Wednesday, November 25, 2009

Stuff the Turkey, Not Your Face

How to avoid gaining weight during the holiday gatherings! The first thing you should do is relax. Stressing about your weight is going to make you eat more. Enjoy your family and friends and be thankful....well...as you should be on Thanksgiving Day. If you are on "Take Shape for Life", don't skip your Medifast meals in anticipation of overeating. That will just make you hungry. Plan your lean and grean around your main dinner. You should hold a tall glass of water. It may help get your mind off the potato chips and dip. If you are going to munch, raw vegies are a always a good choice. Focus on conversation not the food.

At dinner time, fill your plate with salad first. Then add some vegetables before the meat choice. And remember eat slowly. Try to be the last to finish your meal. Choose water as your beverage.

Now its time for dessert. Out comes the hot apple pie and the pumpkin pie that you have been waiting for. This is a no brainer. Have a small piece of each and don't feel guilty about it. Savor each bite. You will not spoil all your past effort. It's the repeated poor choices you make over time that will hurt you; not Thanksgiving dessert. Feel good about yourself. And enjoy the feeling of not being in a overstuffed postprandial food coma.

Most of all have a Happy Holiday

Saturday, November 21, 2009

Mammogram Screening and Breast Cancer

In 2008, approximately 184,450 new cases of breast cancer was diagnosed in the US, with approximately 41,000 individuals dying from the disease. The average American woman has a one in seven chance of developing breast cancer during her lifetime.
Studies have shown that regular screening of women with no symptoms has decreased the number of women who die from breast cancer by approximately 45 percent.

A woman's chance of being diagnosed with breast cancer is:

from age 30 through age 39 . . . . . . 0.43 percent (often expressed as "1 in 233")
from age 40 through age 49 . . . . . . 1.44 percent (often expressed as "1 in 69")
from age 50 through age 59 . . . . . . 2.63 percent (often expressed as "1 in 38")
from age 60 through age 69 . . . . . . 3.65 percent (often expressed as "1 in 27")


The following is Sloan-Ketterings recommendation that I believe we should follow:
Average Risk Women
Annual clinical breast examination (CBE) beginning at age 25
Annual mammography beginning at age 40
Women should be aware of any changes in their breasts. Monthly breast self-examination beginning at 20 years old is optional.

Women with a Family History of Breast Cancer -- i.e. One or More First-Degree Relative (Parent or Sibling)
CBE every three to six months starting no later than ten years earlier than the age at which the youngest family member was diagnosed with breast cancer
Annual mammography starting ten years prior to the age of the youngest family member with breast cancer (but not earlier than age 25 and not later than age 40)
Consider annual MRI (consult with your physician)
Women should be aware of any changes in their breasts. Monthly breast self-examination beginning at 20 years old is optional.


Friday, November 20, 2009

click on image to enlarge


Funny Medical Definitions

Artery.......................Study of paintings
Benign..................... What you be after you be eight.
Bacteria................... Back door to cafeteria
Barium..................... What doctors do when patients die.
Cesarean Section........... A neighborhood in Rome.
Catscan.................... Searching for Kitty.
Cauterize.................. Made eye contact with her.
Colic...................... A sheep dog.
Coma....................... A punctuation mark.
D&C........................ Where Washington is.
Dilate..................... To live long.
Enema...................... Not a friend.
Fester..................... Quicker than someone else.
Fibula..................... A small lie.
Genital.................... Non-Jewish person.
G.I.Series................. World Series of military baseball.
Hangnail................... What you hang your coat on.
Impotent................... Distinguished, well known.
Labor Pain................. Getting hurt at work.
Medical Staff.............. A Doctor's cane.
Morbid..................... A higher offer than I bid.
Nitrates................... Cheaper than day rates.
Node........................I knew it.
Outpatient................. A person who has fainted.
Pelvis..................... Second cousin to Elvis.
Post Operative............. A letter carrier.
Recovery Room.............. Place to do upholstery.
Secretion.................. Hiding something
Seizure.................... Roman emperor.
Tablet..................... A small table.
Terminal Illness........... Getting sick at the airport.
Tumor...................... More than one.
Varicose................... Near by/close by

Wednesday, November 18, 2009

Stop Smoking Now

Smoking Stats
Cigarette smoking is the leading cause of preventable death in the United States. Every year, more than 440,000 Americans die prematurely due to smoking and 38,000 non-smokers in the U.S. die from inhaling cigarette smoke. Yet, there are still 46 million (20.6%) adults in the United States who are current smokers and another 125 million children and adults who are exposed to secondhand smoke.

How To Stop Smoking
Some smoker just stop cold turkey. But most smokers may need to try more than once. Remember that smoking cessation may be a process rather than a single event. You may have been smoking for a long time and have linked smoking to certain situations such as driving, having a drink etc. Your body and mind may be addicted to nicotine's effect. That's why it's so hard to quit. Don't feel guilty about previous failures and don't give up. Pat yourself on the back for starting to move in the right direction. Choosing to stop smoking is the most important decision you can make in your life. So congratulations.

The first thing you should do is to think about the reasons you should stop smoking. It helps if you write them down. Set a quit date and mark it on your calendar. Enlist the support of family and friends and talk to your doctor about which method may work best for you. Nicotine replacement is effective (patch 17%, Nasal spray 30%) . Bupropion is 30% effective. Chantix is about 40% effective. The method that gets you to stop is 100% effective.

The first day you quit throw away your cigarettes and accessories. You may have cravings which will usually pass in several minutes. Keep busy. Practice breathing exercises and drink plenty of water. In the beginning don't hang out with people that smoke and avoid those areas that will likely tempt you. When you quit smoking, you may have to put up with some stuff like bad nerves and crabbiness for awhile. The "crazies" usually last for 1–2 weeks after you quit. After that, your body begins to forget about nicotine and you start feeling better.

The following are links to resources that can help:
Video about controlling cravings by auto suggestion (MC2 Method)
Real cost of smoking
Video demonstration on damaging effect of smoking
GetQuit
smokefree.gov
Free telephone counseling or referrals 1-800-QUIT-NOW (800-784-8669)

Tuesday, November 17, 2009

Now Open: Stages

Stages – the Center for Geriatric Cognitive Functioning is a new and vital resource for families facing the challenges of Alzheimer’s and other dementias. We provide geriatric consults, and work with your primary care physician and the family to develop a personal and long-term treatment plan that improves the patient’s daily life. We want to help you avoid crises in the future by being proactive now. Stages is directed by Rima Reitblat, MD, Board certified in Internal Medicine and Geriatrics. Please download our brochure, or for more information and to make an appointment, call us at (845) 781-8120.

Medication Errors You Can Prevent

First off you should keep a list of all your medication with you all the time. Make sure you have both the brand name and the generic name and as well as the doses. I also recommend that you keep a copy on your fridge. Paramedics will look there first.

One of the main causes of medication errors is poor communication and misunderstanding. If you are not sure of what your doctor is saying ask him to write it down for you. One assumption is that your doctor knows what medications you're taking. Don't bet on it. Your doctor may have your medication list from a visit six months ago. He does have changes that your other providers have made. So when your cardiologist makes a change in your dosage it does not magically update your primary doctors list. Computers make it easier to track things like medication but they are not always correct. Remember the adage "garbage in; garbage out" If an error was made in data entry it will translate into repeated mistakes. One mistake I've seen is patients overdosing on medication because they are taking pills from the generically labled bottle and the same pills from the brand labled bottle thinking they are different. Example: I had a patient taking one lasix and one furosemide not realizing they are the same. Pharmacies can make errors also. Check the medication on the label to make sure it is correct. I have seen Quinidine sulfate (used heart arrythmia) dispensed instead of Quinine sulfate (used for leg cramps). Handwritting is an issue but accidentially clicking the wrong drug on computer is possible also. If you receive desoxin (amphetamine) instead of digoxin (cardiac drug to slow the heart) you're in big trouble.

So here is my list of recommendations:
1) Keep an up-to-date record of your medications with you and on the fridge if you live alone.
2)Let your doctors know of medication changes at the time of the visit
3)Have you doctor write down instructions if you are not sure.
4)Ask if a new medication is an addition to your regimen or a substution.
5)Do not stockpile medications. You will end up with multiple bottles of unknown medications.
6)Do not mix tablets in bottles
7)Check you medication label when you pick it up from the pharmacy.
8)Bring all your medications with you when you go to the doctor.

Sunday, November 15, 2009

Exercise and Weight Loss

If you want to lose wt, exercise alone is not likely the answer. In fact if you are obese, you may be more susceptible to injury. Here's why. In order to lose one lb, you must burn 3500 cal. When you walk one mile you use 100 calories. So to lose one lb, you must walk 35 miles. One serious hour in a gym can burn 300 to 400 calories. So you need about 10 of those sessions to lose one lb.

Now lets look at the food side. One medium coke will add about 300 calories. In one year this could be stored as 25 lbs of fat. One coke can easily negate a heavy workout session at the gym.

My recommendation is you must diet to lose weight but a lifestyle change that includes exercise will put you on a path to achieving optimal health.

Finding medical information online

The best way to search for medical information on line is to use a  trusted site. Look for the HON or URAC logo at the bottom of the page. Avoid googling symptoms. There is just too much misdirection. My favorite patient information websites are Mayoclinic.com, Intelihealth.com and WebMD.com. 

Saturday, November 14, 2009

Killer at Large

"Killer At Large" - an amazing film about a toxin that is killing over a 100,000 people a year. And its already inside your body. see trailer