Category : Health concern
Looking for Health Answers on the World Wide Web
May 16th, 2012We’re all too familiar with the search for that quick answer for our myriad of health questions on the omnipresent Google or WebMD. I confess, I have gone there too. Not a day goes by in the day to day care of patients in my private practice, that I face the popular phrase, “Doctor, I looked it up on the internet.” A small percentage of patients, actually do find reliable, accurate and valuable information, though far too many find themselves more lost, confused and be ridden with fear after their search on the world wide web. Indeed, that may be the reason our anxious patients steadfastly come to us looking for clarification. The key entanglement here is within the name, World, Wide, Web.
World- Our health is directly linked to our community, our local environment. The food we eat, the water we drink, the air we breathe, the environmental pollutants we are exposed to, and so forth. Looking for solutions to our health problems in a world that does not closely resemble that which we live in, can pose serious dilemmas.
Wide- The answers we find on the internet are wide, not specific. People don’t typically search by the name of the disease, they search by symptoms. ‘Blood in stool’, ‘worse headache of my life’, ‘lump in my throat.’ The reason being, they don’t know the name of the diseases associated with such symptoms. Generally, health websites such as Mayo Clinic, WebMD, Wikipedia, Medicinet offer a comprehensive discussion on a particular symptom. You’ll likely find a search for lump in throat produces a 15 item list of all the associated conditions, including lymphoma. Is that helpful? No. Is that scary? Yes.
Web- By definition, a web is a complex system of interconnected elements, especially one perceived as a trap or danger.1 Enough said.
So next time you notice that your health has changed in any way, keep your doctor in mind, not your computer. If it’s in the middle of the night, you’re too afraid to wake him or her up, and must imminently look up a question, go to a trusted site, such as Uptodate.com. There are no advertisers and no drug company propaganda. Only sound, reliable advice to most of your health questions. Spend no more than five to ten minutes reading the discussion, and don’t let yourself get entangled from one site to another. More beneficial though is to search this site after your visit with the doctor, once you have a diagnosis or two in hand, when you can learn more about your condition. Your doctor may already have reliable reading material on hand, don’t be shy to ask. This is a fine example of being a proactive participant in your healthcare decisions, which I guarantee will lead to better health outcomes.
Stay healthy and well.
Dr. Nasimeh Yazdani
Chronic Kidney Disease, aka CKD
March 7th, 2012Kidney disease affects many of our patients here at Seaside Medical Practice. For the most part, chronic kidney disease does not cause any symptoms. Early in its course, the only way to detect it is by blood and urine tests. Once detected, you and your healthcare team will need to take important steps to control the progression.
One of the most effective ways to improve kidney function and delay the progression of CKD is to control blood pressure. A blood pressure of less than 120/80 is optimal for most individuals. You can improve your blood pressure by maintaining a low salt diet, consuming more servings of fruits and vegetables, limiting alcohol intake, and exercising on a regular basis. Stress reduction techniques are always helpful as well.
For diabetics, tight sugar control, and the maintanence of normal sugars, is a must when preventing worsening kidney function. Those with diabetes produce an abnormally high amount of pro-inflammatory cells called advanced glycation end-products. These occur in even in those without diabetes, during the regular break down of sugar in the body. Diseased kidneys in diabetics cannot efficiently remove these products and they therefore progressively accumulate. A high amount of these advanced gylcation end-products in the blood play a large role in inflammatory processes of diabetics such as vascular disease, atherosclerosis, heart attack, nephropathy, and retinopathy.
Patients with CKD should also watch their intake of protein per day. Some studies suggest that a rich protein diet burdens already diseased kidneys. Limiting the grams of protein one consumes can improve kidney function over time.
One of the most significant causes of CKD is chronic use of NSAIDs, such as Motrin, ibuprofen or Aleve. Avoid excessive and chronic use of these medications in order to maintain healthy kidney function.
Numerous studies have shown that regular monitoring by a nephrologist reduces the rates of morbidity and mortality of persons with CKD, and leads to appropriate timing of kidney replacement modalities and transplantation. The role of a nephrologist in the care of patients with CKD is paramount.
If you or a family member have been diagnosed with CKD, or have any concerns about kidney disease, please do not hesitate to call us and set up an appointment for consultation with a nephrologist. We are here to help and educate you as best we can!
The Inflammatory Diet
February 13th, 2012Not until recently have researchers been able to directly link food to the immune system. A fascinating new article in New England Journal of Medicine, a premier medical science journal, “Diet and Intestinal Immunity,” outlines the findings of two studies linking dietary components of certain foods to intestinal immune receptors. The receptors, aryl hydrocarbon receptor (AhR) interacts with the particular food, sends a signal to the nucleus of the cells lining the intestinal tract, and stimulates or inhibits the genes responsible for triggering the immune system. The foods are cruciferous vegetables, e.g. broccoli, cabbage, and brussels sprouts. Laboratory animals with a defect in these receptors, are highly susceptible to infections, have increased vulnerability to immune activation, and altered composition of microflora of the gut. AhR is dampened in persons with IBD, irritable bowel diseases such as ulcerative colitis and Crohn’s disease. These studies raise the question of, “is there such a thing as an inflammatory diet”?
Nutritionists say, “Yes, in deed.” Clinical nutritionist, Shereen Jegtvig wrote an entire book on an inflammation-free diet, SuperFoods for Dummies.
My basic recommendations for an anti-inflammatory diet are:
- The more colorful your plate, the better. Five to eight servings of fruits and vegetables per day. According to the study above, broccoli, brussels sprouts, and cabbage are essential.
- Use more plant-based proteins such as soy, nuts and legumes.
- Avoid highly processed foods, and packaged foods. At the grocery store, perimeter shopping is better.
- Eat more fish, at least 3 servings per week.
- Limit high fat meats. People who consume red meat everyday have lower life expectancy.
- Limit sugars, especially refined sugars and simple carbohydrates.
- Drink water, herbal teas, green tea and milk. Limit sodas and fruit juices with added sugar.
References:
How Did Annick Do It?
January 23rd, 2012As patients check in at our front desk, some of our regular patients quietly wonder if we hired a new office manager. The truth is we did not. Our loveable and knowledgeable Annick is still with us, although she is a more petite version of herself!
We have been receiving a high volume of phone traffic and visitors coming in to specifically see Annick for “the scoop”. Her strategies are definitely working for her and she would love to share them with you.
So what did she do? It’s no secret. Annick has been faithfully following a low carb, high protein diet. Moreover, she would love to share her techniques with you!
We here at Seaside Medical Practice, would love for you to come by and talk to us about your weight concerns. Make an appointment with us, and Dr. Yazdani or Christine our Physician Assistant, will physically evaluate you before starting a diet and exercise program!
Food Journals, No Sweat.
October 31st, 2011One simple and effective way to lose weight is keeping a Food Journal. What you eat and how much of what you eat contributes to your current weight. Before you change your lifestyles in order to drop inches, you must realize that your success is due, in large part to your diet. The rest includes exercise and other factors.
One’s first food journal does not have to be detailed. It is a mere reflection of your day’s menu. After a week, you will be better able to reflect on the details of what was consumed. After a month, you might be able to see some patterns. Although your first journal does not have to be comprehensive, I am sure you will eventually add or subtract information that is more meaningful to you. These journals are private, so be honest with yourself! If you ate a bowl of ice cream at midnight, log it. Only you will know. It will motivate you. In the future, if you don’t want to see ice cream in your food journal, you won’t eat the ice cream.
To start a Food Journal, a small notebook and a pen is sufficient. Write down the date at the top of the page. On the next line, write “Breakfast”, and jot down what you ate. On the next few lines, do the same with lunch, dinner, and snacks. Don’t forget to record liquids.
As time goes on, you could add in categories such as calories, protein, carbs, and how many minutes you exercised that day. You could even record your weekly weight to monitor your progress.
Another great thing about journals is that you can add any significant events or emotions that may have affected your eating pattern. I know that personally, when I am stressed, I will have an extra snack at night. Seeing this in my journal allows me to be creative and think of other ways to unwind.
These days, Food Journals are becoming easier and easier to make. I personally use a free application called MyFitnessPal. What I really like about the electronic method of Food Journaling is that I do not need a nutrition book and calculator to add up my day’s calories. These amazing apps have an extensive system and it quickly summarizes the amount of calories, proteins, vitamins and much more for me. What I find extremely useful on them is a large variety of ethnic foods. Another perk about these applications are the weight logs. After inputting your weight, the application actually graphs your weight! You can easily see your body’s trend, whether your weight is goes up, down, or if you are stable.
If you’re serious about weight loss, give Food Journal a try. It is a wonderful proactive step towards better health!
Christine Soriano, PA-C
Radiation exposure. Should we begin to worry?
April 1st, 2011A danger of radiation exposure thousands of miles away has been the hot topic of conversation and concern here in our Southern California communities. The Center for Disease Control and Prevention (CDC) has reported minimally higher levels of Iodine-131 in several state rivers, lakes, and rain water. They reassure us that “the very low levels of radioactive material currently being measured in surface water and rain water are far below those of public health concern.” The consequences of a nuclear reactor accident depend on several factors, such as population density, weather conditions and dietary habits. Additionally, the response to the accident by authority also plays an important role in reducing the adverse effects of such disasters. Estimates of acute and latent fatalities have been compared with other societal risks, such as cancer and they show much less overall risk. This is due to the fact that nuclear energy disasters are very uncommon, negating from its significant exposure risk.
The symptoms of acute radiation illness is nausea, vomiting and diarrhea. There are two sources, internal and external radiation. Internal radiation exposure is when radionuclides particles are ingested or inhaled, and occurs with close proximity, such as plant workers and firefighters who are first at the scene and responding to disaster sites. External radiation consists of beta-, gamma-, and neutron-radiation released from plume of radionuclides. These forms of radiation exert dangerous injuries to skin and viscera by causing lesions in DNA and other molecules within the cells. If you’ve been to the dentist’s office, you may have noticed the apron shield worn by radiology technician, the purpose being protection of germ cells (ovaries in women, scrotum in men) against radiation. The adverse effects of DNA mutation on germ cells are seen NOT in the person affected, but their offspring. Exposures to radiation on all other cells, (non-germ cells) are categorized into random and nonrandom. Nonrandom are dose-dependent and affect individuals similarly. With higher levels of radiation, there will be higher risk for diseases such as hypothyroidism, cataracts, sterility, and growth retardation. The atomic bomb detonation survivors experienced increased frequency of cataracts, as were higher rates of hypothyroidism seen in Marshall Island residents exposed to radioactive fallout as a consequence of Bravo atmospheric atomic test.
Random effects of radiation exposure are more elusive as data on dose and risk is more uncertain. Two of the most common long-term health consequences are thyroid abnormalities and cancer. When dispersed into the environment, radionuclides, Iodine-131 and Iodine-125, found in high concentrations in nuclear reactors, are absorbed and stored by humans in thyroid cells, causing mutations and cell death. Other cancers are leukemia, breast and lung, which can be seen as late as 10 to 30 years post exposure. Cesium-137 radioactivity has been implicated in non-thyroid cancers.
Debridement and decontamination is very crucial in the early stages of accident, and iodine treatment with potassium iodine should begin immediately in persons affected. Supportive care for bone marrow failure, skin injuries and visceral injuries are to be addressed on a case by case basis, and treatment plans set for evaluation for late complications.
All in all, it is safe to state, for our patients at Seaside Medical Practice and Santa Monica community at large, that we should not worry about radiation exposure as a result of the nuclear reactor spill in Japan.
References:
1. Champlin, R. et al. Radiation Accidents and Nuclear Energy: Medical Consequences and Therapy, Annals of Int Medicine, 11/1/1988
2. CDC Website; http://www.bt.cdc.gov/radiation/isotopes/iodine131surfacewater.asp
