Lawnmower Safety: Most injuries are very preventable

Posted on March 13, 2012 by ushealthworks| Leave a comment

Has that time of year arrived already? Could it really be time to start cutting and trimming the lawn again? With that in mind, it’s also time to consider some safety tips for lawn care.

'Kim' photo (c) 2006, Joe Ferguson - license: http://creativecommons.org/licenses/by-nd/2.0/Lawnmowers are very powerful and needless to say an almost indispensable tool. They not only gobble up the lawn, but often the people operating them. More than 100,000 people a year are injured mowing the lawn. It is usually an adult, but children become victims as well. Most of these injuries are preventable with a small amount of effort and common sense precautions.

The power and danger of a lawnmower can’t be taken for granted. A mower is able to spit out a rock, piece of wood or metal at a speed of 100 miles per hour. The force of a small object striking a person after ejection from a mower is comparable to being shot with a handgun.

The mower blade is able to mangle part of an extremity in literally the blink of an eye. Power or push, ride or walk, they all contribute to an enormous number of serious injuries. Lawnmower injuries most often involve the hand, fingers, wrist, foot, ankle, or toes and account for the large percentage of partial or complete amputations.

A number of simple precautions will go a long way in preventing injury to yourself or your family. Only adults should operate mowers and supervise young people about the dangers and proper use.

In order to maintain adequate control of a mower, no one younger than age 12 should operate a walk-behind mower because a certain amount of growth, strength and coordination is necessary.

A riding mower should not be operated by anyone younger than 14. Again, maturity, exercising good judgment and instruction on how to operate safely is important. Proper footwear and eye protection for the operator is always a must. Since flying objects are a big potential problem, others should be kept away from the area being mowed.

A bag that catches the clippings or a flap plate that covers the opening where the grass is ejected should be in place and in good working order. Mower adjustments and refueling should be done by an adult when the mower is off, cool, and with the ignition off.

Regular maintenance and simple inspection before or between regular use will be a great aid in preventing dangerous malfunctions. Many safety features are built in to mowers, but are overlooked and neglected. They can’t help unless the mower is in proper working order. Working on a hot mower or inadvertent charge from a spark plug that is not disconnected can lead to burns or accidental ignition.

A few simple steps can prevent a life-changing injury. Please treat these tools with the respect and care they deserve.

By Dr. Bruce Kaler

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Fukushima, A Year Later…

Posted on March 8, 2012 by ushealthworks| Leave a comment

As we approach the one-year anniversary of the devastating earthquake and tsunami that destroyed parts of Japan, we look back to what happened and what was learned.

One year ago, Japan experienced a 9.0 magnitude earthquake, right off the coast, a 46-foot tidal wave, a broken and drowned nuclear plant and more than 20,000 of her citizens killed. Whole towns were reduced to driftwood, or washed out to sea all together. Many were never found.

Three nuclear reactors suffered total meltdowns, meaning that the fuel rods got so hot they melted into a blob of intensely radioactive metal in the bottom of the reactors. Then they leaked.

There was no way to put these back together again after that. It would be easier to fix a car after it’s been crushed – now, make that car radioactive, so you have to fix it with really long tools from inside a lead room a mile away – you get the idea.

But the reactors are stable, which is a euphemism for no nuclear explosion or huge release of radiation is expected. It took quite a while to get to where we could even say that.

But what a mess.

Some of the radiation already took care of itself. Radioactive iodine was initially quite high, but with an eight-day half-life, it is virtually gone. Five half-lives is a general estimate of the time required to make something go away (97% gone).

But there is still plenty of radioactive cesium, and with a 30-year half-life, it will take generations to wait out this stuff. Where is this radiation? Everywhere dust can settle, or get blown, or tracked.

There is more radiation on the outside, than on the inside, assuming you closed your windows. It is in the plants, the first couple inches of the ground and on every surface in sight. Nobody is entirely sure how to even clean it up.

The best you can hope for is to sweep up most of the radiation into one place, then bury it, real deep. You can’t neutralize the stuff. Hose it off your roof and now it’s in the water. Don’t even think about firing up your dust blower. So you scrape off the top 2 inches of dirt, scrub everything in site, and package up all the scrub water, dirt, rags, cleaning implements, and everything you couldn’t clean, and cart it off.

To where you ask?

Really good question-they are still working on that one. One house generated 60 cubic yards of contaminated material from just one clean up operation. And consider that about 88,000 people were displaced from the evacuation zone – that is a lot of property to clean up.

Until the whole area is cleaned, the radiation contamination will frequently redistribute itself. The radiation level will gradually drop in the affected communities, partly due to clean up efforts, but also do the averaging of radiation over a wider and wider area.

My organic chemistry professor used to say: “the solution to pollution is dilution.” Much of the cleanup will be dilution of the radiation into the world at large. It is estimated that it will take three decades to clean up the area. The plant itself cannot be rehabilitated.

The other alternative is the Chernobyl solution, where they drew a 20-mile circle and kept everyone out – forever. Japan is a little too densely settled for this answer.

So far there have been no deaths reported from radiation exposure in the accident. People just didn’t receive anywhere near lethal doses of radiation. Radiation in lower doses takes years to do its work.

Those who study such situations expect 1,000 additional cancer deaths in Japan from the Fukushima Nuclear accident. These 1,000 would occur in a country of 127 million people, spread out over the next 100 years. (For comparative purposes, Japan looses 5000 people per year in auto crashes.)

Two more reactors were planned to be built at the Fukushima plant in the next three years.

The world’s attention was captivated by this nuclear disaster. The worst imaginable happened, a triple meltdown. Japan is cleaning up the mess, and will rise from the ashes, again.

Take Care

Dr B.

Image: xedos4 / FreeDigitalPhotos.net

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Have you loaded up on your Bioflavonoids today?

Posted on March 5, 2012 by ushealthworks| Leave a comment

Bioflavonoids are those magic molecules that promise, in theory at least, eternal youth. These plant pigments were first identified while investigating the French Paradox. The French are known both for their rich (and excellent) food and smoking cigarettes (perhaps not so tasty), but surprisingly their people have low rates of heart disease.

It turns out that drinking red wine, a way of life in France, may just be the antidote for fast living. Red wine has lots of bioflavonoids, which are wonderful molecules that are full of beneficial properties. Since these compounds are pigments, it’s no coincidence that they are found in dark things – dark wine, berries, beer, chocolate, coffee and tea.

Why should we care about bioflavonoids? Because like Vitamin C, they are antioxidants, only stronger. The theory is that oxygen, while absolutely essential for life, also ages us, kind of like rust ages a car.

This can be studied on a molecular level that goes like this: oxidative stress on the cell produces free radicals that can damage cell molecules (like DNA) and ultimately can kill the cell. Antioxidants neutralize the free radicals and keep them out of mischief.

Free radicals are believed to be involved in many disease processes. Cancer is one of the most feared of human conditions. Free radical-induced broken DNA has been implicated by some scientists as part the process of cancer cell transformation from normal cells. DNA is precious stuff and we don’t want it damaged.

Next on the worry list is cardiovascular disease. Free radicals are believed to be partly responsible for the oxidation of cholesterol, which causes plaque or blockages in the arteries. So free radicals can make you old, give you cancer, and cause heart attacks. Somebody should do something about them!

We may have already found the answer in bioflavonoids. They are potent, free radical scavengers that reduce oxidative stress on the cell and also possess anti-inflammatory properties. Chronic inflammation has recently gotten some press as part of the process of atherosclerosis. The C-reactive protein test, as you may have heard, is a measure of inflammation and cardiac risk. Both would at least theoretically be improved by generous amounts of bioflavonoids in the diet.

In the lab, bioflavonoids are quite impressive. At high concentrations bioflavonoids are more potent antioxidants than Vitamin C or Vitamin E. All this free radical neutralizing and anti-inflammatory activity is principally shown in the laboratory experiments. The trouble is you can’t get these kinds of bioflavonoid concentrations in the human body. Bioflavonoids are in fact poorly absorbed by the intestinal tract and are quickly cleared from the system.

Despite being amazing in the lab, bioflavonoids have mixed reviews in the body. Diets rich in bioflavonoids don’t show significant measurable antioxidant activity, at least that we’ve been able to measure.

Dietary studies looking at the big picture have been a little more optimistic. Foods rich in bioflavonoids like berries, beans and fruit, have shown some protective value in patients with increased risk of cancer-like smokers. Green tea drinkers have recently been seen as aging better in terms of less disability and dementia.

There is little disagreement that natural sources of bioflavonoids like fruits, vegetables, beans, red wine, and green tea are good for you and promote longevity. Of course, there is a lot of good stuff in there besides bioflavonoids. We just haven’t had much luck at putting those things in pill form yet. If you want the real benefit, you just need to eat and drink the stuff.

With that in mind, more red wine and dark chocolate (picture me toasting) for everyone!

Take Care

Dr B

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A Depressed Nation: Could a dose of optimism be the cure?

Posted on March 1, 2012 by ushealthworks| Leave a comment

Here it is election time again and the rhetoric is flying. Everybody wants to change the fundamental direction of this country. There are spirited, even heated debates about how to get there. More taxes or less; a tighter money supply or looser fiscal policy; bigger government or smaller.

All these theories have sound research behind them and are argued convincingly by well educated and thoughtful people. Where is it exactly that we want to go anyway? Presumably to a society with more optimism and prosperity. Everybody can agree on that. Do you really think a Democrat or Republican can get us there? Register me skeptical. Society needs a medicine man, a healer for the masses.

Looking at society as a very large patient is useful. Mr. Society is exhibiting pretty classic symptoms. Asked about symptoms, Mr. S would have to admit to a feeling of general malaise. Complaints of lack of energy, difficulty focusing, and little enthusiasm for pastimes previously enjoyed. And don’t forget not sleeping well; that’s a big one. Mr. S is clearly depressed. It would be a no brainer diagnosis if Mr. S were a patient who walked into a doctor’s office.

What do we do for depression? Every one of us has been there at one time or another. We all have a bag of tricks that gets us through the bad days. Step one is usually go out and buy something. Treat yourself, buy a toaster or a car, a new shirt or a puppy. That usually helps, at least temporarily. And temporarily is often good enough because you get up the next day feeling better and perhaps a bit foolish about your purchase.

If it takes more than a thing to get you out of your funk, we usually reach out to a friend. We might be lucky enough to be married to one, or dating one. Friends are often pseudo-families. If not, a kindred spirit may be only a click away in this age of the web.

Or we pay someone to listen to us. We call this psychotherapy. The funny thing is it works. It might not be the fastest or least expensive cure, but it clearly works.

Of course, there is always chemical warfare against depression. Prozac and its numerous siblings have been around for 25 years. They weren’t the first effective treatment for depression, but they were much cleaner than any medication that preceded it. Cleaner in this case means most people didn’t feel tired or otherwise bad from the medication. They just feel less depressed. It was such a remarkable medication that a book was written about – “Listening to Prozac.”

Perhaps we can generalize this to society as well. Nations get depressed and can buy things to feel better, too. We bought a trip to the moon and we all felt pretty good. Before that we bought the New Deal, and freedom from dictators (World War I & II). Maybe we just need to buy into something really big, like an idea.

Psychotherapy for the Nation. Our political process seems to have a lot in common with psychotherapy. We tell politicians our problems and they listen (or something like that). Don’t you feel better now? Maybe that’s not the most effective therapy.

There are always antidepressants. Who do we give them to? Make Congress all start taking Prozac and see if things get a little better. Perhaps we include the whole government by using crop dusters to spray a Prozac solution over Washington or put it in the water? I’m jesting of course.

The question remains, is society depressed? Do we need leadership or optimism?

Take care

Dr B

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How Flying Changes the Medical Rules

Posted on February 24, 2012 by ushealthworks| Leave a comment

When you are traveling at 37,000 feet, a lot of things are different – medical issues included.

Aviation medicine actually rates as a sub-specialty these days under the Preventive Medicine Board.

There is a whole physiology of flying, changes in pressure and oxygen that the body needs to adapt to. There’s much more going on than simply picking a drink to sip on, while going the better part of 500 miles per hour.

What’s different about flying?

Pressure for one thing. Here at sea level, we have a couple of miles of air on top of us. The weight of this air puts 15 pounds per square inch of pressure on us. Go up in a plane and there is less pressure, like coming to the surface from the deep end.

You can’t compress a fluid, so most of your body is at peace with the pressure changes. But air spaces do compress, and we have some behind our eardrums, the sinuses, and bubbles in the stomach/intestines.

As the airplane climbs, the pressure lessens. High pressure air in your ear bulges the eardrum out, until it is vented out through the Eustachian tube. After a few hours at altitude, your ear is filled with low pressure air.

On descent, the pressure increases as you dive deeper into the atmosphere. The eardrum gets pushed inward, until higher pressure air is vented in through the Eustachian tube. It is critical that the vent tube is clear or the eardrum will blow out, or blow in. Head congestion, from a cold or allergies will cause swelling in the Eustachian tube, often blocking it.

The same thing happens in the sinuses if a sinus gets blocked. The pressure builds until you think your face will explode – very painful. Keep the head passageways clear before you fly. A good decongestant, or Afrin nasal spray, an hour before you fly, often helps.

The air is thin at 37,000 feet, too thin to breathe.

To keep the passengers conscious enough to choose peanuts or pretzels – and the pilots to fly the plane – the cabin is pressurized. To pressurize an airplane they have airtight doors and windows. Then they pump in the thin air and build up the pressure until the air is as thick as it is at 8,000 feet (25% less oxygen).

There is a handy source for compressed air. Huge multistage compressors make jet engines work, so high pressure air is bled from the jet engine into the cabin. (For the record, they take this jet engine air from the part of the jet engine that isn’t on fire.)

The very air you breathe in a jetliner is a computer controlled, High-Efficiency Particulate Air (HEPA) filtered mixture of outside and recirculated air designed for passenger comfort and fuel efficiency. Since the air coming off the jet compressor is hot (almost 500 degrees) no live germs survive the passage.

As air is recirculated in the cabin, it is HEPA filtered, which removes germs coughed up by passengers. This won’t protect you from the guy with the sniffles sitting next to you, but at least you won’t be breathing everybody else’s germs on the plane.

The air is also very dry, generally just 10 percent to 20 percent humidity, which prompts some people to reach for their Chapstick.

Personal space, or lack of it, is also an issue in commercial air travel. I haven’t felt so packed together since high school basketball games. Airplanes are definitely not the place for someone with claustrophobia, and a bit unnerving for the rest of us.

All that sitting still, with your legs hanging down, slows down the circulation in your legs.

Your feet swell and, in rare instances, the blood in your leg veins clots. This is more likely if you are prone to blood clots, from smoking or birth control pills.

Blood clots in your legs can break free and cause havoc on your heart and lungs.

Avoiding blood clots is fairly easy – get up and move around pretty regularly, maybe every 20 minutes of so. An aspirin before flight also will make the blood less sticky.

Another issue on airplanes is air sickness, a variant on car-sickness or boat sickness – basically motion sickness plus some anxiety.

Conflicting signals from your eyes and inner ear can give you a memorable case of nausea. That is something that is much easier to prevent than to treat.

Bonine (meclizine) is available over the counter and very effective in preventing motion sickness by taking one an hour before getting on the plane.

A consequence of air travel – jet lag – is when your body thinks it’s midnight when it’s only 8 p.m., or the opposite. Your body expects bed and meal times to be sensibly spaced from when you awoke.

Going to bed much less than 16 hours from wake up time, or much more, is tough to do. You can waste the first half your precious vacation as a sleep deprived zombie. Getting home jet lagged, and trying to do all the backed-up work, is also interesting. There are no easy answers to for this. Medications from melatonin to Viagra have been used, as well as a 16-hour fast to reset the inner clock. Try to gradually adjust bed and wake up times a few days before your trip.

Finally, don’t forget about the boredom of long flights – bring a good book or your iPad to fight that ailment.

Some good preparation will go a long way toward making your next crowded flight a bit better.

Have a good trip,

Dr B.

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What You Can Do to Prevent Hearing Loss

Posted on February 21, 2012 by ushealthworks| Leave a comment

Do you need to turn the volume up on the TV, while other people around you can hear it just fine? When there is background noise, do you have difficulty understanding words clearly?

If the answer is yes to either question, you may be among the millions of people suffering from significant hearing loss.

 Hearing appears to diminish in many people due to aging, yet it often goes unnoticed. Repeated exposure to loud noise over many years is known to impair hearing. Short bursts of loud noise usually only cause temporary hearing loss, buzzing or ringing in the ear that resolves spontaneously.

Some people aren’t even aware of how they withdraw from conversations or noisy environments because of their inability to differentiate between similar words like “joy” or “toy.” It creates a lot of frustration when you keep asking people to repeat themselves. You may actually miss some details of conversation that lead to confusion and misunderstanding.

Recent research has suggested a connection between hearing loss and dementia. Diminished hearing contributes to confusion and isolation of the person with the hearing impairment. However, it’s incorrect to assume that decreased hearing causes the dementia.

Hearing is a complex function requiring a mechanical component in the middle ear to translate impulses of sound waves into a digital form that’s ultimately transmitted to the brain, where sound is perceived and interpreted into a coherent message. The cochlea is the hearing center for converting to a digital signal that allows nerves to transmit to the brain.

This marvelous apparatus is working all the time with no vacation or rest. It is vulnerable to overuse, especially by regular exposure to loud noise. Some compare the effects of loud noise to walking on grass. When grass is walked on occasionally it demonstrates resilience. When there is too much traffic grass can be severely damaged.

Workplace standards to protect against loud noise exposure have been outlined by the Occupational Health and Safety Administration (OSHA). Any loud work environment should do baseline and periodic hearing tests of workers to assure hearing conservation.

At the heart of hearing loss is “prevention.” Formable medium density foam earplugs are common, inexpensive, and provide adequate protection for most people. Proper fit and consistent use in a high noise setting is extremely important to preserve hearing and avoid permanent hearing loss. Once damaged, the hearing function is usually permanently impaired.

The good news is you can easily protect your ears so the rest of your life will sound better.

Dr. Bruce Kaler, U.S. HealthWorks

Image: Michal Marcol / FreeDigitalPhotos.net

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Heart Health Month – An Important Reminder

Posted on February 17, 2012 by ushealthworks| Leave a comment

By Timi Gustafson, R.D.

February is “Heart Health Month.” Health advocacy groups and organizations like the American Heart Association (AHA), the National Heart Lung and Blood Institute (NHLBI) and the Centers for Disease Control and Prevention (CDC) want to remind us that heart disease is the most common cause of death in America and deserves more of our attention.

Sadly, heart disease has become nothing short of a national crisis in this country. “Heart disease takes the lives of far too many people in this country,” said Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. “With more than two million heart attacks and strokes a year, and 800,000 deaths, just about all of us have been touched by someone who has had heart disease, a heart attack, or a stroke.”

Heart disease is also very expensive to treat. Cardiovascular disease and stroke hospitalizations have cost nearly $450 billion in health care expenses and lost productivity in 2010 alone.

“The sad truth is that these ailments are usually preventable, and in a perfect world I would be out of a job,” said Mehmet Oz, MD, a cardiothoracic surgeon and host of “The Dr. Oz Show.” “Unfortunately, I’m busier than ever,” he added.

Raising awareness is a crucial way to fight back against the spreading disease. In 2011, the HHS, in collaboration with the CDC and other government agencies as well as private organizations, has launched a program named “Million Hearts,” a nationwide initiative aimed at preventing one million heart attacks and strokes over the next five years. Among its many goals, the program wants to “empower Americans to make healthy choices,” such as avoiding tobacco use and reducing the amount of sodium and trans fat they eat, and to “improve care for people who need treatment” by encouraging them to take steps to better control their blood pressure, cholesterol levels and other major risk factors for cardiovascular disease and stroke.

“Million Hearts” is not the only awareness movement in the country. “Go Red for Women” is a nationwide program by AHA “to fight heart disease as the number one killer of women in America.” Observers can express their support by wearing red clothing or pins. “Choose to Move” is another AHA project dedicated to women’s heart health through physical exercise.

Sending the right messages is vitally important, especially for women, said Dr. Oz. “Many women and their health care providers believe that heart disease is less serious in women than in men. This is simply not true. Studies show that more women than men die within a year of having a first heart attack. Women are two to three times more likely than men to die following heart-bypass surgery, and more women than men die each year from congestive heart failure.

In fact, women may suffer from a completely different type of heart disease than men, according to Noel Bairey Merz, MD, director of the Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles, which is not yet fully understood and harder to detect, and therefore can often remain undiagnosed until it is too late.

The good news is that there are only a few causes of heart disease that are out of our control, such as genetic predisposition, family history and aging. The rest is a matter of choice. Even small lifestyle improvements can make a significant difference. Weight control, good nutrition, regular exercise and stress reduction are all part of that. Each one of these is fully achievable for everyone with enough commitment and willingness to make the necessary efforts. Raising awareness is a good start, but it doesn’t end there.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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CDC Announces the Official Start of the Flu Season

Posted on February 15, 2012 by ushealthworks| Leave a comment

Did I miss something, or are we talking about flu in mid-February? Isn’t that like the kids asking you about Halloween instead of Valentine’s Day? My response, after a microsecond of disorientation, is “What, where did that come from?” That is how I feel about a spring influenza epidemic.

Influenza usually misbehaves in a reassuringly predictable fashion (there’s that kid analogy again). This flu season “beginning” is the latest in the last 30 years, according to the CDC.

A short primer: Influenza germs hang out in poor countries in the Southern Hemisphere where people and animals live together. That seems a surprising thing but, if your pig or goat is your most valuable possession, you don’t let him out of your sight. Most of the new influenza viruses cross over from animals into humans where they live together. Thus animal “flus”: Swine Flu, Bird Flu, etc.

So a new and improved (from the viruses’ view) influenza virus goes out to make its mark on the world. That is somewhat easier these days with our migratory populations of air, rail and ship travelers. There is a several day incubation period where you have the virus and are infected, but you don’t look bad or feel sick yet. That’s the problem.

So why is influenza a winter bug anyway? A lot of scientific study has gone into answering this simple question. There are aspects of the germ that make it winter friendly. The viral coat is soft, fragile and almost like mucus in warm temperature, and hard and durable in cold temperatures. So the virus lives longer in the winter.

We are also better hosts for the germ in the winter. The air is so dry our lips are chapped and cracked and so is the rest of our respiratory tree. These tiny cracks let the germs in easily. We are crowded together in schools, airplanes and churches, breathing each other’s air and, unfortunately, someone is always sick. Buildings are more tightly sealed to keep out the drafts and keep the warm, moist (possibly infected) air on the inside.

For influenza to get going, it has to land in a population of susceptible, unvaccinated people.

So here we are, thinking about spring, and the CDC is telling us influenza is on the rise.

Blame it on global warming, the ozone hole, or the illiteracy rate in America, but here it comes.

Expect a steep rise in cases in the next few weeks. I am already seeing some really sick people in my office. They have high fevers (103), body aches like they took a beating, a headache and sometime nausea. They looked like they wanted to die (I was careful to keep them away from sharp instruments).

So, while it seems a bit late to be talking about flu shots, flu season is finally arriving.

The realities are that flu vaccine is still thankfully available. Flu vaccine is still a really good idea if you want to save yourself some major misery. Remember it takes about nine days to develop good flu immunity after a flu shot. So, what are you waiting for?

Take Care,

Dr B

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Thinking of Your Heart At Valentine’s

Posted on February 9, 2012 by ushealthworks| Leave a comment

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.

'Heart of Hearts' photo (c) 2008, terren in Virginia - license: http://creativecommons.org/licenses/by/2.0/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 while I’m at it – why just improve the inside??). 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.

But, 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.

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Make the Day After the Super Bowl a Better One: Hangovers At A Glance

Posted on February 1, 2012 by ushealthworks| Leave a comment

With the Super Bowl coming this weekend – and the parties and unfortunate hangovers that go with it – it is worth restating that there is no cure for a hangover other than not drinking.

'Super Bowl XLVI' photo (c) 2008, astrolame - license: http://creativecommons.org/licenses/by-nd/2.0/Much has been written and remains in pop culture regarding remedies for the dreaded hangover. A surprising amount of scientific literature fails to explain the hangover syndrome other than it may be a mild version of severe alcohol withdrawal. Headache, nausea, vomiting, rapid heartbeat, thirst, difficulty with concentration, dizziness and general muscle soreness are all common symptoms.

The most extensive review of medical literature in recent past by the British Medical Journal failed to show any convincing evidence of any therapy or dietary supplements that can consistently help the symptoms or help understand precisely why it happens. This year several commercially available products have surfaced that reportedly help cure or treat hangovers. These are entirely unproven claims. Do not waste your money on them.

Understanding a few simple facts that are clear, should be kept in mind any time alcohol is consumed.

There are many moving pieces to this puzzle. Limiting your alcohol consumption and drinking responsibly, if not abstaining entirely, is your best choice.

The less alcohol ingested the less likely you are to experience problems. Making an effort to drink plenty of water may be helpful. We know problems arise when people get dehydrated, which is a common characteristic of hangovers as well as many other medical conditions.

Alcohol is both a toxin to the liver and a diuretic. The liver usually tolerates small amounts of alcohol, but even small amounts are dehydrating. You actually lose more fluids drinking alcohol than you consume.

The type of alcohol consumed may increase risk of hangover. Clear distilled spirits such as vodka appear less likely than dark fermented alcohol (wine, beer, or bourbon) to cause a hangover. According to reliable research, congeners that add to the darker color are toxins created in fermentation and play a greater role in the bad side effects. Again, it is worth emphasizing too much alcohol consumed of any type leads to problems.

A safe amount is hard to identify due to many variations in individual metabolism, body weight and composition, medications, general health, gender and age.

Besides drinking responsibly, consuming plenty of water before and during the times of alcohol ingestion may be helpful in minimizing the ill effects. Some experts recommend a glass of water for every alcoholic beverage. They also suggest consuming only one alcoholic beverage per hour as a rule of thumb.

Use of non-steroidal anti-inflammatory such as ibuprofen or naproxen after drinking seems like it makes sense. However, research has failed to demonstrate any consistent response. Acetaminophen when drinking should be avoided due to its own liver toxicity, which can be magnified in the presence of alcohol.

Drink responsibly. Do not drink and drive. Even small amounts of alcohol impair judgment before you are aware of its effects. Be mindful and pro-active about alcohol consumption. It is the only way to avoid a hangover or worse.

Dr. Bruce Kaler

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