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Using yoga for a healthy heart
Practicing yoga has already been shown to have a positive effect on the overall health of patients with a variety of illnesses including anxiety, depression, cancer and heart failure. Now, a new study by Dr. Dhanunjaya Lakkireddy that was presented at the annual scientific sessions of the American College of Cardiology shows yoga can reduce episodes of irregular heart beats in patients with atrial fibrillation. Dr. Lakkireddy was prompted to study this when he witnessed the improvement in a patient who practiced yoga regularly. Patients in the study participated in a yoga program (which included breathing exercises, yoga postures, meditation and relaxation) three times a week and decreased their irregular heart beat episodes from 2.6 to 1.4. More importantly, they reported an improved quality of life, decreased anxiety and depression.
Here’s another example of how clearing your mind of stress can lead to a healthier body. It’s amazing to me how our physical body is so directly impacted by our mental health. Yoga is just one way to work on improving your mental health. Find what works for you and stick with it…your body will appreciate it!
Is air pollution increasing our risk for strokes?
In the March 23rd issue of JAMA, air pollution is highlighted as am emerging global risk factor for strokes.
Air pollution exposure is already considered to have an important association with mortality world-wide. In fact, in high income countries, 2.5% of all deaths are associated with air pollution. It’s important to note that air pollution has an association with strokes and is not a direct cause based on the information we have now. Although, the American Heart Association has updated their statement on air pollution and it’s relationship with cardiovascular disease and deaths (like heart attacks) saying “The overall evidence is consistent with Particulate Matter playing a causal role in cardiovascular morbidity and mortality.”
The role of air pollution in strokes has not yet been studied thoroughly. It will probably be a while before we have further scientific evidence regarding air pollutions impact on strokes. But, it’s important to remember that it’s not just individual risk factors like obesity and high cholesterol that have increased the incidence in strokes. Our environmental risk factors are also changing and may be having more of an impact on our health that we realize.
How to get the most out of your doctor visit
How often have you been to your doctor only to leave frustrated that you have not had the main reasons you were there addressed? It’s a problem, and one that is getting worse given the pressure on physicians to see more patients in a shorter amount of time. Whether you are seeing your primary care doctor, a doctor in the ER, or a specialist for the first time, here are a few tips on how to get the most out of every visit.
1) Bring a list of all medications that you take, the doses and how often you take them each day.
2) Bring a list of all your medical problems (like Diabetes, High Blood Pressure, High Cholesterol) and surgeries.
3) Bring a list of what medicines you are allergic to, if any.
4) Tell your doctor at the beginning of your visit what you would like to discuss with them.
5) Communicate with your doctor what is the one most important thing to you to be addressed at this visit.
If you bring this information with you, your doctor will not need to spend most of the visit gathering this from you or your medical records and will have more time to discuss with you why you are actually there. Taking responsibility for this information as the patient allows your doctor to more easily address your health concerns. And, communication is important too. A regular office visit usually allows for a doctor to address about 2-3 things with a patient. Any more than that will require a second visit. This is why you must prioritize your most important concerns and communicate that to your doctor.
Tips for a better night’s sleep
One of the most common complaints I hear from patients is “I’m not sleeping well.” While there are several different medications that can be used to treat insomnia, I find many people have very poor “sleep hygiene” which can cause or exacerbate sleep problems. Here are a few tips to improve your sleep hygiene.
- Do not watch TV, play video games or use your computer 2-3 hours before bedtime. These types of activities stimulate your brain and make it more difficult to wind down for bedtime.
- Establish a regular sleep schedule.
- Avoid caffeine after lunch.
- Avoid alcohol near bedtime. (While alcohol does make you sleepy, it disrupts your sleep cycles later in the night making it difficult to stay asleep.)
- Stop smoking, especially just before bedtime.
- Exercise regularly (just not right before bedtime!)
- And lastly, if you can’t sleep, get up! Read until you feel sleepy and try again but don’t just lay there getting frustrated that you can’t fall asleep.
While all of these will help, just simply avoiding TV, video games, computers and caffeine prior to bedtime can have a dramatic impact on your ability to fall asleep quickly at night.
Could TV be a culprit in causing ADHD?
In 1999, the American Academy of Pediatrics recommended that children under 2 years old should not have any TV/screen time. None. Despite this, 43% of kids under 2 years old watch TV every day! Not only should 2 year olds not be exposed to adult TV that may be on in the home, but also should avoid exposure to programs that are specifically marketed to parents with children under 2 years old. ”Learning videos” like Baby Einstein and cartoons like Blue’s Clues have NO scientific evidence that they will help your child become developmentally advanced. And, there are more and more concerns that these videos may be actually harming your child’s brain development!
A study done at The Child Health Institute at the University of Washington has found a concerning correlation between the amount of TV that 1-3 year olds watch and their later ability to pay attention. For every 1 hour of TV/day before age three, a child is 10% more likely to show ADHD symptoms at age 7.
I have thought the main influence on the rise of ADHD we are seeing in our country is mostly due to the lack of consistent parenting and discipline. But, perhaps another huge factor is that we are actually rewiring our children’s brains from the very beginning to be “ADD.” We already know the best way to help babies develop connections in their brain is with social interaction. Most babies favorite thing to look at is a human face- they can stare at their mom’s face for a long time learning to mimic expressions, see shapes, colors, even emotions. When we substitute that human interaction for screen time (even “learning” screen time), it’s as if we’re telling that brain, go ahead and short circuit all those connections you are trying to develop, you won’t need them. But then that child gets to first grade and we expect them to have the wiring in place to be able to sit still and listen to a story when we haven’t given them what they needed early on to develop it.
Of course every mom needs a few minutes to take a shower or have some “me time.” But, next time you’re about to pop in an educational video for your child under 2, remember you may actually be doing harm and they would rather learn from you anyway!
For more information, I highly recommend Bright from the Start by Jill Stamm, Ph.D.
The Work of Byron Katie: “I’m not living up to my full potential.” Is it true?
Have you ever stressed out about something you think other people want you to do? Watch as this man questions the thought, “I’m not living up to my full potential.” Funny how we let our minds convince us our thoughts are true that may not be true at all. And then, those thoughts become beliefs we act on or at least stress and worry about so much it can begin to affect our health and well-being.
Oligofructose…an excellent substitute for sugar and artificial sweeteners
I just did a search on PubMed for “artificial sweeteners” and came up with 162,789 resulted published articles. Wow, it’s no wonder there are so many questions out there about which artificial sweeteners are safe and how much is too much. I haven’t even sorted all that out yet myself- except to say that moderation is the key with sugar and artificial sweeteners alike.
However, I have come across a natural plant fiber used as a sweetener called inulin or oligofructose. The main sources of this are Jerusalem artichoke and chicory. It’s a sugar free sweetener with a glycemic index of approximately zero! This means, it does not cause any surges in your insulin levels after eating making it very different from sugar or complex carbohydrates. Studies have shown it to be helpful in stimulating the immune system, decreasing the bad bacteria in the intestine, alleviating constipation, lowering the risk of osteoporosis (by increasing the absorption of calcium in the gut), reducing the risk of plaques building up in your arteries and lowering the risk of colon cancer. In fact it seems to act very similar to dietary fiber in our bodies and some have even proposed classifying it as dietary fiber instead of it’s current classification as a carbohydrate.
If you’d like to try it out for yourselves, check out these ChocoPerfection bars. They are sweetened with oligofructose. That is definitely the best “sugar-free” chocolate I have ever tried with none of the side effects of sugar alcohols. If you’re looking for a way to satisfy your sweet tooth without the sugar rush followed by the inevitable crash, try these. Absolutely delicious!!
The magic number: 10,000
Have you ever wondered if it is really necessary for doctors to go through a minimum of 11 years of training to be able to practice their field of medicine? I’m not going to lie- I have. After reading Malcolm Gladwell’s, Outliers, I realize again the value in the length of our training.
He states, “The idea that excellence at performing a complex task requires a critical minimum level of practice surfaces again and again in studies of expertise. In fact, researchers have settled on what they believe is the magic number for true expertise: ten thousand hours. ‘ The emerging picture from such studies is that ten thousand hours of practice is required to achieve the level of mastery associated with being a world-class expert- in anything’ writes the neurologist Daniel Levitin.”
Becoming an expert in medicine appears to be the same. A doctor training in primary care has already spent 4 years in undergraduate school then 4 years in medical school learning the basic sciences required to practice clinical medicine. Except for the last 2 years of medical school, these 8 years are not spent actually practicing medicine though. That begins in residency. A family medicine or internal medicine physician will spend 3 years in residency working on average 60 hours a week (seldom <40 hours and by law not more than 80 hours). Working about 49 weeks out of the year at 60 hours a week adds up to 8, 820 hours practicing medicine. Add in 1000 hours from the clinical years in medical school and what do you know- about 10,000 hours. No matter how intelligent someone is upon graduating from medical school they still need the 10,000 hours “practicing” medicine to become an expert.
Interestingly, for specialists the numbers work out too- for example a cardiothoracic surgeon spends the same 8 years in school prior to residency then spends 5 years in a general surgery residency then 2-3 years in cardiothoracic surgery residency. The 8 years of school plus 5 years of general surgery are prerequisites in preparation for the more specialized skill. Then spending 70-80 hours a week (more typical in surgery residencies) over 3 years is just over 10,000 hours.
So, if you’re seeing a young physician or an older, more experienced one, at least you can be assured they have all met their 10,000 hours in their field required to be an expert.
Preventive Medicine
Preventive Medicine refers to preventing medical illness and disease instead of treating a disease after it exists. I continue to be amazed at how many patients I see a day who are physically suffering from diseases that can be prevented (referred to as primary prevention) or at least managed better to have fewer complications (referred to as tertiary prevention). For a doctor this is an important and sometimes overlooked area of practicing good medicine. It’s becoming a more and more recognized part of quality medical care as people are searching for ways to provide good care at a more economical cost. There is even a new field of medical training referred to as preventive medicine. As a patient, I invite you to become more proactive in taking part in your own preventive medicine. YOU are the one that lives your life everyday! You know what you eat and what bad habits you have. Being honest with yourself and your doctor about the effect those habits can have on your health is the first step in looking for ways to stay as healthy as you can.
If our country successfully adopted healthy lifestyles and reduced the incidence of obesity, heart disease and diabetes, our cost of medical care would plummet. Education about healthy diets does not seem to be working. I notice that taking a deeper look at what is driving people to turn to unhealthy food or physical inactivity despite their knowledge about what is good for them is more important. Studying the social determinants of health (for example, those that don’t believe they can afford healthier options or have transportation to get it) and the mental determinants of health (for example, poor coping skills causing a anxious person to turn to food for comfort) I believe is the answer. I invite you to take a look at your own life, what is holding you back from making the lifestyle changes you already believe you should make?
Addressing that is true preventive medicine.
How do you define being healthy?
What does it mean to you to be healthy? When so many are concerned with “being healthy,” perhaps it would be beneficial to take a look at what that actually is. Is it merely being free from any disease or ailments? Is it freedom from any physical suffering? Does it mean not having to take any vitamins, supplements or medications…ever? Does it mean you never have to go see a doctor? If we are not sure what the goal is, how will we ever get there?
The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
“Physical, mental and social well-being.” Physical well-being involves taking care of the body you have to live your life in: nutrition, fitness, medical care. Mental well-being involves a balance of self responsibility and self love, appropriate coping mechanisms to assist you in dealing with stress, freedom from worry, learning you can be happy no matter what circumstance you are in. And finally, social well-being involves having meaningful relationships with healthy communication. When it comes down to it, life is about relationship with yourself and others.
Physical, mental and social well-being are intertwined together. So what do you think, are you healthy? I’ve noticed that if you work on mental well-being first, the rest tends to fall into place.
Next post: how preventive medicine addresses physical, mental and social well-being.