The ONE thing you should do right now

March 23rd, 2020

We are in an unprecedented medical situation in the US right now.  COVID-19 is seeping into every town.  Our country has vastly underestimated the power of the coronavirus.  Unlike the flu or other cold viruses, after infecting people COVID-19 can manifest with mild symptoms at first.  Most people think it’s just a “head cold” or allergies, so they may not feel the need to stay home but during this time they can spread it to other people with even a handshake.  Over a few days, these people can become ill in varying degrees ranging from flu-like symptoms to shortness of breath requiring them to be on a ventilator.

You may think “I couldn’t possibly have the coronavirus, I feel fine”, but if you infect others, they may have severe complications which could land them in the hospital and add more stress to the already overwhelmed healthcare system.  Many hospital across the nation are experiencing unprecedented number of patients, many of whom require ventilators to help them breathe.

Right now, to help your fellow Americans and all of mankind, PLEASE STAY HOME AS MUCH AS POSSIBLE.  Do not go to buy groceries more than necessary, wash your hands and clean all common surfaces in your environment (door handles, faucets, etc.).  Here are some other tips to help stay safe if you do go outside your home.

COVID-19 and How to Protect Yourself

March 2nd, 2020

As you may have heard, we are having a global health crisis caused by a virus known as COVID-19.  This virus in the Corona-virus family is thought to be spread by human to human contact, mainly from respiratory droplets and possibly also from urine and feces.  The main routes of entry into our body is through our mouth, nose, and eyes.

Here are some steps that you can take to protect yourself from infections during this time:

  • Wash your hands!  Make sure you wash with soap and warm water.  The proper duration of an effective hand cleaning is about the time it takes to sing the “Happy Birthday” song twice.  This so so important, especially before eating or touching your face.
  • Limit unnecessary bodily contact with other people.  In times like these, we should be reducing kissing/hugging/handshakes as these can easily transmit viruses.  Try other forms of greeting such as bowing, “namaste” with hands together, and waving.  I recommend placing hand sanitizers in by the doorway in your home, to remind yourself to use it after you entering.
  • Avoid touching things that many other people have touched with your bare hands.  If you do, wash your hands or use hand sanitizer afterwards.  Door knobs, restaurant menus, toilet flushers, subway poles, airline arm rests/tray tables/seat belt buckles, and pens at banks are some examples.
  • Get adequate rest each night.  Your immune system needs adequate rest to be strong enough.  Here are ways to get better sleep.  If you need discipline, set up your phone alarm to ring at a certain time each night.  When the alarm rings, all electronic devices and lights must be turned off and you must get ready to go to bed.
  • If you are flying on an airplane, here are tips to stay healthy.
  • Get your flu shot if you have not gotten one this season (after Sept 2019).  No, it’s not too late!  We are still at the tail end of a very bad flu season.  Flu symptoms and COVID-19 are almost identical.  If you get the flu, you may panic and think you have COVD-19.  Also, the flu could worsen your immune system and make you more likely infected by other germs afterwards.
  • If you are over 65, get your pneumonia shots (Prevnar-13 and Pneumovax 23).
  • Eat a balanced diet with plenty of different colored fruits and vegetables.  Each color represents a different vitamin.
  • Exercise regularly, in moderation.  Exercise can mobilize white blood cells, which are like policemen in the body, to different parts of the body.  Don’t over-stress your body with intense workouts as that could actually reduce your immune function.
  • Prioritize sleep.  This is so important!  Sleep is really one of the most important ways our immune system gets stronger.
  • Avoid extreme dieting/excessive weight loss.  I am a big proponent of trying to reach your goal BMI, however this is not the right time to be losing too much weight.  If you do get infected with COVID-19 and you have fevers and loss of appetite you will likely lose weight and that could be harmful if your weight is already on the lighter side.
  • Don’t smoke or vape.  All respiratory illnesses are worsened with any type of inflammation caused by these chemicals in the lungs.
  • Avoid touching your face with unclean hands.  If you feel an itch that you must scratch on your face, use a clean tissue.
  • Stay hydrated and moisturize.  When your nasal passages dry out, it can cause cracking and irritation which allows viruses into our body.  Just as you would apply lip balm to your lips in the winter, put a tiny amount of vaseline around your nostrils to keep them moist.
  • Reduce stress, meditate.  When your body is stressed out, the immune system function is reduced.  Try to do some meditation, and take your mind away from fearful thoughts.  Avoid watching or reading too much of the news stories, as some of them can be false or paint the worse case scenario.
  • Laugh, interact with friends and family (perhaps virtually, depending on the recommendations about acceptable distance at the time you read this).  A positive outlook can certainly improve immune function.
  • Wear glasses.  If you normally wear contacts, change to glasses.  If you don’t wear glasses, consider using a “blank” set of glasses. Ideally the larger the frame size, the better.  The eyes are a way for germs to enter our body, by having a barrier, you can reduce droplets from getting in contact with your eye.  Also, wearing glasses can be a reminder not to rub your eyes or touch your face.
  • Postpone elective surgeries, avoid going to medical offices if not absolutely necessary.  Many doctors offices now have the capability to do “virtual video visits” where you can speak with you health care provider over video chat.  You really don’t want to be sitting in a waiting room with many other sick people right now.  Be sure not to touch the waiting room magazines!
  • Make sure your chronic medical conditions are under control.  For example, if you have diabetes, make sure your sugar levels are controlled.  If you have high blood pressure, make sure you are monitoring your blood pressure closely at home.  If not, you may need to adjust your medications or diet.  Check in with your medical provider (ideally through a virtual video visit and not in-person), and ask to review your conditions, medications, and symptoms.
  • If the weather is nice, plan gatherings outdoors.   Open spaces are not conducive for viruses to spread from person to person.  The wind current would disperse particles far and wide.  If you must gather indoors, open the windows to allow for fresh air to circulate.  Avoid gathering in tight spaces.  The recommended distance for ideal protection is a six foot radius.  For social events, consider patios, terraces, or backyards.
  • Take Vitamin D3 1000 IU’s per day.  Some studies have shown a correlation between low levels of Vitamin D and reduced immune function.  Vitamin D is usually activated by our body from sun exposure.  During the cold and dark winter months, we are more likely to get sick with the flu and cold viruses because of this.  If you do have a sunny day, go for a walk for at least 10 minutes, that is another way to get adequate Vitamin D.
  • Do not take Vitamin C.  There has been no benefit shown for this vitamin in relation to preventing colds/flus.  In fact, taking excessive Vitamin C can cause kidney stones and other health issues such as heartburn and stomach ulcers.
  • Humidify your home.  Dry air leads to skin and nose irritation.  Here are ways to get more moisture in your home.
  • Moisturize your face, especially your nasal passages and skin on your face.  When your skin gets dry, it cracks and creates openings for viruses to enter.  Use a warm moist towel to add extra moisture to your skin.
  • Make ginger tea and drink daily.  In traditional Chinese medicine, ginger boosts “Yang” energy which can improve immune functioning during winter months.  Simmering ginger tea on the stove will also add humidity to your home.
  • Hydrate, hydrate, hydrate!  Drink enough water/tea/soup.  Your urine should be clear and almost colorless. If it is apple juice or tea colored, you are not well hydrated.
  • Wipe down your electronic devices regularly.  Our phones and tablets can be quite filthy considering how many times we handle them each day and lay them down on all surfaces.  Keep a bottle of glass cleaner spray and paper towels on the counter and remember to clean your devices.
  • Wash your clothes after coming in from outside.  This is more important for shirts as your sleeves are more likely to get contaminated compared to your pants.
  • Clean your phone.  We often forget that we touch our phone so many times in a day.
  • Don’t panic!  Anxiety worsens our immune system function.  Just use your common sense.  Do not let the fear of the virus overwhelm you or make you feel isolated.  Use other forms of electronic communication to stay in touch with loved ones.  Try to continue doing things you normally would, with just a few extra precautions.

10 Benefits to Eating a Plan(e)t-Based Diet

April 23rd, 2019

In the 1980’s I remember the commercials that asked “Where’s the beef?” and “Beef, it’s what’s for dinner!”  They promoted meat as a primary source of protein in our diets and got us thinking that no meal is complete without meat, preferably red meat.  As we are learning more about how diets can affect our health and how our food choices can affect the environment, we are realizing that plant based diets are both better for the earth and for our health.  Here are 10 reasons why you should prepare more plant-based meals

  1. Plants are easier to cook.  Almost all meats take more time to cook.  In our busy schedules, cooking plants and plant based proteins take much less time.
  2. Less concern for salmonella.  Bacteria such as salmonella can exist on poultry but not so easily on vegetables.  Cleaning up after preparing chicken requires thorough rinsing of the cutting board, knives and cooking bowls with hot soapy water.  Cleaning up after cooking vegetables is a snap, just some warm water and minimal soap, with no risk for bacterial contamination.
  3. Plants are cheaper.  You can easily prepare meals with about 50% less money when preparing plant-based meals.  If you are on a budget, going plant-based would be the way to go.  Even when you eat at a restaurant, the vegetable options are almost always less expensive than meat or fish dishes.
  4. Vegetables, herbs and fruits are delicious and provide natural flavors.  I rarely hear people say that the “boiled chicken was so flavorful.”  Most meat intrinsically has little flavor.  In contrast, most vegetables and herbs have strong flavors that can stand on their own.  Not convinced?  Try roasting some fennel in the oven and drizzle some high quality extra virgin olive oil on top and a sprinkling of sea salt.
  5. Vegetables are a great source of fiber and can actually LOWER bad cholesterol.
  6. Ounce per ounce, vegetables take up more room in our stomachs without providing a lot of calories.  Granted, I realize that french fries are also plant-based, but what I am talking about is eating healthy plant-based foods such as salads, roasted vegetables, and stir fries with minimal oil.
  7. Longer shelf life.  Most meats spoil within a few days after you buy them.  On the other hand, vegetables such as onions, sweet potatoes, and carrots can easily last a week.  Frozen vegetables can last months and are so easy to prepare.  There are even some packages of frozen vegetables that you can microwave in the bag.
  8. Plants are a blank slate.  Add your favorite seasonings from any cuisine.  Make it spicy with curries, or add mediterranean seasoning.  They are very versatile.
  9. You can grow your own food!  Gardening is amazing exercise and provides a connection between you and your food.  You can be sure that there are no chemicals or pesticides when you grown them yourself.  By growing plants, you will also be removing carbon from the atmosphere and adding precious oxygen back to the world.
  10. You will feel better!  Many studies have found that eating meat can cause inflammatory chemicals called cytokines to form in our body.  Some people who have switched to plant-based diets have noticed that their joint inflammation, irritable bowel, and even depression have noticed their symptoms improve dramatically.

Try a few plant-based diet this week in honor of Earth Day.  If you’re not good at cooking, here are some suggestions on how you can eat more delicious plant-based food.  Plants, it’s what’s for dinner!

Alcohol 2019

April 17th, 2019

In previous blogs, I mentioned that alcohol can be good to raise your HDL, “good” type cholesterol, which may lead to a reduction of risk in heart disease.  This past year, a global study on alcohol habits sponsored by the WHO (World Health Organization) found that alcohol is a significant contributor to death and suffering worldwide from all causes including car accidents, accidental falls, osteoporosis, cancers, obesity, suicide, and mental illness, just to name a few.  So I pose two questions:  Do the “heart healthy” benefits of alcohol outweigh the massive list of illnesses caused by alcohol?  Should we be continuing to consume alcohol as a “medication” thinking it will prolong our lives?

If you look at the study, we should not be drinking alcohol period.  The increased risk of cancers (including all the major cancers such as colon, breast, prostate, stomach) alone is enough to negate the theoretical lives saved from heart disease by even modest drinking.  Hypothetically, if alcohol was a drug that was presented in front of the FDA today as a newly discovered drug to prevent heart disease, it would by no means pass their standards.  Sure, you may not get a heart attack in 10 years, BUT you will die in a car accident from excessive drinking in just one night, or you could die a miserable death from liver cancer at any point.  I can just imagine the TV commercial would be hilarious, and the side effects would go on for at least 10 minutes.  I would say, at this point, if you are drinking alcohol (in moderation, of course) because you enjoy it, that is fine, but if you have a family history of any cancer and want to reduce your risk, then I would say it may be prudent to remove alcohol from your life.  However, if you do not enjoy drinking a glass of wine each night and are doing it solely because your healthcare provider told you it would be helpful to raise your HDL, I would recommend you stop now.  I’m glad there has been new studies shedding light on this serious health issue, which has largely been ignored.

Antibiotics and the Looming Disaster

April 7th, 2019

The New York Times reported in an article titled, “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy” on the front page today that a new fungus called Candida auris is causing several deaths worldwide.  This could be what the medical profession has been dreading for the past 50 years, an antibiotic resistant microorganism for which we have no arsenal of weapons to fight.  How did we know this was inevitable?  Right now, antibiotics are overprescribed with approximately one in three prescriptions considered unnecessary.  In addition, much of our food supply has been tainted with antibiotics.  Animals raised for food are often susceptible to infections, so they will often be given antibiotics even if they aren’t sick.  How does this translate into antibiotic resistance?  It’s all a matter of numbers.  When you kill 99% of the bacteria with antibiotics a small number will develop resistance to that medicine and multiply.  Magnify this by the number of people taking antibiotics and how much we can easily travel from continent to continent and we have a recipe for disaster.

Even worse, there have been no new antibiotics developed in the past 10 years and there doesn’t seem to be any new development to fight the resistant microorganisms.  What can we do about this looming crisis?  Here are some things you can do.

  • Don’t take unnecessary antibiotics.  Cold and flus are caused by viruses and antibiotics do NOT work on them.  Some people think that because they took a friend’s Z-pack last time they had a cold and “miraculously got better really fast” that the antibiotics had anything to do with it.  If they had been given placebo (or candy), they may have recovered just as quickly.  The perception that if a pill is a prescription, it is automatically “stronger” is a fallacy.  Do not pressure your healthcare provider into prescribing antibiotics.  If you health care provider prescribes an antibiotic, ask him/her if it is really necessary.  In some healthcare settings such as urgent care settings, some providers have gotten so used to prescribing unnecessary antibiotics for colds because they have become tired of arguing with patients and would rather just prescribe it.  This is a sad situation that many hope will be changing.  I have seen in my own practice, patients who become very irate when they don’t get their “Z-pack”.  Instead, ask the provider what other things you can take to feel better.  Maybe ask the provider if you could check back in 3 days and be reevaluated if things aren’t better.  As a rule, most sinus infections, coughs, and sore throats do not require antibiotics.
  • Eat certified organic, antibiotic-free foods.  It’s shocking how much antibiotics are being given to livestock and farmed fish.  These antibiotics ABSOLUTELY get introduced into our bodies when we eat them.
  • If you are prescribed antibiotics, take the entire course as directed by your healthcare provider.  Do not stop because you feel suddenly better.  Resistance is more likely to occur when you don’t eradicate enough of the bacteria.  Also, do not save the antibiotic pills for a future infection. I have had many patients who said they did this.  Antibiotics can not be taken without proper medical supervision.
  • Discard antibiotics appropriately.  Unused pills should never be thrown in the garbage or flushed down the toilet.  Many studies have found antibiotic resistant bacteria in fish living in waters contaminated by sewage likely because of the introduction of these chemicals.  Instead, bring the leftover meds to your local pharmacy or healthcare provider office.  Both of these places will have proper medication disposal systems that won’t pollute the environment.
  • Increase the “good” bacteria in your body.  Here is blog on probiotic foods.
  • Stay out of the hospital.  Many resistant bacteria start off in hospitals.  They can spread easily via surfaces such as doorknobs.  No matter how clean a hospital is, there is always a potential for coming in contact with resistant bacteria each time you enter a hospital.  Try to limit unnecessary visits to hospitals (social visits).  Does someone really need 20+ family members visiting their loved one?  It can also be stressful for person who is sick as they feel obligated to thank each of their guests.  Save the visits for after the person goes home.  If you are on an immunosuppressant medication for an autoimmune disorder (IBD, psoriasis, rheumatoid arthritis, MS, lupus, etc.) you absolutely should not go to hospitals if you do not need to.  As an alternative, set up a “virtual visit” with your loved one via video chat, or maybe create a video card they can see on their phone.
  • If you do go to visit someone in the hospital, check in with the staff on duty first.  If there has been a resistant bacteria detected on your loved ones body, you may need to wear gown, gloves, and possibly a mask.  I would also recommend washing the clothes you wear immediately after you get home.   Use hot water and high heat dryer setting.
  • Avoid bringing home items from the hospital.  Some people bring home the flowers and balloons they get from visitors.  Please avoid doing so, as they may have been contaminated.  I recommend leaving those items at the hospital with the nurses who have provided you with care.  If you brought clothing to the hospital, make sure you wash them thoroughly after you get home.