I was asked over the weekend what do I do to workout when I get tired of running.  At first, to be honest I was kind of at a loss.  I mean, I know that I do other things, but when I was asked spot on, I couldn’t really answer.

I am all about the “prison” workout.  So, I usually do go running, mostly because now I have my dogs totally hooked on a daily run, and during my run I try to find an area where I can stop, give the pooches a break, and do 1 to 2 sets of pushups (1 set= 100 pushups), and if I can find a secluded street with a good curb, I do, what I like to call, curb work (sometimes I am really imaginative!!)  I will alternate feet and lift one so that it lightly touches the top of the curb, while the other is on the street, quickly and in rapid succession; it is almost like running in place but with a higher step and I try to do a couple of sets (150= 1 set) it makes for great calf muscles.  And, if it is a grassy area, I will try to do usually 300 crunches (100 straight crunches and then 100 to the right/left working the external obliques).  I then continue on my run home.  But, if I find a bar or pole that I can do some pull-ups on, I am a happy girl (despite the fact that I stink at pull-ups; I can only do around 8 and then I just look like a fool attempting to pull myself up!!)  I usually do another 900 crunches when I get home (it sounds like a lot but it only takes like 10 minutes and I work all my ab muscles) and then usually lift low weights (10lbs) to tone my biceps and triceps with various different lifting techniques. That is my normal daily work-out; I can do it anywhere, I don’t need a gym, and I can do it at any time- all I need is my sneakers, an ab ball, my 10lb weights,  and preferably with an ipod, my dogs, and a piece of peppermint gum (mint helps to open the bronchioles and allow for better air movement- as an asthmatic, I swear by it with every run and it cuts down on inhaler use.)

On days that I don’t feel like running, or I have achey legs, etc. I will do interval training.  I try to find either a semi empty parking lot, or a non-busy street and I pick out a set space that can be easily land-marked (approx 1/8th-1/4th of a mile between trees, or a driveway, house, etc…something that cannot move as I have been duped by cars before that get moved!) And I will alternate between wind sprints, forward lunges, and side lunges.  Again, I will do push-ups, curb work, crunches, and I can also do reverse push up to work my triceps (sit on the curb, put your arms directly next to you, push up to get your butt off the curb and lift yourself up and down without resting- it is a small triceps movement but in high reps it is great for toning.)  I try to mix in squats, I use weights to work my biceps (when I get home), I try to work my obliques/abs just a little everyday BUT it is important to focus more on one part of the body each workout and give the other muscles a break.

Other times, I will ride my bike, go for long walks, find a nice hike, do hot power yoga, or (GASP) take a day off!!  Your body is really smart, and when you workout hard, and a lot, your body will tell you that it needs a break. I used to really push myself because I was fixated on these goals that I set for myself, and it is part of my competitive nature, but I found that I got a few injuries and that laid me up from running, and then I had to start all over.  It is best to do what your body wants….not to sit on the couch all day every day BUT give it a rest for a couple of days after a really hard workout.

Listen to your body and your workouts will be more enjoyable because you won’t be forcing yourself to run/bike/etc through pain, and switch up your routine.  That is precisely why I like my prison workouts, I do different things depending on where I am running- it is really great not to feel tied to a gym, I can workout anywhere.

I hope this helps those of you who were looking for advise on switching up routines and interested in how I keep in shape.  So, keep up the good work, and remember to listen to your body!

Yours in Good Health

B

Not that this is fresh news, but a large study was conducted in the UK ( Scotland, more specifically), and it looked at the specific risk factor of tooth brushing and cardiovascular disease (which can lead to strokes/heart attacks).  It was found that people who do not brush at least twice a day, have a much higher risk of cardiovascular disease than those who do not.  The study took into account family history of heart disease, lower socioeconomic status, age, sex, body mass index, diabetes, hypertension, smoking, and physical activity.  Despite all of those factors being taken into account, it still showed that less frequent trips to the dentist for proper cleanings (i.e. longer than 6 months between visits) and less than twice a day brushing can significantly increase the risk of cardiovascular disease by causing a state of chronic inflammation in the oral cavity and increasing the bodies inflammatory markers in the blood.  This can cause a build up of atherosclerosis, thus increasing the risk of cardiovascular disease.  This can also effect the breakdown of lipids (fats) in the body and lead to a build-up of lipids in the body.

This is not to say that, for example (because she came out a few weeks ago stating that she only brushes her teeth once or twice a week), Jessica Simpson will definitively get cardiovascular disease, BUT she is at a much higher risk.  Brushing less than twice a day is a risk factor just like smoking, sedentary lifestyle, eating a high fat diet, etc.

So, it is important to maintain your oral hygiene, and really encourage oral hygiene for your children too.  This is another way that children learn from examples of their parents, and if they earn it is part of their daily routine as a child, then they will continue on as adults.  You all may be happy to know that Jessica Simpson’s mom told the press that she is going to reiterate with Jessica the importance of oral hygiene- I know I will sleep better at night now 😉

And, as a shout out for my dentist buddies out there, please floss too!!  I know that sometimes it can seem quite laborious, but it really only takes an extra minute or so, and it is crucial to oral hygiene. So, keep brushing and flossing your way to a long healthy life!

Yours in Good Health

B

I wouldn’t be a very responsible healthcare blogger if I didn’t talk about something that just made the New England Journal of Medicine (kind of a big deal in the medical world), that I never really thought about bringing up with patients before: texting while driving.

PCP’s are now giving information to their patients regarding the use of cell phones while driving ,as they would regarding smoking cessation, eating healthy, and exercising regularly.  Apparently, studies have shown that people who are texting are more impaired as drunk drivers, due to their lack of attention to the road, and are 20x more likely to crash than those who are paying attention to the road ahead.  Texting while driving is also on par with sleep deprivation.  It is totally scary to think that people who are not under the influence of drugs/alcohol, can basically drive like they are solely because they are texting.

I remember on my old school phone that I could text like a champ without looking at the phone because I could feel the keys and I really could take on any teenager and give them a run for their money…BUT with the touch screen phones, that isn’t the case.  And, with the number of, specifically, Iphones out there, people actually need to look at their screens to type and that takes away from watching the road (approx 400% more time with eyes off the road per one recent study) and diminishes response times to other cars on the road; it can make a teenagers response time that of a 70 year old.

Creepy statistics?  In 2008, during daylight times over 800,000 Americans were texting whilst driving and over 6,000 people were killed in that same year from distracted drivers.  25% of annual car accidents are caused by people talking on their cell phones. People who are texting while driving a re 6 times more likely to get in a care crash than those who are intoxicated!!  And, while this is old data, I found it very interesting; in 2002 the Harvard Center for risk Analysis found that 2,600 people die each year as a result of using cell phones while driving and 330,000 are injured. Also, according to one survey, 85% of people surveyed agreed that texting/talking while driving was dangerous, yet of those people, 80% stated that they still did it anyway.  Hmmm, so we know it’s dangerous, but we still do it…..

I must say, on a recent cross country road trip with a dear friend, we watched and saw so many people swerving in/out of lanes, and you would swear they were drunk, but as you passed them saw that they were chatting on their phones, texting, putting on makeup (my personal favorite at 80 MPH), and other drivers were literally speeding past at any chance just to get away from them.  Really watch the road and see who is texting and chatting; we blame teenagers all the time, but I think that I see more adults talking, texting, working on a COMPUTER, putting on makeup, etc than I do teenagers.  So, maybe we should all practice what we preach and use hands free devices or just do what we did in the old days and sit back, listen to some tunes, and get where we are going safely…make the phone calls when you get to your destination!

I know that I will encourage patients, family, friends to drop the phone and pay attention to driving, and I hope that these statistics encourage you all to do the same, it may save a life 🙂

Yours in Good Health

B

I wanted to talk and clear up a rumor I have heard from a few people and received emails about recently related to cancer.  I have heard, from many different people, that you shouldn’t get an operation for cancer because it makes it spread (i.e. once cancer is open to air to spreads.)  Mostly because they have heard about people going in for an operation to have a tumor removed but more is found, leading to subsequent operations, chemo, radiation, etc.

So, this is completely not true!  Cancer being exposed to air does not spread the cancer.  Cancer can be “seeded” if an encapsulated tumor sac is opened, as in during a biopsy, for example.  All that means is that the tumor is opened and the cancer cells can spread and possibly affect other areas of your body.  But, operations that are performed to remove a tumor, are for just that purpose.  Many are done laparoscopically (a few small port holes are placed and the surgeon operates using small tools and a camera inside of you) by skilled surgeons, so they aren’t even exposed to the air until removed.  But, even if you have an open operation (area is completely exposed) it does not spread the tumor.

Now, during your work-up to find out if you have cancer, and when you are getting ready for surgery, you will have many different tests like x-rays, CT scans, possibly MRI’s, which are all to help locate the tumor, its source, and possible metastases.  It may be thought that you have one tumor based on imaging, but when your surgeon goes in to operate, a whole new picture may arise for you…they may find metastases or that the tumor starts/ends somewhere else making subsequent operations, or a different treatment plan necessary.  Modern medicine and imaging is really advanced and amazing, but it is not always 100% accurate, and it doesn’t take the place of human touch and interaction with your body.

The only ways we currently have scientific proof of, to remove cancer from your body is through surgical removal, chemotherapy, and radiation.  And, while radiation and chemo can cause various side effects during their treatment, surgical removal of a tumor does NOT spread the cancer.  So, if you are told you need an operation to remove a tumor, always get a second opinion, but don’t fear that the operation will make it spread!

Yours in Good Health!

B

I know that people talk about “superfoods” and antioxidants a lot, and how they can help to prevent certain diseases such as cancer, Alzheimer’s, HIV, etc. but I don’t think that many people know how they work or what they do.  And, why they can be so good for you!

What are antioxidants?

They come in a bunch of forms such as vitamin A, C, E along with plant-derived polyphenols (found in bright/colorful fruits and veggies), and in selenium, which is found in nuts and broccoli. Basically, these compounds (antioxidants) are able to neutralize the harmful molecules in our bodies, known as free radicals. Free radicals have unpaired electrons, which leave them highly reactive, and allow them to attack various components of our cells and these attacks can cause cancer.  Free radicals can be the by-products if different cellular reactions on our bodies and also from cigarette smoke, air pollution, UV light, and exposure to radiation.

Antioxidants neutralize free radicals either by providing the extra electron needed to make the pair (because they only have one electron) or by breaking down the free radical molecule to render it harmless (essentially attacking the free radical to kill it off). Antioxidants can help stop the chain reaction of free radical formation and benefit our health by boosting our immune system. Because antioxidants are used up in the process of free radical neutralization, a diet rich in antioxidants is essential to ensure a constant supply.

Have they been shown to work?

Research has shown that antioxidants can have an important impact on serious diseases. In one recent study, the addition of a polyphenol-rich blueberry gel to the diet of oral cancer patients prevented recurrence of the cancer. Another experiment demonstrated that increased levels of selenium in the diets of a group of HIV-positive patients significantly delayed progression of the disease.

What does this mean for me?

Do HCP’s suggest you go run out and pop supplement antioxidant pills?  No!!  But, I do suggest to patients to eat diets high in antioxidants, i.e. eat healthy diets that have lots and lots of colors (from fruit an veg- not artificial colors) on each plate.  And, try to limit exposures to free radical causing activities, such as steering clear of cigarette smoke, limiting radiation exposure (or wear lead to protect yourself), and limit high UV light exposure (i.e. the middle of the day).

Yours in Good Health!

B

The associated press released a little snippet about sunblock being bad for you and “causing cancer”.  Totally not true.  I first heard about it on Howard Stern when Robin was reading the news, and I nearly drove off the road as they were all chatting that they weren’t going to wear sunblock anymore!!!

The issue at hand is that some sunblocks were found to not have as much UV-A protection as they claim to.  UV-B protection is usually the SPF (sun protection factor) they are referring to. UV-A is most frequently the causative agents of some skin cancers.  The environmental working group is just releasing 2010 Sunscreen Guide which they tested 1400 different sunscreens indepedently to test their validity of SPF claims.

Go check out their web site and see if your brand is listed as a good one, if not, then toss it and grab a brand that has UV-A and B protection!!  PS- they also found that the SPF’s greater than 30 (i.e. 55, 75, etc) don’t have any more protection for UV-A than SPF 30, but more UV-B protection.  SPF is never a bad thing to wear, it protects your skin from the damage of the sun and it keeps your skin looking younger and healthier.

Enjoy the outdoors and the beautiful weather but PLEASE put on sunblock!!!  Just grab one that has UV-A protection too….if you want that fab deep tan look, just rock out with a self tanner, you spare yourself the wrinkles down the road and you can choose what color you are (and no, you don’t have to have that beautiful orange glow of the days past!)

Yours in Good Health

B

Eating red meat has been linked to an increased risk of heart disease and diabetes in recent years, leaving HCP’s  to tell their patients with heart disease to stay away from red meat all together .  Well, good news to meat lovers: a study from the Harvard school of Public Health just published this week showed that the risk of heart disease and diabetes is only with processed meats!!  Mostly, they found, that the risk of increased heart disease is due to the amount of salt, fat, and other chemicals used as preservatives.  A separate study, specifically on the ingestion of processed meats, showed an increased risk of pancreatic cancer by 67%.

What are some processed meats to avoid?
Bacon ( this one seriously makes me cry)
Bologna
Sausage
Salamis
Hot dogs
Spam
basically any meat in a can…..
and beware of all meat that is previously prepared (like in fast food restaurants, etc)

Now, this doesn’t mean that you can totally gorge in Filet Mignon daily BUT, it does mean that when you get a craving for steak, go get one!  And, if you want a hamburger, go for it.  What I like to do, since my Kitchenaide mixer rules my world, is to buy organic grass fed meat, and grind my own meat to make hamburgers (after watching food, inc. I can never eat meat from a grocery store again).

I still do encourage a diet high in fruits and veg  and fish, but I also realize the need for red meat that some people have (like me), so you don’t have to feel guilty for giving in to your red meat cravings, just eat meat smarter.  By smarter, I mean try to eat organic grass fed meat (from a local farm whenever possible)and stay away from processed meats whenever possible.  Don’t feel guilty about the 4th of July hot dog, or the Fenway frank every once in a while, but please try to not make it a habit.

Yours in Good Health
B

There is a social stigma related to herpes simplex virus, and I think mostly because people don’t really understand it, or want to talk about it! Firstly, more than 100 million Americans have been exposed to the HSV-1(herpes simplex virus 1)and most all of them were exposed as children, but only 5% as adults ever have outbreaks.  Approximately 40 million Americans have the HSV-2 (herpes simplex virus 2) virus and most of them were exposed as teenagers and adults.  HSV-1  is usually referred to as cold sores because historically HSV-1 is the type of herpes that hangs out, in its latent (inactive) form in the ganglion nerve near your jaw/ear so the outbreaks usually occur on your lips and lower face area. HSV-2 is the type of herpes that is located in its latent from in the base of the spine, therefore the active outbreaks occur in the groin/genital area.  So, now that I covered that, I will confuse you with the fact that now, due to the increased transmission rates (which I believe is due to people not understanding the disease or its transmission)you can have HSV-1 present in your groin and HSV-2 that will present in your face…awesome how viruses adapt to modern life, huh?  Mostly due to oral sex transmission is how this fun little adaptation occurred.  The good news is that HSV-1 in the groin has low rates of recurrent outbreaks, and same for HSV-2 present in the face.

HSV can have no signs or symptoms when latent, but still can be transmitted to another person (5% of people with HSV-1 can transmit through their saliva even in a latent phase.)  Although, it is most easily spread when there is an active outbreak.  HSV-1 is the most common of the two viruses, making it the most commonly spread of the two viruses.  The good news (kinda)?  If you have HSV-1, you have some immunity due to the creation of antibodies by your immune system, so you are at a lower risk for getting infected by HSV-2.

What can trigger HSV outbreaks?
UV light exposure (i.e. sunburns- so always wear SPF lip protection when in the sun if you are prone to cold sores)
Stress
Hormonal changes (PMS)
Cold, flu
Changes in the immune system
Trauma to the skin

How do I know an outbreak is coming?
Most people can tell a few hours before the outbreak occurs because they feel a tingling in the area that the virus is replicating, you can see redness, and feel some heat and pain in the area.  Within an hour or a couple of hours the sore occurs….they can be large vesicles that are fluid filled (appeared to be filled with pus) and are surrounded by a reddened area.  The first outbreak is usually the worst and all recurrent outbreaks are usually not as painful or large.

What can you do?  There are topical treatments that are over the counter, such as Abreva and Releev (benzalkonium chloride with echinacea).  Abreva claims to shorten cold sore duration by a few days, and Releev claims to relieve symptoms within 24 hours.  Prescription topical treatments are Acyclovir cream and Denavir cream, which claim to reduce cold sore times by only a half a day.  And a prescription oral pill is Valcyte which can be taken daily as a prevention for outbreaks, or can be taken at the first signs of outbreaks and can significantly decrease outbreak lengths.  BUT, all of these treatments need to be started before the vesicle (or sore) actually appears…so, at the first sign of tingling, you should have a treatment on hand (whichever your HCP suggests works best for you) and start treatment immediately.  And, as noted above, wear sunblock on areas prone to outbreaks, limit stress, and note when your outbreaks occur (are they PMS related?)

Also, people with decreased immune systems due to chemotherapy, HIV/AIDS, cancer, other illnesses, are at a much higher risk for outbreaks due to a decreased immune system, so if you are someone with a history of either HSV-1 or 2 and have any of these issues also, please discuss with your HCP and they will most likely give you a standing prescription for treatment.

If you are one of the MANY Americans affected by HSV, don’t be embarrassed!  So many people are affected, and granted it is not the best week of your life walking around with a sore on your face, but that is why there are drugs to treat it, and noticing the early signs are important, so that you can talk to your HCP about an standing prescription maybe or how best to treat/prevent your outbreaks.  And, bring this up with your HCP, there may be a stigma in the general public, but within the medical field, we understand and want to make your comfort and health a priority.  Talk to your HCP and bring it up, drop the stigma!!!

Yours in Good Health
B

It’s also Celiac Awareness Month!!!  Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy. Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered—or becomes active for the first time—after surgery, pregnancy, childbirth, viral infection, or severe emotional stress. Celiac disease is a digestive disease effecting the small intestine and interferes with absorption of nutrients from food.  People with the disease cannot tolerate gluten which is a protein in wheat, barley, and rye.  Gluten can also be found in many foods but also as a filler in many products that are not foods such as lip balms, medications, vitamins, supplements, etc.  Celiac disease is once of malabsorption and an immune response to gluten, which makes it a very uncomfortable and difficult disease to have.  The little villi (the finger-like protrusions in your small intenstine that absorb nutrients from the foodstuffs in your intestine)get destroyed by the immune response to the gluten. Without healthy villi, you will be malnourished because your body cannot absorb any of the nutrients from food.


Symptoms?  For Infants and children the symptoms are usually more digestive, but can vary person to person:
Abdominal pain and bloating
chronic diarrhea
vomiting
constipation
weight loss
pale, foul smelling, fatty stool
*for children, a poor nutrition at a young age can cause stunted growth, poor enamel on teeth, delayed puberty, and failure to thrive in infants

Symptoms for adults are usually more varied:
unexplained iron-deficiency anemia
fatigue
bone or joint pain
arthritis
bone loss or osteoporosis
depression/anxiety
tingling/numbness in hands or feet
seizures
missed menstrual periods
infertility or recurrent miscarriage
canker sores inside of mouth
itchy skin called dermititis herpetiformis

People with celiac disease may have no symptoms but can still develop complications of the disease over time. Long-term complications include malnutrition—which can lead to anemia, osteoporosis, and miscarriage, among other problems—liver diseases, and cancers of the intestine.

Celiac disease affects people in all parts of the world. Originally thought to be a rare childhood syndrome, celiac disease is now known to be a common genetic disorder. More than 2 million people in the United States have the disease, or about 1 in 133 people. Among people who have a first-degree relative—a parent, sibling, or child—diagnosed with celiac disease, as many as 1 in 22 people may have the disease.  Celiac disease is also more common among people with other genetic disorders including Down syndrome and Turner syndrome, a condition that affects girls’ development.

Celiac disease is usually diagnosed through blood tests, biopsies of the small intestine (through endoscopy where a small tube is entered through the mouth into your stomach and a small sample is taken- don’t worry you will gets lots of happy drugs and not remember anything!!), through diagnosis of dermatitis herpetiformis, and through screening for autoantibodies (which is not routinely done in the US unless you have an affected family member).

Treatment?  A gluten-free diet!!!  It is much harder than you think…there seems to be gluten in everything these days.  Here are some foods that are allowed and should be avoided:

American Celiac Disease Alliance
2504 Duxbury Place
Alexandria, VA 22308
Phone: 703–622–3331
Email: info@americanceliac.org
Internet: www.americanceliac.org


American Dietetic Association
120 South Riverside Plaza, Suite 2000
Chicago, IL 60606–6995
Email: hotline@eatright.org
Internet: www.eatright.org


Celiac Disease Foundation
13251 Ventura Boulevard, #1
Studio City, CA 91604
Phone: 818–990–2354
Fax: 818–990–2379
Email: cdf@celiac.org
Internet: www.celiac.org


Celiac Sprue Association/USA Inc.
P.O. Box 31700
Omaha, NE 68131–0700
Phone: 1–877–CSA–4CSA (272–4272)
Fax: 402–643–4108
Email: celiacs@csaceliacs.org
Internet: www.csaceliacs.org


Children’s Digestive Health and Nutrition Foundation
P.O. Box 6
Flourtown, PA 19031
Phone: 215–233–0808
Fax: 215–233–3918
Email: mstallings@naspghan.org
Internet: www.cdhnf.org
www.celiachealth.org


Gluten Intolerance Group of North America
31214 124th Avenue SE
Auburn, WA 98092–3667
Phone: 253–833–6655
Fax: 253–833–6675
Email: info@gluten.net
Internet: www.gluten.net


National Foundation for Celiac Awareness
224 South Maple Street
Ambler, PA 19002–0544
Phone: 215–325–1306
Email: info@celiaccentral.org
Internet: www.celiaccentral.org


North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
P.O. Box 6
Flourtown, PA 19031
Phone: 215–233–0808
Fax: 215–233–3918
Email: naspghan@naspghan.org
Internet: www.naspghan.org
www.cdhnf.org

The Celiac Disease Awareness Campaign

To meet the need for comprehensive and current information about celiac disease, the National Digestive Diseases Information Clearinghouse (NDDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), launched the Celiac Disease Awareness Campaign. The Awareness Campaign is the result of the combined ideas and efforts of the professional and voluntary organizations that focus on celiac disease, along with the NIDDK, the National Institutes of Health, and the Centers for Disease Control and Prevention.
Visit www.celiac.nih.gov to learn more about the Awareness Campaign.