When actress Carrie Fisher died in January, her mother, Debbie Reynolds, took it especially hard.
“I just want to be with Carrie,” Todd Fisher said were his mother’s last words. Reynolds, 84, died the day after her daughter’s death, reportedly of a stroke.
Was this just a sad coincidence, or can grief really kill a person? Actually, it can, either quickly, as in Reynolds’ case, or over a relatively brief period of time.
Although New Year’s resolutions are sometimes seen as an exercise in futility, research shows that approximately 45% of those who make them are still sticking with them six months later.
There is nothing wrong with using the start of a brand-new year to turn the page on old health habits and create new ones. But while approximately 40% of adults say they make New Year’s resolutions, fewer focus on helping their children use this practice to initiate new health habits.
You’ve heard the old expression, “An apple a day keeps the doctor away.” Well, your concierge physicians at MD 2.0 Jupiter wouldn’t go that far; apples are definitely good for you, and are certainly part of the balanced diet you need to stay healthy. But if you really wish to reap a host of health benefits at low risk and even lower cost, consider taking an aspirin a day.
There’s no getting around it: It’s that time of year. Even here in South Florida, colds peak through the winter months. And of course you’ve heard the old saying: “They can put a man on the moon, but they can’t cure the common cold.” It’s true. We can’t. So the second-best alternative is to avoid them altogether.
The Centers for Disease Control (CDC) says that adults average two or three colds per year, with even more in children. It also notes that most people contract their colds during winter and spring, but that colds are a year-round curse. They’re the main reason people miss school and work, according to the CDC.
Feeling kind of blah lately? Not as much energy as you had all summer? Not so willing to drag yourself to parties, or even out of bed? What about swimming? Tennis? Volleyball? Can’t think of even one good reason to chase a little white ball around with a stick when they couldn’t keep you off the course all spring and summer?
Maybe you’re depressed. Or maybe you’re just normal. We here at MD 2.0 Jupiter often begin to notice a subtle change in many of our clients around this time of year, even here in Florida, where we don’t have to face the extreme plunges in temperature. Nothing serious, just a little less enthusiasm, a bit less cheerfulness, a little less energy. Carb cravings and changes in sleep patterns are also a part of the syndrome. It doesn’t happen to everyone, but if you’re feeling something less than your usual perky self, rest assured there’s a scientific reason for it.
It has several names: “winter depression,” “seasonality,” “seasonal affective disorder (SAD),” but the fact is, researchers have determined that the shorter days in winter are the chief cause of winter blues. This likely has an ancient-survival connection, as humans learned to restrict activity when food sources were scarce. Of course, that’s not a problem today, but the tendency may still be hardwired into our biology, and people may experience symptoms on a sliding scale from barely noticeable to full-blown clinical depression.
Your body’s circadian clock, which triggers sleep and wake cycles among other bodily regulatory mechanisms, also decrees the output of serotonin, the so-called “mood” hormone. Studies have revealed that the circadian-related output of serotonin drops markedly with the decrease in light during the winter. This has led to fairly successful attempts to boost the winter mood of sufferers with light-box therapy, which employs specially built full-spectrum lamps to alleviate symptoms.
If you feel the “winter blues” are impacting your life, your concierge practitioners at MD 2.0 Jupiter can help you employ the correct light therapy, prescribe such antidepressants as Paxil and Prozac, or recommend cognitive behavioral therapy. Meanwhile, there are steps you can take to mitigate milder cases.
1. Stay active, preferably outdoors
Exposure to early morning light has been shown to be the most effective at reducing symptoms, as has vigorous exercise. An early morning walk or run might be all you need to boost your spirits.
2. Light up your life
If you can’t get outside, at least let the sunshine in as much as possible. Open blinds and drapes first thing in the morning, and keep them open all day.
3. Eat right
Yes, we’re still singing that same ole song, because it’s important. Simple carbs and sugars wreak havoc with your blood sugar, and hence, your mood. Lean meats, fruits, vegetables and complex carbohydrates are what your body needs to keep your brain in top shape.
Meanwhile, be sure to let us know if your low mood begins to interfere with your daily functioning. We can help.
Everyone forgets things from time to time, but with publicity these days so focused on Alzheimer’s, even middle-aged people can worry that forgetting their car keys or their mother’s phone number can signal the onset of dementia, of which Alzheimer’s disease is a subset.
Yet there are many other reasons—usually benign—why people have trouble remembering things. Let’s look at a few.
A top contender is side effects from medications. Sometimes the drugs themselves can include memory impairment as a side effect (statins for cholesterol control and some diabetes drugs, for example); other times it’s the combination of drugs that when taken alone are fine but when taken in combination produce unexpected side effects. The concierge physicians here at MD 2.0 Jupiter are prepared to discuss these concerns with any drug you are taking.
Another possible reason for memory impairment is sleep apnea. Along with many other negative effects, obstructive sleep apnea has been associated with spatial navigational memory, the kind that helps you find objects or addresses. ADHD and minor or “silent” strokes can also cause you to have difficulty remembering things. So can anxiety, depression, an underactive thyroid, and poor nutrition, especially low vitamin B12. As we age, it becomes harder to assimilate B12 from foods, which can lead to fuzzy thinking, confusion, even dementia. Please discuss all these possibilities with us.
Often, though, poor memory is simply attributable to the stress of ordinary, day-to-day life. It even happens to younger people. Look at the parents who leave their children in hot cars. Over 30 infants and children have died that way just this year. How could anybody forget their own child, we wonder. And yet, despite all the warnings, all the tricks to help parents prevent this tragedy, it happens over and over.
The answer is simple: information overload. Think of your brain as a large room. If that room has only five items in it, when asked to locate your keys in there, it’s a simple task. But if that room has 5,000 items, or 50,000 or 500,000, you’ll eventually find them, but it’ll take quite a bit longer. This is what happens to our brains as we age. When we’re children, we may have five items in our brains. But as we grow older, we’re now storing everything from our high school locker combinations to our Aunt Sally’s banana cake recipe, not to mention everything we learned in school, have read in books and newspapers, and seen on TV. And these days we’re probably also on the Internet, with its constant bombardment of information. We need to remember how to do math, the date of our niece’s baby shower, and user names and 10-digit passwords for all kinds of things. Is it any wonder our brains take a little longer to find and retrieve a single piece of information, even if we think it should be a simple thing?
The rule of thumb is, if you can’t find your keys, it’s probably nothing. If you forget what your keys are for, that’s a red flag. Either way, if you’re worried, please call us.
When the FluMist spray was introduced in 2003, the medical community rejoiced, hoping the nasal spray which became available in place of the annual flu shot would induce more people to get protected. Parents were happy, too, in being able to dodge the tears from their little ones.
Unfortunately, the Centers for Disease Control has decided that FluMist cannot be used for this upcoming flu season because it is ineffective. First licensed by the FDA in 2003, FluMist contained a weakened, live flu virus. The injection uses an inactivated virus. Early clinical trials seemed to show that the spray worked as well as or better than the shot, which led an estimated 20 million people to opt for FluMist last year.
In June of this year, however, the CDC released a study which showed that the nasal spray was effective only three percent of the time in children from two to 17 years of age during the 2015-2016 flu season. By contrast, the flu shot last winter was effective 49 percent of the time in adults and 63 percent in children. FluMist’s effectiveness rate seemed to plummet in 2013 when makers of the spray switched from including three strains of live virus (a trivalent) to four (a quadrivalent), although no one seems to be able to say how that impacted efficacy. The bottom line is, it’s not an option for the 2016-2017 flu season.
Keep in mind that the influenza virus kills thousands of people each year, so the flu shot is strongly recommended. Thus, the concierge physicians here at MD 2.0 Jupiter want to offer a few tips on how to make it a little less ouch-inducing for our clients.
1. Distraction seems to work best, not only for children but for adults, as well. Don’t look at the needle. Check out your smart phone, daydream about your next vacation, replay Sunday’s game in your head. Have your kids blow bubbles, play with a toy, eat a cookie (and don’t make a big thing out of getting a shot—treat it casually in front of them).
2. For fearful or pain-sensitive adults and children, let us know. We can administer a local anesthetic cream to the skin prior to the injection.
3. Hold your breath before and during the injection. This increases blood pressure which helps to decrease pain sensitivity.
4. Relax your muscles as much as possible before receiving the shot. Tensing up causes more pain both during and after the injection.
5. Apply either ice or a warm compress (try both to see which works best for you) to the site after the injection, and be sure to use your arm as much as possible in the ensuing hours to increase circulation.
6. If soreness persists after three days, call us! That’s why we’re here!
When those of us who practice concierge medicine visit with our patients, we often find they’re self-dosing with numerous over-the-counter supplements, everything from multivitamins to herbal supplements to mysterious concoctions meant to prevent various illnesses, aid in weight loss and body building, even enhance sexual performance.
With over 30,000 supplements on the market today, most of them unregulated, we are concerned that our patients may be unaware of hidden side effects and even dangers with many of the pills or concoctions they innocently consume. Between 2007 and 2012, the FDA received reports of more than 6,300 reports of serious adverse events linked to dietary supplements, including 115 deaths and over 2,100 hospitalizations.
And yet, many continue to take these vitamins and supplements in the belief that—because they’re “natural” or that they’re sold over the counter—they can’t do you any harm. A 1994 law (the Dietary Health and Education Supplement Act) actually prevents the FDA from regulating dietary supplements, or removing them from sale unless it can prove a supplement is unsafe.
Thus, many supplements sold over the counter are unregulated; analysis of some supplements have found little or none of the advertised content actually existed in the product. But even when the ingredients in supplements contain exactly what they’re supposed to, that doesn’t necessarily mean they’re safe. They can interact with other supplements and prescription medications you’re taking, interfering with effectiveness. And they can cause other problems.
Most people have heard of the dangers associated with some of the diet supplements targeted for weight loss and body building. However, sometimes even the most innocuous-seeming supplements may do more harm than good. For example, you may not be aware that vitamins A and E are not water soluble, and will not be excreted in the urine. Instead, they can build up in the body’s tissues and lead to an inadvertent overdose. Another example: Vitamin E and beta carotene supplements can actually increase the chances of developing lung cancer in smokers.
Herbal supplements raise similar concerns. St. John’s Wort, for instance, is sold over the counter for mild depression. Some potential side effects include dizziness, sun sensitivity, insomnia, anxiety and headaches. It can also reduce the effectiveness of birth control pills and certain heart medications. Fish oil can cause nausea and diarrhea, and increase the levels of LDL (bad) cholesterol and increase the risk of bleeding. Some people have suffered such severe liver damage with green tea extract that they required a liver transplant.
The fact is, any foreign substance introduced into the body can cause a negative reaction. Just ask anyone with a peanut allergy. Remember: “Natural” doesn’t necessarily mean safe. Tobacco is “natural.” So is poison ivy, ragweed, and deadly nightshade.
Before you take any supplement, check out the source for quality, and always mention it to your doctor. We here at MD 2.0 Jupiter are thoroughly conversant with dietary supplements and their pros and cons, and stand ready to discuss any questions or concerns you may have.