A large proportion of people suffer from the occasional headache.  In fact, it’s one of the most common reasons for visits to primary care providers.  There are a multitude of causes of headaches ranging from stress to brain tumors.  Fortunately, only a very small are due to the latter.

Most everyday headaches are classified as “tension” headaches.  The most common reason for this type of headache is a change in our usual routine.  If you find yourself having headaches, start keeping a journal or “headache diary”.  By keeping a log of your activities, you may start noticing trends and possible triggers/causes for your pain. I have listed some common foods and lifestyle changes in the table below.  The main issue is sudden changes in your lifestyle (whether they have a positive impact or not).

• Lack of sleep/too much sleep
• Stress
• Alcohol (especially red wine)
• Too much caffeine or sudden decrease in your usual dose of caffeine, aka “caffeine withdrawal”
• Relaxation.  No, this is not a mistake!  some people can actually get headaches on their vacations since this is a change in their usual routine of a stressful workday
• Irregular eating habits/skipping meals.  The body likes to have a steady source of energy.  Like your car, it does not like to run on empty.  Be sure to carry a snack with you if you think you may have to skip a meal.
• Too much phone/tablet/computer use.  Eyestrain associated with headaches indicate an underlying vision problem.  Schedule an appointment with your eye doctor if this is occurring.  You may need your vision checked and may need to have a glaucoma screening.
• Medications such as antibiotics, blood pressure medication, nasal decongestants, cough/cold medications, ad many more prescription and over the counter medications can cause headaches.
• High blood pressure.  Anyone with a headache should have their blood pressure checked.  Fortunately, headaches caused by high blood pressure usually get better when the blood pressure returns to normal.
• Carbon monoxide is a colorless, odorless gas which can accumulate inside your home from heat sources or car exhaust.  It is most dangerous during the winter, when we keep our windows closed and light our fireplace.  Make sure you have carbon monoxide detectors in the home.  If you keep having headaches in your home but not anywhere else, you may need to check your carbon monoxide levels.  If the levels are high, you will need to find the source and open the windows to vent out your home immediately.

Disclaimer:  If your headache is severe or the “worst headache of your life” associated with other symptoms such as fever, neck stiffness, weakness, loss of vision, or gets worse with bowel movements/straining during exercise or sex, you should see your medical provider immediately.  These are considered red flags and indicate a need for more thorough workup which may include a neurological exam and possibly imaging of the brain.

Our feet take a lot of punishment each day.  It’s amazing that they can support our body weights with each step we take.  My mother always said that you can save money on clothes, but never try to save money on shoes.  A good pair of shoes can prevent you from foot pain, injuries, back pain, and knee pain. In my practice, I see that “flip flop” sandals are being worn in more places than the beach or around the pool.  They are being used for walking to work and strolling on city streets.  Not surprisingly, I am also seeing a number of injuries directly related to the wearing of these flimsy plastic sandals.  Here are some examples about why you should save them for beachwear only.

• They do not provide support for your feet.  This is particularly true for people with “flat feet”.  In fact, walking in flip flops can increase your chances of getting a condition called “plantar fasciitis” which causes severe pain on the bottom of the foot often lasting for months.  Because of the instability, you are also more liable to twist or sprain your ankle.
• They are usually poorly made.  Many of them have a small knob that is threaded through a hole in sole.  This can often pull through the soft rubber and cause you to trip and fall
• Having your toes exposed and low to the ground puts you at risk for getting cut by metal or glass that may be on the street.  The thin rubber in these sandals is also vulnerable to punctures from nails or tacks that may be in the street.  If you had a thick soled shoe, this would be much less likely.   I have pulled many small shards of glass from peoples feet in New York City.  Even worse, a lot of times cuts on the feet can easily get infected.  Think about all the grime, animal urine, and bacteria that fill the streets.  If you get cut with a piece of glass that’s been sitting on the street you can bet it will be dirty.
• You are more likely to be stepped on by others and have serious injuries to your heels, toes and toenails.  These areas are completely exposed and leave your feet vulnerable.

We all recognize some of the healthy things we should be doing, but something I see people frequently leave out is meditation.  I think we sometimes associate this relaxation practice with something exotic, spiritual, or that it can only be done hours at a time in a far away mountain temple.  I would propose that meditation should be accessible and an integral part of our daily lives.  Did you ever daydream when you were a child, staring out the window while sitting in a classroom?  Sit on a beach watching the waves crash upon the sand?  “Zone out” with your favorite song while on an airplane?  All of these are variations of meditation!  It is no surprise that children will daydream without any formal teaching.  Meditation is our mind’s way of “clearing out the clutter” of thoughts in our minds.

As with anything, it takes practice and commitment to change.  Here are ways that you can incorporate meditation into your life:

• Dedicate time (5 minutes is a good start) to meditate.  I like meditating to separate the different phases of my day.  For example, you could meditate for 5 minutes after arriving at work in the morning, and meditate for 5 minutes before heading home at the end of your workday.  In this way, you can leave behind “home” issues before you start working, and work issues at work so you don’t “bring them home”.  Ever have a tough day at work, then find yourself annoyed at everyone at home?  Meditation can help you so that you won’t bring the stress home.  This may sound a little obsessive-compulsive, but I find that setting a Microsoft Outlook reminder or physically setting an alarm on your phone for a certain time each day, helps me to be disciplined.
• There’s an APP for that!  Headspace is an app that you can download which you can listen to while commuting.  It generally guides you through breathing meditation and they have different lengths of time to fit into your schedule.  They offer a free trial which is great to see if it is right for you.
• Put a picture on your desk of your last vacation where you felt pure joy.  We all have tons of pictures from vacations, sunrises, sunsets, beautiful flowers, etc.  I recommend selecting a photo without any people or words.  Now when you feel stressed, imagine yourself in that place and immerse yourself with all the senses and focus on the details.  For example, I imagine myself on a beach in Cape Cod.  The temperature is 80 degrees, I can feel the sun on my face, shoulders, I can feel the warm moist sand between my toes, I can hear the waves crashing on the shore, I can hear the birds in the distance, I smell the salt in the air with a light breeze.  I don’t have a care in the world…  In 5-10 minutes, you’ve mentally left where you are and gone on a mini-trip to your “happy vacation place”.
• If you subscribe to a religion, reciting prayers can be meditative.  Poetry can also be soothing.  While I am not Christian, I like reciting what is commonly known as the Serenity Prayer, “God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.”  I feel the words are very meaningful.
• Dedicate a space in your home for meditation.  Set up a comfortable chair in an area with a pretty view, or in front of a painting or picture that you enjoy.
• It is not surprising that most religions have a “mantra”, which is series of repeated words or phrases.  In Catholic tradition, it is the rosary. In Hinduism, it’s “Om Shanti” and in Tibetan Buddhism, it’s “Om Mani Padme Hum”.  By reciting a set phrase over and over, sometimes hundreds of times, your mind is able to break free of distressing thoughts.  I call it the “Etch a Sketch” effect, referencing that famous magnetic childhood toy that would erase any designs if you shook it rapidly for a few seconds..  By focusing on something else intensely, like pronouncing syllables, you “erase” other thoughts that were present before.
• Try, try, again!  Don’t lose heart if you can’t get the hang of meditation.  No one gets it right the first time!

The New York Times published an article by Nicholas Bakalar titled, “Boxers or briefs, It may depend on your fertility goals” which reported that men who wore looser fitting underwear produced more sperm and better quality swimmers than those men who wore tight briefs.  I think this makes complete sense, as the whole reason why nature has designed men’s genitalia to extend outside of the body is because sperm cannot survive in high temperatures, whereas ova (eggs) in woman can tolerate higher temperatures.

Here are some additional advice for men considering becoming fathers:

• Eat organic foods, especially when with fruits and vegetables that you will be eating the skin, have broad leaves or those that grow underground.  Typically organic produce is grown without pesticides.  If you think about it, pesticides are meant to kill small, rapidly growing insects and worms.  Guess what?  Sperm have very similar qualities.  Ingesting high amounts of pesticides could certainly reduce sperm reproduction.  Fruits and vegetables where you have to peel a thick skin (bananas, oranges, grapefruit, pineapple, pumpkin, etc.) may not always need to be organic as the thick rinds make it less likely for the pesticides to penetrate inside.
• Avoid crossing your legs.  For the same reason that tight underwear reduces sperm count by raising the temperature of the testicles, crossing your legs achieves a similar result.
• Avoid uninterrupted sitting.  Have you ever sat in a chair for a long time and started feeling warm in the pelvis?  Sitting in chairs, particularly in upholstery that doesn’t breathe such as leather, plastic, or vinyl can increase the temperature of male genitalia.  Stand up and stretch every so often.  Change your office chair to a mesh chair.  You can also purchase a small fan to place under your desk to promote air circulation.
• Avoid sitting in hot tubs or steam rooms.  These are known sperm killers as the temperatures can be as high as 110 degrees Fahrenheit, far too high for sperm to survive at long periods of time.
• If you smoke, stop smoking!  There are so many reasons to not smoke!
• If you drink alcohol regularly, drink in moderation.  This means no more than 2 drinks in 24 hours for men. (1 drink= 1 shot of liquor OR 1 bottle of beer OR 1 glass of wine)
• Increase your water intake.  Dehydration is not good for any organs in the body.
• Get regular exercise.  When you exercise, your heart pumps blood to all parts of the body including your legs, brain, and your reproductive organs.  In particular, I recommend “male Kegel exercises” which are designed specifically to strengthen the muscles down there.  Imagine exercise as a way to “flush out” old blood and bringing oxygen to those areas.
• Reduce stress.  Try meditating even 10 minutes a day. Don’t know how?  Here is a post on how to do it.
• Get adequate and proper sleep.  While we are asleep, our body repairs itself and relaxes.
• Eat shellfish or take a multivitamin.  Sperm need certain trace minerals to survive and grow.  One of these is zinc, which is naturally found in shellfish.  I believe the old wive’s tale that oysters stimulate libido is likely stemmed from this.  Be careful that the seafood you eat doesn’t contain too much mercury.  Find out more about seafood and mercury here.

There are some things in my day to day life that I find to be very helpful and keep me healthy.  Here are some of them and why they are favorite things, click on the hyperlinks for quick purchase through Amazon:

• Insoles for shoes.  We are on our feet all day, if your shoes are not adequately supporting your weight, your feet and knees can become overstressed leading to fatigue and pain.  Unfortunately, I have found that many shoe manufacturers have been skimping on quality of materials used in the soles.  Adding extra support with gel or foam insoles can greatly improve the comfort of your shoes.
• Antibacterial wipes.  I don’t travel anywhere without these.  Bacteria and viruses are spread easily when objects are touched by multiple people.  When do you think that airplane tray table, restaurant menu, or subway pole was last cleaned?  Likely not in the last few months.
• Large water bottle.  Hydration is so important.  When you have a large water bottle, you will likely drink more water.
• Facial wash.  During the day, our face can accumulate oils, dirt and pollen which can cause acne, eyelid swelling (stye),  and irritation.  Water alone rarely removes these adequately.  A facial wash keeps your skin fresh and clean.
• Aquaphor ointment.  For minor skin irritation, dryness and itching, Aquaphor is a must.  People suffering from eczema and psoriasis should always have this nearby as moisturizing can keep these conditions from getting worse.  I keep a tube in every drawer in every room so I can get immediate relief.
• Natural tears.  Most of us are suffering from dry eyes either from allergies or chronically looking at computer screens/tablets.  These individually packaged drops are close in chemical composition to our own tears and keep your eyes moist.  I use them every afternoon and right away I feel more energetic as if I had a cup of coffee!  When our eyes are dry, they tend to cause eye strain and fatigue.
• Bluetooth speakers.  Music can affect our moods and overall well being.  Some studies have shown that listening to classical music has a calming effect and can also boost cognitive functioning!  The theory is that the melody stimulates different parts of our brain.  Some busy train stations have even started playing classical music to calm busy commuters.
• Sunglasses with thick sides.  Excessive sun exposure can cause damage to the delicate structures of the eyes leading to chronic eye conditions such as cataracts and macular degeneration (which can cause serious vision issues later in life).  It is also important for allergy sufferers to choose sunglasses with thick sides, as pollen is very sticky and can fly into the eye with the slightest breeze causing eye irritation and watering.  Thick sides on sunglasses can prevent this from happening.  I often choose sunglasses that are worn by cyclists as they have this exact purpose in mind.