Can I get the Flu from the Flu shot?

 This is a very common question I get during flu season.  It is a serious question from the patients who ask, and it is a main deterrent in the fight against the flu.  If you think the West Nile is scary, the Influenza virus kills up to 30,000 people annually.

To put minds at ease, it is impossible to catch the flu from the flu shot. There are no living organisms in the vaccination.  The dead virus particles cannot cause a disease. 

What some people might feel when they get the vaccine is possibly a reaction. And by reaction that means the immune system responding by building antibodies against the flu particles.  When the Immune system is in hyper drive, sometimes people can fill ill, but the large majority of reactions from the flu vaccines are smaller reactions.

Some people get a localized reaction and their arms are painful where they received the vaccine.  When I got the shot last year I felt sore for 3 months.  However, it is possible to still catch the flu even if you had the flu vaccination.  If this happens usually it is a mild flu illness.  This happened to me 2 years ago.

Finally, it is impossible to catch the flu from the flu shot, and because this year's flu is vicious, it is more important than ever to get the vaccine.  It is not even peak season and we're seeing very high numbers of influenza like illness as well as positive flu numbers in the ER and clinics in this area.

In fact Texas is one of the highest number of positive flu like illnesses and flu positives in the nation. 

So my all means please get your new flu vaccine as soon as possible if you haven't received it already.

 

 

Health Benefits of the "50 Shades of Grey" Novel

One day while I was rounding on hospital patients, I received a provocative text message from my wife.  Being a professional in a professional setting requires somewhat a stoic persona, but this text dropped my jaw.  I felt a rush of warmth come to my face and no doubt flushed with embarrassment - I retreated to a small office alcove.

I almost started sweating, as the heat got caught under my suit jacket.  Loosening my tie, I struggled to make sense of this overwhelmingly erotic text message.  This was just not normal, my wife rarely lets loose her creative energies in the form of words on me.  Her creativity is fixed on cute little "roses are red, violets are blue" poems.   As my heart raced, and my adrenal glands secreted catecholamines-- I finally recognized what happened.

It all started a week prior when my nurses recommended that I buy the new book, "50 Shades of Grey," by E.L. James, for my wife.  This, I thought, was unusual.  Rarely do I receive recommendations to read a fiction piece from nurses.  In fact, I have never been given recommendations to read anything by nurses. The occasional book worm patient and I will bounce authors' names back and forth, but to have the nurses on the floor discussing the book with such grandiosity peaked my interest.


"You won't regret it!" they encouraged me.  At the time, I wondered why they had those mischievous smiles.


So I ventured into Target that week and found a paperback "50 shades," and proceeded to the check out.  The cashier's half smile at me gave me no hint as to what possibly this book could do.


Carrying the prize home to the wife, I fantasized about what potential awaits our marriage, both in the form of emotional and physical rewards.  What subsequently occurred was not what I had expected, and moreover, it had opened a new chapter for us in our 7th year of marriage.


The health benefits were many.  First of all, I had an increased physical attraction to my wife.  It has been over 10 years since she used to call and talk to me provocatively.  I was a lowly medical student and had no real love life.  Second, enhanced intercourse and all the benefits of a cardio workout subsequently occurred.  The increased interest in sex in both, its most basic form, and the plethora of advanced forms, helped renew my motivation to improve in my own areas of confidence and vigor.  


The nurses knew best, as they usually do, and I gladly won't ever regret their advice.  For all who look for more ways to get healthy--give this book a try.  It's definitely an A++

Headaches in Children

Children can get headaches just as often as adults.  It is debilitating issue for a kid to feel both pain, and the inability to go out and play.

The two most common causes of headaches in children are the Migraine type and the Tension types.

The FDA hasn’t approved medication for migraine medicine in children, however, there are ways to decrease pain.  In children, the treatment for both Migraine and Tension type headaches are nearly the same. 

For physicians, the goal is to make sure the headache is not a brain tumor, which necessitates imaging.

After a brain tumor has been ruled out, therapy for headaches rests on controlling the environment.  First, put the child in a dark quiet room, and encourage him/her to sleep.  Both physical and environmental stress acts as a trigger and a consequence of headaches. 

Continue to control the child’s environment by having scheduled times for meals, bedtime, relaxation, and exercise.

Tension headaches often respond to medications, such as  Ibuprofen and acetaminophen. 

Never underestimate the power of behavior therapy for headache treatment, as headaches can be a sign the child is having a lot of stress in their life.   

And may good health be with you.

Camping and Water-borne Illnesses

Welcome to summer -- It is definitely hot and this is the time of the year for families to go out camping prior to the beginning of the new school year.

When you decide to go camping it is most likely going to involve water-- rivers and/or lakes.  The best way to prevent waterborne illnesses while you are camping is to make sure you do not swallow the water that you are swimming in.

I remember very clearly as a kid taking a bottle of water from the pond and looking under the microscope and seeing all kinds of different little fungi and protozoa.

It just so happens when somebody comes in with severe diarrhea of unknown etiology, we check for ova and parasites in the stool.

If you do have diarrhea, do not go swimming in the first place for the safety of other campers, as diarrhea or stool particles can be in and around the rectum  and therefore leak out while swimming.

Drink nice filtered water when you're out camping and make sure that you always swim with somebody. 

Always take a shower before and after swimming as this helps get rid of some of the bacteria and germs and fungus that might be living on your body.

And remember if you are boating, canoeing, and/or kayaking, always wear your life jacket if you're in and around water.  Finally, be sure to avoid alcohol.

Now go camping and have fun!

Guts, Bugs, IBS, and the CDC

A recent study showed that Irritable Bowel Syndrome (IBS), a collection of symptoms including diarrhea, painful bloating, abdominal pain, and alternating stool patterns, is definitively related to the overgrowth of bacteria in the gut. 

In the study 60% of diarrhea- predominant IBS patients had small intestine bacterial overgrowth, or SIBO.

The authors of the study also discussed the use of antibiotics that are absorbed in the gut being very effective for treatment of IBS.

My personal favorite treatment is Asacol, prescribed at three times daily for 10 days for IBS flares, and once daily for prophylaxis.  Antibiotics haven’t been my mainstay, but I have treated abdominal pain IBS with Cipro and Flagyl in the past with good effect.

On other news front, the CDC released a 3 year study from 2007 to 2010 looking at clinical data and seeing how preventive medicine is being utilized. 

They found that 47% of patients with Heart Disease were recommended their daily dose of aspirin.  This may be due to the fact that they are on Plavix or another blood thinner if they have coronary vessel stents.

In the past 5 years, only 33% of men and 25% of women had been screened for high cholesterol.  The question I have is, are these only annual exams that the study is looking at?  If so, it’s a travesty.

And finally they found that only 1 in 13 smokers were prescribed medications to assist smoking cessation.  I can believe this as it is very hard to get a patient to try Chantix or Wellbutrin (Zyban).  More often than not, a patient hasn’t reached the stage of agreement on even quitting.  After they agree to quit, they have a spouse that needs to quit with them.

After the patient and the spouse both agree to quit, they must agree to come to the doctor’s office together.  There are a lot of steps in between getting a patient a prescription for Chantix. 

I would happily try to help each smoker quit, but unless your heart is in it, it is wasting time.  A great video done by Allen Carr, a heavy smoker who quit, gives you the sense that the anxiety you feel between cigarettes is actually your body going through withdrawal for your addiction, not real anxiety.  He also wrote a book.  I recommend smokers look at his video on Youtube.


Thanks everyone, and stay healthy!

Why do I have Chronic Diarrhea?

This is a very good question and is becoming increasingly common. If you have diarrhea for more than four weeks – it is chronic, although many who have suffered will call it chronic after just a day.  The misery of diarrhea felt by patients is equal to the amount of investigation we do to figure out what kind of diarrhea it is.

Besides an infection or inflammation, some people have diarrhea from irritable bowel, while some people suffer from medications.

Some people will not just have diarrhea but actually will have fecal incontinence from inflammation occasionally caused by fecal impaction or chronic constipation.

It's important to know if there is any previous travel to tropical areas.   Doctors will test for celiac disease, irritable bowel syndrome, Type I Diabetes, thyroid disease and iron deficiency anemia,  weight loss, infertility, elevated liver enzymes and chronic fatigue syndrome.

There are a lot of drugs that can cause diarrhea including citrates, magnesium-- containing antacids, anti-arrhythmics, antibiotics, calcitonin on steroidal anti-inflammatory medications stimulant laxatives and cancer medication.

Whatever the cause of your chronic diarrhea, this is a challenge for physicians to figure it out and the best start is to go to the doctor and give them an appropriate history on your diarrhea. Our first goal would be to figure out and categorize the type of diarrhea that you had, and once that is done, the rest is as they say smooth sailing.

Taking care of our Fathers

The week leading up to Father’s day has been celebrated as National Men’s Health Week.  So it is important for this community to focus on the health and well-being of the men and our fathers. 

Men do not see physicians for their annual exam nearly as often as women.  Men are dying of the top causes at higher rates than women.  Men are more likely to be uninsured than women.  Approximately 30,000 men die each year from prostate cancer.

Men need to start checking their testicles at the age of 15, and if they notice lumps they should be seen by a physician asap.  Annual skin exams should be done at 18 years and above.  Men should be seeing a dentist every 6 months.  Eye exams should be done once in the 20s and twice in the 30s to rule out cataracts or glaucoma.

A lot of young men who have families in this wonderful county do not have insurance, which is a great reason to have a hospital district.  The hospital would be able to assist better than current county requirements for indigent care.

At 35, men should have their thyroid checked, diabetic screening should be done on obese and overweight men, and blood pressure readings recorded. 

At 50 years of age, men should get screened for colorectal cancer with a colonoscopy every 5-10 years.  Men with risk factors should be evaluated for osteoporosis at this age as well.  

The Texas Department of State Health Services reports that “due to a lack of awareness, poor health education, and culturally induced behavior patterns in their work and personal lives, men’s health and well-being are deteriorating steadily.”

We need to take care of our men in this community, and the first way is to get them to one of our local GRMC physicians.

Why is Azithromycin causing Heart Attacks?

A recent study done by Ray and colleagues created an uproar among patients because they have been on Azithromycin, aka “Z-pack.”  I would like to reassure everyone about a few points.

The study looked at patients in Tennesse on Medicaid from 1992 to 2006.  This isn’t representative of the national population. 

Next, they found that almost 350,000 scripts were written for Azithromycin.  Out of 350,000 scripts written for a 5 day course, 45 patients had died.  22 of the patients had sudden death from cardiac arrest. 

Compared to auto accidents which numbered 6,420,000 in 2005, in which 42,636 people died, or 1 death every 13 minutes, an antibiotic is pretty safe.  That means it is safer to take an antibiotic than it is to get in your car every day.

Another point is the controls.  I love it when they compare the controls with antibiotic treatment.  Nobody died who weren’t taking antibiotics.  Well, when you are healthy, you probably don’t need antibiotics.  And when you are on antibiotics, you are probably sick.  And if you smoke, have high blood pressure, coronary artery disease, and possibly have pneumonia, there is a pretty good chance you could have a heart attack, too.

So rest assured, and do not let the media scare you away from your local doctor.  

Teenage Drinking Termination

It seems like a broken record when news stories say the same thing, such as, “Drunk Teenager Kills Best Friend in Police Chase.”  The stories are sad and exude many exasperated wails of pain in those personally touched by tragedy.  But there is hope.

Programs such as the successful Shattered Dreams done by the Glen Rose School District do much to curb underage drinking.  The first step in preventing teenage drinking and alcohol abuse starts at the parent.  The parents need open lines of communications with their children. 

Teenagers already in rebellious mode will have the most difficulty with resuming already strained communication.  Love and Logic books can help rescue that relationship so that mutual respect can develop.

Early underage drinking starts when there are no expectations discussed.  Parents need to tell their children, “No drinking until you are 21.”  That is an easy to understand expectation. 

Teenagers drink the most between 3 and 6 p.m., therefore it is paramount to have them participating in extracurricular activities.

Teaching your kids adequate coping and stress management strategies are also very important.  The best way is involving your children in church or spiritual meetings at home. 

At home, try to decrease family conflicts in front of children.  Increase parental supervision and let your children know that they are cherished.  Above all, do not make a show of drinking in front of your children, as that increases the risk that your children will do it.

Good luck Parents.  Let’s keep our children safe.

Treating Teenagers

To celebrate adolescent month in May, I'm going to have a series of articles on adolescents. In my brief fatherhood experience which is a total of 7 human years, I’ve yet to parent adolescents.  However, I have taken care of many adolescents in the 16 years I have been involved in the healthcare industry. 

The main issues in adolescence are physical, emotional, and psychological changes.  Some of these changes can create lots of challenges across the spectrum of healthcare as well.  It is important for doctors to build relationships with young people to help them become responsible health-care decision makers.  I think social issues that dominate an adolescent’s life can be actively managed with that personal relationship.

If you take the top 3 causes of death in adolescents; accidents, homicides, and suicides, you can see the importance of building a relationship with adolescents.  At the intersection of important social issues of life, adolescents can do real well and be successful, or they can go down a road that can lead to prison.  

As adolescents mature, the doctor can assist them and the parents with those changes.  Because of the sensitivity of some of these issues, it is important to communicate the legalities of adolescent medicine.

When a minor is able to consent remains a sensitive issue.  Some young people do not want their parents in the room when they are with a doctor.  The important thing to remember is that the doctor is legally required to maintain confidentiality except as permitted by Texas law.  I always have patient parent in room at first, and if it is a general exam, I like to ask patient sensitive issues in private.  It is important to know if they are engaged in intercourse, if they have friends, and if their friends are doing things that make them uncomfortable.  These are just a few of the many questions we need to ask.

A minor can consent to treatment by a physician if they are in active duty with armed services, 16 years or older, living away from parents, managing their own finances, unmarried and pregnant, unmarried and parent of child and has actual custody of the child, and consenting to diagnosis or treatment of infectious disease, or communicable disease that is reportable to the Texas Department of State Health Services (DSHS).  A minor can consent to examination or treatment for chemical addiction, dependency, for counseling for suicide prevention, or sexual, physical or emotional abuse. Texas Family Code 32.003-.004

The overall well-being of adolescents begins with a good parent-patient-doctor relationship.  And getting patients to coincide with good health is our goal.  May good health be with you!

What is Prediabetes?

When the American Diabetic Association recognized a possible increased risk of diabetes in 1997 via blood sugar levels, they called it impaired glucose tolerance.  It is diagnosed when a fasting blood sugar is between 100-125.  Recently the Hemoglobin A1c was officially added as one of the screening tools for diabetes.  But that doesn’t translate into being a screening tool for Prediabetes.
 

Prediabetes is not a disease per se, rather it means that the risk of diabetes is there.  Primary care aggressively treats Prediabetes nowadays.  I will prescribe a medication commonly given in diabetes called Metformin, especially if the patient is overweight.  Metformin is the best medication by pill form that reduces the Hemoglobin A1c.  

Prediabetes, like Prehypertension denotes necessary lifestyle changes.  If lifestyle modifications are not followed, the end result is the official diagnosis of diabetes.  

Eating a healthy diet, exercising regularly, and living an active lifestyle all improve your chances of “curing” yourself of Prediabetes.

Update on Rhinosinusitis

Recently the Infectious Disease Society of America released first guidelines for treatment of Rhinosinusitis.  These guidelines help PCPs in treatment of upper respiratory symptoms. 

Symptoms include high fever, facial pain, purulent nasal drainage, and/or headache.

Be sure to call your doctor if you exhibit severe sinus symptoms for more than 3-4 days, or a “double sickening or worsening” for 3-4 days or for unrelenting moderate symptoms for over 10 days. 

These 3 examples all qualify for antibiotics.  If improvement is exhibited after 3-5 days, complete 7 day course of antibiotics.  If no improvement, then a CT or MRI is indicated.  

I hope all you stay well during the upcoming rainy season.  The allergies will soon be upon us.  To partially quote Star Wars, “may good health be with you.”

A Walk in My Moccasins

Well, here it is finally.  Something I can say that is no longer a "work in progress, stack on my desk, or permanent New Year's Resolution."  A Walk in My Moccasins is an easy to read book, memoirs of the trials I "enjoyed" trying to find my way in life.  Hope you all enjoy it as well.  Please show your support and purchase a copy on Amazon or createspace.com.  Thank you.



https://www.createspace.com/3786815

Real Physicians = Real Results, Technology's Race to Replace Physicians Still a Long Way Off

I love the Iphone, and asking Siri mundane questions elicits many chuckles.  My wife and I can pass the long hours on a road trip asking her questions.  You can ask Siri nearly anything and she has an answer.  It may not be the right answer, but she can search the web if you want.  She answers easy questions, locates addresses, and can carry a short conversation. 

Being a doctor, I decided to see how far technology still has to go with medical care.    Hence the following conversation with Siri:

Me: “I have a headache."

Siri: "I don't know where you are but you can help me find out.  Go to location settings and turn on Siri.

Me: "It's sharp and achy."

Siri: "I don't understand “it's sharp and achy.”

Me: "My right eye feels like it's coming out."

Siri: "I don't know what you mean by “my right eye is coming out."

Me: “Can you help me get a doctor please.”

Siri: “I don't know where you are at but you can help me find out…..”

So as you can see technology has a way to go before people start relying on it for medical advice. Don’t ask Siri for any medical advice.  Until further advancements are made, stick with the old fashion family doc. 

Vaccines, Texting, and Festivals

Regarding local county health information, the influenza numbers are good.  An update on the Influenza epidemic shows so far this year GRMC has cultured 115 Influenza-like illnesses (Ili), and 14% have been positive for Influenza A or B.  That is better than the national average quoted by the CDC in its weekly Fluview at 21%.  Congratulations on the efforts of GRMC during its vaccine drive. 

We have received updates on the Zostavax- the vaccine for Shingles.  The FDA approves it for ages 50 and up, but recently the ACIP (committee on immunizations) doesn't recommend for ages 50-59 because of supply issues.  The safety of the vaccines is not questioned, and it remains important for anyone above the age 50 to get their Zostavax.

Don't Text and Drive!  Recent reports detail ability to drive is decreased significantly similar to being impaired with alcohol. 

How about a festival?  I am very interested in starting a weekend festival here in Glen Rose, and would like any input from readers as to what we could do to increase the sense of community while improving health and wellness.  Being a transplant doesn’t hamper my idealism for this community, and hope that we can offer something annually we all look forward to.

It seems that every small town I grew up in had a major festival.  In Oxford Kansas, they had the Watermelon Festival.  In Okmulgee Oklahoma they had the Pecan Festival.  Okmulgee has been competing with another small town for largest Pecan Pie ever made.  The local university cooking school claimed the prize when they made a large 30 foot diameter pecan pie. 

Please email me any questions or concerns to runsinthewynd@gmail.com

What is the Difference between a Mole and a Melanoma?

Moles can come in all different ways.  Some are brown, tan or even flesh covered.  Most are usually less than the size of a pencil eraser.  An ordinary mole can be present at birth and remain the same size, and color for many years. 

Melanomas are often larger than moles.  While common moles are less than 1/4^th an inch, a melanoma can be larger.  Common moles usually are the same color throughout, while melanomas have several colors or an irregular pattern.

Normal moles are usually round or oval with no border irregularity.  Melanomas do not have even borders and may be notched.  Melanomas are asymmetrical which means one half is different than the other half. 

Melanomas usually occur in people who have a higher number of moles, both irregular and larger.  If a family member has melanoma, there is higher risk for others in the family as well.

Lifestyle choices also contribute to potential melanoma development.  Frequent sun exposure, multiple sunburns at an early age, having fair skin, easily freckling, or having red or blonde hair can be a predisposition for risk of melanoma.

Be aware of any mole that changes, or a sore that doesn't heal.  Look closely at the borders of all moles and see if any of the pigment is spreading from the border into surrounding skin.  Be aware of any changes in sensation which may include itching, tenderness, or pain at a mole site.  Look for changes in the surface of a mole, if it oozes or bleeds.  Also look out for a mole that stands out differently than the other moles on your body. 

If anything looks or feels different come by the office and get a biopsy.  Pathology reports in about 7-10 days. 

Thanks for the questions.  Keep them coming. 

Justus Peters MD

Update on: A Walk in My Moccasins, Memoirs of a Deaf Physician

Greetings all,

I am very excited to finally finish this work in progress since i started over 10 years ago.  I hope it provides my readers with some insight to what life is like being deaf.  I've decided to go with Amazon's Createspace.com for publishing.  I have sent the final draft to the amazing Alexander Becker to do his magic.  For any aspiring writers check him out at http://www.alexanderbecker.net/

My next project is a long time dream of writing a novel.  I will also be starting a video log for this blog site.  If anyone has any questions, please do not hesitate to email me at runsinthewynd@gmail.com 

Happy Trails!

Justus Peters MD

Is it Food Allergies or Intolerances, and what to do about it?

Our immune system is continuously evolving to develop both immunity and allergies to new foods, drugs, chemicals, and the like.  But the recent guidelines released by the National Institute of Allergy and Infectious Diseases (NIAID) report that food allergies are increasing in prevalence. 

A clinical food allergy exists when a specific food causes an allergic reaction, namely hives, lip swelling, vomiting within 30 minutes of intake.  The most severe reaction is called anaphylaxis.   

Anaphylaxis is a potentially fatal reaction that causes swelling of skin and mucosal tissue like swollen lips, tongue and uvula.  It causes respiratory distress by constricting airways.  It causes decreased blood flow to end organs, like brain, muscle, bladder causing weakness, fainting, and incontinence. 

Almost always, anaphylaxis includes the skin with a rash that occurs within minutes to hours of eating a certain food.  These reactions should be taken to the ER as soon as possible. 

Milder reactions to food include flushing and itching of the skin.  These milder reactions can be treated with antihistamines like Benadryl. 

Children can outgrow allergies-- in fact about 80% of them outgrow allergies.  When adults develop food allergies, those tend to persist longer.

The NIAID recommends primarily prevention of offending foods to minimize allergies.  However, for expectant or breast feeding mothers, there is no reason to be eliminating foods.  They do recommend breast feeding in the first 4-6 months.  There is also no recommendation to avoid foods after that 4-6 month period. 

The best test for food allergy is the food challenge.  The food challenge is the best diagnostic test and should only be done under medical supervision where ability to treat anaphylaxis is near.

Food intolerances are simply reactions that are not severe enough to cause symptoms of flushing and itching or anaphylaxis. 

I hope this is helpful and please do not hesitate to email me at runsinthewynd@gmail.com, or blog at http://www.askjustusmd.blogspot.com/ 

Question: I am growing facial hair and can't have a baby. What gives?

I wish I could tell you what gives, but I think a couple things stick out.  One is that although the question holds a clue, I assume you are female, and two, that you have tried at least for a year to have a baby. 

Infertility is the failure to conceive after a year of trying.  A lot of things need to be looked at to determine why this may be happening.  The first thing to do is to make sure that the male spouse has sperm that work.

Sperm are supposed to do one thing and that is to swim in a straight line.  However, when observed under a microscope, doctors can see if there is possible insufficient sperm that cannot swim straight, but instead swim in circles or look like they seem to not care to swim at all.  The sperm count must be adequate as well.

The next step would be to have a doctor do a physical exam and make sure structurally all is well, and then order labs.  Hormone irregularities can cause a host of issues. 

Imaging the pelvis can tell us if you have any deeper structural issues.  One that comes to mind is possibly Polycystic Ovarian Syndrome (PCOS).  Diabetes will have to be ruled out, as well as uterine cancer, or endometrial hyperplasia.

Usually a doctor can diagnose this disease in the clinic, however, most PCOS show changes in menstruation, increased androgen hormones --hence the hair (hirsutism), or acne, obesity, and infertility.  1 in 5 women with PCOS have no symptoms at all. 

If a doctor suspects PCOS, labs will need to be done, a vaginal ultrasound to look at the ovaries will have to be done, and a treatment plan instituted.

If this is a problem you think you might have, call your doctor ASAP.  We would be glad to help in anyway. 

Remembering Resolutions and Keeping Them: A New Year’s Challenge

The first time I saw a New Year’s resolution list was when I was in Nursing School. A college educator and friend showed me his list and I became intrigued. New Year’s Resolutions are about starting over, and keeping a promise. New Years are synonymous with renewal of time, and thus a renewal of your soul and spirit. This enables many to think of challenging ourselves to be better. Some resolutions involve major change and some are small changes. But in order for your resolution to be successful, it is important have some good advice.
Keep it simple. The chance of failure increases when you set your sights too high. Making it a simple baby step with a specific detailed goal. A goal of weight loss of 10 lbs is more realistic than obtaining a model’s body.

Plan ahead. Thinking about how you will succeed in your resolution depends on good planning. There is a very good planning quote from Mark Twain, "the calamity that comes is never the one we had prepared ourselves for."

Utilize friends and family for support. In training, have a running buddy have your shoes, and you have their shoes. This way, you will have to meet up with the other in order to work out. Using family members for support is essential for motivation. They can help keep you on track and be your sounding board when you complain.

Understand that failure is not the end. If you have tried many times to complete your resolutions, just to fail by February, try to find out how and why. I know that it took Edison awhile to develop the light bulb, and Michael Jordan said, "you miss 100% of the shots you don’t take." Failure is just a stepping stone on your journey to success. Good luck with all your New Year’s resolutions!

The Best Winter Activities

I just returned from Orlando Florida after finishing the Walt Disney World Marathon, and I have some real good advice on cold weather activities, also known as "exercise".  We’ve talked about nutrition and simple over the counter remedies for winter health, and now we can discuss exercise. 

Simple 30 minute activity exercises daily can help boost your immune system by opening your airways, your sinuses, and “pasteurizing” your blood.  You don’t have to sweat, in fact, in cold weather, you don’t sweat as much, and you lose more calories. 

Proper warm up is essential and can include as much as 3-5 minutes of stretching to as little as 10 to 20 seconds of jumping jacks.  Don’t shock your body by getting out in to the cold weather and start running.  Even jumping up and down 10 times is a good enough warm-up.

Insulating your body with some moisture wicking material is crucial, so that your body’s natural cooling system doesn’t make you shiver.  Winter running gear has a wide selection on undergarments to wear.  Be sure that the outer garment is wind and water resistant.  This makes for a very comfortable activity outside in the cold weather.

When you have completed your activity, be it washing your car, going for a walk, run, bike, or most outdoors activities, then you would help your body best by maintaining the elevated temperature in your body for 5-10 minutes when you come inside. 

This means no stripping down and jumping in the shower, but rather just letting your body’s natural thermo regulators do their job.

For most during the holidays, exercise is taboo, and the “Holiday 10 or 15” pounds that are gained will hopefully be taken care of with their New Year’s resolution.  However, if you can try to treat your body well you won’t have to worry about that.

Got the Winter Blues?

Seasonal Affective Disorder making people SAD.

SAD is an acronym short for Seasonal Affective Disorder.

It is a form of depression that occurs during the cold winter months starting in December.  The days get shorter and colder, and some people call it the “winter blues, or winter depression.”

The symptoms can include fatigue, sadness, hopelessness, helplessness, weight gain, poor sleep, poor sex drive, irritability, poor concentration, no energy, thoughts of suicide, and crying spells.

The treatment for SAD is light therapy, and includes not only sunshine light, but also fluorescent light daily in morning and night.  30 minutes a day is appropriate light exposure.

While most anti depressant medications help with SAD, there are some other home remedies to try. 

In the morning when you awake, eating a nutritious breakfast with complex carbs and proteins, with cinnamon and black tea. 

If you can open your mind and focus on good things in your life, be active with things you like to do, and smile, all of these increase natural endorphins in your body to make you feel good. 

Carrying around a bag of peppermint leaves and smelling them increases your mood.  If all else fails, pull up a PHQ 9 questionnaire from online.  Fill it out and bring it to your doctor. 

The score is a good objective number to have to determine if you have mild to moderate to severe depression.  I like to check these scores every month while patients are being treated for first 3-6 months.