat a healthier diet.

What exactly is Alli?
Alli is an over the counter medication, that is a lower dose of a prescription medication known as Xenical (orlistat).  Alli is 60mg versus Xenicals dose of 120mg.  And, Alli is only available over the counter to adults (age 18 and over) in the United States.

How does it work?
Well, Alli is a fat blocker, basically, so it aids in weight loss.  The way it works is kind of two-fold: it decreases the fat absorption ability of your intestines, and also it effects your lipase, which is an enzyme secreted from your pancreas that helps to break down fat to an absorbable form, so that it no longer works.  You are encouraged to eat a low-fat diet, you need to eat small amounts of "good fat" in your diet to be healthy, and eat a healthy low calorie diet, getting in lots of fiber and protein.  And you are encouraged to take it three times a day with a meal.

Side effects?
Well, here's the kicker, Alli is made to be taken by obese people who need an assist with losing small amounts of weight in addition to a healthy diet and exercise.  So, if you take the drug and eat a high fat meal, watch out!  You can have urgent bowel movements, diarrhea, and gas with oily discharge (a "shart" as some might know it). Some people have even noticed these side effects with lower amounts of fat in their diet. Yikes!!  As well, your bowel movements will be very oily and the oil will separate in the toilet, not really something that is horrible, but it can be a little off putting when you first see it.  And, the biggest "side effect" that has been associated with Xenical (the sister drug of Alli) is liver dysfunction, so you need to stop taking the drug and see your HCP immediately if you notice jaundice (a yellowing of the eyes and skin), extreme fatigue, or urine that is so dark it looks like a pilsner beer (almost brown).

Does it work?
The deal is that Alli is FDA approved, but most of the studies done that show proven weight loss is from the prescription drug Xenical, which shows (per research) to have an average extra 5-7lb weight loss per year, and it is assumed that using the 1/2 dose of Alli, there will be a 3-5lb weight loss.  And, it needs to be re-stated that this is weight loss that HAS to occur along with a change in diet and exercise.  To put this all in perspective, it is estimated that the average person, with just diet changes and adding exercise to their regimen, loses 8-12lbs a year.  Most of the weight loss occurs within the first 6 months of taking it, and users state that they regain all the lost weight when they stop taking it, so you will most likely need to stay on the medication indefinitely to keep the weight off.

Who Shouldn't take this medication?
-If you are of normal weight/ Body Mass Index [(weight lbs)/(height in)2] x 703.  (average for adults: 18-5-24.9)
-If you are taking immunosuppressant drugs (i.e. cyclosporine) post organ transplant
-Have a baseline of difficulty absorbing food (IBS, Chron's, etc)

It also needs to be noted, that because this is a fat blocking medication, you will have difficulty absorbing fat soluble vitamins (A, D, E, & K) so you will need to take a vitamin at some point in the day between Alli doses, so that you will prevent vitamin deficiencies.  And, despite tis being and over-the-counter medication, I strongly urge you to talk to your HCP and let them know that you are taking tis medication so that they can track your progression and make sure that there are no other side effects occurring.  So, if this is a drug you want to use, talk to your HCP, make a plan, and eat low fat....or bring a change of undies!!!

Yours in Good Health
B

Got a headache?

There are so many different kinds of headaches: cluster headaches, sinus headaches, tensions headaches, etc but what it comes down to is that you are uncomfortable and it can be difficult to get through your day due to a headache, and sometimes they can be completely debilitating!  Now, I am not talking about migraines, which I blogged about previously and have a different treatment and etiology. Headaches can be a dull pain, sharp pain, radiating across your head or located in just one area, they can be transient and last a short period of time, or last for hours or days. In short, headaches can just suck.  If you are having the worst headache of your life and your head feels like it is splitting open especially if you have dizziness a stiff neck, or changes in vision, it is a MEDICAL EMERGENCY, so call 911 or go to the closest Emergency Department! Headaches can be very deceiving and mean a lot of different things, or just mean that you are having a tough day!

What are the types of headaches?
Medically, there are primary headaches and secondary headaches.  Primary headaches are headaches caused by over activity of pain sensors in your head and is usually primary symptom of either increased or decreased blood flow (from caffeine, etc), muscle tightness in your head/neck, or chemical changes within your brain (could be electrolyte imbalances, from diet or medication).  Secondary headaches are the symptom of a disease that activates the pain sensors in your head.

What are types of Primary headaches?
Migraine
Tension (from stress)
Cluster
Chronic (daily)
Cough (from hard coughing can strain muscles in head and neck)
Exercise induced (dehydration and overexertion)
Sex (some people have headaches after an orgasm...not a big deal medically, but crappy luck!)

Causes?
Primary headaches can be triggered by alcohol, sleep deprivation, poor posture, skipping meals (hunger), dehydration, or sex.

What are types of Secondary headaches?
Brain Aneurysm
AVM (Arteriovenous malformation in the brain- changes blood flow paths and present at birth)
Brain tumor
Carbon Dioxide poisoning
Hangover
Meningitis (especially if stiff neck and pain present)
Flu
Stroke
Withdrawal (caffeine, alcohol, nicotine, pain medication, etc.)
Other growths/malformations in the blood vessels, tissue, skull of head.

Causes of Secondary headaches?
There is always a trigger, whether it is caused by something mechanical (the actual structure of your brain) or from something triggered elsewhere, for example, a headache from a hangover is caused from a hormonal imbalance and dehydration due to the insult of the alcohol ingested previously.

*All headaches that seem common or are relatively frequent should be worked up by an HCP and you should know the reason that you are getting them, so that you can prevent them or know if something more serious is going on.

When are headaches a serious problem requiring immediate medical attention?
Confusion
Slurred speech
Vision changes
Numbness or weakness
Trouble walking or moving
High fever 102F+ (39C+)
Nausea or vomiting
Stiff neck

What are some Treatment options?
For a Mild Headache:
Acetaminophen (no more than 2500mg per day)
NSAIDs- non steroidal anti inflammatory drugs (i.e. ibuprofen, naproxen)
Aspirin

For Moderate to Severe:
Treatment of underlying cause or prevention of triggers
Antidepressants can help (i.e. Pamelor, Prozac, Sarafem)
Beta Blockers, usually for treatment of high blood pressure and increased heart rate (i.e. metoprolol, propranolol)
Anti-seizure medications (i.e. Topamax or Neurontin)
NSAIDs
Botox injections to certain "trigger points" or nerves that aggravate headaches

Alternative therapies:
dark room (decreased light for eyes)
cool washcloth to back of neck/forehead
 fluids
caffeine (coffee/tea)
acupuncture
massage
biofeedback
Vitamin b-12 (riboflavin)- still being studied for effectiveness
Coenzyme Q10- still being studied for effectiveness

How do I Prevent headaches?
Make sure that you are eating well, drinking plenty of water, if you drink caffeine or ingest anything that will cause a headache if you don't take it, don't abruptly stop taking it.  If you have allergies, then take allergy medication and be aware of the pollen levels, try a neti pot to clear out your sinuses!  Talk to your HCP so that you can learn your triggers and try to prevent them, and know the cause and source of your headaches.

If you get headaches with frequency enough to cause you aggravation and interfere with your life, then go see your HCP and get a work up, it may be something more serious, or it could be something really simple that needs a quick fix.  Also, it is best to let your HCP know that you have these headaches, so you can get follow-up care and try different medications that might help to alleviate your pain.  You don't need to live with these headaches every day, and usually some Advil and a cup of coffee should fix your problem, but if it doesn't or you suspect something more serious, please go seek help!  And try alternative therapies to see if they will help with your pain!!

Yours in Good Health
B

Stop stressing!

Stress effects everyones lives in so many ways every single day, and high levels of continuous stress can really effect your health in a bad way.  I know that it is easy to say "just decrease your stress, stop sweating the small stuff" because I am someone who has SO much difficulty relaxing when my life gets super stressful, but I always think about the physical and mental toll that stress takes out on you and there are a bunch of small things that you can do for yourself to try and decrease your stress or at least help to contain it.

Why is stress so both good and bad?
Your body has specific stress response hormones, known as catecholamines (epinephrine (adrenaline) and norepinephrine (noradrenaline)) that are responsible for surging in times of stress.  BUT that response in the body is supposed to be for a short period of time to get yourself out of danger, like if you see a car about to hit you while walking, you are able to get a huge burst of energy and get out of the way.  You feel a little shaky afterwards, from the release of the adrenaline rush because it increases your heart rate, blood pressure, and blood glucose levels.  When your body is constantly stressed, you have a slow adrenaline release; which isn't ok.  It is meant to be a short term response to get yourself out of danger, not as a constant state of living.

What are some of the health effects of stress?
-Neck pain (tight muscles/spasms)
-Headaches
-Anxiety (possibly panic attacks)
-Depression (unable to feel happy or get out of bed; losing inspiration)
-Exhaustion
-Constipation or diarrhea
-Weight changes (some people gain weight and some lose weight)
-Insomnia
-Stomach pains
-Tight jaw/ear pain (TMJ- temporal mandibular joint disorder)
-Relationship strains
-Erectile dysfunction
-Decreased immune system
-Grinding teeth
*Every person is different and will react to stress differently, but these are some of the signs, they could also be signs of things that are more serious.

What can I do to de-stress my life?
Honestly, making a conscious decision to de-stress your life is the first step.  Often, you are so focused on getting done what you need to get done, that you don't even realize your stress level.  But there are some things that I do, and that I tell patients to do, to at least get their stress levels under control; you don't want your stress to control you, YOU need to control it:

- Make a list of what you need to get done in a day, and have a plan
-Set realistic goals for yourself
-Ask people for help
-Take time for yourself; wake up a little bit early, and have a moment to yourself to take some deep breaths, meditate, and get ready for the day
-Talk to a good friend, family member, counselor and vent about what is bothering you
-Eat a healthy diet (eating well can make you feel better vs. eating comfort foods that might be easy but make you feel gross later on)
-Exercise regularly (go for a walk with a friend- kill two birds with one stone and walk and talk!!)
-Don't overextend yourself (i.e. give yourself enough time to get places)
-Feel free to say "NO" to people
-Do something that makes you feel good- no matter if it is a hobby, exercise, reading a book, sex....whatever you need to feel good (besides drugs and alcohol- they will make you feel worse and make your stress worse in the long run!)
-Keep positive
-Don't stress about things that you cannot control (i.e. weather)

Go see your HCP for a referral for a counselor or for medication therapy if you experience panic attacks or moderate physical responses, or too much for you to be able to function normally on a daily basis.  Some of this seems so self explainatory, but when  you are stressed out, you can't see outside of yourself.  You need to plan, make time, and prepare.  If you are prepared for stress, then you can plan for it, and it won't overtake your life.  I make lists every day, and I give myself appropriate timelines, so I can feel like I have accomplished things, even if my whole list doesn't get done.  I also ask people for help, utilize your friends when at home, and ask your co-workers for help when working. All stress ends, and there is a light at the end of every tunnel, it is just a positive attitude and planning that will help you get there.  A trip to your HCP to get checked out can also rest your mind at ease that your physical symptoms are just a response to your stress and will reverse, and they can help you to get appropriate therapies to prevent long term effects from stress.

Make some "Me" time and get a release, the stress will end, just stay positive!

Yours in Good Health
B

What really is our radiation risk?

I was listening to Howard Stern yesterday morning, as I normally do, and I was shocked to hear them talk about Howard's cousin who is apparently running around buying hand held geiger counters and potassium iodide to ward off radiation poisoning (AKA Acute Radiation Syndrome.)  I never even thought about when the Japanese reactors started acting up because we are SO far away and the amount of radiation present diminishes across distance and with buildings or other such structures blocking it.  That being said, I wanted to let people know what radiation poisoning is and what you can do to prevent it.

What is Acute Radiation Syndrome (ARS)?
It is caused by a large amount of radiation exposure quickly and can cause a whole slew of health issues that effect your blood, GI system, and neurovascular systems. And the symptoms can include a low blood count (anemia), nausea and vomiting, loss of appetite, abdominal pain, dizziness, headache, and loss of consciousness.  As well, you can get reddened, blisters that form on the skin post exposure.

What are sources of radiation?
There are natural sources, nuclear medicine, medical x-rays, radiation placed inside the body and numerous other sources.  The nuclear reactor breakdown in Japan was clearly unexpected and is a huge source of radiation exposure for people in Japan at this time

What can we do to prevent exposure?

Well, as I stated above distance between you and the source diminishes the risk of exposure as well as time.  Radiation doesn't just stay lingering forever, as time goes on the strength of the exposure decreases too.  And potassium Iodide is another way to prevent exposure, which is an over the counter medication that pharmacies are running out of at ridiculous rates right now, because it has its own side effects.  Potassium iodide protects the thyroid because it is absorbed by the thyroid so that the radioiodine is not absorbed.  It was approved by the FDA in the 1980's for nuclear war emergencies only because it has its own risk of causing thyroid cancer, so it shouldn't be taken unless you are in immediate danger.

Bottom line?
Here in the US we are at a very low risk of ARS and there is no need to start taking potassium iodide (KI) and worrying at this point. For all of you in other parts of the world, assess your risk and talk to your HCP about your own prevention strategy. If you have concerns talk to your HCP about pros and cons of taking KI and you may want to keep some IN CASE of a nuclear emergency near where you live.  But please don't start taking KI without talking to an HCP first!

Yours in Good Health
B

More bad news for people who drink sugar daily...

We all know that drinking soda is bad for us, it is filled with empty calories from high fructose corn syrup and other sweeteners, it causes cavities in your teeth, and now there is some new research performed collaboratively in the US and UK that shows it increases your blood pressure!  Unfortunately, it isn't just soda either, that we could blame on transient increases in blood pressure from caffeine, but it is all sugary beverages including non-caffeinated sodas, fruit juices, and sugary sports beverages.

What is the down and dirty?
Around 2700 patients were studied, they are all within the 40-59 age group, and over a course of 4 days and they had to have their blood pressure checked numerous times throughout this time period.  On average the systolic blood pressure (top number- the maximum pressure your heart exerts) increases 1.6mm Hg and the diastolic blood pressure (bottom number- the minimum pressure your heart exerts) increases 0.8mm Hg.  And, if you tend to have higher sodium levels, when you consume these sugary beverages, your systolic bp can be raised 2.5mm Hg and diastolic bp 1.7mm Hg.

Why is this important?
I am sure that many of you are reading this thinking, so what is the big deal, it isn't increasing your blood pressure all that much.  Well, here is the issue: sometimes people have to attempt multiple drug therapies to get their blood pressures decreased by approximately 10mm Hg.  When you are drinking 3 or 4 sodas a day, along with other forms of sugars and salt from your normal diet, your blood pressure can be increased pretty significantly and require the need for medications.

What can I do?
If you have increased blood pressure or have been told that you have 'borderline' blood pressure, then lay off the soda/juice/sugar beverages and stick to water!  Keep a healthy diet without any extra added salt, and check your blood pressure frequently on your own, keep a log, and discuss your diet and blood pressure changes with your HCP.  And note any changes that occur when you decrease your sugary beverage intake, and hopefully your blood pressure will adjust to within a good range!

Yours in Good Health
B

Need a healthier lifestyle? A dog can help with that

This topic just so happens to be near and dear to my heart, because my long time readers know that I LOVE my two pooches, they are (gulp) my best friends in the whole world, they don't judge, and they are my running buddies every single day....even if another human decides to come along!  It has always been long presumed that dogs encouraged people to be more active because they need to walk their dogs and get exercise, but especially in this day and age were people tend to be more sedentary, the medical community is actually starting to do real studies on the effects of canines on human health!

The University of Michigan recently performed a study that found people with dogs 34% more likely to meet their daily exercise requirements, and in light of the information I gave you guys a week or so ago about a majority of Americans missing the boat on meeting exercise targets, this is HUGE!!  People have reported feeling healthier and losing weight after getting a dog.  A different study in the American Journal of Public Health found that dog owners were 57%-77%more likely to get the recommended amount of daily activity because of their pets!  Honestly, where I live, it is torrentially raining, and I have already suited up in my wellies and gone out for a walkies with the dogs, which I normally wouldn't have done on a day like today when I don't have to be out the door for a few hours.  And interestingly, in the study, it was found that not only were the owners of dogs getting activity from walking their dogs, but they showed an overall higher amount of physical activity.  Walking is the most accessible form of activity for people, and getting out to do any small form of physical acivity encourages you to do more!

I must say, I got so excited reading these studies, that maybe some of the millions of dogs waiting to get adopted all over the world might get placed by those hoping to get in shape.  But, I also think about the fact that I still see obese people with dogs, that are happy to go sit at a dog park while their dogs exercise, so it did make me question the validity of the study.  I then found a recent study from the University of Virginia looking at the effects of dogs on children; children who grow up with or frequently interact with dogs get much more moderate to vigorous physical activity a week.  Considering the current obesity rates of children today, this can be so helpful in getting kids excited to get exercise and do something physical without being forced!  Kids love to play with dogs, it makes common sense that it will have a positive health benefit on the whole family!

A few other weaker studies have shown some different health effects as well such as increased life expectancy for the elderly (especially those living on their own), a decreased rate of adult asthma in children living in homes with dogs (most likely due to increased physical activities), pet owners have stronger immune systems, and that interactions can help reduce stress, signs of depression, and blood pressure.

Who would have thought that dogs can act as an alternative therapy to blood pressure medication?  I guess anyone with a dog knows that coming home after a stressful day, and seeing someone so excited to see you that they can't stop loving you, and want nothing from you other than a little love back, it absolutely priceless as far as de-stressing and lifting your mood.

I realize that not everyone can run out and get a dog, but maybe you can offer to help out with a friends dog, a neighbors dog, or start a dog running service (I have actually seen a lot of college kids offering this on craigslist as a way to get paid for doing what they would do anyway!)  But, if you have been thinking about it, go get a dog, get out there with your new pal and get some exercise!!  I am not going to lie that a puppy is a lot of work, integrating a dog into your life at any time is, and a monetary investment (vet bills, preventative care, FOOD) but it will be so worth it, and the whole family will benefit!

 

Go out to your local shelter and get a dog, do something good for the community AND for yourself!

Yours in Good Health
B

losing elasticity?

There are tons of reasons that people get stretch marks, also known as striae on the dermis (fancy term), and there are so many products on the market that supposedly make them "disappear"....but do they?  The best way to treat stretch marks is to prevent them, and to prevent them you need to know why they appear!

What are Stretch Marks?
To be honest, they are just what they sound like: a form of scarring on the skin with a change in color from your normal skin tone, due to a tearing of the dermis (the middle skin layer). They are usually a deep pink, purple, or red color (depending on your skin tone) when they first appear and then they gradually fade over time but they are almost always visible as scar tissue closer to your natural skin tone, and they are usually found in areas of the body with higher fat content.

Why do Stretch Marks occur?
They can occur from any cause of stretching of the skin such as rapid weight gain or loss, pregnancy, rapid muscle building, or during puberty when the body changes shape.A study from the British Journal of Dermatology found that pregnant women who gain more than 31lbs during pregnancy, with a higher body mass index score, and pregnant teenagers have the highest rates of stretch marks from pregnancy.  Also, genetics are thought to play a role, so if you notice that your family members have stretch marks then you might be at a higher risk.

How do I prevent them?
A few studies in Europe have shown that the highest risk for developing stretch marks during pregnancy are during the 3rd trimester, and women who consistently used creams containing vitamin E had fewer stretch marks than those who used a placebo cream.  Some of the creams that were tested also had other ingredients, but had similar results: Trofolastin (Gotu Kola extract & collagen hydrolysates) and Verum (panthenol, hyaluronic acid, elastin, & menthol).  Cocoa butter was also studied with moderate results, but it was a poor study and not noted whether vitamin E was present in the cocoa butter lotion. From the results of the studies, it appears that vitamin E oil is the best prevention, and bio oil (along with other products) have not been studied.

What can I do to make Stretch Marks go away?
The best is prevention, but once you get stretch marks, plastic surgeons and dermatologists can use laser treatments to decrease the visibility of the marks by zapping them over 5-6 treatments, causing micro wounds and making your body respond to the new wound and re-heal more appropriately; weak studies from the US and Brazil show a 75% decrease in the stretch marks with positive patient responses.  Also, for lower abdominal and hip stretch marks, a tummy tuck (abdominoplasty) can be performed to remove the affected tissue.  In the case of extreme weight loss, a panniculectomy can be performed (and extreme removal of stretched skin)

So, the long and short of it is it can be genetic, hormonal, due to weight changes, and muscle mass changes.  And while none of the research is amazing other than on controlled situations where stretch marks are known to occur (such as pregnancy), and it appears that creams/lotions used daily with vitamin E present help to prevent the scars from occurring, once you have them, there is no ideal way to get rid of them other than time or invasive procedures.  If you have stretch marks that you find upsetting or embarrassing, talk to your HCP and find out your options, and if you want to spend tons of money on the various creams on the market, I don't think they will hurt the situation, but I am not sure that they will help either :(  So sorry to be the bearer of bad news.  I do know people who swear by bio oil, but there is nothing to say that it actually works (research based) and I am not sure that they ad severe stretch marks to begin with!!  Talk to your HCP and go see a dermatologist to find out what your options are for treatment, but if you are trying to lose weight, build muscle rapidly, get pregnant, etc my best advice is to use a cream/lotion daily with vitamin E and it might help with your skins elasticity!!  Let me know what works best for you!

Yours in Good Health

B

Got a pit in your stomach??

In times of high stress, I tend to not eat a lot (I am the opposite of most people who tend to eat when they are stressed out) because when I do eat, I feel like I literally have a burning pit in my stomach.  Originally, I freaked out that I had an ulcer and ad a whole work up, then as it ended up, my HCP just diagnosed me with being super stressed; as soon as the stress ended, so did the symptoms!  But, many people do have symptoms of peptic ulcer disease and they self treat instead of getting a proper work up.  And sometimes peptic ulcer disease is caused by bacteria that is treated with two weeks on an antibiotic, instead of a lifetime of OTC antacids!!

What exactly is a peptic ulcer?
It is basically an open sore on the inside of your esophagus, stomach lining, and/or s mall intestine. These ulcerations can cause pain from contact with stomach acids.  Usually it causes pain, but there can be other symptoms as well.  And, it is usually a bacteria or medication that causes these ulcerations and not stress or diet as it had always been presumed in the past.

What are the symptoms?
-You can have pain and or burning anywhere from underneath the breastbone down to your navel area.
-Pain that is decreased with the use of antacids
-Increased pain with an empty stomach
-Vomiting blood *(immediately seek treatment at the closest Emergency Department)
-Dark blood in bowel movements (Go to see your HCP ASAP)
-Nausea and vomiting that is not related to an illness and random
**if any of these symptoms are continued you should go to see your HCP and if you are worried at any time you should seek help.

Why do you get ulcers?
-It can be caused by an infection with a bacteria called Helicobacter pylori (H. pylori is its more common name).  This bacteria causes irritation to the stomach lining and eventually ulcerations; and it can be transmitted person to person and through food and water.
-Certain medications like OTC pain relievers can cause ulcerations as well.  Aspirin, Ibuprofen, and Naproxen can cause ulcers if not taken with food, or taken with frequency.  Tylenol is one OTC pain medication that does not cause ulcers and is a safe alternative for those diagnosed with ulcers.  Also medications for osteoporosis (i.e. fosamax) can cause ulcers too!

Is there anything I can do to decrease my risk?
Don't smoke, limit drinking, and try to limit your stress (I know, easier said than done.) And, while stress doesn't "cause" ulcers, the medical community still accepts it as a risk factor, so we encourage stress relieving techniques for patients with high stress.

What happens if I have an ulcer that is untreated?
-You can have ulcerations that cause internal bleeding, requiring surgical procedures to treat and stop the bleeding.
-You can have scar tissue build up which can caused slowed digestion and malnutrition problems and excessive vomiting
-You can also get an extensive infection due to the overwhelming bacteria overgrowth

How will I be tested?
-H. pylori can be tested by drawing a blood sample, through a stool sample, or a breath test (you drink a glass of a medication that reacts with the bacteria, so wen you exhale into a bag, it will have high levels of the medication and C02.)
-Endoscopy: you will have to stop eating at midnight the night before, go in to the clinic, and you will get an IV and some medications to make you VERY sleepy so you actually don't remember anything, and a small scope is passed from your mouth into your stomach and small intestine so they can visualize any ulcerations and take samples of tissue if bacteria is still suspected.
-Barium Swallow Study: you will drink some barium then a series of xrays are taken to see if there are any ulcerations present.

Treatment options?
-If it is bacterial, you will be given an antibiotic, such as Flagyl, for two weeks.
-Histamine-2 (H2) blockers decrease the amount of stomach acid produced (such as pepcid/famotidine)
-Proton Pump Inhibitors (PPI's) block acid production and create a healthy environment for healing. An example of PPI's are protonix (pantoprazole), prilosec (omeprazole), and prevacid (lansoprazole).
-Cytoprotective agents coat the lining of the stomach and do cause slower digestive times but create a barrier for acids, making it harder to create new erosions (i.e. carafate) but you do have to be careful with other medications as they might not absorb as well.

And make sure after starting to treatment to follow-up with your HCP to ensure that your treatment is appropriate and how long you will require treatment.  Continue to live a healthy lifestyle with exercise, healthy diet, smoke-free, limit alcohol, and try to keep stress to a minimum.  If you do experience any of these symptoms, while it could be nothing, as it was in my case, or it could be pretty serious and you should talk to your HCP about it so they can be aware and maybe get some preventative treatments in place!

Yours in Good Health
B

Do you get enough?

I am clearly an avid athlete. I run almost daily, and I work out in some form every single day. BUT I also understand that most people don't have this option due to work constraints and life in general.  A really scary study just came out from the Center for Disease Control (CDC) looking at the exercise that the average American gets, and we all know that there are so many benefits of exercise: better mood and feel better, cardiovascular strength (heart and veins/arteries), pulmonary strength (lungs), boosts immune system, and helps your body work more efficiently so you can lose weight and stay healthy!

What did the CDC find?
Less than 2 in 10 Americans get the recommended amount of daily exercise (meaning 20-30 minutes a day of activity for a total of 150 minutes a week) and around 25% of all Americans get NO physical activity at all.

Where is the lowest amount of physical activity found?
The Southern region of the US and Appalachia where around 30% of residents reported no physical activity at all, even light activity like gardening or golfing.  In Alabama, Tennessee, Kentucky, Louisiana, Mississippi, and Oklahoma in certain counties up to 70% of residents report no activity.  These are shocking statistics!! These areas also have very high rates of obesity and type II diabetes.

Where are the most active areas?
The Northeast, West Coast, Colorado, and Minnesota are the ares with the most active residents, so kudos!!

Why are certain areas more active?
The theory is that it is all related to cultural norms.  If you see people being active and walking/running/exercising then you will be more active yourself and more apt to join in.  When everyone else you know exercises, you are more than likely to join in, in some form, too!

Why is this so bad?
Well, the CDC estimates that 34% of Americans are clinically obese and 34% are overweight, which isn't good as a baseline, but add to that the fact that, on average, people who are obese spend 40% more on healthcare every year when compared to those of normal weight, this inactivity hits your wallet too!!

The CDC is going to start recommending that employers have mandated exercise time, to encourage healthiness and well being, and get people up and moving.  Especially in a time where we are all tightening the amount of money we spend, going for a walk is totally free, and even going for a run (we don't need all the bells and whistles that many of us use) is free, and it will save you money on healthcare bills and help you feel better and look better.  So, lead by example and get out there as the weather warms up, encourage others to get out there too and get (at a minimum) that 150 minutes of exercise, in any form that you choose....I promise you will feel better AND look better!!

Yours in Good Health
B

What IS that??

I just wanted to take some time to dedicate to my favorite tumor.  I know that sounds like a creepy statement, but these are more common than people realize especially in pregnant women, and I don't think that everyone understands what they are, why they occur, and how they are treated.

What is a teratoma?
A teratoma is a tumor that contains various tissues or organ components and can contain hair, teeth, bones, eyes, and when larger even a hand, torso, feet, or other limbs. Sometimes they can fill with fluid and it can look like a fetus is within the structure, but it may just be lung or liver tissue with fluids present. They can be either benign (mature) or malignant (immature) and found in both men and women and are found in about 1 of every 40,000 births.

How do they occur?
They are considered congenital tumors in that they are present at birth but they just aren't found until later in life, sometimes randomly, many times in women they are found in prenatal ultrasound.

Are there any complications from these tumors?
Malignant teratomas can spread to various parts of the body and can be associated with other types of tumors such as Acute Myelogenous Leukemia (AML), small cell carcinoma, etc.  You will usually have symptoms such as chest pain, cough, fatigue, increased shortness of breath, etc and will require a chest x-ray, CT Scan, MRI, blood tests, and a possible biopsy for diagnosis.
Benign teratomas can have complications for the fetus inutero, if it is large enough  to steal some of the blood flow from the fetus and lead to vascular and heart damage.

Treatments?
Usually in benign teratomas, a surgical removal is the only treatment necessary.  For malignant teratomas, chemotherapy is required, which may be the only treatment necessary and then possible surgical removal of any remaining tumor left over.

So, while this is something you won't run into every day, it is more common than you realize, so don't freak out f you are diagnosed with one, and they are easily treated and removed.  For malignant teratomas, they are a little more intense in treatment, and do have actual symptoms, that are pretty generic, so let this be a lesson that you should have a relationship with your HCP and go see them with any new symptoms.

Yours in Good Health
B