Category Archives: Uncategorized

The Land of Milk and Honey

The study of obesity in American adults traditionally focuses on people, not food. And there is no lack of people to study.

For most of the past 100 years, the obesity rate for adults was stable at less than 15 percent; often assumed to be a genetic based. However, in the last three decades the obesity rate has steeply increased to 45 percent, much to the dismay of health professionals, and to many of us getting dressed in front of a mirror each morning.

During this same time period, food production in our country has radically changed. In 1930, it took 24 percent of all working adults to produce the food to stock our pantries. And today that figure is just 1.5 percent! This is possible only because farming has become agribusiness, where principles of efficiency and competition meet nature.

For crops, that involves abundant nitrogen fertilizers, pesticides and genetic selection of the hardest and fastest growing plant species. Factory farming of animals means high stock density; pigs and cows lined up like corn in the fields.

Ultimately the equation is simply maximizing pounds of sellable meat per 100 pounds of feed, and per acre. The animals don’t have room to walk around, which means like us, they gain weight faster.

A significant percentage of an animal’s food intake feeds the bacteria in the livestock’s gut, not the livestock. Putting antibiotics in the feed gets rid of much of this normal gut flora. The result: a 10 percent greater weight gain.

Growth hormone, an anabolic steroid, has been synthesized for many commercial farm animals. Unlike human growth hormone, for some reason cattle and swine growth hormone is cheaply produced.

Given by injection or implant, it dramatically increases muscle mass and speed of weight gain. This adds an additional 15 percent to the marketable muscle mass (steak) of the animal.

The process is not unlike automobile design and manufacturers in Detroit. If the maximum miles per gallon is the desired result, certain things can be done to achieve that. The car can be made much lighter, more streamlined or use a smaller engine. Tradeoffs are expected. The lighter the car the worse it will do in a crash; all other things being equal. It’s the classic double-edge sword effect.

In meat-producing areas like Chicago and Omaha, pressure exists to design meat that can be produced as inexpensively, quickly and safely as possible. Antibiotics and growth hormone serve that master.

This is done with appropriate concern, and the producers are acting in good faith.

Any drug given livestock has a published time necessary for that drug to wash out before slaughter. Meat is tested for these drugs and they are required to not be above a certain low level. The food production system in the United States has never been safer (the proof is that food borne illness – staphylococcal food poisoning, botulism, and bacterial contamination – are lower than ever).

But we may need to cast a wider net, perhaps, than simply poisoning by food when we’re talking about health. We may consider facts such as young girls are entering puberty at a much earlier age, which is believed to be from low level hormones in meat. And we should be concerned that weight loss programs by and large don’t work despite the millions spent by Americans who continue to grow fatter every day.

One has to wonder if our gut bacteria may be influenced by low level antibiotic contamination of meat. Are we spending all of our time trying to influence obesity-producing behaviors, when people might just be on a less intense version of our cattle fattening program?

It’s definitely something to ponder.

Take care,

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

 

To Report or Not to Report – That is the Question

This is a question supervisors, bosses, and HR specialists ask themselves
constantly, albeit quietly.

Everyone wants zero injuries and companies have been known to insist on watchful waiting before committing to medical care and a reportable injury. This is a risky game, but I offer some guidelines that should help you avoid some of the deepest pitfalls.

Does this “injury” need medical care?

I will start with the disclaimer that the safest thing to do is have any injury evaluated. The injured employee will do better and you and your company will stay out of trouble. But if I were a supervisor, I would want some help in trying to sort the serious from the nonsense.

In looking at a possible injury, the first thing an employer naturally considers is who the employee is. They are thinking of his HR file: attitude, reliability, productivity, attendance.

Essentially, are they a great employee, or a marginal one? That approach may guide you in determining whether the employee will be here next year or will get a promotion. But it’s the wrong place to start for work-related injuries as it has nothing to do with the outcome from a specific event.

So put down the HR file and start somewhere else.

A good place to start is with the “mechanism of injury.” That is a term for “what happened” – the employee got hit with a hammer, fell down, or lifted something heavy. Would you expect a serious injury from this particular circumstance? How much force is involved?

For example: If someone falls off the loading dock onto concrete, and doesn’t land gracefully on their feet, a fracture is more than possible, even expected. The opposite circumstance is someone hitting an elbow against a doorframe while walking through an opening. That would not be expected to produce a major elbow injury. So consider the force put upon the body at the time of injury.

Rule 1: Big force causes big injuries. That tells you to be very concerned about even an apparently minor injury if there was major force involved. An employee falls off the roof – have them checked out, even if that person attempts to brush it off.

Injuries come from outside forces acting on the outside of the body. Since the body is conveniently covered with flesh and blood, there is often physical evidence of this injury. Especially in an extremity, there will often be swelling, a black-and-blue skin coloring, tenderness and sometimes “it just doesn’t look right” – because there is a minor deformity. If it doesn’t look right, that’s a definite sign, so beware.

Rule 2: All of these suggest more injury rather than less. So the second rule is if it looks injured, get it checked out sooner.

Rule 3: Minimize the downside risk. In medicine, downside risk is a tragically bad outcome, disability, death, medical complications – all very bad stuff.

Doctors are trained to instantly think the worst, and go about proving to ourselves it isn’t that bad. That approach avoids missing something important that will cause great grief if missed.

In essence, you ask yourself: “What is the chance of this becoming a big problem if it doesn’t get treatment quickly?” That is, admittedly, difficult to do without a lot of medical background, but we can suggest a few scenarios.

A head injury with even a brief loss of consciousness or appearing dazed is concerning. This is a brain injury. Brain injuries are always serious, because they can quickly turn out very badly. This employee needs to be evaluated even if they claim to be fine. The downside risk is too great not to aggressively look for trouble.

Broken bones can have really lousy outcomes if not addressed. Quite often the injured employee can tell you they have a broken bone. They hear or feel the bone break. Believe them and get them checked out promptly.

Foreign bodies in eyes are a very common industrial injury. The employee will tell you they have something in their eye. They are almost always right. If a foreign body is not removed it will become harder and harder to remove and put your eye and vision at risk.

It’s always worth trying to wash the eye out at work, and if that solves the problem, no worries. But don’t waste more than 10 minutes trying to wash it out. If you can’t get it out right away, it needs to be removed by a doctor.

All employers attempt to separate the truly injured from the minor stuff. A little common sense when combined with some thought about mechanism of injury, signs of injury, and downside risk will go a long way toward helping you make safe decisions.

Of course, the safest course of action is to have a medical provider evaluate the injury right away, which is our recommendation.

Remember that medical advice is a phone call away if you need specific and immediate advice.

Take Care.

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

 

Image courtesy of Stuart Mills / FreeDigitalPhotos.net

Marriage Tax Pay Off: Living a Longer Life

You’ve probably heard of the “marriage tax.” It amounts to something like $10,000 per year if filing jointly instead of individually. But what Uncle Sam “taketh away,” you perhaps make up thanks to a healthier lifestyle.

A significant reduction in “lifestyle disease” among married couples is no huge surprise. One just has to consider, perhaps wistfully, your single life for a few seconds to make this clear. Single people tend to live life at the extremes. There typically is more drinking, smoking, not sleeping or eating right, and in general fast-lane living among the unattached. We might want to blame this on youthful exuberance, but we also see this behavior rediscovered in divorced middle-aged people. Married folks tend to moderate each other’s behavior and consequently the lifestyle diseases such as hypertension, diabetes and heart disease are significantly reduced.

All manner of traumatic death is also dramatically reduced in the married population. With a little more sleep, and less alcohol, motor vehicle fatalities are much lower among married people.

I gave up skydiving once I got married, perhaps saving me a violent end. Other violent deaths like suicide are also much lower. Depression, perhaps not coincidentally, is lower in people with a soul mate.

If cancer is one of your big fears in life, marriage is one of your best defenses. The lifestyle cancers attributed to smoking and drinking are all understandably reduced, most notably lung cancer.

Interestingly enough, the cancers having no obvious connection to any specific human behavior are similarly reduced in the married population.

Lymphoma, leukemia and pancreatic cancer are examples. In fact, the fatality rate from virtually any cancer you can name is lower among the married.

Most startling to me during my medical education was the lower death rate in married people goes across the vast spectrum of human disease and frailty. Pick the wildest thing you can think of – death by shark attack, getting hit by lightening – and you are less likely to die of that while you are married.

So let Uncle Sam take his cut, the pay off is married people have a better chance of living a longer, healthier life.

Take care.

Dr B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

Image courtesy of David Castillo/ FreeDigitalPhotos.net

Coffee: The Natural Wonder

Because March is National Caffeine Awareness Month,
I thought it would be an appropriate time to discuss this beverage that most of us require to get energized each morning.

This much maligned beverage has made headlines for being – surprise – a healthy beverage. Now this is no huge revelation to me as I feel positively suicidal before I have my first morning cup-a-joe. Coffee extends my life every morning.

Coffee got its bad reputation from associating with undesirables. People are natural multi-taskers. They like to do something while they smoke, sometimes combining smoking, drinking, and talking all at once.

Coffee or whiskey was perhaps used to wash down the bad taste of the smoke. The result was coffee was considered a co-conspirator with cigarettes in research showing increased mouth, throat and lung cancer.

It turns out it was all the cigarettes. Combine cigarettes with the most innocent of beverages (dandelion wine, mint tea, mother’s milk), and the results will be the same. The coffee was simply an innocent bystander.

The latest research on coffee is the result of a “Mega-study.” Mega-anything sounds impressive, but a mega-study is a powerful statistical technique to combine dozens of smaller, weaker studies and get a big strong study – and hopefully some bullet- proof answers.

This time the analysis showed stroke risk was significantly lower among coffee drinkers. When all the usual suspects for stroke (hypertension, high cholesterol, diabetes), were accounted for, coffee drinkers came out ahead.

But cutting down on the stroke risk is only the puff of steam in the volcano of coffee benefits. Coffee is low-cal. If you like it black, it’s like celery, takes more calories to digest than it contains. Even with sugar and a splash of cream, it’s less than 50 calories. That is half the calories of most soda, juices or margaritas.

Perhaps coffee can save us from the obesity epidemic, venti mocha with whip notwithstanding.

Coffee has antioxidants, those magical molecules that are believed to help everything, including aging. No guarantees that coffee will make you any younger, but the risk of heart disease is lower in coffee drinkers.

Colon cancer, gall bladder disease and Parkinson’s are all less frequent in roasted bean enthusiasts. Even the risk of diabetes is lower.

But coffee is not for the faint of stomach. The acid level in the stomach is measurably increased by coffee, as any college student up late for finals will attest. There are also better beverages for insomniacs. Caffeine when taken in excess can turn you into a jittery mess, again channeling my undergraduate years.

But strokes are nasty things and any way to avoid one is a blessing.

One more thing about coffee: Drink it regularly and you’re guaranteed not to sleep through your life.

Take care,

Dr. B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

Image courtesy of Stuart Miles / FreeDigitalPhotos.net

 

Osteopathic Physicians and Surgeons of California Honors Dr. Minh Nguyen of U.S. HealthWorks

Although he’s only been involved with the organization’s leadership a short time, Dr. Minh Nguyen of U.S. HealthWorks has made a big impression as a member of the Osteopathic Physicians and Surgeons of California (OPSC).

At the annual OPSC convention in February, Dr. Nguyen received the “Rookie of the Year” honor thanks to his many efforts as a leader in the prestigious professional medical organization.

The award is presented to an osteopathic physician who has recently become active in OPSC leadership. Dr. Nguyen served as the Workers’ Compensation committee chair person from 2010-12, and was a member of various other committees, including legislative, budget, and new members.

Kathleen Creason, Executive Director of OPSC, offered these words of praise when presenting Dr. Nguyen the award at the San Diego convention.

“This award is presented to an individual who is newly active in the organization. This year’s recipient – Dr. Minh Nguyen – has jumped right into involvement in the organization. With an interest in occupational medicine, he has worked tirelessly on workers’ compensation and legislative issues. He has shown a willingness to take on any task that is asked of him, and he clearly has a bright future ahead of him.”

Dr. Nguyen has been employed by U.S. HealthWorks since 2007 and is currently the Regional Medical Director for the San Diego area and the Los Angeles South Bay Region.

“I’m humbled by this award, acknowledging my time and commitment to OPSC,” said Dr. Nguyen, who has been an OPSC member since 1999. “OPSC has represented me so well at all levels of my professional career that I can only hope to give back to the organization through my efforts and involvement.”

The mission of the OPSC is to advance the practice of osteopathic medicine as an independent, scientific and complete system of medicine for the restoration and preservation of good health. The organization also provides programs of education and information that contribute to the effective, professional practice of osteopathic healthcare for the benefit of all members of the profession.

In 2013, Dr. Nguyen will chair one of the most active and busy OPSC committees – the Legislative Committee. Previously he has participated in meetings on behalf of OPSC, particularly in the area of workers’ compensation. He has also volunteered to give educational lectures at the annual conventions, including this year’s topic on Tuberculosis Exposure.

Dr. Nguyen lives in San Diego with his wife, Quynh. The couple has two children Sydney, 8, and Quincy, 6.

Visit www.USHealthWorks.com for more information.

 

Our Youth-Crazed Society Misusing Testosterone

The airwaves are full of it: talk of testosterone.

Testosterone has had a colorful history. Early work on the steroid had a Harvard professor self-injecting a “rejuvenating elixir.” This was prepared from an extract of dog and guinea pig testicles. It seems even professorial types yearn for virility.

It wasn’t until the 1930s that testosterone was identified, and shortly afterward was synthesized (made from scratch). It didn’t take much longer for men to start experimenting with it.

Testosterone is the primary male hormone. It is classified as an androgenic steroid. All hormones are steroids and androgenic ones help build strong muscles.

Testosterone is closely related to, and synthesized from cholesterol (of all things). In men, 90 percent comes from the testicles. In women, who have a small percent of the testosterone that men do, it comes from the adrenal glands.

This androgenic steroid has only a few mainstream applications, probably not enough to support a national television advertising budget. Just how many men are running around without testicles? And how many would admit it? To my knowledge no one is doing focus groups of eunuchs figuring out how to sell testosterone cream.

The whole reason for synthetic testosterone to exist is off-label use, which is using a medication for some other condition than it is approved for by the DEA. There is nothing illegal about this and it’s very common for many drugs. It also has been problematic for a few medications.

Testosterone gradually decreases in men as they age. This is a normal finding, or at least it used to be. But in our youth-crazed society this is now a “testosterone deficiency.” So virtually every middle-aged male is a potential customer. Now that’s a demographic worth an advertising budget.

Many of the issues of middle-aged men look like they are made for testosterone replacement. Loss of muscle mass and strength – check. Loss of libido – check. Loss of energy, erection and general manliness – check on all three. Kind of makes you want to stop reading this and find a doctor and a pharmacy.

Not so fast – this is an anabolic steroid we are talking about. And steroids are among the strongest medications made. Lance Armstrong and Marion Jones, among many other known steroid users, can attest to that.

Testosterone does increase protein production and adds to lean-muscle mass. It will speed maturation in young males and makes bones stronger. Certain types of anemia are also improved with testosterone treatment.

On the other side, anabolic steroids have many side effects if received in higher than physiologic doses. If someone is taking a physiologic dose (a normal dose that mimics what their testes would produce), there is really no point.

Anabolic steroids like testosterone commonly elevate blood pressure. Combine that with extreme physical exercise and you have a great one-two combination for a stroke.

Steroids also change the lipid ratio in the blood in the exact wrong direction (opposite of what Lipitor or your favorite statin does). The “bad cholesterol” rises and the “good cholesterol” goes down.

This increases the risk of heart attack, kidney disease and just about anything else that needs blood (meaning everything). And if that isn’t enough fun, steroids accelerate baldness and can make the testes atrophy.

A good case can be made for bringing males to normal testosterone levels for their age. Push it further in some effort for eternal youth and you might get just the opposite.

Take care,

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.

photo credit: Linden Tea via photopin cc

Thinking of Your Heart as Valentine’s Day Nears


Valentine’s Day brings hearts and chocolates, romantic thoughts and perhaps the bittersweet memory of young love lost.

Heartache is a pain like no other, utterly indescribable to one untouched by romantic catastrophe. The heart has been the center of the human intellect and our very soul for 99 percent of human history.

No less than Aristotle taught reason and love emanated from the heart. Makes sense, that’s where you feel the pain of heartbreak.

The familiar red heart symbol dates back at least 3,000 years and is believed to originate from the shape of mating swans necks, or more colorfully, women’s buttocks. The color red is assumed to come from the color of blood.

We know a lot more about curing heartache from clogged arteries than, unfortunately, unrequited love.

The physical side of the heart is simply a pump, weighing just over half a pound and making blood go round and round. It is built like the energizer bunny and is good for 2, 3, occasionally even 3.5 billion beats.

The heart, perhaps unfortunately, doesn’t get its oxygen from the blood in the heart, but rather from coronary arteries outside the heart. Blood and oxygen to the heart muscle go from the outside in, not, as commonly believed, the inside out. A somewhat precarious arrangement, as these coronary arteries tend to clog.

Making the heart last a long time is all about the quality of the heart you are born with, and maintenance, like so many other things in life. Hard to change build-quality without picking your parents. (If we get to pick our parents I want to be taller, smarter and better looking). Maintenance however, is at least as important as what you get to start with.

Avoiding a “broken heart” is a worthwhile exercise, as heart disease is the leading cause of death in America. Speaking of exercise … yes, exercise is one of the most important things you can do to keep your heart in good working condition.

Exercise is actually a “three-fer.” Exercise lowers your blood pressure, helps you lose weight and raises your good cholesterol. If blood pressure and cholesterol are still out of sorts despite exercise, they can be lowered with medication.

It is probably occurring to you that how you live has a lot to do with your risk of heart disease. Blood pressure, cholesterol, body weight and diabetes are all worsened by the typical high fat/high calorie American diet. Until recently, a lot of heavy meals were finished off with coffee and a cigarette or two. Smoking is rapidly dying out. Fortunately coffee isn’t bad for you.

Despite so much negativity, life still needs to be a little fun – especially on Valentine’s Day. Alcohol and dark chocolate are good for your heart. A glass of wine with a healthy dinner should help you not miss the double cheeseburger quite as much; and a piece of chocolate for dessert should satisfy the sweet tooth of your sweetheart.

So flowers, red wine and chocolate are romantic and heart-healthy Valentine’s Day gifts. And remember, a little romance also counts as exercise.

Take Care and Happy Valentine’s Day.

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona

 

Healthy Habits Top 10 List

Every time we turn on the TV or pick up a magazine, we’re told to do this or don’t do that. And if we follow the guidance, it will greatly decrease our risk of getting some horrible disease.

If I added up all the reductions in risk I would live to be 143! Kind of puts a whole new spin on the Social Security solvency issue. At the risk of ruffling a few feathers, I would like to suggest some order to the risk hierarchy. A logical starting place, if you plan to live a long time and are actually doing something to facilitate it, should begin here.

1. Stop smoking (or don’t start). This is the most researched topic and has absolute consensus in the medical community. Smoking cuts 5 to 10 years off your life. If you do only one thing to help you live longer, do this one.

2. Diet. I am reserving the No. 2 slot for what you eat, not how much you eat.

If you want to live a long time, eat grains, fruits and vegetables and avoid meats of all kinds, especially red meat. This is also very well researched and results in a dramatic decrease in cancer and heart disease – the No. 1 and No. 2 killers in this country. Your life expectancy will increase by five or more years from this.

3. Exercise every day. Do some form of exercise 20 minutes every day and that will get you the most life for your time investment. Your life will be a few years longer, and perhaps more importantly, you will be able to do more things and feel better. The cancer and heart disease rates are lower in exercisers.

4. Treat lifestyle disease. We are talking hypertension, Type 2 diabetes, and high cholesterol. Some of these are a result of excessive living and some just genetic roulette – blame your parents. Treating these illnesses almost completely neutralizes the dramatic decrease in lifespan that they can cause. Treating these diseases can easily add a decade to you life.

5. Weight Control. It’s not what you eat, but how much. Excessive body weight contributes to hypertension, heart disease and cancer. This can easily take a decade off your life, and make the rest of it pretty unhappy.

6. Seat Belts. Protect yourself from an untimely death in a motor vehicle. There are about 40,000 deaths per year in theUnited Statesfrom motor vehicle accidents. Seat belts have added a bunch more years than Vitamin C and the rest of the alphabet combined.

7. Deal with your depression. Depression measurably shortens life, but makes it feel way too long. The solution can be regular exercise, good friends or medications. The important thing is do something about it. Living a long life takes the will to live – that means treat the depression.

8. Stay married or get married. Married people have a measurably lower mortality rate then unmarried people. Sounds curious, but this is a well researched and a reproducible fact. However, a good marriage helps you live longer and bad marriages don’t. Make sure you know the difference (hint – if your spouse is your closest friend, you have a good one).

9. Sleep well. Insomnia and poor sleeping contribute to accidents, cardiovascular disease and poor health. Sleep apnea is one treatable culprit and can add years to your life.

10. Take vitamins. This is No. 10 because vitamins have precious little good scientific evidence of extending your life. There are a couple of exceptions (like Niacin) but 98 percent of vitamins are unproven.

The recommendation here is start at No. 1 and go as far down the list as you can.

Take care

Dr B.

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy of photostock / FreeDigitalPhotos.net

What’s Behind Those Winter Blues

The season got you down? Struggling with the motivation to get moving, even though you know it will help? Do you find the color red mildly depressing?

You may have a serious case of righteous indignation with the superficiality of life, or perhaps just the winter blues. While we don’t specialize in existential funks, we know something about depression and its cousin, colorfully named Seasonal Affective Disorder (SAD).

Our brains are immersed in a neurochemical and hormonal stew that is dauntingly complex, but a lot of work in the last decade has given us understanding of at least the broad strokes. It’s pretty complicated up in the head.

It is completely normal to slow down some in the fall; your body is conserving energy to get you through the cold winter.

For up to 10% of people, this is much more than simply banking the fires; it is a life changing and unwelcome annual ordeal. An affective disorder is a fancy way of saying a mood problem. The namesake symptom of SAD is depression.

Depression is usually associated with varying degrees of fatigue, increased need for food and sleep, weight gain and difficulty concentrating.
This occurring during the holidays is particularly irksome – when the need for energy is greater than normal. The increased appetite when the house is full of Christmas cookies is torture to anyone trying to maintain an ideal body weight.

An additional 10% of people have a milder form of the condition that may only have fatigue as a symptom.

The scientists tell us that the decrease in daylight triggers a decrease in brain serotonin and increase in daytime melatonin levels. You probably remember serotonin; that is the brain chemical that Prozac increases. Serotonin is good.

You would be right in deciding that medications like Prozac would be helpful in Seasonal Affective Disorder.

For those inclined toward more natural cures, we just need to trick your body into thinking it’s summer.

Your body mostly wants a sunbeam, like a cat. That is something we know how to do. Light therapy is essentially a portable sunbeam. The UV light is filtered out so you won’t get skin cancer, or unfortunately, a suntan. Light therapy with the intensity of 10,000 Lux seems to work the best, with 30 minutes every morning commonly recommended. Sitting in your sunbeam after work can also help, but occasionally causes insomnia. This treatment actually can work in as little as a week. That is three times faster than is usually seen with medical pill treatment.

Melatonin is also commonly used to treat Seasonal Affective Disorder. Melatonin is a hormone that is produced by your body in dim light. Taking supplemental melatonin in the afternoon can reset the hormonal clock.

Light therapy isn’t the only unusual treatment for SAD. Use of a negative ion generator in the bedroom at night shows a 50% response in patients with SAD.

Medications of the SSRI class work well but take a few weeks to become effective. Prozac is the best known SSRI, but any of them are effective.

The seasonal nature of Seasonal Affective Disorder favors the non-drug approach to the disorder. In people with SAD it usually returns each winter. Light therapy can be started in the fall before symptoms occur and can be useful in preventing the onset of SAD. Many find this more palatable than starting and stopping medications every year.

Seasonal affective disorder is often the cause of winter blues. A variety of treatments are usually well tolerated and effective. In the meantime, have a Christmas Cookie, can’t hurt.

Take care,

Dr. B

Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic. 

Image courtesy of [image creator name] / FreeDigitalPhotos.net

U.S. HealthWorks Announces Flu Vaccine Available At All Clinics As CDC Says Most of U.S. Now Reporting High Levels of Flu

Despite the fact that it is still early in the flu season, the U.S. Centers for Disease Control and Prevention is reporting that most of the country is experiencing high levels of the influenza virus and is encouraging people to get the flu vaccine now.

To view the CDC’s report visit: http://www.cdc.gov/flu/weekly/summary.htm.

U.S. HealthWorks, a leading operator of occupational healthcare and urgent care centers in the nation, said today all of its 182 centers in 17 states have flu vaccine available – and its medical providers will even come to businesses to vaccinate employees to decrease the likelihood of an influenza outbreak in the workplace.

“Many employees intend to get flu shots but for whatever reason don’t end up getting vaccinated,” said Dr. Leonard Okun, National Medical Director for U.S. HealthWorks. “We have vaccine available and anyone can come to one of our centers to be vaccinated. In addition, we will come to workplaces and vaccinate employees.”

Under the program, a U.S. HealthWorks professional would visit your business and administer flu vaccinations and also provide educational information on flu prevention. The on-site program is available to businesses providing vaccinations for 25 employees or more and located near a U.S. HealthWorks facility.

In a statement issued Friday, Dr. Joe Bresee, Chief of the Epidemiology and Prevention Branch in the CDC’s Influenza Division, made the following comment: “While we can’t say for certain how severe this season will be, we can say that a lot of people are getting sick with influenza and we are getting reports of severe illness and hospitalizations. Anyone who has not already been vaccinated should do so now.”

Seasonal flu vaccines protect against the three influenza viruses that research indicates will be most common during the upcoming season. The viruses in the vaccine can change each year based on international surveillance and scientists’ estimations about which types and strains of viruses will circulate in a given year.

About two weeks after vaccination, antibodies that provide protection against the influenza viruses in the vaccine develop in the body.

To set up a date and time for U.S. HealthWorks to administer flu shots at your business, or for more information regarding this program, contact www.ushealthworks.com.
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