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 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.

Obesity Is a Little-Known Cancer Risk

Lifestyle, Preventative Health

When you think of ways to prevent cancer, you think of stopping smoking, avoiding the sun, getting regular screenings, and so on. But one way that might not occur to you is losing weight.

Therefore, our concierge family practice doctors in Jupiter thought you should know that there are 13 different types of cancer linked to overweight and obesity.

The risk

A recent article in The Washington Post reported that, although smoking is the number one preventable cause of cancer, killing more than 500,000 people in this country every year, “obesity is poised to take the top spot, as Americans’ waistlines continue to expand while tobacco use plummets.” It also appears that the more overweight a person is, the higher the cancer risk.

According to the National Institutes of Health (NIH), the types of cancer that may be influenced by overweight include:

  • esophageal
  • thyroid
  • colon
  • renal
  • liver
  • melanoma
  • multiple myeloma
  • rectal
  • gallbladder
  • leukemia
  • lymphoma
  • prostate in men
  • post-menopausal breast and endometrial in women

Being overweight also makes it more difficult to survive once a cancer is diagnosed.

The American Cancer Society (ACS) says that excess body weight is thought to be responsible for about eight percent of all cancers in the United States, as well as about seven percent of all cancer deaths. In addition, having too much belly fat, regardless of body weight, is linked with an increased risk of colon and rectal cancer, and is probably linked to a higher risk of cancers of the pancreas, endometrium, and breast cancer in post-menopausal women.

The reasons

Despite the apparent links, researchers are not certain of the reason that increased weight raises the risk of cancer. But they do have some theories. The ACS believes that timing of weight gain plays a role.

“Being overweight during childhood and young adulthood might be more of a risk factor than gaining weight later in life for some cancers,” the ACS says. “For example, some research suggests that women who are overweight as teenagers (but not those who gain weight as adults) may be at higher risk for developing ovarian cancer before menopause.”

The Post reports that researchers are homing in on the “visceral” fat that surrounds internal organs as the culprit.

“Rather than being a harmless glob, this fat is a ‘metabolically active organ’ that produces hormones such as estrogen, which is associated with a higher risk of breast and some other cancers, according to the American Institute for Cancer Research. . . . The fat also secretes proteins that drive insulin levels higher, which may spur cell growth and increase the possibility of cancer. And it can cause chronic inflammation, another risk factor for the disease, according to the group.”

“It’s a complex interplay of metabolism, inflammation, and immunity,” Jennifer Ligibel, a breast oncologist at the Dana-Farber Cancer Institute, told the paper. “It creates an environment that is more permissive for cancer.”

It’s also possible that lifestyle choices which cause overweight—poor diet and lack of exercise—are themselves contributing factors.

The upshot

While the effect of losing weight on reducing cancer risk is still uncertain, the ACS believes reducing body weight is a good move.

“Some body changes that occur as a result of weight loss suggest it may, indeed, reduce cancer risk. For example, overweight or obese people who intentionally lose weight have reduced levels of certain hormones that are related to cancer risk, such as insulin, estrogens, and androgens.”

To improve cancer odds, Ligibel of Dana-Farber told The Post that even a five percent reduction in body weight produces a beneficial result on blood sugar and inflammation.

We know dieting is difficult, but the results are well worth it, not only in reducing the risk of cancers and heart disease, but in improved quality of life overall. If you are overweight, please see us for tips and advice on simple ways to slim down.

protect child from drowning

How To Protect Your Child From Drowning

Children, Concierge Medicine, Healthy Living, Lifestyle

Drowning is one of the leading causes of death in children. Our concierge primary care doctors in Jupiter, want to emphasize the importance of teaching children not only the rules associated with being in and around water, but how to swim at an early age.

The American Academy of Pediatrics (AAP) recently released updated guidelines recommending swimming lessons for toddlers, revising long-standing guidance against swimming lessons for children under age four.

Start early

The earlier guidelines were based on the belief that children under four could not master the skills required to hold their breath and coordinate their limbs properly to develop adequate swimming skills. There was also a lack of evidence that swimming lessons would help prevent drownings in the under-four age group, as well as the suspicion that swimming lessons for such young children might confer a false sense of security in their parents.

But one study reported that lessons between the ages of one and four produced an 88 percent reduction in drownings. These findings, coupled with the fact that children between the ages of one and four are at the highest risk for drowning, eventually changed the thinking and led to the revisions. Of course, they’re not all going to be mini-Michael Phelps, but the AAP stresses that they can be taught basic water skills and water safety skills.

“Floating, grasping the wall, climbing in and out of the water, turning back to the wall . . . a lot of times children end up falling into the water and they look to the furthest point, and if they just turned around they would be better off,” Katie Lee of the Goldfish Swim School in Long Island, New York, told CBS News.

It’s a matter of allowing very young to feel comfortable in the water, and not panic if they find themselves in it unexpectedly. You can start by holding your baby in your arms, moving them slowly back and forth, allowing them to feel the silky sensation of water on their skin. You can sing to them, and even bob them up and down, reinforcing the feeling that being in water is fun.

Slightly older children can be taught to blow bubbles in the water, thus learning how to avoid swallowing water. You can also teach them how to float on their backs and kick their legs as you hold them up. Formal swimming lessons with a certified swimming instructor can start as early as age one, depending on the child’s physical abilities and emotional development.

Reduce risk

In addition to teaching your child basic water skills, it is critical to be vigilant at all times to prevent a tragedy. Young children can drown in as little as two inches of water, and within 90 seconds without breathing, oxygen in the brain begins to drop. Other experts cautioned that the perception of children flailing around in the water when they fall in is largely myth. Very young children tend to fall in and immediately sink.

“Don’t even run into the house for a second to go to the bathroom or grab the phone,” Dr. Mark Waltzman, a pediatric emergency medicine expert, told CBS News.

Other suggestions from AAP to prevent drowning include the following:

  • Parents should never leave children alone or in the care of another child while in or near bathtubs, pools, spas, or other open water.
  • Empty water from buckets and other containers immediately after use.
  • Never leave young children alone in the bathroom. Toilet locks can prevent drowning of toddlers.
  • Even with older children and better swimmers, the supervising adult should focus on the child and not get distracted with other activities.

Tips for homes with pools include these useful guidelines:

  • Never turn your back on a child in the water, even for a moment.
  • Be sure to install child-proof fencing all the way around the pool. Fences should be at least four feet high, with self-closing and self-latching doors that open outward. Consider door alarms for those that open directly into the pool area.
  • Also remove any structures that would allow them to circumvent the fence, such as ladders and toys.
  • If a child is missing, always check the pool first—seconds count.
  • Empty portable pools when not in use.
  • Always make sure a responsible adult is watching the children playing in or near the pool area (with no distractions, e.g., smartphones off).

If you have questions about age-appropriate swimming lessons and activities for your child, don’t hesitate to contact us.

Take Sleep Seriously – World Sleep Day

Health Basics, Healthy Living, Lifestyle, Preventative Health

Our concierge family practice doctors at MD 2.0 in Jupiter know that sleep is often the best medicine for any illness or injury. Conversely, lack of adequate sleep can not only interfere with recovery, but it can also trigger a host of diseases.

This Friday, March 15th, is World Sleep Day, designed to highlight the critical role sleep plays in maintaining health. World Sleep Day is hosted by the non-profit World Sleep Society (WSS) and was created because “Time and time again, sleep medicine professionals and researchers came up against the belief that sleep was not important enough in personal health and well-being to be a priority,” the WSS explains. It added that “society’s 24/7 flow” exacerbates what some medical professionals and researchers have called a national health crisis.

Several causes

The health issues associated with lack of sufficient sleep are myriad: obesity, type 2 diabetes, cancer, cardiovascular disease, dementia, depression . . . even a shorter lifespan overall.

How does poor sleep impact health? In short, the time we spend sleeping is time the body uses to repair itself, which it can’t do when we’re eating, working, playing, active, or stressed. From a medical standpoint, during sleep the immune system releases cytokines, which are a type of protein the body needs not only to sleep, but to fight the effects of stress, illness, or injury.

Research has shown that lack of sleep also reduces the number of certain antibodies used to fight infections. In addition, Japanese researchers found that losing six hours of sleep over a single night resulted in significantly elevated blood glucose and triglyceride levels, warning signs for increased risk of heart disease and diabetes.

Effects of poor sleep

According to the National Institutes of Health (NIH), here are some of the effects of insufficient sleep on adults, as well as children and teens.

Brain and emotions

Sleep helps form new pathways to enhance learning, memory, problem-solving, decision-making, and creativity. Sleep deficiency has been linked to anxiety, depression, suicide, risky behavior, and inability to cope with change. The loss of even a single night of sleep has been shown to increase formation of the proteins associated with Alzheimer’s disease. In addition, children who are sleep deficient may feel angry and impulsive, have difficulty paying attention, and get lower grades.

Physical health

Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke in adults. It also increases the risk of obesity in all age groups. In addition, insufficient sleep hinders the body’s ability to repair itself, including hampering the immune system. Sleep also supports healthy growth and development in children and teens, helping to boost muscle mass.

Performance and Safety

A loss of even one to two hours of sleep a night over several nights has the same effect as if you haven’t slept at all for a day or two. Sleep deficiency not only interferes with the ability to drive a car, it can affect people in all lines of work, including health care workers, pilots, students, lawyers, mechanics, and assembly-line workers. So insufficient sleep is not only affecting those who experience it, but can impact others, as well. The NIH estimates that driver sleepiness is a factor in approximately 100,000 auto accidents each year, resulting in about 1,500 deaths.

What Is Healthy Sleep?

The Centers for Disease Control and Prevention (CDC) estimates that up to a third of Americans do not get the recommended seven hours of sleep a night. If you’re sleeping well, you:

  • will fall asleep within 15 to 20 minutes of going to bed;
  • will sleep between seven and nine hours per night (longer than that is also unhealthy);
  • will remain asleep for the entire night;
  • will awaken feeling refreshed, and will remain alert and productive during the day; and,
  • will not snore, gasp for breath, or feel restless while you’re trying to sleep.

If you typically skimp on sleep during the week and try to catch up by sleeping in on the weekends, a new study published last month in the journal Current Biology has some bad news for you. Researchers found that so-called “recovery sleep” has no benefit to the body in the long term. As reported in The Washington Post, participants in a sleep laboratory who we limited to five hours of sleep on weekdays then allowed to “binge sleep” on weekends still gained nearly three pounds over two weeks and also experienced metabolic disruption that would increase the risk of diabetes later in life.

To help you obtain the proper amount of sleep, you should:

  • go to bed at the same time every night
  • don’t try to sleep on a full stomach
  • refrain from using caffeine or alcohol after dinner
  • turn off “blue-light” devices (TVs, computers, smartphones) at least an hour before bedtime; and,
  • restrict activity in the bed to sex and sleep (i.e., no working, reading, TV, etc.)

Because healthy sleep is so crucial to your health, please let us know if you have any difficulty falling asleep or staying asleep so we can help uncover the cause and provide solutions.

Dietary_Supplements

Think Twice About Dietary Supplements

Healthy Living, Lifestyle, Medications, Preventative Health

Because dietary supplements are a $40-billion-a-year business in this country, our concierge family practice doctors in Jupiter, want to make you aware of the latest research on these popular products. Numerous studies have found little benefit to taking any of the thousands of dietary supplements available on the market. And the U.S. Food and Drug Administration (FDA) has recently taken action regarding some of the health claims made by their manufacturers.

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