Building a Bigger Brain.

24 Dec

Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you, and for you to teach others. We want you to know how much control you have over both the  quality and length of your life.

What do your favorite wool sweater, your retirement savings account, and your brain have in common? They’re all better off if they don’t shrink! But the brains of the 79 million Americans (and millions more Canadians) are at risk of not only shrinking but not growing right from the start!

“All work and no play makes Jack a dull boy.” That proverb has been around since at least 1695, and it was a creepily obsessive phrase in the 1980 movie The Shining (and look what happened there!). Yet, this very simple and profound observation has somehow gotten lost in our modern scramble to make kids smarter. Recess, that time honored tradition that lets kids work off their restless energy and teaches them everything from being part of a team to negotiating conflicts with classmates, has virtually disappeared from many school districts. (In some school districts instituting recess is a challenge. In Chicago, for example, nearly 100 elementary and middle schools have no playgrounds.)

But people who make such policies are finally beginning to realize that it’s a huge mistake to eliminate  playtime. The benefits of recess include: stimulation of creativity and imagination, improved physical health and control of obesity, building friendships, and an improvement in classroom attention and learning. Kids who have an hour of play first thing in the day learn better. Social-emotional learning should be woven into academic learning because it enhances a child’s ability to learn and to thrive.

So if your child goes to an elementary school that does not have recess, or you have school administrators who do not think recess is important, then speak up and step in.  If you have no outdoor space for recess, then help school teachers find creative ways to make the gym or a classroom work. If you have to take the issue up at parent-teacher meetings or the PTA, then do it. Your child’s health, happiness, and school success depend on it.

On to another topic…

Intestinal bacteria are big news: Breast milk contains 700 varieties (that’s good because it seems to build an infant’s immune system and digestive health). We now know these bacteria break down and generate amino acids and neurotransmitters that affect mood (these are true gut reactions); and it seems disruption of a healthy balance of gut bacteria may cause (or be the result of) type 2 diabetes. But perhaps the most astounding news is that a fecal transplant (putting someone else’s, um, healthy mix of gut bacteria into the GI tract of a person suffering with Crohn’s disease or a C. difficile infection) can banish chronic diarrhea PDQ. But it sounds so… what’s the scientific word? Icky.

Well, now there’s an artificial mixture of gut bacteria that’s called, we kid you not, RePOOPulate.  In tests, people with “untreatable” C. difficile infections (that’s the bacteria that can thrive in the gut after treatment with antibiotics) saw their diarrhea clear up in three days after RePOOPulate-ing. Six months later, they were still free of the sinister bug. This not-quite-as-personal bacterial transplant successfully rebalanced their gut with a healthy bacterial mix.

If you have chronic intestinal problems, get onboard with a probiotic regimen (we recommend Culturelle and Sustinex) and make sure you eat plenty of apples. They’re loaded with pectin (it’s what’s called a prebiotic); it helps balance gut bacteria in favor of the good guys. Asparagus, chicory root, garlic, onions, and oats are other prebiotics. And if that doesn’t help, talk to your doc about repopulating your intestines with friendly bacteria.

Thanks for reading.

Young Dr Mike

NOTE: You should NOT take this as medical advice. 

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

You can follow Dr Roizen  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

Feel free to continue to send questions to youdocs@gmail.com. You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime.

 

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Carpal Tunnel Syndrome – 13 Fun Facts!

24 Dec

Carpal Tunnel Syndrome (CTS) results in numbness, tingling, and sometimes weak grip strength due pinching of the median nerve as it travels through the carpal tunnel at the wrist. There are many conditions that are similar to CTS, many of which we have discussed in the past. The following is a list of “13 fun facts” aimed at helping to properly identify CTS, knowing what to do about it, and at helping to make an informed decision as to whom to seek help for it.

CTS is most common in women, age >50, who work in a repetitive, rapid moving manually demanding occupation (typing/computer work, line assembly work, waiting tables, and more).

CTS is complicated by the presence of obesity, diabetes, hypothyroid, pregnancy, taking birth control pills, and other conditions that cause inflammation (rheumatoid arthritis and others).

CTS may develop on the dominant side, the non-dominant side or both– each case is individual.

CTS symptoms may FIRST present as morning or night time numbness that can wake the sufferer up once or many times during the night.

CTS sufferers USUALLY wait for weeks, months or even years before seeking help for it, which is a risk factor for a delayed recovery – GET HELP ASAP!!!

CTS can often be managed without surgery– especially IF you have it treated sooner rather than later.

CTS surgery may be necessary if non-surgical care fails. This may be due to the nerve being damaged beyond a certain point (an EMG/NCV or, electromyography/nerve conduction velocity helps determine this along with an accurate history and examination).

CTS non-surgical care includes: chiropractic manipulation of the wrist, elbow, shoulder and/or neck– depending on the case. All health care providers usually include a night wrist splint, anti-inflammatory measures, ergonomic modifications of work stations, and stretching exercises.

CTS non-surgical success favors chiropractic because of the inclusion of the manual therapies. When only exercise, night splinting, and NSAIDS are used, the success rate drops off dramatically.

Reduced thyroid function makes CTS worse because of the unique type of swelling associated with hypothyroidism called “myxedema.” Because of the confined space available in the carpal tunnel, a small amount of swelling can result in nerve compression and the classic numbness/tingling symptoms in the middle three fingers on the palm-side of the hand.

CTS is worse at night because it is impossible to control the position of the wrist while we sleep. As a result, we tend to curl the wrist and hand under our chin, and when the wrist bends forwards or backwards, the pressure inside the carpal tunnel increases significantly due to the change in tunnel size. This is why wearing a wrist splint at night REALLY HELPS as it keeps the wrist from bending, keeping the tunnel as wide as possible, thus lowering the pressure within it.

CTS patients respond well in some cases to vitamin B6. This is due to the healing effects of B6 (peridoxine) on neuropathy and/or it’s anti-inflammatory qualities. Other anti-inflammatory nutrients include ginger, turmeric, boswellia, bioflavinoids, white willow bark, quercetin, and others.

CTS patients do not always improve after surgery. This can be due to the fact that the median nerve is frequently “pinched” in more than one area such as the neck, thoracic outlet (shoulder), pronator tunnel (elbow) as well as at the wrist. When more than one compression is present, this is referred to as “double” or “multiple crush syndrome.”

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

 

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Low Back Pain and Balance Specific Exercises.

24 Dec

Low back pain (LBP) and its relationship to balance has been the topic for the past two Health Updates, and an initial discussion regarding specific balance exercises was introduced last month. This month’s Health Update will complete the discussion about what you can do to preserve your current balance skills, or better yet, improve them! Remember, wear your foot orthotics and don’t forget to move them between your different shoes. Similarly, if you have leg length imbalance, move your heel lift to other shoes or simply purchase additional lifts and keep the heel lift in several pairs of shoes. Also, test your balance skills now before starting a balance exercise program and re-test every 2-4 weeks to measure improvement (see the January 2013 Health Update for the testing protocol).

The initial exercise we discussed was standing with your feet together and holding that position for progressively longer times (eyes open and closed). Once you can hold this position with your eyes closed for ≥ 30 seconds, start increasing the balance challenge by:

Move your heel of the left foot next to the big toe of the right foot and repeat the exercise with the eyes open and closed. Repeat on the other side! When successful for ≥30 sec., do it with eyes closed…..

Place your left foot in front of the right foot/toes (like standing on a balance beam) and repeat the exercise with the eyes open and closed. Repeat on the other side! When successful for ≥30 sec., do it with eyes closed…..

Repeat #1 and #2 standing on a thin pillow and/or a wobble cushion or rocker board, making sure you are “safe” by standing in the corner of a room or in an entrance to a room where you can grab the door frame when needed. DO NOT RISK falling!

Rocker board exercise options:

Rock forwards/backwards (FW/BW) looking straight ahead (don’t look down at your feet). Make sure the board you are using is “safe” (where you can safely step off forwards and backwards). Don’t use a board that is too high off the ground (about 3” is maximum). Repeat the FW/BW rocking slowly for 10 minutes periodically opening and closing your eyes.

Repeat “A” but stand at a 45° angle to the front/back direction so you are rocking at an angle using the same methods and time frame.

Repeat “A” but stand at a 90° angle to the front/back direction so you are rocking at an angle using a similar method and time frame.

You can then “make up” exercises standing on the rocker board or cushion like simulating a golf swing, tennis stroke, or other favorite sport, yoga move, etc. Be creative and make it fun!!!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Preventing Breast and Prostate Cancer.

20 Dec

Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you, and for you to teach others. We want you to know how much control you have over both the  quality and length of your life.

Perhaps nothing scares a woman more than a call back for a mammogram like “you have something suspicious…” Or, for a guy, something like, “I feel something hard where I shouldn’t have” when that digital rectal exam is over. Or being told, “your PSA rose too much this year, we need to talk about a 12 or 14 quadrant biopsy of your prostate.”  So, what are some things you can do to prevent having to hear any of this from your doctor? Two months ago we promised to talk about ways to prevent prostate and breast cancer—and there are five basic principles:

1. Feed Your Immune System and Don’t Stimulate RAS. These days, you don’t have to be a dietitian to know that certain foods will create some serious stimulation of genes (The RAS family is one example) that encourage prostate and breast cancer growth and others that inhibit such genes and growth. Simple carbs, added sugars, added syrups, saturated fats and trans fats are five choices that start, accelerate, and magnify the inflammatory process. These stimulate the RAS family, and promote breast and prostate cancer, and there is no reason to have them around. That donut, that added sugar, that corn syrup, that full-sugared cola, and that chili-drenched hot dog doesn’t just add to your lousy cholesterol, they also stimulate your genes to facilitate cancer growth. We could spend an entire book talking about the fat around our waists (oh, wait, we already did that twice—YOU: ON A Diet, The Owner’s Manual for Waist Management, Revised is the current version). But we also need to spend some time talking about the fat in your diet. Most of us know that dietary fats come in two general forms: Either they’re good for you, or they’re more destructive than tire tread marks on armadillos. You probably know that you should avoid the bad kinds (saturated and trans fats) the way you avoid telemarketers.

Cruciferous veggies (cauliflower, broccoli, brussel sprouts, cabbage, watercress and arugula) and walnuts (not other nuts) inhibit breast and prostate cancers. Ten years from now, we may know a lot more about specific foods for your specific breast or prostate genomes, but these choices are clear ways to help avoid breast and prostate tumors for now.

2. Get Your Clothes Wet. We may not like to see sweat on treadmills or public speakers, but we want to see it on you. While we recommend different kinds of physical activity in different circumstances (including resistance exercise, walking, and stretching). The way to improve immune function is to sweat more than a kid in the principal’s office. In addition to thirty minutes of daily walking to reach 10,000 steps a day, aim for a minimum of sixty minutes a week of cardiovascular or sweating activity—ideally in three twenty-minute sessions—in which you raise your heart rate to 80 percent or more of its age-adjusted maximum (220 minus your age) for an extended period of time. How to do this? We recommend low-impact activities like swimming, cycling, or using an elliptical trainer to get your heart rate up without compromising the quality of your joints in the process (and to change activities, so you don’t get repetitive use injuries from doing the same activity over and over). We also recommend interval training—that is, alternating periods of maximum effort with periods of recovery—for the maximum benefit of your heart. (Check with your health professional beforehand; her or she may want to try it in the controlled setting of a stress test first.) Even doing one minute at the end of every ten with maximum effort can be beneficial.

3. Kiss YOUR Butt goodbye. No we’re not talking about weight, but about tobacco. It’s still the leading cause of cancer. If you don’t smoke but live or work in a smoke-filled environment, that’s still going to age you. We even speak about avoiding living or breathing within 2 blocks of a freeway. Spending just one hour in the presence of secondhand smoke is the equivalent of smoking four cigarettes. Whether the smoke you’re breathing is from your own cigarette or someone else’s, or even from someone else’s water pipe or e-cigarette, it weakens your immune system, and promotes cancer. We have a way to help you—try http://www.EnforcerEcoaching.com (Note: there is a charge).

4. Create Your Backup Plan: Stress is almost as great a cause of heart attacks as tobacco is; but stress isn’t all-bad. It’s what gives you the concentration and ability to finish a project or meet a deadline. But stress can linger around like week-old leftovers and create its own kind of stink. So in periods of high stress, you need to have a plan that works for you. Exercise and meditation work for some people, and both of them will help you manage chronic stress through the release of such feel-good substances as nitric oxide and brain chemicals called endorphins. But in the heat of the moment, at peak periods of high intensity, you should be able to pull a quick stress-busting behavior out of your biological bag of tricks. You can find a great teaching program for this at http://www.clevelandclinicwellness.com (look for “Stress Free Now”). Whatever backup plan you have, practice it daily.

5. Add A Helper, and Avoid A Bad Actor. 1st helper, 162 mg of aspirin. We recommend half a regular aspirin or two baby aspirins (162 milligrams total) every day if you’re a typical man over thirty-five or a woman over forty. Why? Many studies of primary prevention have shown that two baby aspirins decrease the risk of breast cancer by 40+ percent, and nine other cancers (colon rectal, esophageal, liver, prostate –what is good for the breast is usually good for the prostate, and visa-versa, etc). Aspirin has risk, so check with your health professional before you begin. You can reduce potential gastric discomfort by drinking a half glass of warm water before and after taking aspirin; the pills dissolve faster in warm water and are less likely to cause stomach irritation and ulcerations and bleeding.  Avoid more than 600mg a day of calcium in supplements. They are associated with increased prostate cancer (and as we said above, what’s usually bad for the prostate is also bad for breasts). You want to get your calcium (you need about 1200 mg a day) mainly from foods.

Thanks for reading.

Young Dr Mike

NOTE: You should NOT take this as medical advice. 

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

You can follow Dr Roizen  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

Feel free to continue to send questions to youdocs@gmail.com. You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime.

Does Neck Surgery Improve Long-Term Outcomes?

20 Dec

How many times have you heard, “I have a pinched nerve in my neck and have to have surgery.” Though there certainly are cases where surgical intervention is required, surgery should ONLY be considered after ALL non-surgical treatment approaches have been tried first (and failed). It is alarming how many cases of cervical radiculopathy (i.e., “pinched nerve”) end up being surgically treated with NO trial of non-surgical care. Hence, the focus of this month’s article will look at research (“MEDICAL EVIDENCE”) that clearly states neck surgery DOES NOT improve the long term outcomes of patients with chronic neck pain.

Chronic neck pain (CNP) is, by definition, neck pain that has been present for a minimum of three months. This category of neck pain is very well represented, as many neck pain sufferers have had neck pain, “…for years” or, at least longer than three months. Depending on the intensity of pain and it’s effect on daily function, many patients with CNP often ask their primary care provider, “…is there anything surgically that can be done?” The desire for a “quick fix” is often the focus of those suffering with neck pain. Unfortunately, according to recent studies, there may not be a “quick fix” or, at least surgery is NOT the answer. The December 2012 issue of The European Spine Journal reports that spine surgery did NOT improve outcomes for patients with CNP. Moreover, they pointed to other studies that showed some VERY STRONG REASONS NOT to have spine surgery unless everything else has failed. One of the reasons was a higher hospital readmission rate after spine surgery. Another reported that most studies on surgical vs. conservative [non-surgical] care showed a high risk of bias, suggesting the research on surgical intervention was biased in the research approach used. They further reported, “The benefit of surgery over conservative care is not clearly demonstrated.” It is important to point out that the research analyzed studies that included patients with and without radiculopathy (radiating arm pain from a pinched nerve), and myelopathy (those with pinching of the spinal cord creating pain, numbness, weakness in the legs, and/or bowel / bladder dysfunction).

In February of 2008, the Neck Pain Task Force published overwhelming evidence that research supports the use of cervical spinal manipulation in the treatment of both acute and chronic neck pain with or without radiculopathy. Bronfort published similar findings in 2010 in a large UK based study that looked at the published evidence supporting different types of treatment for various conditions. They found cervical spine manipulation was effective for neck pain of ANY duration (acute or chronic). Chiropractic utilizes manipulation, manual traction, mobilization, muscle release techniques, home cervical traction, exercise, as well as a multitude of physiotherapy modalities when managing patients with CNP. Given the overwhelming research evidence that surgical intervention for CNP is NOT any better than non-surgical care, the greater amount of negative side-effects, and the obviously long recovery time post-surgically, chiropractic treatment of anyone suffering from CNP should be tried FIRST.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Whiplash “Anatomy.”

20 Dec

To better understand Whiplash, let’s take a look at the anatomy and what is actually injured in a whiplash injury.  Our spine is basically a long chain made up of blocks that are larger at the bottom and smaller at the top. This means the low back vertebra are huge compared to the neck vertebrae. The vertebrae fit together in a way that “locks” them together by the small joints in the back called “facets” and in the front by the disks. These joints function as shock absorbers between the blocks or “vertebral bodies.” Also in the front, there is a tough piece of tissue called the “anterior longitudinal ligament” that provides a barrier so that when the neck is bent backwards (into “extension”), it becomes tight and stops that movement so it doesn’t over-extend, which could fracture the small facet joints in the back.

There are ligaments, or tissues that hold bone to bone, in the back of the spine that connect between the “spinous processes,” or bony “bumps” in the middle of the back. These ligaments check or stop excessive forward motion of the neck during whiplash. Joint capsules surround joints, which we all have seen when we separate a chicken leg from the thigh. Remember how smooth and shiny the end of the chicken leg is? That smooth surface at the end of long bones is call “hyaline cartilage”, and it allows for slippery gliding between the ends of our bones when we move any joint, including our fingers, wrists, shoulders, hip as well as the facet joints of the spine. Joint movement is facilitated by the presence of an oily substance called “synovial fluid” which acts like a lubricant for the joint allowing for pain-free movement.

A “sprain” occurs when we damage a joint capsule or a ligament, or when the muscle or its attachment (tendon) is injured. These are graded as mild, moderate or severe, or grades 1, 2,or 3, with grade 3 being the worst at 75% or greater tearing, and healing takes progressively longer with each grade.

During a whiplash injury, the classic rear-end collision results in over stretching of the ligaments in the neck, and tearing can occur (sprain, grades 1, 2 or 3). If one of the nerves gets pinched, then numbness, pain, and/or weakness can occur, radiating down the arm to a specific location. When this occurs, the long-term prognosis is worse. Concussion can also occur if the brain is slammed against the inside of the skull. Chiropractic adjustments, when administered early, yield the best results for treating whiplash, according to many studies.

We realize you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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