Choosing Between Pills and Push-Ups: The New Weight-Loss Dilemma in America

Health Basics, Healthy Living, Uncategorized

In recent times, we’ve observed a significant trend in healthcare, especially concerning weight management. Millions of Americans are now opting for weight-loss drugs as their primary strategy for losing weight, rather than traditional methods like gym memberships. This shift raises several critical points worth discussing from our primary care doctors’ perspective.

Understanding the Trend

First, it’s essential to understand why this trend is occurring. Weight-loss medications have become more accessible and are perceived as a quick fix compared to the time and effort required for regular exercise. Furthermore, the pandemic has undoubtedly played a role, with many people finding it challenging to maintain a regular gym routine due to restrictions and personal safety concerns.

The Role of Weight-Loss Drugs

As healthcare providers, we acknowledge the potential benefits of weight-loss drugs. They can be particularly effective for patients with certain health conditions, such as obesity-related comorbidities, where losing weight is crucial for improving overall health. When used correctly and under medical supervision, these medications can offer significant benefits.

The Importance of Holistic Health

However, it’s crucial to emphasize the importance of holistic health. Weight-loss drugs can aid in reducing body weight, but they do not necessarily improve all aspects of health. Physical exercise, on the other hand, not only aids in weight management but also improves cardiovascular health, mental health, and overall physical fitness.

The Role of Primary Care

In our practice, we advocate for a balanced approach. When a patient expresses interest in weight-loss drugs, we ensure a thorough evaluation. This evaluation includes understanding their medical history, current health status, and lifestyle. We also emphasize the importance of incorporating healthy eating habits and regular physical activity into their routine.

Educating Patients

Education plays a vital role. We inform our patients about the potential side effects of weight-loss drugs and the importance of using them as part of a broader lifestyle change. It’s not just about the medication; it’s about developing a sustainable, healthy lifestyle.

Collaborative Healthcare

We also collaborate with other healthcare professionals, such as dietitians and fitness experts, to provide a comprehensive weight management plan. This team approach ensures that our patients receive the best possible care tailored to their individual needs.

Conclusion

The preference for weight-loss drugs over gym memberships is a complex issue. As primary care providers, we strive to guide our patients toward making informed decisions that best suit their health goals. It’s about finding the right balance and ensuring that the journey towards weight loss is healthy, sustainable, and beneficial in the long term.

New Year, New Health Goals: Top Wellness Tips for 2024

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Welcome to 2024! A New Year Brings New Opportunities for Health and Wellness

As we step into 2024, it’s the perfect time to reset our health and wellness goals. Living in sunny Florida offers unique opportunities and challenges for maintaining our health. Whether you’re a long-time resident or new to the Sunshine State, our primary care doctors in Jupiter explore some practical and achievable health goals for this year.

1. Embrace Outdoor Activities

Florida’s climate is ideal for outdoor activities year-round. Consider incorporating more walks, bike rides, or beach activities into your routine. These activities not only improve physical health but also boost mental well-being by connecting you with nature and your community.

2. Stay Hydrated

Florida’s warmth requires us to pay extra attention to hydration. Aim to drink at least eight 8-ounce glasses of water daily, more if you’re active or spend a lot of time outdoors. Staying hydrated keeps your body functioning optimally and can improve skin health, cognitive function, and overall energy levels.

3. Sun Protection is Key

With Florida’s abundant sunshine, skin care becomes crucial. Apply a broad-spectrum sunscreen with at least SPF 30 every day, even when it’s cloudy. Don’t forget to reapply every two hours when outdoors. Sun protection helps prevent skin cancer and delays signs of aging.

4. Incorporate Seasonal Fruits and Vegetables

Florida’s agricultural bounty means we have access to a variety of fresh fruits and vegetables. Aim to include these in your diet to boost your intake of essential vitamins, minerals, and fiber. Seasonal produce like citrus fruits, tomatoes, and leafy greens can be particularly beneficial.

5. Prioritize Mental Health

The New Year is a great time to focus on mental health. Whether it’s through meditation, yoga, or simply taking time for yourself, mental well-being is a crucial part of overall health. If you’re feeling overwhelmed or struggling, remember that our concierge service offers personalized care, including mental health support.

6. Regular Health Check-Ups

Staying on top of your health means regular check-ups with your primary care provider. As a concierge healthcare office, we offer personalized and attentive care to help monitor and manage your health throughout the year.

7. Set Realistic Fitness Goals

Whether it’s improving endurance, strength, or flexibility, set achievable fitness goals. Remember, small, consistent efforts often lead to significant long-term benefits. Our team can help tailor a fitness plan that’s right for you.

8. Sleep Well

Aim for 7-9 hours of quality sleep each night. Good sleep is essential for health, affecting everything from mood to immune function. Create a relaxing bedtime routine and ensure your bedroom environment promotes restful sleep.

Conclusion

As we embrace 2024, let’s focus on these achievable health goals to make the most of the year ahead. Remember, your journey to health and wellness is unique, and our concierge healthcare team is here to support you every step of the way. Here’s to a healthy, happy, and vibrant New Year!

Ketamine: Understanding Its Medical Use and Risks in Light of Matthew Perry’s Tragic Death

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The recent passing of Matthew Perry, a beloved actor, due to the “acute effects of ketamine” has brought this drug into the public eye. Our primary care physicians in Jupiter want to educate our patients about ketamine – its medical uses, potential risks, and the circumstances surrounding Perry’s death.

What is Ketamine?

Ketamine, initially developed as an anesthetic for medical and veterinary use, is a dissociative drug. This means it can cause a feeling of detachment from one’s body and environment. It may lead to hallucinations and profound changes in thoughts and emotions. However, its medical utility, especially in mental health, is notable.

Ketamine’s Therapeutic Use

In recent years, ketamine has gained attention for its off-label use in treating severe depression and certain pain conditions. The FDA-approved nasal spray form, Spravato (S-ketamine), is specifically for treatment-resistant depression and suicidal ideation. It is strictly regulated, used only under medical supervision in a healthcare setting. This ensures its safety and effectiveness when combined with other antidepressants.

The Case of Matthew Perry

Matthew Perry’s death highlights the potential risks associated with ketamine. According to the autopsy report, Perry had “acute effects of ketamine” in his system, alongside other conditions like coronary artery disease and buprenorphine. This tragic event underscores the importance of understanding ketamine’s impact, especially in individuals with preexisting health conditions.

Risks and Dangers of Ketamine

While beneficial in controlled medical settings, ketamine poses significant risks if misused. High doses can lead to cardiovascular, respiratory, and neurological complications, potentially fatal. Users may experience elevated blood pressure, breathing difficulties, amnesia, seizures, addiction, and urinary tract problems. Perry’s case demonstrated how ketamine could exacerbate underlying health issues, leading to severe consequences.

Educating Patients on Ketamine Use

As healthcare providers, our role extends beyond treating illnesses. We must educate our patients about the medications they use or may encounter. For ketamine, this means discussing:

  1. Controlled Medical Use: Emphasize that ketamine treatment for depression is a regulated process, requiring close medical supervision.
  2. Potential Risks: Inform patients about the dangers of misuse or combining ketamine with other substances, especially for those with existing health conditions.
  3. Recognizing Misuse: Encourage patients to seek help if they or someone they know may be misusing ketamine or other substances.
  4. Understanding Mental Health Treatment: Discuss alternative treatments for depression and chronic pain, highlighting that ketamine is one of many options.

Conclusion

The loss of Matthew Perry to ketamine-related complications is a somber reminder of the delicate balance in drug therapy. As primary care providers, our responsibility is to ensure patients are well-informed about their treatments, understanding both the benefits and risks. By doing so, we can help prevent tragedies like Perry’s and provide safe, effective care to our community.

Regular Cardiac Health Checks: Even Without Apparent Heart Issues

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The heart is the symbolic and biological epicenter of our existence, powering life as we know it. With each beat, this robust muscle keeps blood coursing through our veins, supplying vital oxygen and nutrients to all of our organs.

Whether you’re an exercise enthusiast or a confessed couch potato, whether you’ve been diagnosed with a heart condition or not, it’s crucial to regularly check your cardiac health. But why is it so important, particularly if you’re not exhibiting any obvious signs of heart disease? This blog aims to answer that question, highlighting the reasons why routine cardiac health checks are indispensable, regardless of your heart disease status.

  • Prevention is Better Than Cure

One of the primary reasons to conduct regular cardiac health checks is to spot potential problems before they escalate. Even in the absence of symptoms, certain risk factors—like high blood pressure, high cholesterol levels, diabetes, or being overweight—can silently affect your heart health. These conditions can gradually lead to serious heart problems, often without presenting any noticeable symptoms until the damage is significant.

  • Early Detection Saves Lives

Heart disease remains the leading cause of death globally. What’s particularly troubling is that many who succumb to heart-related conditions showed little to no prior symptoms. Regular cardiac health checks facilitate early detection, increasing the likelihood of successful intervention and treatment. The sooner a potential issue is identified, the more options there are for treatment, and the better the outcomes generally are.

  • Heart Disease can be Stealthy

Symptoms of heart disease aren’t always as dramatic as what we see in movies. In reality, heart disease often sneaks up silently, and its symptoms are sometimes mistaken for less serious conditions like indigestion or stress. Regular check-ups can help uncover these stealthy conditions, ensuring that any issues are treated promptly and effectively.

  • Lifestyle Impact

Modern lifestyles are increasingly sedentary and stressful, which can negatively impact our cardiac health. Regular monitoring provides a reality check and an opportunity to modify these lifestyle factors. Simple adjustments, like regular exercise, a balanced diet, stress management, and quitting smoking, can significantly improve cardiac health.

  • Genetic Predisposition

Even if you’re currently heart-healthy, you may be genetically predisposed to heart disease. If a close family member has experienced heart disease, particularly at a young age, your risk is higher. Regular cardiac health checks help track any changes over time and help you manage your risk effectively.

  • Aging and Heart Health

As we age, the risk of heart disease increases due to the natural wear and tear of the heart and blood vessels. Regular check-ups can help monitor the aging heart and implement necessary precautions and treatments to keep it healthy.

In conclusion, maintaining regular cardiac health checks, even if you have no existing heart issues, plays an essential role in overall health maintenance. Your heart may be silently shouldering the burden of lifestyle, genetic factors, or hidden conditions. Our concierge doctors in Jupiter often encourage our patients to check with various specialists even if they have no symptoms for these exact reasons. Uncovering these potential issues before they become problematic can add healthy, quality years to your life.

It’s time we started prioritizing our heart health the same way we do our professional growth or personal development. Remember, it’s never too early or too late to start taking care of your heart. After all, a healthy heart is a happy heart.

Staying Safe In Flooding Events

, , , , Environment, Health Basics, Natural Disaster

In light of last month’s flood disaster in Fort Lauderdale, and the fact that such events are happening more often, our primary care concierge doctors in Jupiter want to review what you should know to stay safe in similar situations.

Not only are extreme flooding events more likely these days, but here on the east coast of Florida we also regularly deal with the threat of hurricanes. And with hurricane season arriving in just a few weeks, it pays to be prepared.

More to Come

In the aftermath of the Fort Lauderdale flooding, Kevin Guthrie, director of the Florida Division of Emergency Management, said, “This is the second most-catastrophic flooding event that I’ve seen in my tenure as emergency manager . . . over the last 33 years,” with Hurricane Ian being the worst.

Unfortunately, with the changing climate, such events are becoming more common, both in Florida and across the country. Warmer air holds more water vapor than cooler air, thus intensifying rainfall amounts.

The National Weather Service (NWS) reports that flooding kills more people than almost any other weather-related hazard. That’s why it’s important to know what to do in storm emergencies.

Before the Storm

  • Be sure you have a 30-day supply of your medications—both prescription and non-prescription—on hand before the storm hits. See us if you need refills of any drugs you may be taking.
  • If your medications need to be refrigerated, talk to us about how to keep them properly stored if your power goes out.
  • If you are on dialysis, talk to the doctors or staff at the dialysis center about where to go after the storm.
  • If you use medical devices such as ventilators or oxygen concentrators, be sure the batteries are fully charged, and know where to go if the battery doesn’t work.
  • If you are on a special diet, be sure to have enough food available to last at least a week. And have enough bottled water available for everyone in the household to prevent dehydration. The rule of thumb is one gallon per person per day.
  • If you have service animals or pets, ensure they have enough water, food, and any medications to last at least 10 days after the storm.
  • Be sure to have plenty of hand sanitizers and hand wipes available.
  • Make sure to take all your medical paperwork with you if you evacuate: a list of current medications, a list of drug allergies, insurance cards, and contact numbers for your physicians.
  • If you haven’t had a tetanus vaccine in the past 10 years, see us now to be inoculated. During after-storm cleanup, tetanus bacteria can infect you from even a minor cut or scratch.

Driving Safely

Flash floods are caused by slow-moving thunderstorms, or storms that move over the same area one right after the other, known as “training,” because they follow each other like train cars. The NWS says that most deaths associated with floods occur at night or when people become trapped in cars that stall while driving in flooded areas. 

In April’s flooding, CNN reported that a month’s worth of rain fell on Fort Lauderdale in just one hour. Many of the city’s streets turned into lakes as two feet of rain left over 1,000 people calling for help.

If you encounter flooding, remember: Turn around, don’t drown. It takes just a foot of water to float a car; two feet will float most vehicles, including pick-up trucks.

One final tip from the man who helped create the “turn around, don’t drown” slogan: Hector Guerrero, formerly with the NWS, tells NPR that floodwaters can make it challenging to open car doors or windows. That’s why he keeps a safety hammer in his car in case he gets stuck in rising waters.

“You hit the corner of that windshield,” he says. “You can break it out if it has to come to that.”

Then head to higher ground: a nearby hill, a building, or even a tree.

After the Storm

Many deaths and injuries occur after a disaster. So here’s what you need to know to stay safe.

  • Avoid floodwaters if at all possible. They are filled with such contaminants as oil and gas, infectious diseases, household chemicals, and sewage, not to mention displaced animals. Water may also cover potholes and sinkholes.
  • If you’re using a generator to maintain power, be sure it’s far enough away from the house to prevent carbon monoxide from seeping into the home.
  • Do not eat any food or water that may have come into contact with floodwater. If in doubt, throw it out.
  • If lifesaving drugs have been exposed to floodwaters, the U.S. Food and Drug Administration (FDA) says that if the container is contaminated but the contents appear unaffected (i.e., the pills are dry), they may be used until replacements are available. Other types of drugs or drug products such as inhalers, oral liquids, drugs for injections, and so forth, should be discarded if they have come in contact with contaminated water.
  • Insulin loses its potency according to the temperature it is exposed to and the length of the exposure. Under emergency conditions, you might still need to use insulin that has been stored above 86 degrees Fahrenheit. When a fresh supply becomes available, discard any questionable insulin remaining.
  • Take care during cleanup. Be aware of downed power lines, the hazards of power tools like chainsaws, and the dangers of overexertion and heat.

Is Exercise Better Than Drugs for Mental Health?

, , , , , Concierge Medicine, Health Basics, Healthy Living, Lifestyle, Preventative Health, Uncategorized

If our primary care concierge doctors in Jupiter could prescribe a single treatment for a host of different health concerns, it would be exercise.

For example, one study published in the journal BMJ compared exercise alone versus drug therapy alone and found that for heart disease, diabetes control or prevention, stroke rehabilitation, and treatment of heart failure, regular physical exercise was just as effective as prescription medications in treating many of these conditions.

And according to the Mayo Clinic, some of the disorders that benefit from regular exercise include:

  • Heart disease – In addition to strengthening the heart muscle and lowering blood pressure, exercise can help you be more active without experiencing chest pain or other symptoms.
  • Diabetes – Regular exercise can not only help insulin more effectively lower your blood sugar level, but also help control weight and boost energy.
  • Asthma – Exercise has been shown to control the frequency and severity of asthma attacks.
  • Back pain – Regular low-impact aerobic exercise can help increase the strength of your back muscles and improve endurance and muscle function.
  • Arthritis – Exercise is the primary approach to reduce pain, help maintain muscle strength in affected joints and reduce joint stiffness.

What About the Brain?

It makes sense, then, that the benefits of exercise would also impact the brain.

And that’s just what a new study, published in February in the British Journal of Sports Medicine, revealed. Researchers from the University of South Australia correlated data from 1,039 studies involving more than 128,000 volunteers.

They found that physical activity was 1.5 times more effective for managing depression than either counseling or the leading medications typically prescribed for the disease.

The review showed that exercise interventions that were 12 weeks or shorter were the most effective at reducing mental health symptoms, showing how quickly physical activity can make a difference, Science Daily reported.

“Our review shows that physical activity interventions can significantly reduce symptoms of depression and anxiety in all clinical populations,” lead researcher Dr. Ben Singh said in a statement.

“We also found that all types of physical activity and exercise were beneficial, including aerobic exercises such as walking, resistance, training, Pilates, and yoga,” he said. 

“Importantly, the research shows that it doesn’t take much for exercise to make a positive change to your mental health.”

Even a Little Bit Helps

This last finding is important because one of the hallmarks of depression is a lack of energy. So asking them to engage in the Centers for Disease Control and Prevention’s (CDC) recommendation of 150 minutes of moderate physical activity every week is akin to asking them to climb a mountain with a broken leg.

Another study, published this month in the journal JAMA Psychiatry, offers similar reassurance that any regular movement can make a difference.

For this study, the researchers looked at 15 studies involving more than 190,000 subjects.

They found that people who engaged in brisk walking for a total of 2.5 hours a week had a lower risk of depression than those who didn’t exercise at all. 

“Most benefits are realized when moving from no activity to at least some,” the study authors wrote. 

“Our findings, therefore, have important new implications for health practitioners making lifestyle recommendations, especially to inactive individuals who may perceive the currently recommended target [of 2.5 hours a week] as unrealistic,” they added.

How Does it Work?

There are several reasons exercise has such a positive effect on depression and anxiety, according to Dr. Antonia Baum, an assistant clinical professor of psychiatry and behavioral sciences at George Washington University, who was not involved in these studies.

It can improve blood circulation to the brain and have a positive impact on inflammation and the body’s immune response, she told U.S. News, noting the connection between heart health and depression. There may also be intangible benefits such as getting stronger or feeling empowered or gaining a sense of well-being.

Yet another recent meta-review of 41 studies involving 2,265 people with depression found that almost any type of exercise substantially reduces symptoms of depression, The Washington Post reported.

“We found large, significant results,” said study leader Andreas Heissel, an exercise scientist at the University of Potsdam in Germany.

Although more exercise produced greater results, “Something is better than nothing,” Heissel noted.

Small Moves

Jennifer Heisz, a neuroscientist and an associate professor in the Department of Kinesiology at McMaster University in Ontario, Canada, who was not involved in these studies, was even more encouraging.

“Any movement, every movement, every step counts,” she told U.S. News.

“It doesn’t have to be as much as you need for physical health,” she added. “You can get by with half of that, and this is very consistent with the literature.”

Heisz suggested that people try to move a little every day, even if it’s just a five- or 10-minute walk, or a two-minute movement break every half hour for those who sit all day.

“That’s how simple we need to get, especially for people who are not moving at all, and to acknowledge that there is this additional barrier of motivation for people who are suffering from depression,” she said.

One final word: It’s important not to try to treat depression yourself. We can help guide you through different approaches or even recommend other professionals that can help.

If you have thoughts of harming yourself, dial or text the new national suicide hotline number 988 for immediate help.

Progestin-Only Birth Control Slightly Increases Breast Cancer Risk

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Our family practice concierge doctors in Jupiter have heard from some of our patients that they’re concerned about a new study regarding the safety of certain contraceptives.

In fact, many observers think this study’s findings are reassuring, and should not unduly alarm women.

According to the Centers for Disease Control and Prevention (CDC), among women ages 15 to 49 in the U.S., about 14 percent of those using contraception use oral contraception, and around 10 percent use long-acting devices like IUDs.

Contraceptive Risks and Benefits

Since their inception, birth control pills have been associated with various risks to the women who take them.

In 1960, the U.S. Food and Drug Administration (FDA) approved the first birth control pill, Enovid. It combined two types of hormones designed to prevent ovulation: estrogen and progestin. According to Planned Parenthood, it contained far more hormones than were needed to prevent pregnancy, which is why it was also responsible for occasional severe side effects and increased the risk of heart attacks and strokes.

Later forms of the pill, as it came to be called, used much lower formulations, but they are still implicated in a slightly increased risk of breast cancer, heart attack, strokes, blood clots, and liver tumors.

Many see these risks as being outweighed by the benefit of preventing unwanted pregnancies. In addition, studies have found a decreased risk of ovarian, endometrial, and colorectal cancers in long-term users of the pill, as compared with non-users.

Birth control pills are also prescribed for women with excessive bleeding and/or painful periods, apart from their use in pregnancy prevention.

Another UK study of more than 46,000 women who were followed for up to 39 years showed that their use of the pill not only didn’t increase their risk of mortality but also appeared to have increased longevity.

The New Study

Progestin-only formulations in various forms of birth control were thought to lower the risks of complications because estrogen is known to increase the incidence of the most common side effects.

Progestin-only pills thicken the mucus in the cervix, preventing sperm from reaching an egg. One form of the progestin-only pill can also stop ovulation.

“We’ve known for a while that estrogen and progestin birth control pills, oral contraceptives, have a slightly increased risk of breast cancer,” Dr. Jennifer Ashton, a board-certified OB-GYN, and ABC News chief medical correspondent said on “Good Morning America” when the new study was released.

“What we didn’t know is the newer forms of progestin-only pills, IUDs, injectable implants, what their associated risk, if any, was in comparison,” she explained.

The study that made the news last month was published in the journal PLOS One. Researchers in the U.K. analyzed data on nearly 10,000 women who had been diagnosed with invasive breast cancer between 1996 and 2017.

They then compared these subjects’ profiles with more than 18,000 women who did not have breast cancer.

“On average, 44 percent of women with breast cancer and 39 percent of matched controls had a hormonal contraceptive prescription, with about half the prescriptions being for progestagen-only [i.e., progestin-only] preparations,” the study authors wrote.

Explaining the Results

The findings “suggest that the 15-year absolute excess risk of breast cancer associated with the use of oral contraceptives ranges from eight per 100,000 users (an increase in incidence from 0.084 percent to 0.093 percent) for use from age 16 to 20 to about 265 per 100,000 users (from 2.0 percent to 2.2 percent) for use from age 35 to 39.”

In other words, those who use the progestin-only forms of contraceptives have about the same slight risk of breast cancer as women who use the combination pill.

They also found that the longer a woman is off hormonal birth control, the lower the risk.

Claire Knight, a senior health information manager at Cancer Research UK, which provided core funding for the study, told CNN that hormonal contraception is a personal choice, as “there are lots of possible benefits to using contraception, as well as other risks not related to cancer.

“Women who are most likely to be using contraception are under the age of 50, where the risk of breast cancer is even lower,” she explained.

Reassuring Users

Gill Reeves, a co-author of the study and professor of statistical epidemiology at the University of Oxford, told The Washington Post that “it may be reassuring to know that these newer contraceptives that women are using in increasing numbers do not have any untoward effects that might be unexpected. 

“They do seem to behave pretty much like traditional contraceptives,” she added.

Ashton, who was not involved in the study, stressed that it’s important to recognize how slightly the use of hormonal contraceptives raises the risk of breast cancer.

“It’s about individualizing the risk-benefit and option risk for the woman,” she told GMA.

“If you talk to any OB-GYN, they will say, we have a line: ‘Pregnancy is much higher risk than any associated risk with birth control pills or hormonal contraception.’ ”

“For anyone looking to lower their cancer risk, not smoking, eating a healthy balanced diet, drinking less alcohol, and keeping a healthy weight will have the most impact,” Knight told CNN.

All the experts suggest that women discuss the risks and benefits with their doctors.

What to Know About the Newest Migraine Drug

, , Health Basics, Medications, Uncategorized

Our primary care concierge doctors in Jupiter have a great deal of sympathy for our patients who suffer from migraines. It can be a debilitating condition and is often difficult to treat. So we welcome any new drug that can help relieve the pain. 

The latest such treatment is a new nasal spray that the U.S. Food and Drug Administration (FDA) approved earlier this month. In a clinical trial, the drug was found to provide relief from migraine pain in as little as 15 minutes.

According to health experts, nearly 40 million Americans suffer from migraines.

“They often interfere with daily functioning, keeping patients away from their work and unable to enjoy time with their loved ones,” neurologist Leah Croll at the Lewis Katz School of Medicine at Temple University, told ABC News.

“The faster we can bring relief to people suffering from a migraine attack, the sooner we can give them back that lost time,” she said.

What is a Migraine?

A migraine is not technically a headache, but a neurological disorder that includes a constellation of symptoms, with a painful, long-lasting headache at the center. Its main symptom is a severe throbbing pain or pulsing sensation in the head, which feels like a very bad headache, usually on one side of the head, but in a third of migraine attacks, both sides are affected.

It is often—but not always—preceded by what is known as an “aura,” strange tricks of vision that can encompass anything from a blind spot in the vision to flashing or shimmering lights to wavy or zigzagging lines.

Migraines are also usually, but not always, associated with such symptoms as nausea, vomiting, and extreme sensitivity to lights and noises, and can also include a pins-and-needles sensation in the arms and legs or a weakness or numbness on one side of the face or body.

One or two days before the onset of a migraine, patients often experience subtle body signals (called “prodrome”) that can alert them to an upcoming migraine. These changes can include neck stiffness, constipation, increased thirst and urination, food cravings, frequent yawning, and mood swings from depression to euphoria.

It is also possible to have many migraine symptoms, especially the aura, without a headache. The primary signs of a migraine, however, are the extreme incapacitation associated with the headache pain involved.

The Nasal Spray Advantage

According to the National Institute of Neurological Disorders and Stroke, migraines are caused by the activation of nerve fibers in the wall of brain blood vessels. 

Calcitonin gene-related peptide (CGRP) is a chemical messenger in the brain that controls pain and inflammation. The newly approved drug, Zavzpret, works by blocking CGRP’s pain signals, according to its maker Pfizer.

Pfizer says Zavzpret (generic name “zavegepant”) is the “first and only” CGRP nasal spray for treating migraines with or without an aura. A March study published in the journal Lancet found the drug began working to treat symptoms in as little as 15 minutes, offer normal functioning in 30 minutes, and provided some relief for up to 48 hours for 24 percent of migraine sufferers.

The rapid relief Zavzpret provides offers an advantage over existing oral treatments, Dr. Emad Estemalik, a headache specialist at the Cleveland Clinic, told NBC News.

“A lot of patients, when they have migraines, they’re throwing up, for instance, so they may not be able to hold oral medication,” he said. “That’s where an intranasal comes as an advantage.”

Kate Mullin, a board-certified neurologist at the New England Institute for Neurology and Headache who helped conduct the trial for Pfizer, explained to ABC News that at least 60 percent of migraine sufferers also experience nausea, making it difficult to swallow pills.

“You can’t absorb oral medications when you’ve got what’s called gastroparesis of migraine,” she said.

“Your gut pretty much falls asleep and is not in a place to absorb mediations effectively for many migraine sufferers,” she added. “A nasal spray helps bypass the gut altogether to optimize absorption.”

Some Reservations

As with all drugs, of course, there are side effects to Zavzpret.

The FDA listed the following side effects reported by participants during the clinical trial:

  • taste disorders (18 percent)
  • nausea (four percent)
  • nasal discomfort (three percent)
  • vomiting (two percent)

Still, those who treat migraines welcomed the addition of the new drug to the migraine arsenal. 

Elizabeth Kraus, Phar.D., Neurology Clinical Pharmacy Specialist at Corewell Health, told Prevention that while she’s not overly impressed with the 24 percent success rate, Zavzpret may be better for those whose migraines tend to progress rapidly, those who don’t do well with oral medications, and individuals who struggle with severe nausea.

Amit Sachdev, M.D. M.S. medical director in the Department of Neurology at Michigan State University told Prevention that he, too, wasn’t happy with the 24 percent success rate.

“I would like to see a more broad effect, but the current trial results wouldn’t keep me from thinking of this medication [for patients],” he said.

Kraus concurred.

“If I can give someone something that will act fast and have a more lasting effect . . . That’s what I care about,” Kraus said.

The new drug is expected to be released in July of this year.

Live Longer with Blue Zone Foods

Environment, Health Basics, Healthy Living, Lifestyle, Nutrition, Preventative Health, Uncategorized

Of all the diet trends available today, one our primary care concierge doctors in Jupiter can highly recommend is the Blue Zone way of eating: fresh, healthy, unprocessed food, from as close to its source as possible, in meals shared with family and friends.

The term “Blue Zone” was coined nearly 20 years ago by journalist and researcher Dan Buettner in a 2005 National Geographic cover story titled, “Secrets of Living Longer.”

His team of anthropologists, demographers, and scientists had traveled the world to find the world’s longest-living people, and to discover the secrets to their longevity.

Buettner’s team found five seemingly disparate places where the people live exceptionally long, healthy lives: on average, around 100. (The term “blue zone” came from the blue circles the researchers drew on a map during their quest.)

The five places are:

Okinawa, Japan
the Nicoyan Peninsula in Costa Rica
the Seventh Day Adventists in Loma Linda, California
Sardinia, Italy
Ikaria, Greece

More than Diet

Of course, healthy eating is key to a healthy body, but the Blue Zone residents had more than good food on their side. Genetics, as always, plays a big role in how long anyone will live no matter where they are.

Other factors the team found the Blue Zones had in common were:

Natural movement: no marathons or gym visits, just long walks, hiking, gardening, etc.
Hara Hachi Bu: an Okinawan term for eating until they’re about 80 percent full
Plant slant: a preference for plant foods over meat
Grapes of Life: one to two servings of red wine daily (except for the Seventh Day Adventists, who eschew alcohol)
Plan de Vida: or “why I wake up in the morning,” i.e., a sense of purpose
Downshift: controlling stress, a sense of serenity
Belong: participation in a spiritual community
Loved ones first: making family a priority
Close tribe: social connectedness

Blue Zone Meals

The Blue Zone diet, which Buettner details in his latest book, “The Blue Zones American Kitchen: 100 Recipes to Live to 100,” is a cornerstone of the Blue Zone program, and closely resembles the Mediterranean diet, but with even less emphasis on fish and meat.

“The five pillars of every longevity diet, including the Blue Zones, are whole grains, vegetables in season, tubers, nuts, and beans. In fact, I argue the cornerstone of a longevity diet is beans,” he told CNN.

Legumes, in fact, are key, he told The Washington Post. They are rich in fiber, which is key to improving cholesterol and blood sugar levels.

“Figure out how to get a cup of beans into your diet every day,” he told the paper. “Just one cup gives you half of all the daily fiber you need.”

What Not to Eat

And even though the Mediterranean diet includes a certain amount of meat and fish, Blue Zone diets contain little, if any.

“People in Blue Zones don’t eat nearly as much fish as the Mediterranean diet prescribes, only three times a week and only three ounces,” he told CNN. “Meat is eaten only five times a month. There’s no cow’s milk in any Blue Zone.”

Instead, people eat goat and sheep’s milk cheeses such as feta and pecorino, he said.

In addition, “no more than three eggs are consumed per week,” he told NBC’s Today show.

“The Blue Zone eating pattern is 98 percent plant-based foods—whole food-based and high carbohydrate,” Buettner told CNN.

“But only complex carbs, not the simple carbs like salty snacks and candy bars and soda pop. You say carbohydrates and people are horrified, but the healthiest foods in our food system are complex carbohydrates,” he added.

Time and Place Count, too

In keeping with the other factors that affect longevity, sharing meals—especially with family—is another component. While our busy schedules might not often permit this, Buettner says it’s worth doing as often as possible.

“Families that eat together tend to each much more nutritiously, they eat slower, and there’s good research that children have fewer issues with disordered eating if they’re eating socially,” he told The Post.

And it turns out the recent trend toward intermittent fasting appears to have some validity. Buettner reports that people in Blue Zones tend to eat earlier in the day.

Okinawans, for instance, traditionally eat a big breakfast and a moderate lunch.

“They don’t even have dinner,” he told the paper.

And the Seventh Day Adventists in Loma Linda would eat a big breakfast at 10 a.m. and a moderate lunch at 4 p.m. “And then they’re done for the day,” he said.

Small Moves

Of course, there’s more to the Blue Zone lifestyle than just food, as we mentioned earlier. Three of the five Blue Zones are isolated, which forces tight social connections and a lot of walking.

“Walking is one of the best forms of exercise and you can do it without thinking about it,” Buettner told Today, suggesting that people think about adopting a dog as a strategy to encourage regular walks.

“We’re all looking for magic dietary pills or serums or supplements, but you see none of that in the Blue Zones,” he said. “It’s mostly small things driven by the right environment,” he said.

That includes social connections.

“We’re genetically hardwired to crave social interaction, and when you don’t have it, there’s a level of subconscious stress that grates away at you,” he added.

Nature Can Heal in More Ways Than One

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Humans evolved in the natural world. We may have retreated to caves or huts to protect ourselves from the elements, but we spent much of our time outdoors, hunting, gathering, cooking, telling stories, and so on. Our lives these days, though, are largely spent cut off from nature.

This way of life has sparked a wealth of studies showing that our loss of contact with nature—dubbed “nature deficit disorder”—has a real impact on our physical and mental health.

So our primary care concierge doctors in Jupiter weren’t too surprised to learn of a new study published this month in the journal Occupational & Environmental Medicine, which found that enjoying nature up to four times a week reduced the odds of needing mental health medications by 33 percent.

It also reduced the odds of using blood pressure pills by 36 percent and asthma medications by 26 percent.

The Study

Researchers interviewed about 6,000 people who live in large cities in Finland, asking about their access to and use of green and blue spaces, including parks, zoos, rivers, lakes, or the sea. 

They also asked subjects whether they could see views of nature from their homes, how often they spent time outdoors as well as how much they exercised while outdoors.

The study also accounted for other possible factors such as traffic-related outdoor air pollution and noise, which have been proven to have an adverse effect on health.

Respondents were then asked about their use of medications for depression, anxiety, high blood pressure, asthma, or insomnia, and correlated these with time spent in nature.

As noted above, the results were markedly better for those who were regularly exposed to green or blue spaces. Notably, those who lived in areas with a lot of green spaces or who simply looked at nature from their windows showed no improvement in any of these categories.

“Frequent green space visits, but not the amounts of residential green or blue spaces, or green and blue views from home, were associated with less frequent use of psychotropic, antihypertensive, and asthma medication in urban environments,” the study authors wrote.

Confirming Prior Research

Numerous earlier studies have found significant benefits from spending time in nature.

One meta-review of 143 other studies published in the journal Environmental Research, for example, found that people with access to green space generally had a slower heart rate, lower blood pressure, and fewer blood levels of the stress hormone cortisol. Researchers also found significantly fewer cases of diabetes and lower rates of mortality from heart disease in the group regularly exposed to nature.

An American Institutes for Research (AIR) study in 2005 found that sixth-grade students who attended three outdoor education programs showed marked improvement in conflict resolution skills.

Another study in China in 2013 involved 60,000 children between the ages of two and 17. It showed that regular exposure to nature, or “greenness” around their schools, reduced the incidence of attention deficit/hyperactivity disorder (ADHD). A more recent study at the University of Illinois produced similar results.

And a 2016 study of nearly 100,000 women conducted over eight years found that having access to the greenest space not only improved the subjects’ mental health but also reduced their death rate by 12 percent.

Nature Deprivation Hurts

Author Richard Louv coined the phrase Nature Deficit Disorder (NDD) in his 2005 book “Last Child in the Woods: Saving Our Children from Nature Deficit Disorder.” In it, he argued that elements of our urbanized lifestyle, including few natural spaces, a car-focused culture, more screen time, changes in the perception of risk (e.g., fear of “stranger danger”), less leisure time, and increased time pressure from work or school, combine to decrease or even eliminate contact with nature for both adults and children, according to the National Institutes for Health (NIH).

“The average young American now spends practically every minute—except for the time in school—using a smartphone, computer, television, or electronic device,” Tamar Lewin reported in a Kaiser Family Foundation study on the subject.

According to the Children and Nature Network (C-NN), which was co-founded by Louv, an expanding body of scientific evidence suggests that nature-deficit disorder contributes to:

  • diminished use of the senses
  • attention difficulties
  • conditions of obesity, and
  • higher rates of emotional and physical illnesses

Make the Connection

Unfortunately, to get back to nature, you may need to make a specific effort, because in our harried lives trapped indoors, focused on our screens, we have very little time for real relaxation.

Therefore, it’s often necessary to add nature breaks to our schedules the same way we schedule everything else.

One way is to undertake the Japanese practice known as “forest bathing,” or shinrin-yoku. As Kaiser Permanente’s’ online Thrive explains, “Heading out to a heavily wooded area isn’t required. You could take a trip to a nearby park, your favorite local trail, the beach, or any natural setting. Just be sure to turn off or silence your phone or other devices.”

Psychology Today explains, “Forest bathing is an antidote to pinging distractions, impending deadlines, and never-ending obligations . . . . The idea is to immerse yourself in a natural environment and soak up the many health benefits of being in the green woods.”

However, you manage it, for the sake of your overall health we recommend you take the time to reconnect with the natural world as often as possible.

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