A recent study from the University of Buffalo cited in Men’s Health, found that smokers who ate more fruits and vegetables tended to smoke less and were three times as likely to quit smoking than their counterparts.  Another observation is that they also waited later in the day to have their first smoke.  It is believed that fruits could alter the taste buds so that the taste of tobacco is no longer pleasurable, like when you drink orange juice after brushing your teeth.  Another thought is that eating fruits satisfies hunger, which smokers may misinterpret as being a need to smoke.  While I’m not sure increasing your intake of fruit can replace other treatments for nicotine dependence, it is always good to get the antioxidants in fruits to counteract the carcinogens in tobacco.  Very few people in the U.S. get the recommended 3-5 servings of fruits and vegetables per day.  This is yet another reason why we all should.

I have many patients tell me they know they need to get more exercise, but can’t get motivated to do it.  As the New Year has just begun, this is a great time to start new healthy habits and keep them!  Here are some tips to keep the momentum going.

• Workout with a friend, your partner, or your kids.  You get the benefit of spending quality time together and burn calories together.  This also makes you accountable to someone else.  Its easy to make excuses for yourself, but hard when you have to make excuses to another person.
• Tell yourself “just 10 minutes”:  A workout does not need to be an hour long to be effective.  We all find ourselves between obligations like work and dinner with less than an hour, and it is easy to make an excuse that the time would not be enough for a decent workout.  I believe that “every bit counts” no matter how short the exercise time.  You will be surprised how much exercise you can do in 10 minutes!
• If you are feeling tired, exercise may be the last thing on your mind.  Don’t let that be an excuse.  In fact, you will feel more energized after a workout.  If you need a boost, drink a cup of green tea, listen to a motivational song (create a playlist on your iTunes for just those moments), or splash your face with cold water to get your energy level up.
• Cold weather doesn’t mean you cannot get exercise.  Just because you usually run outdoors, and you don’t have a treadmill at home does not mean you can’t burn fat.  Crunches, push-ups, sit-ups, step aerobics, and yoga can all be done in your living room.
• During your lunch break, find a stairwell in your office and walk up and down for thirty minutes.
• Update your workout gear.  A new set of sneakers or perhaps bluetooth headphones will get your running.
• Keep a gym bag by the door with all your workout clothes and sneakers.  This will make it even more convenient for you to go to the gym.
• Download workout apps.  There are tons of apps that can track your run, workout, and challenge you to do more.  Some even allow you to compete against other users.

There is a law in physics that a body at rest tends to stay at rest and that a body in motion tends to stay in motion. This is certainly true with the human body.  So keep moving!

The tragedy that occurred in Newtown, Connecticut last week has stirred strong emotions and a sense of tragedy in the U.S.  There have been too many instances of the same type of seemingly non-sensical mayhem to be just a coincidence.  Though some call the shooters “loners” or social outcasts, we must look to why these individuals needed to turn to violence and self-destruction.  As we are delving into the cause of this recent massacre, I am reminded about how little mental health support is available right now.

In my years of practicing, I have found it appalling that there are so many barriers to the few mental health providers practicing in our country.  Many do not accept insurance, and conversely many insurances do not cover psychotherapy without loads of red tape.  I remember having a patient who had just lost her job, was in the midst of a messy divorce, and had the added responsibility of taking care of three children and her ailing mother.  She had a panic attack that day and came to see me because she felt there was nowhere else to turn for help.  A social worker in my office tried finding a psychiatrist for her to see, but the earliest appointment was months away.  Even if she was able to get an appointment, how far along do you think the follow-up appointments would be? Certainly, this was not the best situation. I ended up treating her with anti-anxiety medications and scheduling multiple appointments just to talk about her problems.  My social worker also took time out of her busy day to comfort her and called to check on her daily and the patient did finally get to see a psychiatrist three months later.

The sad realization is this:  if she had a heart condition, stomach ulcer, or cancer, there were plenty of resources and she could be seen in a timely manner.  For mental health, there is a disproportionate lack of providers and centers where care can be coordinated with social workers and case managers.  As the recent tragedy in Newtown illustrates, adequate access to mental health care is just as important as other public health issues.  People suffering with anxiety, depression, bipolar disorder, and schizophrenia among others, need better access to mental health providers.  Part of the blame, I believe is that the spectrum of psychiatric illnesses are still stigmatized in our society.  Many people find it difficult to understand what it is like to suffer from illnesses such as depression.  Trust me, it doesn’t mean someone is merely “lazy” or doesn’t have motivation in life.  It is a real chemical alteration in the brain, just as real and concrete as finding atherosclerotic plaques in the coronary arteries of someone with a heart attack.
It will take a long time for us to recover from the recent upsetting events.  Out of despair often comes hope.  I sincerely wish that this will be a wake-up call for the U.S. Government to realize that the lack of access to timely and cost efficient mental health services needs to be addressed immediately.

In my office, I perform a nasal swab which can test for influenza A and B with results in less than 10 minutes.  So far, I have confirmed several cases of the seasonal flu already, with the earliest in mid-October. This is not a good sign for the coming months.  Usually, the flu season does not begin until January/February.  As people head home to their family gatherings for the holidays and crowd into stores shopping, the flu epidemic will likely be devastating this year.  Fortunately, the strains that we are seeing have been incorporated into the flu vaccine developed for this year.  The key is to make sure everyone gets their flu shot.  Flu shots are widely available and still in full supply.

The flu is often spread among children in school, who then bring it home to their family members.  Make sure you teach your children good hand hygiene and to cover their mouths with their forearms when they cough.  Most importantly, make sure that all your children over the age of 6 months get their flu shots.  If your child is sick with the flu, keep him or her at home to prevent the spread to others at school.

There is a medication that can ease the symptoms of the flu called Tamiflu (oseltamivir).  This prescription treatment can reduce the severity and duration of the flu by and average of one day.  However, it must be started between 24 and 48 hours of the first sign of the flu.  It is important, especially if you have not gotten the flu shot, that if you do experience the first signs of the flu, such as severe muscle aches, tiredness, sore throat, that you contact your primary care doctor immediately so that he/she can assess if Tamiflu should be prescribed.

Protect yourself from the flu by keeping your immune system healthy.  Get adequate sleep, drink plenty of water, exercises regularly, and manage your stress.  Be sure to wash your hands frequently!

After any disaster, war, or traumatic event, we often see a surge in all types of mental illness.  This can be an exacerbation of a pre-existing mental illness such as anxiety disorder, or a new diagnosis of clinical depression or PTSD (Post-Traumatic Stress Disorder).  Mental health is just as important as your cardiovascular health.  Every time I meet with someone I haven’t seen since Hurricane Sandy, the encounter always starts with a 5-10 minute exchange of how we survived, evacuated, or managed to get by still without electricity.  We were all affected to some degree, and everyone has suffered emotional stress.

It is important to recognize that you may be fine physically, but emotionally exhausted.  Perhaps you can’t sleep well at night now, or see everything as being dark (“glass is half empty”).  Maybe you are more withdrawn socially and spend the nights alone.  If this is severe and disruptive to your work and life, you may need to seek professional mental health.

Here are some tips to mitigate the effects of stress:

• Talk to your friends and family often.  They are your support network and are there to help you.  Make dinner dates, or perhaps a potluck at someone’s house.
• Leave the situation if you can.  Take a trip to someplace warm like Florida.  You would be surprised how much your mood would change after you are around people who are not all suffering, not to mention the Vitamin D you would replenish from the sun there.
• Keep regular sleeping hours.  When we sleep, our minds sort out the problems from the day.
• Pray or meditate.  Even closing your eyes for 10 minutes in the middle of the day can be helpful.
• Continue your usual leisurely pasttimes.  If you normally like to knit, run, shop, watch movies or read, keep doing those things.
• Exercise regularly
• Avoid drinking alcohol excessively.  Alcohol is a depressant and can worsen depression symptoms.
• Get as much fresh air and sunlight as possible.
• If you are a caregiver or first responder, realize your limits.  How can you care for others if you yourself need help?
• Within reason, do not postpone important celebrations.  Birthdays and anniversaries are occasions for realizing how fortunate we are, even if we observe them modestly.
• Take time to count your blessings and put things into perspective.  Material possessions may come and go, but your health and life are irreplaceable.