Right now, most of the US is going through a heatwave.  This can be just as dangerous to your health as a bitterly cold blizzard.  You need to take steps to ensure you and your family remain safe during this time.  Here is a previous KaiMD blogpost on the subject.

Here are some tips that you need to make sure you follow:

• Stay AHEAD of your thirst.  Drink plenty of water!  By the time you are thirsty, your body has already lost a significant amount of water.  As you get older, your sense of thirst diminishes and you may not actually feel like you need water, but it is important to drink anyways.  We all lose water through sweat and when it is hot, we lose a lot more water at a rapid pace.  Limit your caffeine and alcohol intake as these beverages can cause more loss of water.  Fresh fruits and ices are a delicious way to stay hydrated and cool.
• During a heatwave, air conditioning is a must.  It is unsafe to just use fans to cool off.  When your body reaches dangerously high temperatures it can shut down, leading to heat exhaustion or even worse, heatstroke.  When these occur, you may need to be hospitalized and organ failure can occur.  Taking a cool shower, jumping into the ocean, lake or pool, or placing cool wet towels behind your neck can cool your body down.
• Avoid staying outdoors for prolonged periods of time and avoid outdoor exercise.  Go to an air conditioned gym instead.  If you must be outdoors, make sure to stay in the shade or a place where you can go indoors with air conditioning in case you feel overheated.
• Check in with your elderly relatives.  Give them a call and make sure they are OK.  Encourage them to drink water and turn on the air conditioner.
• Protect yourself from the sun.  Make sure to use SPF 30+ sunscreen and lip balm at all times when you are outdoors.  Wear a hat or visor and sunglasses.

I see many sporting injuries in my practice.  Often these are fall into some major categories and my recommendations on how to prevent yourself from injury:

• Weekend warrior: who are essentially sedentary from Monday to Friday and decide they want to engage in high intensity sports on the weekends.  This usually involves some serious injuries to muscles and joints.  The Fix:  Be a weekday AND weekend warrior.  Engage in some form of exercise during the week.  Ideally, this should be something that is similar to your sport.  For example, if you play basketball, run a few miles on the treadmill.  You’ll see your game performance will be much better!
• Cardio fanatics:  Repetitive stress injuries from people who do the same exercise (working a limited number of muscles and joints) again and again with little rest in between.  Distance runners and cyclists usually fall into this category  The Fix:  Cross train.  One group of athletes I almost never see in my practice are triathletes.  I recommend doing something different each day for example, one day run on the treadmill, the next day use the elliptical machine, and the day after do some cycling or swimming.  This helps you work different muscles (which leads to more stability) and allows your muscles and joints to rest in between intense workouts.  
• Aging athlete:  This is someone who may have played sports in high school or college, but has not played for years (maybe gained 20 or 30 pounds over the years) and feels a sudden inspiration to play again with people half his/her age.  The Fix:  you should gradually work up to the level of intensity desired.  Start off slow and track your goals each week.  For example, if you were a track star in high school but haven’t run on pavement for years, start off with some brisk walking for 2 weeks, then advance to a light jog, and then increase the distance.  As mentioned above, cross training is important for this type of athlete.
• Gym watcher and doer.  This is someone who goes to a gym and watches others do exercises and then tries to do them himself without personal instruction.  He may have read about the exercises in an illustrated magazine but has never done them himself.  Injuries usually result from improper form or using excessive weight that is not matched to his physical ability.  Many workouts with weights need instruction and guidance of a trained professional.  You wouldn’t try to learn how to drive a car by just reading books or watching people driving, would you?  The Fix:  Hire a trainer or enlist a friend who works out regularly at the gym and have them show you how to do the exercises and critique your form.  If you feel severe pain in your muscles the next day, that could be a sign you may be doing the exercises improperly.  With any exercise, always start out with the lowest resistance/weight when you first start to do it and build up gradually to heavier weights/resistance.

In my practice, I am finding many people who are having trouble sleeping.  The common factor is the use of electronic devices.  With tablets, cell phones, and TV’s every home fighting for our attention, our minds are finding it difficult to relax and recharge.  Studies have shown that there are light sensitive receptors behind our eyes that help our brains decide whether to get up and tackle the day or relax and prepare for sleep.  With many electronic devices emitting blue ray light, which are the rays which are found to stimulate these receptors the most, and screens so bright our bodies can be easily fooled into thinking it’s daylight.  Ever wonder why you feel a “second wind” after using your tablet even though you may have initially been exhausted.  In particular, TV’s and LED lights in our lamps contain much more blue ray lights than their predecessors.  While technology does simplify our lives in many ways, we need to make sure it is not affecting our health and wellness negatively.  Here are some tips to help you get better sleep.  Think about how even an extra half hour of sleep would make you feel the next day.  Will you be more productive?  Will you be less hungry?  Will you have more energy to run an extra 10 minutes?  Indeed, sleep has many benefits!

• Keep electronic devices out of the bedroom.  If you must have a phone for emergencies, turn it to vibrate and place it upside down on your nightstand.
• Avoid using electronic devices one hour before bedtime.  A Kindle or a reading device that does not emit strong light is fine.
• Start dimming the lights in your home an hour before bedtime.  I strongly recommend putting dimmer switches on your lamps and light fixtures.
• Avoid any television shows or internet media with intense topics.  Some people can get emotionally distressed after watching images of wars, terrorism, or disasters.  This can translate into restless sleep or worry that can affect initiation of sleep.
• Set a reverse alarm.  This is an alarm that you set on your clock or phone for a specific time each night after which all devices must be turned off and lights dimmed or turned off.  This can be quite effective if you are the type of person who likes to surf the web from one page to another or “binge watch” TV series.  Hours can go by without realizing it quite easily!   An alarm would help you to set limits.

Father’s day is a time to thank our dads for the sacrifices they made to make us who we are today.  It’s also a time to talk about men’s health.  Here are some facts that you should be aware about  (unfortunately, it’s mostly bad news but you can change most of it!):

• Men generally live shorter lives than women.
• Men in the US are less likely to have health insurance coverage than women. If you don’t have insurance coverage and live in the US, find out if you qualify here.
• Men are more likely to smoke, drink excessive amounts of alcohol, and work in dangerous professions such as firefighting, mining, and  law enforcement.  It’s important that you stop using tobacco products and drink alcohol responsibly (<2 drinks in 24 hours).
• Men have higher rates of heart disease.  Some of this can be attributed to uncontrolled chronic issues such as high blood pressure, diabetes, and high cholesterol.  Men are less likely to have regular physicals and routine medical follow-ups that can detect and treat these issues before they cause more serious problems. Get your annual physical this month!
• Prostate cancer is the second most common cause of cancer-related death in men.  Discuss prostate screening with your healthcare provider.

The phrase, “one size fits all”, does not apply to health screenings.  Researchers are finding that certain ethnicities have higher prevalences of diseases and that specific screening which takes ethnicity into consideration is important.  Here are some recent guidelines which I incorporate into my practice.

• Asians and Asian Americans:  BMI (Body Mass Index) cutoffs are lower.  Overweight is considered a BMI 23-26.9, above 27 is considered obese.  For Caucasians and African Americans, overweight is considered a BMI 25-29.9, and above 30 is considered obese.  What this means is that an Asian person with a BMI of 23 should be screened for diabetes, hypertension and hypercholesterolemia yearly and encouraged to lose weight through diet and exercise.  Asians and Asian Americans are at higher risk for developing diabetes than other ethnic groups, even if they don’t appear to be “overweight” physically.  The cause is not known, but experts cite environmental and genetic factors.  Here is a link to the Joslin Diabetes Center, Asian American Diabetes Initiative about the topic.
• Hispanics:  As with Asians, Hispanics are at much higher risk of diabetes.  Here is a link to the American Diabetes Association with information on screening and prevention.
• African Americans:  Colon and prostate cancers often appears earlier in this population.  Current recommendations are to start earlier screening from the America College of Gastroenterology and the American Cancer Society are to start screening at age 45 rather than 50 for other populations.  Screening for colon cancer usually consists of a procedure called a colonoscopy, while prostate cancer screening consists of an educated discussion with the healthcare provider about the possibility of tests such as a PSA (prostate specific antigen).  Breast cancer incidence in African American women is lower, but mortality from dying from breast cancer is higher.  This is thought to be due to less screenings performed for numerous reasons.  Here is a great discussion about breast cancer in different ethnicities from the Susan G. Komen website.  High blood pressure is also more common among African Americans, though we are not sure exactly why.  That means blood pressure screening is very important.  Early detection is important, here is a great site from the American Heart Association about the topic.
• Ashkenazi Jewish Population:  Many genetic diseases are common in this population.  These are generally of concern when couples try to conceive.  For example, Tay Sachs disease is a fatal disease that occurs when a child is born from two parents who each have one gene for the disease (the chance is 25% for each child conceived).  Here is a link to find out more about this and other diseases in the Ashkenazi Jewish population from Albert Einstein College of Medicine.

It is always important to ask your health care provider about these and other health screenings on your annual physical exam.  If you have a family history of any diseases you may also be at higher risk and should be screened for those.  Be sure to let our provider know about them.