get the best sleep

Get a Good Night’s Sleep On a Hot Summer Night

Concierge Medicine, Health Basics, Healthy Living

The concept of air conditioning was first proposed by Florida physician and inventor Dr. John Gorrie in the 1840s. Gorrie believed that cooling was the key to avoiding diseases like malaria and making patients more comfortable, but his rudimentary system for cooling hospital rooms required ice to be shipped to Florida from frozen lakes and streams in the northern United States.

To get around this logistical challenge, Gorrie began experimenting with the concept of artificial cooling. He designed a machine that created ice using a compressor powered by a horse, water, wind-driven sails, or steam, and was granted a patent for it in 1851.

But it wasn’t until 1902 that Willis Carrier perfected the process and introduced it at the St. Louis World’s Fair in 1904.

Nowadays, most Americans, especially here in Florida, have air conditioning in their homes. But if you’re one of those who prefer not to use it, or if your power goes out, or you travel somewhere that lacks it, our concierge family practice doctors at MD 2.0 in Jupiter want to offer some tips on how to get a good night’s sleep in the summer heat.

The only thing worse than having insomnia is having insomnia on a hot summer night. To keep your cool, try the following.

 

Cool the room

According to the National Sleep Foundation (NSF), if you are sleeping and the temperature rises above 75 degrees Fahrenheit, it can wake you up. So be sure to keep the room as cool as possible by:

• closing the blinds and windows during the day to prevent heat buildup during the hottest part of the day;

• using a fan to keep the air circulating and supply “white noise” to block out street sounds;

• placing a bowl of ice or ice packs in front of the fan, which will help chill the air;

• dampening a sheet and hanging it across the window, both to block out light and heat, and to take advantage of cooling evaporation as it dries.

 

Cool the bed

• Use cotton, linen, or bamboo sheets, which provide breathability. Also avoid high-thread-count sheets, which tend to trap body heat. Opt for sheets with thread counts under 400.

• Some pillows—like those stuffed with buckwheat—are specifically made to stay cool. Or you can try putting your pillow inside a plastic bag in the freezer for an hour or so before bedtime. Alternatively, place ice packs inside the pillowcase.

• Remove all extraneous bedding, including blankets and extra pillows, which tends to hold heat.

 

Cool yourself

• Avoid alcohol or heavy meals—especially carb-heavy foods—in the evening. Alcohol dehydrates you as well as making you feel hotter, and large meals produce extra heat in your body during digestion.

• Take a cool bath or shower or a dip in the pool just before bedtime. The evaporation of the moisture on your skin acts to cool you.

• Fill a hot water bottle with water and freeze it, then take it to bed and place it beneath your knees or neck, or on your chest or wrists.

• Be sure to stay hydrated throughout the day, because your body needs water to help keep you cool.

• Remember that warm air rises, so if you have the option, sleep on the lowest floor in the house.

 

What if none of this helps?

If you’re still having trouble getting sufficient shut-eye in the summer, you might try the supplement melatonin. A hormone made by the pineal gland, it has been used successfully by many people for sleep issues. Most people can take it without a problem, but some experience such side effects as dizziness, anxiety, or daytime sleepiness. It is also contraindicated for those taking several medicines (blood thinners, birth control pills, and immunosuppressants, among others). So check with us first.

In extreme cases, let us know. If necessary, we can prescribe sleep medications for a few nights. These will help you sleep but can also induce troublesome side effects. Ideally, they should be used only for short periods of time in conjunction with cognitive behavioral therapy. We can also recommend various types of sleep studies that might help pinpoint more serious issues such as sleep apnea.

downside of marijuana

Be Aware of the Downsides of Marijuana

Concierge Medicine, Medications

Florida legalized the use of medical marijuana this past March. Thirty-four other states have already done so, and 10 states and the District of Columbia have legalized the use of recreational marijuana. But our concierge family doctors at MD 2.0 in Jupiter want to offer a few words of caution about the possible downsides of this increasingly legal drug.

First, be aware that any drug can cause side effects. This includes prescription or over-the-counter (OTC) medications, alcohol, even aspirin. Every body is unique, and reacts differently to different substances. What can cause problems for some people won’t have the same effect in others.

That said, despite many decades of illegal use, little scientific research has been performed on marijuana because until recently federal law has forbidden any scientific studies of the drug. So reports of its effects are largely anecdotal. Many users compare it favorably to alcohol, noting the lack of a hangover after use, the lower potential for addiction, and statistics showing that marijuana rarely results in the violence so often associated with alcohol abuse.

 

What is known, however, is that:

a) today’s marijuana is far more potent that that used by previous generations;

b) the higher THC content can trigger problems not seen in earlier users of the less potent varieties; and,

c) there are more recent reports of adverse effects on younger users, especially teenagers and young adults.

Let’s examine each of these individually.

 

Potency

Due to advanced growing techniques and hybridization, the marijuana available today has a far higher concentration of THC, or tetrahydrocannabinol, than even as recently as the 1980s. (THC is the psychoactive compound that produces the classic marijuana “high.”) Federal officials say the THC potency then averaged around four percent. Today’s levels have been found to be as high as 20-30 percent. In the 1960s it was around two percent.

Some products made from marijuana, often designed to be used with vaping devices—such as some edibles, oils, and substances called shatter, crumble, budder, and crystalline—have an even higher THC concentration, averaging 68 percent and occasionally as high as 95 percent. As the popular expression has it, “This is not your father’s weed.”

 

Side effects

These higher levels can increase the chances of an adverse reaction, either in new users or in those who haven’t used the drug in decades. These side effects can include:

  • anxiety or panic attacks
  • increased heart rate
  • dizziness
  • breathing difficulties
  • impaired memory
  • concentration difficulties

 

Danger to younger users

Other more serious side effects have been reported in younger users, especially in Colorado and Washington, where recreational use was legalized first. Children’s Hospital Colorado in Denver reported 777 cases of cyclic vomiting, paranoia, psychosis, and other acute reactions among their emergency cases in 2015. Heavy use of high-potency marijuana during adolescence up to the age of about 30 has also been associated with creating or worsening such mental health problems as anxiety, depression, psychosis, and suicidal ideation.

This is partly due to the high potency and partly to the incomplete development of the adolescent brain. Most experts consider the brain to reach full development between the ages of about 25 to 30. Until that time, neural pathways are more susceptible to damage from psychoactive substances.

 

Medical marijuana

As noted, medical marijuana (low-THC cannabis or synthetic cannabis) can now be prescribed to legal Florida residents by qualified physicians for certain conditions, including chronic pain, anorexia due to HIV/AIDS or cancer treatment, glaucoma, seizure disorders, terminal illness, and others.

Depending on the type employed, users may or may not experience the “high.” Some medical marijuana has been specially formulated to eliminate the mood-altering effects while still providing relief from symptoms.

However, users may still encounter one or more of the negative side effects listed above. This is why, with marijuana, it is especially important not to self-medicate, but instead allow us to help you find the right symptom relief associated with your condition.

 

While recreational marijuana is still illegal in Florida, we know that some will use it anyway. Just be aware of the potential downsides to this common substance.

Celery Juice: Refreshing Tonic Or Miracle Medicine?

Healthy Living, Nutrition

Our concierge family practice doctors at MD 2.0 in Jupiter have been receiving questions lately from some of our patients regarding the latest fad in “miracle cures,” celery juice. Touted on the Internet, in women’s magazines, and in a recent book as the answer to everything from diabetes to heart disease to heartburn, the benefits attributed to daily consumption of celery juice seem too good to be true.

So we thought we’d take a look at some of the claims for the efficacy of celery juice and see whether there’s any science behind it.

 

The claims

Celery juice, the so-called “miracle elixir,” is said to contain “previously unknown sodium cluster salts that actually neutralize pathogens secretly causing hundreds of symptoms and conditions.” The juice is also said to reduce inflammation throughout the body, which is known to trigger numerous health issues.

As a result, proponents claim, a daily glass of celery juice can lower blood pressure, reduce LDL (known as the “bad” cholesterol), ease arthritis, asthma, joint pain, and a host of other chronic illnesses, as well as promoting rapid and effortless weight loss and even curing some cancers.

 

The reality

Celery is a healthy vegetable, containing such vitamins and minerals as vitamins C and K, folate, calcium, potassium, and magnesium. And, like other vegetables, it is high in antioxidant polyphenols, known to reduce inflammation, boost the immune system, and neutralize free radicals which are responsible for cellular damage. But what about the “miracle elixir” claims?

First of all, nutritionists say there is no such thing as “sodium cluster salts.” Celery does, however, contain salt, and juicing the vegetable concentrates the amount of salt you get. The recommended intake of celery juice is 16 ounces in the morning, 30 minutes before breakfast. One bunch of celery, the amount needed to make 16 ounces of celery juice, contains approximately 800 mg. of sodium, The Washington Post reported recently.

“That’s more than you’ll get in two orders of french fries,” Charleston, S.C.-based registered dietitian Debbie Petitpain told The Post. Petitpain is a spokeswoman for the Academy of Nutrition and Dietetics.

Second, while inflammation can be a trigger for many serious and even deadly illnesses (see our recent blog, “Inflammation: The Silent Killer”) there’s no evidence that celery juice can reduce inflammation any better than numerous other fruits and vegetables, including beets, cabbage, parsley, or lettuce.

Finally, juicing any fruit or vegetable extracts some of the healthy fiber they contain. Fiber is not only filling, it helps maintain regularity, prevents the development of diverticulitis and hemorrhoids, and lowers cholesterol and blood glucose levels.

 

The conclusion

“There is no one ‘superfood’ that can meet all of our daily requirements,” Petitpain told The Post. “And in fact, research continually shows that the best nutrition comes from consuming a variety of food groups and various foods within each group.”

The popular book on celery juice also recommends, in addition to the morning drink, a diet high in fruits and vegetables, free of dairy, sugar, and processed foods. This alone would lead steady weight loss and better health overall, even without the juice.

There is no question that celery is high in many nutrients and antioxidants that can help alleviate many diseases. Unless you’re allergic to celery, as some people are, there’s no reason not to try it if you’re not on a low-salt diet.

But we believe that the most sensible eating plan is one that includes a wide range of fresh fruits, vegetables, low-fat meats and seafood, whole grains, legumes, and nuts. If you’d like more information on this or any related topic, be sure to contact us.

temperatures

How To Stay Safe in Scorching Temperatures

Health Basics, Lifestyle, Preventative Health

We’re not even halfway through summer yet, and we’ve already seen record-high temperatures here in south Florida, which can bring dangerous health impacts. The two most serious are heat exhaustion and heat stroke. Our concierge doctors in Jupiter want to remind you of ways you can keep your family safe as temperatures soar.

 

What to watch for

The Red Cross warns that some people are more at risk of developing a heat-related illness. These include: people aged 65 and older, who are less likely to sense and respond to changes in temperature; people with chronic medical conditions, who may be taking medication that can worsen the impact of extreme heat; infants and young children; and, outdoor workers and athletes, who may be more likely to become dehydrated, particularly in extreme heat.

When keeping an eye on the weather forecast, here’s what the various warning terms mean:

  • Excessive Heat Watch: Conditions are favorable for an excessive heat event to meet or exceed local Excessive Heat Warning criteria in the next 24 to 72 hours.
  • Heat Advisory: Heat Index values are forecasted to meet locally defined advisory criteria for the next one-to-two days
  • Excessive Heat Warning: Heat Index values are forecasted to meet or exceed locally defined warning criteria for at least two days.

 

Consequences of extreme heat exposure

Such excessive heat as we’ve been experiencing recently can lead to life-threating heat exhaustion and heat stroke. Most people have heard these terms, but may not fully understand what they mean. We want to explain the differences between the two, because the treatments for each are different.

Heat exhaustion

The Centers for Disease Control and Prevention (CDC) says muscle cramping might be the first sign of heat-related illness. It lists the warning signs of heat exhaustion as:

  • heavy sweating
  • weakness
  • cold, pale, clammy skin
  • fast, weak pulse
  • nausea or vomiting

If you or someone you’re with experiences these symptoms, you should move to a cooler location, lie down and loosen your clothing, apply cool, wet cloths to as much of your body as possible, and sip water. If you have vomited and it continues, seek medical attention immediately.

 

Heat stroke

The signs of heat stroke are:

  • high body temperature (above 103 degrees)
  • hot, red, dry, or moist skin
  • rapid and strong pulse
  • possible unconsciousness.

 

This is a medical emergency. Call 911 immediately. While waiting for the ambulance, move the person to a cooler environment, and try to reduce the person’s body temperature with cool cloths, or if possible, a cool bath. Do NOT try to give fluids.

 

Staying safe in the heat

Here are steps you can take to avoid experiencing either of these serious conditions.

  • Limit outdoor activity. The sun is hottest from 11 a.m. (D.S.T.) to 3 p.m., so try to stay indoors, or at least in shaded areas, during those times. If you must be outdoors, take frequent breaks, preferably in air-conditioned environments, and, if possible, take cool showers or baths to cool down.
  • Dress appropriately. Wear loose, lightweight, light-colored clothing. Wear a hat with a wide brim.
  • Drink water frequently, from two to four cups of water every hour. Don’t wait until you’re thirsty to drink, because by then you’re already started to dehydrate. Monitor urine color: If your urine is dark, you’re not drinking enough water. Urine should be light yellow or clear. And avoid alcoholic drinks, which can not only impair judgment regarding time spent in the heat but also dehydrate you.
  • Never leave children or pets in cars for any amount of time. Also check on animals frequently, ensuring they have access to shade and plenty of cool water.
  • Check on family, friends, and neighbors who do not have air conditioning, who spend much of their time alone, or who are more likely to be affected by the heat.

 

Keep these safety tips in mind as you enjoy the outdoor fun in summer, and check with us if you feel more bothered than usual by the heat. This could be a sign of a medical condition that warrants investigation.

jupiter inflammation doctor

Inflammation: The Silent Killer

Concierge Medicine, Disease

If our concierge primary doctors at MD 2.0 in Jupiter could pinpoint a single factor that is responsible for more illnesses than any other, it might be inflammation. This is the result of various attacks on the body by irritating or even harmful stressors on the body, such as pathogens, injuries, or poor lifestyle habits. The body then tries to heal the resulting tissue damage by rushing white blood cells and their protective chemicals to the site.

Thus, inflammation is necessary to keep the body healthy. But when the body is repeatedly assaulted by various harmful stimuli, the inflammation never ends and can eventually cause long-term damage.

 

What is inflammation?

There are two types of inflammation: acute and chronic. Acute is the healthy kind, in which the body mounts a defense against sudden injury or illness like the flu. Chronic is the dangerous kind, in which the body spends months or even years attempting to fight off constant, lower-level threats, such as pollution, poor nutrition, and the effects of ongoing stress.

 

A cause, not just a result

Because inflammation is seen with injuries, people used to believe it was the result of disease or illness. But over the years, it became more apparent that inflammation actually caused numerous chronic and deadly diseases.

 

Some of these include:

  • allergies
  • Alzheimer’s
  • anemia
  • asthma
  • cancer
  • Crohn’s disease
  • colitis
  • depression
  • diabetes
  • gout
  • multiple sclerosis
  • Parkinson’s
  • Polycystic Ovarian Syndrome (PCOS)
  • psoriasis
  • rheumatoid arthritis
  • wrinkles and other signs of aging

 

Inflammation linked to heart disease

The deadliest condition that was recently confirmed to be linked to inflammation is cardiovascular disease. Cardiovascular disease (CVD) is the leading killer not only in the United States, but also worldwide, claiming the lives of 634,000 people in this country and 15 million people around the world in 2015.

The connection between inflammation and atherosclerosis (“hardening of the arteries”) has been suspected since the 1800s. No definitive research had actually confirmed this hypothesis, however, until a study released in 2017.

Known as CANTOS, the study included over 10,000 patients who had previously suffered a heart attack and were then were given a drug meant to reduce inflammation. The drug, which costs about $200,000 per year, is not only prohibitively expensive, but its fatal side effects offset any gains in cardiovascular mortality reduction.

So why were cardiologists so excited about this research? Because it proved that reducing inflammation in the body will result in fewer heart attacks. (The drug also proved effective against certain forms of cancer, another illness thought to be tied to chronic inflammation.)

The drug had no effect on cholesterol, which is what is reduced with the use of statins, thus proving that inflammation reduction was solely responsible for the mortality reduction seen in the study. In reducing inflammation and demonstrating a marked decrease (15%) in cardiovascular events or death, it paved the way for possible development of safer, less-costly drugs that can accomplish the same thing.

 

Prevention is the best route

Of course, we can intervene medically with various drugs and treatment that can address all these illnesses and diseases, but the best treatment is to reduce inflammation before it causes a problem.

Some causes of chronic inflammation are beyond our control. These include environmental pollutants and certain genetic factors.

But many other causes are within our control. Here are some steps you can take to reduce chronic inflammation throughout your body.

  1. Quality sleep

Sleep is when the body lowers cortisol and repairs the damage to cells encountered during the day. Seven to eight hours nightly is optimal.

 

  1. Exercise

When you engage in moderate-intensity exercise for two hours and thirty minutes every week, the cells release a protein called Interleukin 6, which has an anti-inflammatory effect throughout the body.

 

  1. Healthy diet

Poor-quality foods—sugar, salt, fats, processed foods—all trigger inflammation throughout the body. Opt instead for fresh fruits and vegetables, nuts, high-quality/low-fat protein, whole grains, beans and legumes, and water.

 

  1. Stress reduction

Chronic stress causes the body to react with chronic inflammation as it tries to “fight off” what it perceives as an invader. Relaxation exercises, deep breathing, meditation, yoga . . . anything that helps reduce stress will also reduce inflammation.

 

  1. Stop smoking

Every puff of a cigarette triggers inflammation throughout the cardiovascular system.

 

If you’d like more information on inflammation’s effect on the body and how to combat it, please talk to us.

primary care jupiter fl

The Danger In Ultra-Processed Foods

Health Basics, Nutrition, Preventative Health

Sausages. Mayonnaise. Pizza. Potato chips. Bacon. Even whiskey, gin, and rum. All these foods and many more share two common traits: All were “processed” into their familiar form by humans, and all have been implicated in an increased risk for early death.

Our concierge primary doctors in Jupiter want to make you aware of the latest studies on the dangers of consuming these foods as the primary part of your diet.

The difference in these studies is that they don’t just address so-called “junk” foods like cookies and fast foods, but many of the items that all of us have in our kitchens and rely on as staples of our diet.

 

The studies

Published last month in the journal BMJ, one study followed more than 100,000 adults in France for five years. They found that those who ate the most processed foods were 23 percent more likely to experience a heart condition or stroke than those who consumed the lowest amounts.

The second study, also published in BMJ, tracked 20,000 Spanish adults over 20 years. Those who ate the most processed foods were 62 percent more likely to die during the study period than those who ate the lowest.

“High consumption” was defined as four or more servings of ultra-processed foods daily, with health risks rising 18 percent for each additional daily serving.

While researchers cautioned that correlation doesn’t prove causation, both studies controlled for such other possible risk factors as lifestyle, demographics, physical activity, weight, and overall health in drawing their conclusions. They also noted that their findings correspond to other earlier studies showing an association between highly processed foods and higher risks of obesity, high blood pressure, high cholesterol, and some cancers.

 

The cause

Researchers classified foods into roughly three categories:

  • “unprocessed or minimally processed” foods included fruits, vegetables, milk, eggs, legumes, meats, poultry, fish and seafood, yogurt, white rice and pasta, and natural juices;
  • “processed” foods included cheeses, breads, beer, wine, ham, and bacon;
  • “ultra-processed” foods included potato chips, pizza, cookies, chorizo, sausages, mayonnaise, chocolates and candies, artificially sweetened beverages, and whisky, gin, and rum.

 

They also created a separate category called “processed ingredients,” which included salt, sugar, honey, olive oil, butter, and lard.

The problem seems to stem from the processing, which changes foods from their natural state into something that will last longer on our shelves. These tend to be high in poor-quality fats, additional sugar, salt, and preservative chemicals, and low in vitamins and fiber. The common factor can be summed up in the phrase “convenience foods”; that is, foods that are quick and easy to prepare at home.

Dr. Andrew Freeman, a cardiologist who was not involved in the study, told CBS News, “I like to say: The longer the shelf life, the shorter your life.” Freeman directs cardiovascular prevention and wellness at National Jewish Health in Denver.

 

The solution

The takeaway in both these studies, as well as preceding ones is, the closer to a food’s natural state that you can eat, the better the effect on your overall health.

Freeman told CBS News that the most heart-healthy diet is one rich in whole foods, particularly plant-based foods like fruits and vegetables, legumes, whole grains, and nuts. He added that, for affordability and convenience, fresh-frozen vegetables were perfectly acceptable.

Simply switching from sodas to water is another good choice, as well as substituting fresh fruit for sweets. Options for quick snack foods include such treats as homemade sweet potato chips, and oven-“fried” vegetables like cauliflower and broccoli, as well as celery and carrot sticks cut up and stored in water.

If you have any questions about a healthy eating plan, please let us know. We can help you substitute a healthy diet for foods likely to negatively impact your health.

jupiter family doctor

How To ‘Break the Grip of the Rip’

Healthy Living, Lifestyle

This week is National Rip Current Awareness Week, so our concierge doctors in Jupiter want to acquaint you with this common, often-deadly, phenomenon. The National Weather Service (NWS) has already reported 17 surf zone fatalities nationwide this year, including one in Jupiter, and another nearby, from rip currents. The beach, while beautiful, needs to be approached respectfully.

An average of 100 people die in rip currents every year, and nearly 80 percent of all rescues—30,000 a year—made by lifeguards at ocean beaches are from rip currents. Although they can occur at any time, they are especially prevalent when the ocean is churned up with powerful offshore storms.

But bad weather is not necessarily a requirement for developing a rip current. Great weather for the beach does not always mean it’s safe to swim, or even to play in the shallows. Rip currents often form on calm, sunny days.

 

What is a rip current?

Rip currents are often incorrectly called “rip tides.” A tide is something different: a very gradual change in the level of water, occurring on a regular basis over a period of hours.

A rip current is a powerful, narrow channel of fast-moving water that can rush at speeds of up to eight feet per second, pulling swimmers away from the shore out into open water. They usually extend through the line of breaking waves, but can flow a hundred yards or more offshore. They can be as narrow as 20 feet or as broad as several hundred yards wide.

Often referred to as “undertow,” rip currents don’t actually pull swimmers under the water. The strongest pull is actually felt about a foot above the bottom of the ocean’s floor, which can knock your feet out from under you, making you feel you’re being pulled under, even though you’re not. But because of the current’s power, as the shoreline rapidly recedes, swimmers panic, struggle, exhaust themselves, and drown.

 

How to spot a rip current

Rip currents are most prevalent at low tide, when the water is already receding from the beach. They are also more likely to occur with a strong onshore wind.

Though often difficult to discern from the shore, some of the telltale signs are:

  • an area with a noticeable difference in the color of the water, caused by sand and sediment being churned up by the water;
  • a line of foam, seaweed, or debris moving out to sea; or
  • a place where the waves aren’t breaking, but has breaking waves on either side.

 

Remember, though, that many rip currents are completely invisible. The only time you can be certain there are no rip currents hidden in the water is if there are no breaking waves. No waves, no rip.

 

How to ‘Break the Grip of the Rip’

jupiter family doctorThe U.S. Lifesaving Association (USLA) warns that not even Olympic swimmers can swim against a rip current, because the pull is simply too powerful. According to the USLA, the most important thing to do when caught in a rip current is to remain calm. This helps you conserve energy and think clearly. Realize that you will not be pulled indefinitely out to sea; remember that most rip currents dissipate within a hundred yards of shore.

  • Don’t fight the current. Swim out of the current in a direction following (that is, parallel to) the shoreline. Once you’re out of the current’s pull, swim at an angle through the waves back to shore.

 

  • If for some reason you can’t reach shore, draw attention to yourself: Face the shore, wave your arms, and yell for help.

 

  • If you see someone in trouble, get help from a lifeguard. If one is not available, call 911. Throw the victim something that floats and yell instructions on how to escape. Remember, many people drown while trying to save someone else from a rip current.

 

Finally, never swim at a beach without a lifeguard nearby. The USLA reports that the chances of drowning at a beach with a lifeguard are 1 in 18 million.

 

If you have concerns or questions about this or any other health-related topic, please feel free to contact us.

Coping with Pet Grief

Lifestyle

Our concierge family practice doctors in Jupiter have heard it more than once: “I don’t understand it. I’m grieving more for my pet than I did when my parent died.”

That statement may be shocking to some, but research has shown this reaction is not uncommon. This may be due to a number of reasons.

 

Not ‘just an animal’

People who have never had pets, or who haven’t shared a close relationship with them, may not understand the deep bond that can exist between a human and their companion animals. They may minimize or even dismiss the grief that can accompany the death of a pet.

 

Pet owners may grieve more for their animals than humans in their lives because our relationship with our pets may be more uncomplicated than those we share with humans. They offer unconditional love, and let us offer that to them. In addition, we see our animals every day, whereas parents, siblings, and friends may not be as physically close to us.

 

As with the loss of humans in our lives, we also feel grief when a pet dies because, as anyone who has spent time around an animal knows, each of them possesses a unique personality, so we miss that “person” as we would any human individual we’ve come to know and love.

 

Finally, there’s the fact that our animals totally rely on us to feed and care for them, offering a kind of normalcy to every day, similar to the way infant children are dependent on their parents for constant care.

 

Guilt often involved

This dependent relationship also complicates the loss, because pet owners may feel unneeded after an animal dies, or—quite commonly—feel they’re somehow responsible for the death.

 

“If only I’d taken him to the vet sooner.” “Why didn’t I close the gate so she didn’t get into the road?” “I should have had him euthanized sooner/later” is an especially common reaction. These natural feelings add to the grief, and may make it more difficult to cope with.

 

When guilt rears its ugly head, it’s best to remember you did the best you could for the animal you love given the information you had at the time. If the pet died through a preventable accident, you need to forgive yourself and remember it wasn’t deliberate. Also, try to focus on the good life you gave him/her.

 

How to cope

  1. Jettison any expectations that you will “get over” your pet’s death. With any loss, we don’t “get over” it; we eventually learn to live with the new reality and incorporate it into our daily lives. And never set a timetable for when you should start feeling better. Grief is different for every person, and depends on many factors, including your relationship with the animal, your social network, and other things going on in your life.

 

  1. Try to find at least one person you can talk to, not only about your grief, but about what made that particular animal special. If no one in your life offers this safe place, there are numerous online and in-person support groups that can provide this service. Your veterinarian likely knows of support groups in your area.

 

  1. Memorialize your pet. Hold a funeral or memorial service; create a photo album; write down memories; plant a tree. If you were present for the death of your pet, you may become “stuck” on those last moments. Focusing on the entirety of the pet’s life can help you put those final memories in perspective.

 

  1. Take care of yourself. Grief is exhausting. If the pet was ill for a long time, by the time he or she died, you were already worn out from the worry and medical care you gave the animal. Try to eat a healthy diet, get plenty of sleep, and at least take walks if you’re not yet up for strenuous exercise. You need to support your body as it recovers from the difficult work of mourning.

 

Finally, check with us if your grief interferes with your life, you feel that these steps aren’t helping, or you have thoughts of suicide. We can help.

heat summer

Beware the Danger of High Temperatures

Concierge Medicine, Health Basics, Lifestyle, Preventative Health

May 30th is Heat Safety Awareness Day, so our concierge family doctors at MD 2.0 in Jupiter want to take this opportunity to acquaint you with this important health concern. The fact is, heat is a killer, and we here in south Florida need to pay particular attention to the danger high temperatures can present.

Heat exhaustion, heat stroke, and dehydration are some of the leading weather-related killers. For example:

  • A 1980 heat wave killed more than 1,250 people.
  • In 1995, a heat wave in Chicago took more than 700 people (the deadliest weather event in Chicago history).
  • In August 2003, a record heat wave in Europe claimed an estimated 50,000 lives.

 

Some people are more susceptible to negative effects from the heat. These include:

  • people 65 and older, who are less likely to sense and respond to changes in temperature;
  • people with chronic medical conditions, who may be taking medication that can worsen the impact of extreme heat;
  • infants and young children; and,
  • outdoor workers and athletes, who may be more likely to become dehydrated, particularly in extreme heat.

It’s vital to know the difference between heat exhaustion and heat stroke, the warning signs for each, and what to do in the event you or someone else experiences them. You should also know how to avoid these serious conditions.

 

Heat exhaustion

The Centers for Disease Control and Prevention (CDC) says muscle cramping might be the first sign of heat-related illness. It lists the warning signs of heat exhaustion as:

  • heavy sweating
  • weakness
  • cold, pale, clammy skin
  • fast, weak pulse
  • nausea or vomiting

If you or someone you’re with experiences these symptoms, you should move to a cooler location, lie down and loosen your clothing, apply cool, wet cloths to as much of your body as possible, and sip water. If you have vomited and it continues, seek medical attention immediately.

 

Heat stroke

The signs of heat stroke are:

  • high body temperature (above 103 degrees)
  • hot, red, dry, or moist skin
  • rapid and strong pulse
  • possible unconsciousness.

This is a medical emergency. Call 911 immediately. While waiting for the ambulance, move the person to a cooler environment, and try to reduce the person’s body temperature with cool cloths, or if possible, a cool bath. Do NOT try to give fluids.

 

Stay safe in the heat

Following are steps you can take to avoid experiencing either of these potentially deadly conditions.

Limit outdoor activity. The sun is hottest from 11 a.m. (D.S.T.) to 3 p.m., so try to stay indoors, or at least in shaded areas, during those times. If you must be outdoors, take frequent breaks, preferably in air-conditioned environments, and, if possible, take cool showers or baths to cool down.

Dress appropriately. Wear loose, lightweight, light-colored clothing. Wear a hat with wide brim.

Stay hydrated. Drink water frequently, from two to four cups of water every hour. Don’t wait until you’re thirsty to drink, because by then you’ve already started to dehydrate. Monitor urine color: If your urine is dark, you’re not drinking enough water. Urine should be light yellow or clear. And avoid alcoholic drinks, which can not only impair judgment regarding time spent in the heat but also dehydrate you.

Check the car. Despite all the awareness and warnings in the last few years, more children—51—died in hot cars in 2018 than any year on record. It happens to the most conscientious parents who simply have too many things on their minds. When transporting children, place something necessary—a purse or briefcase—next to the child. Keep car doors locked and never allow children to play in a car. And countless numbers of pets die when owners leave them alone in a hot car “just for a couple minutes.” Never leave pets alone in a closed car, even for a few minutes.

 

Check with us to see whether any medical conditions might make you more susceptible to heat.

screen time for kids

Screen Your Kids’ Screen Time

Children, Healthy Living, Lifestyle

Our concierge family doctors in Jupiter understand that, in a world dominated by screens, trying to limit your children’s screen time can be a daunting task. But the World Health Organization (WHO) recently released new guidelines that largely track those issued two years ago by the American Academy of Pediatrics (AAP).

 

What is ‘screen time’?

First, let’s define what constitutes “screen time.” The AAP defines it as time spent using digital media for entertainment purposes. The organization does not include time spent doing homework in its recommendations. The WHO has a similar definition of passively watching entertainment on a screen. But the overall thrust of its guidelines were aimed, not just at the sedentary activities of viewing computers, smartphones, and televisions, but at improving physical health through sufficient exercise and sleep.

In addition, the AAP guidelines addressed screen time for children of all ages, while the WHO recommendations focused on children under age five.

 

Problems with infants

Both groups recommend no screen time at all for infants 18 months and younger.

“The noise and activity of a screen are distracting for a child,” Dr. Yolanda Reid Chassiakos told CNN. Chassiakos is the lead author of the AAP’s report. She said banning screen time for babies is crucial, not only for brain development but for healthy parent-child connections.

 

“Even if the baby isn’t directly looking at the screen—for example, if a mother is nursing her child on the couch while watching TV—the baby can be overstimulated by the lights and sounds, which may cause distress and sleep problems.”

 

Chassiakos also noted that screens tend to interfere with creating intimate bonds between parents, children, and siblings and that tech-free bedrooms can help promote better sleep. Other experts have warned that screen time may inhibit a child’s ability to develop language and social skills.

The WHO took these recommendations a step further, noting that improving physical activity and sleep among young children, while limiting sedentary behaviors such as screen viewing, can help prevent problems later in life stemming from becoming overweight and out of shape.

 

The recommendations

Here are the WHO’s new guidelines:

Infants younger than one

  • no screen time at all
  • physical activity several times a day, including floor-based play and 30 minutes of tummy time
  • limiting restraint (in a stroller, high chair, or caregiver’s back) to less than an hour at a time
  • 14-17 hours of quality sleep, including naps, for infants three months and younger
  • 12-16 hours of quality sleep, including naps, for those between four and 11 months

 

Children between one and two

  1. no screen time for one-year-olds
  2. one hour of screen time for two-year-olds
  3. 180 minutes a day in physical activity (not necessarily structured exercise)
  4. limiting restraint to less than one hour at a time
  5. between 11 and 14 hours of quality sleep, including naps

 

Children between three and four

  • one hour of screen time
  • 180 minutes a day of physical activity, including 60 minutes of vigorous running and jumping games
  • 10-13 hours of quality sleep, which may include naps

 

“Too often, I see tired, overscheduled kids who eat on the run during the week and become sedentary on weekends because they are exhausted,” Dr. Jennifer Shu, an AAP spokeswoman, told CNN.

 

As always, we are here for you and your family, so feel free to consult us regarding any questions you may have about shielding your children from excessive screen time.

1 … 24 25 26 27 28 … 41