Current Health Topics and Trends in Medicine Archives - Lake Washington Primary Care - Dr. Robert Goode

A Healthy Summer!

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Tips for a Healthy Summer

A healthy summer! Here some tips to get the most out of summer.  I am so happy the warm, sunny months are here!  I love living in the Pacific Northwest year-round but especially in the summer when there is so much to do outside.  Whether it is hiking in the mountains, water skiing on one of the lake reservoirs, going for long relaxing walks, or boating in Puget Sound, there are outdoor activities for everyone.  Here is an article that gives some useful tips to help you get the most out of the summer months.  I hope you and your family have some fun activities and vacations planned this season!  http://www.healthy.net/Health/Essay/10_Tips_for_Staying_Healthy_in_Summer/676 


Staying Healthy In the Summer

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Summertime always brings up good memories for us: warm sunny weather, vacations, time off from school, gardening, countless outdoor activities either by ourselves or with family and friends, and the list goes on. The following article gives us some good ideas about staying healthy in the summer. Look beyond the slight sales pitch for his book and supplements, and you will see the article has some good content. I hope everyone has a safe and fun summer!  http://www.healthy.net/Health/Essay/10_Tips_for_Staying_Healthy_in_Summer/676


Digital Medicine

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Everything in society is becoming digitized including healthcare. Significant breakthroughs in medicine continue to occur regularly which is great for our patients and exciting for us as clinicians. With continued forward momentum, medicine is becoming increasingly high tech with digital devices starting to play a major role in every day medical care. Digital medicine will be commonplace in the years to come and eventually the standard of care. Here is an article from last summer that discusses digital medicine and what we can expect in the future. Some of the products we are already using such as “Smart Wearables” (Fitbit) and “Health Apps” on our smart phones. At the bottom of the first article is a graph that shows the expected medical advances in the next 5, 10, and 15 years. I am excited as we continue to move toward highly personalized medicine. Stay tuned as more pioneering discoveries will surely continue to unfold. Here is the link to the article: http://www.forbes.com/sites/reenitadas/2014/07/14/top-20-technologies-that-will-change-our-lives-next-up-digital-medicine/


Obesity-New Treatments

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Obesity-new treatments. Obesity continues to be one of the most significant health problems facing Americans today. It is a major contributor to the most common causes of death (heart disease, stroke and cancer) and causes a myriad of other health problems. I have worked with overweight and obese patients for 20 years now. My heart really goes out to them because it usually has been a lifelong struggle. Most people have tried the usual diets, weight loss programs, supplements, and weight loss pills. Unfortunately, most of these methods do not have good long-term success at keeping weight off. The one exception I know is the local PRO Sports Club’s 20/20 Lifestyles Program which has a much higher than average success rate at keeping weight off for 4-5 years+: https://www.proclub.com/Wellness/20-20-Lifestyles  In recent years more patients have headed to the operating room for weight loss surgery, which typically has a higher success rate than the usual measures, but many are reluctant to take what they consider such a “drastic step”.

There is a new device that was approved this year called VBLOC Therapy. It is a pacemaker-like device that is implanted in the body by laparoscopic surgery and stimulates the vagus nerve which transmits signals between the stomach and the brain. It helps decrease hunger and makes patients feel full. As a result they eat less and lose weight. Long term results are not available yet. Here is the link to this interesting article which discusses the VBLOC device and other new treatments on the horizon that will hopefully help us treat obesity more effectively. There is hope! http://www.webmd.com/news/breaking-news/future-of-health/#obesity-treatment-toc/advances-in-obesity-treatment 


Medical Identity Theft

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We are all aware of identity theft: someone steals and uses another person’s personal information usually for financial gain. A similar problem, medical identity theft, is on the rise. In this scenario an individual gets your personal health insurance information and uses it for fraudulent activity including seeing a doctor, getting prescriptions filled, filing false medical claims, etc. This can lead to unpaid medical bills which, left accumulated, can hurt your credit report. This article talks about medical identity theft, early detection, and some ways to protect yourself. It is worth reading:  http://www.consumer.ftc.gov/articles/0171-medical-identity-theft


Vaping

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Electronic cigarettes (e-cigarettes) have been around for over ten years. They first appeared in the United States in 2006. The New England Journal of Medicine published an article on 1/22/2015 about the use of e-cigarettes (also known as vaping). Vaping has become very popular with increasing use among teenagers. Their study found that vaping e-cigarette liquid at the highest voltage settings produced formaldehyde, a known carcinogen (cancer causing agent), at 5-15 times higher levels than with regular cigarette use. There are likely other effects from vaping that we do not know about yet. Additional risks may not be known for another 10-15 years as we gather more data from the effects of long-term use. With researchers just starting to evaluate the safety of vaping, I’m sure we will learn more in the months and years to come. It should not be considered a harmless alternative to cigarette smoking although it may be less dangerous. Here is the link to an NBC article that references the New England Journal of Medicine’s study: http://www.nbcnews.com/health/cancer/you-vape-high-levels-formaldehyde-hidden-e-cigs-n290826


New Year Resolutions

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January is a month when many of us resolve to make important changes in our lives. A fresh new year is a good starting point for making those positive changes. However, you can implement healthy lifestyle choices anytime of the year! Below are two links to WebMD articles. Each one discusses healthy New Year resolutions that men and women can make. Of course there are many others that may be equally important to us. Eating healthier and exercising regularly are the most common resolutions. Quitting smoking is also high on the list.

I always encourage my patients to only make changes they feel are sustainable and that they can maintain long-term; not just ones they can do for a short while. Sometimes tackling each problem individually and gradually making small incremental changes will be more successful than trying to make several major changes all at once. I will summarize the main points from the two articles below and add a couple that I think are important.

1. FOOD. Eat healthier and consume smaller portions. Focus on lean protein, plenty of fruits and vegetables (try to get at least 5 different colors a day), complex carbohydrates, and healthy fats (nuts, avocados, etc.). Limit refined carbohydrates, highly processed foods, sugar, and salt. Avoid/minimize regular and diet soda pop. Portion control: use a smaller plate for your food, take smaller servings, and eat slowly which will help you feel full sooner.
2. EXERCISE. Think outside the box when it comes to exercise. Some people really like going to the gym. It helps get them in the right mindset for a workout. However, many people don’t have the time or desire to go to the gym. Be creative in ways to integrate exercise into your daily life. Going up and down stairs at work, parking further away in the parking lot or walking around the parking lot a couple of times before/after going inside, working outside in the yard, exercising using an app on your smart phone are all great ways to get moving. Recreational activities such as playing different types of sports, hiking, and doing the martial arts are great way to exercise. Find something you enjoy doing and stick with it. Both aerobic exercise and strength training are important. Aerobic exercise helps with cardiovascular health, weight loss, and stress reduction. Strength training helps maintain vital muscle mass. Be sure you are healthy enough for exercise.
3. WEIGHT. Maintaining a healthy weight is very important but can be quite challenging, especially as we get older. By eating healthier and exercising more, people can reach their weight goals. Be realistic in how much weight you can lose and how quickly you should lose it. Generally 1-2 pounds a week is considered a healthy weight loss.
4. TOBACCO USE. As we all know, quitting smoking will help us live longer and healthier. It will also leave more money in our wallets! If you cannot quit on your own, talk with your primary care physician about nicotine replacement products or medications that may help you kick the habit. Consider alternative methods such as acupuncture or hypnosis. I have had patients successfully quit smoking long-term using both of these methods. Support through in person groups, online groups, and friends is very important. There are many resources available once you have made the decision to quit smoking; find the one that works best for you. If you don’t succeed the first time, don’t worry you can always try again until you are able to quit.
5. BONE HEALTH. Osteoporosis (low bone density) is a major health problem for men and women as they get older, with women being affected more often. Calcium: aim for 1000-1500 mg a day mostly from natural sources such as dairy products and non-dairy products that contain calcium. To make up for the rest, you can take small amounts of calcium citrate with magnesium. Vitamin D: depending on where you live, you typically need between 1000-5000 international units of vitamin D a day; take with food to improve absorption. Your doctor can check a blood test and recommend the appropriate amount of vitamin D for you. Exercise: daily weight-bearing exercise helps keep bones strong. Smoking, some medications, certain foods, some medical conditions, and possibly soda pop can thin out the bones.
6. MEDICAL. See your doctor regularly for routine preventive exams/screening tests that are recommended for your age. Stay on top of your chronic medical conditions so they are well controlled.
7. STRESS. Long-term elevated stress levels can have many negative health effects: weight gain, insomnia, immune system suppression (increased risk of illnesses and possibly some cancers), cardiovascular disease, depression, and anxiety. Stress reduction can be accomplished through exercise, meditation, sitting quietly doing an activity you enjoy, yoga, biofeedback therapy (deep breathing and relaxation techniques), and any other activity that allows you to disconnect and de-stress. Some people find it useful to see a therapist or psychologist.
8. SLEEP. It is important to get the right amount of shut eye each night. This varies widely from person to person. Get the amount of sleep you need to wake up feeling refreshed and energized throughout the day.
9. RELATIONSHIPS. Strong relationships with our significant other, family, friends, and coworkers are essential. Our social networks provide us with valuable support, encouragement, and strength. They can help us live longer and better. Nurture them.

Women

http://www.webmd.com/women/features/health-resolutions-for-women

Men

http://www.webmd.com/men/features/5-healthy-new-years-resolutions-for-men


Staying healthy during flu season (AND the rest of the year!)

Robert Goode Current Health Topics and Trends in Medicine Leave a comment  

I came across an interesting article today that I wanted to share with you. It was written in November 2011 but is still very relevant today. It gives 15 tips for staying healthy during flu season. However, many of the recommendations are applicable to year-round good health. That is what intrigued me and prompted me to share the article with you. The focus is on helping your immune system stay strong and eliminating things in your life that weaken it. I am a big believer in preventive medicine. Here is the link to the article: http://www.prevention.com/health/health-concerns/your-winter-stay-healthy-guide

There are a couple of points from the article that I have some additional comments on regarding staying healthy in flu season.

1.  Flu vaccine. Because of a bigger genetic shift in the flu virus from last year, this year’s flu vaccine is only about 50% effective. It is still helpful to get one.

2.  Goal setting. This is helpful for some people but not everyone.

3.  If you get at least five colors of fruits and vegetables in your diet each day, you are most likely getting an adequate daily supply of vitamins and nutrients; a multivitamin may not be necessary. Additional nutritional thoughts: focus on lean protein, complex carbohydrates and healthy fats. Limit sweets, salt and simple carbohydrates. Drink plenty of water (4-6 glasses a day) to stay well hydrated.

4.  Astragalus. Talk with your regular doctor or naturopathic physician to see if this would be beneficial for you.

5.  Getting three hours of exercise a day would not be possible for most people. The general guidelines are to get 30 minutes of moderate to vigorous exercise most days of the week. Any exercise you do helps!

6.  Zinc. Studies have shown conflicting results as to whether it actually reduces the duration of the common cold. I do not currently recommend zinc to my patients.

7.  Flu medication. Only take antiviral flu medication if your physician has tested and diagnosed you with influenza (the real flu). It only shortens the duration of symptoms by less than 24 hours, so it may not be necessary for everyone. There are many other viral upper respiratory infections during the winter months that mimic the flu but are not the flu.  They do not respond to anti-flu medications such as Tamiflu or Relenza. For these infections we treat the symptoms and let them run their course.


National Diabetes Awareness Month

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November is National Diabetes Awareness month. Diabetes is a major and increasing health problem in the United States. The current statistics are staggering. Thirty million adults and children in the United States are living with diabetes. Another 86 million Americans have prediabetes and are at risk for developing diabetes. There are two types of diabetes: type 1 and type 2. I will discuss prediabetes as well.

Type I diabetes only accounts for 5% of the cases of diabetes. It typically hits children and younger adults. The exact cause of type 1 diabetes is unknown, but it is thought that something triggers the body’s immune system to turn against the insulin-producing cells in the pancreas and completely destroy them. Here the patient needs insulin to survive. Type 2 diabetes is the cause for the remaining 95% of people with diabetes. The reasons people develop type 2 diabetes are complicated (genetic, environmental, lifestyle) with the end result being that their body becomes resistant to insulin and/or the pancreas does not produce enough insulin to adequately control the person’s blood sugar.

Some of the more common symptoms of diabetes are excessive thirst, frequent urination, increased appetite, fatigue, and weight loss. It is important to diagnose diabetes early to minimize the negative impact it can have on multiple systems throughout the body.

The diagnosis is made either by a fasting blood sugar, a random blood sugar, or blood test called a hemoglobin A1c which measures the average blood sugar over the last 3 months. Talk with your primary care physician to see how often you should be screened for diabetes. Eating a healthy diet, exercising regularly, losing weight if needed, managing your stress level, and getting adequate sleep are effective lifestyle ways to treat diabetes along with medication recommended by your physician.

To learn more, here is the link to the American Diabetes Association: http://www.diabetes.org/in-my-community/american-diabetes-month.html

PREDIABETES is an ever increasing problem in the United States. It is estimated that 86 million Americans have prediabetes, many of them probably unaware of it. That is a lot of people! This condition occurs when a person’s blood sugar is higher than normal but not high enough to be considered diabetes. If left untreated, these patients are at much higher risk of going on to develop diabetes within 10 years or less. One of the dilemmas with prediabetes is that usually there are no specific symptoms indicating someone has it, making it a challenge to diagnose. It, like diabetes, is diagnosed by blood work. Ask your primary care physician if you are at risk for prediabetes and how often you should be checked for it. The good news is if treated early, many people with prediabetes may not develop diabetes.

The most effective ways to treat prediabetes are to exercise regularly (moderate aerobic exercise for at least 30 minutes a day most days of the week), eat a diet that is low in simple carbohydrates and sugar and higher in protein and complex carbohydrates (seeing a nutritionist is very helpful), lose weight when indicated, manage stress level well, and get plenty of sleep. Sometimes patients will take metformin, an oral diabetes medication, to reduce their chance of developing diabetes. Metformin has been shown to be effective in reducing the progression of prediabetes to diabetes in some people.

It is important to note that the above lifestyle changes are also VERY helpful in reducing your risk of developing prediabetes and diabetes. So if you take a few proactive steps now, you can significantly reduce the chance of developing either condition. Please keep that in mind!

Here is a link from the Mayo Clinic that discusses prediabetes: http://www.mayoclinic.org/diseases-conditions/prediabetes/basics/definition/con-20024420


Ebola virus update

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We continue to get flooded with information about the Ebola virus from the news, social media and people all around us. Understandably so because this is the worst epidemic of Ebola virus since it first appeared in 1976. It is wreaking havoc in western Africa and now is starting to appear in the United States. Many Americans are becoming quite concerned and frightened. Education about the Ebola virus is an important first step to help reduce fear and anxiety. Here is an Ebola virus update and link to an article that I hope you find useful.

Hospitals across America are reviewing their protocols on how to quickly identify patients that may have the Ebola virus and to isolate them until the diagnosis is confirmed or refuted. This will help patients get prompt medical treatment and minimize the risk of exposure to others including healthcare workers. Locally the Washington State Hospital Association, the Washington State Department of Health, and Seattle and King County Public Health departments are working together to help hospitals throughout Washington be ready to quickly identify and take the necessary precautions in patients with suspected Ebola. What happened in Dallas is most unfortunate and hopefully will not be repeated.

Stricter measures have been put in place at five United States airports where 90% of the passengers coming from the main West African countries with Ebola are arriving. This will help to quickly identify patients who may have the disease as soon as they get to the United States so that they can be isolated from other people. This should reduce the number of people with Ebola coming into the United States.

What we have historically been told is that it is hard to catch the virus through casual contact while being out in public. It is not typically spread through the air or by food and water. You have to come in direct contact with the bodily secretions of an individual with Ebola virus. It can only enter through a break in your skin or through your mucous membranes (eyes, nose and mouth. This is true.  HOWEVER, THE CDC HAS NOW RECOGNIZED THAT YOU CAN CONTRACT EBOLA THROUGH THE AIR IN CERTAIN SITUATIONS. Here is the direct quote from their website: A cough from a sick person could infect someone who has been sprayed with saliva. Because of that, being within three feet of a patient for a prolonged time without protective clothing is considered to be direct contact.” Keep this in mind if traveling or if Ebola is discovered locally in your state. At this time the CDC believes the Ebola virus is not aerosolized, meaning you can’t catch it from breathing the air around you (unless you are in the specific situation described above).

This information is going to be confusing and frightening for many people with the cold and flu season coming because so many people around us will soon be coughing. Here are my thoughts:

1. AT THIS TIME WE DO NOT BELIEVE THE EBOLA VIRUS CAN FLOAT IN THE AIR BY ITSELF AND THUS CANNOT BE CAUGHT BY BREATHING THE AIR WHEN OUT IN PUBLIC. IT CAN ONLY BE SPREAD BY THE RESPIRATORY ROUTE WHEN SOMEONE IS COUGHING SALIVA DIRECTLY ONTO ANOTHER PERSON’S MUCOUS MEMBRANES (EYES, NOSE, MOUTH) OR THE SALIVA IS INHALED.

2. AVOID FACING PEOPLE WITHIN THREE FEET FOR AN EXTENDED PERIOD OF TIME (NO ONE KNOWS HOW LONG YOU MUST STAND THERE TO BE EXPOSED) WHO HAVE A WET PRODUCTIVE COUGH THAT YOU CAN FEEL ON YOUR FACE WHEN TRAVELING OR IF EBOLA IS DISCOVERED LOCALLY IN YOUR STATE.

3. THERE ARE NO RECOMMENDATIONS AT THIS TIME TO WEAR MASKS WHEN YOU ARE OUT IN PUBLIC IN THE UNITED STATES.

4. CONTINUE TO REGULARLY WASH YOUR HANDS WITH SOAP AND WATER OR PURELL WHILE OUT IN PUBLIC AND WHEN YOU RETURN HOME.

Here is a link to an article with an Ebola virus update:  http://www.nytimes.com/interactive/2014/07/31/world/africa/ebola-virus-outbreak-qa.html?_r=0