flu vaccine jupiter fl

Get Your Flu Shot by Halloween

Halloween is full of scary fun. But here’s something to really be scared about: not getting a flu shot. While you’re planning your costume and your parties, remember to carve out a moment to get protected against this dangerous disease.

The Centers for Disease Control and Prevention (CDC) has recommended that all adults and children over the age of six months receive their flu shot by the end of October, and our concierge family doctors in Jupiter second that advice.

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get the best sleep

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

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

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.

jupiter inflammation doctor

Inflammation: The Silent Killer

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.

heat summer

Beware the Danger of High Temperatures

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.

unhealthy food

Our Diets Are Killing Us

Question: What causes more deaths worldwide than smoking?

Answer: Food. And it’s not tainted food; it’s the unhealthy food we put on our plates every day.

Our concierge primary care doctors in Jupiter have told you many times about the importance of a healthy diet. Now a new study published this month in the journal Lancet warns that as a species, we don’t eat properly, and we’re paying for it.

“In many countries, poor diet now causes more deaths than tobacco smoking and high blood pressure,” Ashkan Afshin, lead study author, told CNN.

Afshin is an assistant professor at the Institute for Health Metrics Sciences at the University of Washington.

And it’s not just the bad things we eat—salt, red meat, sugar—that are contributing to premature deaths around the world; it’s the good things we don’t get enough of: fruits, vegetables, nuts and seeds, and so forth.

“Poor dietary habits . . . overall cause more deaths than any other risk factors globally,” Afshin told CBS News.

Dietary risk factors

The study took place over 27 years in 195 countries. Israel had the lowest number of diet-related deaths, followed by France, Spain, Japan, and the principality of Andorra. Uzbekistan had the highest, with the U.S. ranking 43rd out of 195.

The study results attributed one in five deaths (about 11 million people) annually around the world to the following dietary risk factors:

  • high sodium
  • low whole grains
  • low fruit
  • low nuts and seeds
  • low vegetables
  • low fiber
  • high trans fats
  • high sweetened beverages
  • low legumes
  • high red meat
  • high processed meat
  • low calcium
  • low milk
  • low omega-3s
  • low polyunsaturated fatty acids

Note: Omega-3 fatty acids are found in seafood. Polyunsaturated fatty acids are found in some nuts and seeds, salmon, and vegetable oils.

Healthy beats unhealthy

In their analysis of the 15 dietary factors, researchers found that the lack of healthy foods was worse than consumption of unhealthy foods. In other words, not eating fruits, vegetables and so forth was responsible for more deaths than eating red meat, processed foods, and the like.

As a result, Afshin recommended that policy makers should not just focus on what not to eat, but what to replace those foods with. The study estimated that three million deaths globally could be attributed to high sodium intake, but another three million were caused by lack of whole grains, with two million more caused by inadequate fruit intake.

They estimated that cardiovascular disease (CVD) was the leading cause of diet-related deaths around the world, followed by various cancers and diabetes, all of which were attributed to diet. Of course, other factors—including physical inactivity, environmental, economic, and social factors—contribute as well, according to Bruce Lee, associate professor of international health at Johns Hopkins Bloomberg School of Public Health.

“Diet can contribute to noncommunicable disease (NCDs) via increased body weight and obesity, elevated blood pressure, hyperlipidemia or high levels of fat in the blood, and conditions that lead to high blood sugar levels,” he told The Washington Post. Lee, who is also executive director of the Global Obesity Prevention Center, added that another problem is that “unhealthy foods such as those that are highly processed with artificial ingredients are often cheaper to make, store, ship, and prepare. Therefore, such foods have replaced more natural and healthy foods in foods systems around the world.”

Another factor is the profit motive.

“Refining grains is highly profitable,” Corinna Hawkes, director of the Centre for Food Policy at the University of London, told CNN. “Take corn, for example. You can refine it into different ingredients: animal feed, refined flours, and high-fructose corn syrup, to name three. So manufacturers are generating multiple value streams from this refining process.”

What you can do

As much as possible, try to adhere to a Mediterranean-style diet: abundant amounts of nuts, seeds, fresh fruits and vegetables, use of olive oil in cooking, moderate portions of fish and poultry, and little red meat.

Also beware of marketing claims that a product is “whole grain,” because often a whole grain has been stripped of one or more of its components: the bran, the germ, or the endosperm. Look for the stamp provided by the Whole Grains Council that certifies a product actually contains all three of these components.

And as always, check with us for any questions or concerns you may have about the food your family eats.

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