Are you feeling worn down?

One of the most common complaints I hear from patients is that they are feeling worn down and tired.  They feel they just don’t have the energy they used to have.  This can be a symptom of many medical diseases that need to be checked out by your doctor.  However, if those are checked and everything comes back normal, there are other things you can do to get that energy back!

Let’s take a look at the average American lifestyle for a moment…it can be summed up in four words: sedentary, poor diet and stressed.  Do you see that in your own life?  How do we expect our bodies to function properly when we fill them with unhealthy foods and become so sedentary that even a walk through the grocery store can be difficult .  And, when our minds are racing constantly with thoughts related to stress in our lives (“I need to get up earlier to get more done” “My house is a disaster” “My job is taking up too much of my time” “My family is driving me crazy!”) it puts stress on our bodies as well.  Our minds never slow down and just rest.  If our minds are not rejuvenated daily, our body will not be either, especially if it’s already struggling to overcome the fuel we are feeding it.

You cannot expect your body to feel energized unless you are caring for it properly.  It may hang in there for a while, but eventually it will catch up to you and you will begin to feel worn down.  I notice that for many people who feel that way, it’s because they ARE worn down.  Give your body a break and stop expecting it to function at 100% when you’re only giving it 1%.

Get active, cut the trash out of your diet and find a way to de-clutter your mind.  Your body will thank you for it.



Are you getting enough sleep?

Most studies suggest that an average of 8 hours of quality sleep per night is what people typically require to maintain their mental and physical health. Not getting quality sleep in the right quantity for your body can have detrimental side effects on your well being.  Some of these include decreased cognitive function, depression or anxiety, low energy, decreased libido, poor judgement, increased risk of dying (especially from motor vehicle crashes or work place accidents), increased blood pressure and heart disease, decreased immune function and increased appetite!  Our sleep is important to rejuvenate our bodies so that they can work properly for us.  Here’s a quick test to see if you have excessive daytime sleepiness which may be related to poor sleep quality at night.

How likely are you to doze off or fall asleep in the following situations?  Use the following scale to answer the questions then add up your score at the end.

0= would never doze    1= slight change of dozing   2= moderate chance of dozing   3=high change of dozing


1. Sitting and reading

2. Watching television

3. Sitting inactive in a public place ( a theater or meeting)

4. As a passenger in the car for an hour without a break

5. lying down to rest in the afternoon

6. Sitting and talking to someone

7. Sitting quietly after lunch

8. In a car, while stopped in traffic


If you score a 10 or greater, check with your doctor for an evaluation. You may have a sleep disorder preventing your body from getting the good quality sleep it needs, not to mention making you cranky and overweight!


Finding trustworthy medical information online

Sometimes mass media medical reports feel just about this random. It seems like everyone is using Dr. Google to diagnose or treat their medical ailments; but, how do you find quality health information online?  Here are some accurate, authoritative online medical resources that are user friendly too…


2) – patient information from the American Academy of Family Physicians

3) MedlinePlus – great health information from the National Institutes of Health.  This site has video tutorials for lots of different medical procedures like an MRI.  So, you can check these out before your procedures to have an idea what it will be like.

Another tip for finding trustworthy medical information online is to use the Google “Advanced Search” option.  Click on “Advanced Search” to the right of the Google search bar at  On the next page, there will be an option to “search within a site or domain.”  If you enter .edu or .gov in this box, it will limit your search to more reputable sources than just anywhere on the world wide web.

Of course, nothing can take the place of asking in person your own doctor, but perhaps this will give you a place to start researching.  Good luck!

Note: Cartoon by Jim Borgman, first published by the Cincinnati Inquirer and King Features Syndicate 1997 Apr 27 and reprinted in the New York Times, 27 April 1997.

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.

Part 2 here.

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!!

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.