Tag Archives: health

Straight No Chaser: About that 'Strep Throat'

General Health and Wellness, Head/Eyes/Ears/Nose/Throat, Pediatrics/Kids Health, , , , , , ,

strep-throat Strep-Throat-without-use-of-antibiotics-300x202
Here’s a pretty common scenario. You’re a first time parent with the most adorable kid in the world. You’re in full tiger mom or dad mode, and you’re not going to let anything in the world hurt your baby. Your child has a sore throat, and you’re worried that it could be strep throat. You want to know if s/he needs antibiotics (Actually, you’re demanding antibiotics, but that’s another conversation!).
If a physician is actually using evidence based medicine to treat you instead of just throwing antibiotics at you to make you feel better (We call that ‘treating the parents’), there are criteria (based on what is called a Centor score) that determines when antibiotics are indicated and will make a difference (because most sore throats are caused by viruses and don’t respond to antibiotics; they’ll get better on their own in time). The Centor score is simple enough that you could figure it out yourself. Here are the components.
The patients are judged on six criteria, with one point added for each positive component.

  • History of fever
  • Tonsillar exudates (those white patches in the back of the throat)
  • Tender anterior cervical lymph nodes (those swollen lumps in the upper neck right below the angle of the jaw)
  • No coughing
  • Age <15 add 1 point (because strep is more likely at this age)
  • Age >44 subtract 1 point (because strep is way less likely at this age)

After that, you’ll have a number. Physicians use that number to guide management as follows:

  • 0 or 1 points – No antibiotic or throat culture is necessary; the risk of strep. infection is less than 10%.
  • 2 or 3 points – A throat culture should be done, and the patient should be treated with an antibiotic if the culture is positive.
  • 4 or 5 points – The patient should be treated with an antibiotic (The risk of strep. infection is 56%), and no throat culture needs to be done.

So… if you do this calculation at home and get a 0 or 1, don’t expect antibiotics, and don’t get mad when you don’t get them. There are consequences to inappropriate usage of antibiotics. As I’ve discussed in the past (as with Staph becoming MRSA, for example), antibiotic resistance is a real phenomenon with dangerous ramifications for patients. At a patient, you really don’t want to take medications unnecessarily. Microorganisms develop resistance when you’re taking medications inappropriately. You want to remain such that when you need them, they work.
I’m happy to answer any questions or take any comments. Thank you.
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Straight, No Chaser: The Treatment of Erectile Dysfunction

Genital/Urinary, Medical Treatment, , , , , , , , , ,

Smiling_BobPenis-Pump-For-Penis-Enlargement-font-b-Erectile-b-font-font-b-Dysfunction-b
Well, here’s what many of you’ve been awaiting.  Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.
The medications
A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.
Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it.  Unfortunately, that’s not the entire story with these medications.  ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.).  If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds.  Therefore, this leads to two very important cautions regarding ED meds.  You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick).  These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician.  This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).
There are actually even more intricate medications used to treat ED.  Taking testosterone injections is an increasing means of addressing low hormone levels.  Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods.  You’d be given these options by your urologist if necessary.
The counseling
If your ED is due  to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance.  If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.
Surgery and additional methods

  • If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps.  These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump.  A tension ring is placed about the base of the penis to maintain the erection during intercourse.
  • Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
  • Penile implants are an additional option.  Inflatable rods are placed into the sides of the penis.  These rods are simply inflated when needed.

Penile-Prosthesis-300x168
If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering.  As I usually conclude, prevention would have been a much better course of action.  Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician.  Good luck, and I welcome your comments and/or questions.
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Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

General Health and Wellness, Neurology, Health Prevention, , , , , , ,

brainaging

Last but not least, in the first part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.
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Straight, No Chaser: Erectile Dysfunction, Part Two – Causes

General Health and Wellness, Genital/Urinary, Health Prevention, , , , , ,

Causes-of-Erectile-Dysfunction-ED-Treament-Today
In my last post on erectile dysfunction (ED), I gave a simplistic way to understand and address it.  However, the truth of the matter is the overwhelming majority of cases of ED are not related to stress or other psychological issues.  First, some sense of ‘reasonable’, expected performance should be established, especially as one ages (as discussed here).  Beyond that, you should know that approximately 90% of ED cases involve an underlying medical concern, including, but not limited to, the following:

Diabetes

High blood pressure

Changes/disease to your blood vessels

Low testosterone

Kidney disease

Smoking

Alcohol and Drug abuse

Obesity and High cholesterol

Effects of your medications

Therefore, today’s message is simple and brief, but I’d suggest it’s probably more important than you have previously thought. You should consult your physician if and when you or your partner’s sexual performance becomes an issue. You may actually discover something that will not only save his performance, but his life.
Finally, in the next post we will review the wide variety of treatment options for ED.
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Straight, No Chaser: Erectile Dysfunction, Part One

General Health and Wellness, Genital/Urinary, Health Prevention, , , , , , ,

erectile-dysfunction
It seems appropriate to follow-up a post on age-related changes in your genitourinary system with a discussion on erectile dysfunction (ED).  The nature of the topic is such that I’m going to approach this in two different ways.  Today, I’ll give you a functional, overly simplistic view of ED and tomorrow, I’ll look at it from more of a clinical orientation, because there really are nuances involved. So keep in mind the lead picture. There are many medical and psychological issues that can lead to problems having erections.  I’ll get into that more tomorrow.
In many ways, your health is related to the quality of your blood flow, both in quantity (successful circulation to tissues) and quality (relative absence of toxins we ingest and deliver throughout). This is true for the brain (mental health, absence of strokes), the heart (stamina, absence of heart disease/attacks), and your penis (sexual function, lack of impotence), as well as every other organ.

Excluding truly medical considerations, the two surest ways I know to be a sexual stud (without implants or being of a certain age) are to have a legitimately healthy ego (psychologic health) and more importantly, to be in good physical shape and otherwise healthy. However, for now, given that an erection simply results from strong blood flow to the penis, your overall health better enables that process (the first time as well as if you want multiple contiguous encounters). Everything being equal, the best way for a guy to be able to have sex for whatever you define as a ‘sufficient’ period of time (besides being of a certain young age) is to maintain good cardiovascular health by spending that physician-recommended 20-30″ or more at a time on a treadmill, bike, running, etc.

Drugs like Viagra, Cialis, etc. are really nothing more than drugs that lower blood pressure (and resulting demands by other bodily organs on your blood), such that your penis’ call for an erection is otherwise unimpeded.  Sounds good?  The risk is varying forms of a ‘steal syndrome’, where that blood isn’t being distributed to your heart and brain, which could result in a heart attack or stroke.  That’s why you must “ask your doctor if you’re healthy enough for sex” before using…
Bottom line: practice for good sex and stamina during sex by working out.  It’s just another benefit to being healthy.
I welcome any questions or comments you may have.
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Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Genital System

Genital/Urinary, Health Prevention, , , , , , , ,

repro
The third part of this series is about your genital system after 40. There’s a lot here both for the ladies and the gentlemen, but  everyone should want to know all the information provided. As before, I’m going to go through changes – challenges – solutions. I welcome any questions or comments.
Prologue: Sex is good for your long-term genital and mental health. I can’t think of a better, more sexy application of the truism ‘knowledge is power’. Men, feel free to discuss this with your ladies. Ladies, I promise you I’m not being biased here (wink).
Changes: Allow me to start with the most important point: sexuality is not truly an issue of aging as much as it is more an issue of education, psychological response and health. However some changes specific to the genital system do occur with aging. In men, the prostate may enlarge (does so in 50% of men at age 50), potentially causing frequent and urgent needs to urinate and difficultly holding urine. However, more changes occur in women than in men. In women, the uterus shrinks, and several changes occur in the vagina, resulting in decreased lubrication and elasticity being lost.
Challenges: The challenges here are interesting ones. Simple rules to better genital health – Women: Stay sexually active! Men: Be confident in your sexual stamina! It is important to understand that the changes that occur in the genital system are not as related to age as they are to one’s sense of sexuality. The physical changes in the genital system should be non-problematic, especially if sex has been occurring without long periods of abstinence.
Venus Challenges: On the female side, the physical changes all can be dealt with if the woman has maintained some regular level of sexual activity. Yes, genital responses to stimulation slow gradually in both men and women, but you can have normal sexual relations at any age, as long as you are healthy. If after the age of about 40, a woman abstains from intercourse for prolonged periods (such as 3 to 5 years) the ability to secrete lubricating fluids, and much of the elasticity of the vagina are permanently lost.
Mars Challenges: On the male side, a particularly annoying challenge for some men with prostate enlargement is to avoid self-wetting. The even greater challenge is (not believing, but) ‘knowing’ your sexual prowess and stamina are still intact, particularly if dealing with an intimidating female partner (e.g. better conditioned, more adventurous or perhaps younger). For males, premature ejaculation and impotence are dramatically reduced in men when they become legitimately confident in their sexual skills set. Work on that! Women, feed your men confidence! It will come back to you!
Venus Solutions: Masturbation can effectively help to maintain female capabilities to provide lubrication and elasticity, especially if object insertion is included. Since most research shows that less than 50% of women practice object insertion during masturbation, these women who also abstain from intercourse lose some vaginal elasticity, even with regular masturbation. In the event that the woman has been sexually abstinent for a period of 3 to 5 years or more, the use of K-Y Jelly or some other non-alcoholic, non-petroleum lubricant specifically designed for compatibility with the chemistry of the vagina may sufficiently reduce discomfort in sexual intercourse.
Mars Solutions: Remember that most sexual problems are social/psychological problems, and they occur at all ages. Men: work on learning what’s necessary to give you confidence, and better performance will follow. For some it’s a certain partner, for others it’s a pill. Do not underestimate this point: if you’re otherwise healthy, that enhances your ability to perform sexually! It’s all about blood flow anyway.
Solutions Epilogue: The main solution to age-related issues of the genitalia are all within your reach (no pun intended): it’s all about activity, especially continued regular sexual activity, exercise, good nutrition and other healthy habits.
Post-script: Petroleum products such as baby oil and vaseline must never be put in or on the vagina, as they will upset the pH balance of the vagina, making it susceptible to yeast infections and other problems like BV (bacterial vaginosis).
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Straight, No Chaser: When Sex Hurts Her – Vaginismus

Medical Treatment, Obstetrics and Gynecology, , , , , , , , , , ,

vaginismus

The human body is fascinating and mysterious in so many different ways. Unfortunately, that’s not always a good thing. Not every medical condition has to be life threatening to have a powerful and detrimental impact on one’s life. Vaginismus is an example of that. It’s a condition in which women suffer involuntary contractions of the floor of the vaginal walls. These contractions can be so violent and incapacitating that it renders sex very painful and uncomfortable at best and physically impossible at worst. No, this is not esoterica. Many women suffer through this, not knowing what it is or ascribing the pain to ‘size’.

Here’s three things you need to know:

She’s not faking it. 

Vaginismus is horrible for the sufferer, as you’d imagine, and it’s a tremendous stress on relationships.  It is the number one cause of unconsummated marriages, and can be complete or situational.  It may be complete, impacting ability for a physician to complete a pelvic examination or for a woman to even place a tampon.  These contractions can be reflex occurrences such that the symptoms occur when presented with any effort to penetrate the vagina.  That said, the reflex is thought to be physiologically learned, and it has been demonstrated that it can be unlearned (Consider your immediate impulse to lift your arm when a fast object comes at you; one episode of vaginismus can prompt a lifetime of similar reactions during efforts at sex.).

Vaginismus can be cured.

It stands to reason that in the many cases in which vaginismus is a learned reflex, the reflex can be overcome.  Muscle training and control are the keys to overcoming vaginismus and is a process that can be accomplished over weeks to months.  The good news is developing this level of training and control can also have wonderful benefits for couples that do get past the problem.  Many women are familiar with Kegel exercises from prenatal classes.  Application of these in the correct manner (with systematic progression until penetration is possible) provides success in approximately 90% of patients.  If you require details, feel free to ask, or discuss this with your physician.

Vaginismus requires patience (and flexibility) to overcome.

Healthy sex lives are enjoyed by many couples without penetration.  This is an important frame of mind to have, less the additional stress can hinder treatment and torpedo the relationship.  It may seem like a lot to ask for some, but believe me, many couple maintain happy relationships in the midst of this, either during treatment or throughout a lifetime of suffering through it.  Taking this mindset into the period during which treatment is ongoing can lead to a very happy outcome once the vaginismus has been overcome.
I welcome your questions or comments.
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Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Musculoskeletal System

General Health and Wellness, Health Prevention, Musculoskeletal System, , , , , , , , ,

Physical Therapist Working with Patient
The second part of this series is about your muscles. This section combined with the previous skin section explains why you wrinkle. As before, I’m going to go through system – changes – challenges – solutions. If you’re keeping score, especially focus on the take home messages within solutions. I welcome any questions or comments.
Changes: Did you know that muscle cells are unable to replace themselves once they are formed? Therefore, muscle cell loss is permanent. Plus, muscular response gradually slows with age. That said, the loss of muscular capabilities over time is by far the result of cell loss due to inactivity. As muscle cells are lost, weakness and slowness increase. Plus, some of you don’t exercise at all, or as much/vigorously as you used to, so you’re not building up anything new.
Challenges: The effects of these changes on our health status are mostly due to the fact that the muscles are the main tools for effecting strong circulation throughout the body (i.e. muscular contraction pushes blood around). As the muscles become smaller, including the muscles in the face, and as fat tissue accumulates, including in the face, the entire appearance changes to that of an older person, with all the ramifications described in the post on the description of skin changes with aging. In addition, as muscle fibers decrease, weaken, and slow, it becomes increasingly difficult to keep up with younger people, who may make allowances, but who may also become avoidant. Your recognition of this creates a vicious cycle, and you eventually settle into ‘being old’.
Solutions: In two words – exercise & activity. A well designed, consistently followed exercise program addressing both strength and response is indispensable for the maintenance of muscle cells, and of good health over time. A personal trainer is a pretty good idea after a certain age. You neither need to under nor overdo your weight lifting regimen. In any event, move those muscles as much as you can, whether via walking, yoga, running or sex. Being a couch potato is never a good thing.
Post-scripts:

  • Another thing that very few of us do is stretch. Those old muscles are tight, and the tendons/ligaments are short and ready to pop. You really must stretch before your weekend warrior events or most any big exertional activity. That’s a big part of why yoga promotes longevity.
  • Fortunately, the main muscles of the heart and the diaphragm (your breathing muscle) do not lose muscle fibers with age because they are continually active. Yet, your heart and lungs have their own problems besides the muscles. That topic is forthcoming. All that said, be mindful that through ongoing exercise and training, you can stem the tide on these changes.

Young is as young does.

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Straight, No Chaser: Life Begins (to End) at 40 (Unless It Doesn’t) – The Skin

Skin/Dermatology, Health Prevention, , , , , , , , ,

agingsmoker
Being on the other side of 40 is a trip. I’m still pushing the rock up the mountain, but I’ve seen the challenges of maintaining and continuing to advance. This is a lot to digest, so I’m going to go through five different body systems this week in a simple way: system – changes – challenges – solutions. If you’re keeping score, especially focus on the take home messages within solutions. And don’t be depressed! Forewarned is forearmed. Take action! I welcome any questions or comments.

Part 1/5: Your Skin

Changes: As the skin ages, blood flow to the skin is decreased, and nerve endings are lost or become less sensitive. As a result, the skin loses some of its effectiveness as a protector against bacteria, as an insulator, as a heat/cold regulator, and as a sensory receptor. These losses cause wrinkling, loss of elasticity, freedom of movement, and expression are inhibited. The slowing of circulation results in slower healing. The loss of color is also seen, as the hair becomes gray.
Challenges: The skin generally functions well throughout life though, and most changes in the skin due to aging are not life threatening. Most of the damaging changes in the skin are cosmetic. The drying and thinning result in sagging and wrinkling, the hair becomes sparser and gray or white, and the fingernails become rigid, tend to yellow, and are prone to splitting. Skin disorders more common in the aging skin include enhanced itching, thickening in patches, skin cancer, ulcers/pressure sores, and herpes zoster (shingles). These effects bring social implications based on a significant cultural tendency toward ageism. One’s social life becomes more limited as younger people view elders as “not fun”, “slow”, “grumpy”, less desirable as friends and sexual partners, and so on. These views spill into the workplace or what might be a potential workplace, as one who looks “old” is not considered as having ‘much’ to offer.
Solutions: Two words: hydrate and moisturize. Avoid excessive exposure to the sun, maintain moisture in the skin, provide adequate nutrition so that the skin can be maintained and repaired, and get regular exercise to maintain circulation in the skin. Sounds simple, but we really fail to adhere to this consideration. Many of these changes can be delayed for very long periods of time.
Post-Script: I would be remiss if I didn’t point out that those of you of all races and ethnicities must be diligent in getting rapidly growing or changing moles evaluated. It is an untruth that Blacks and Browns don’t get skin cancer.
Post-Post-Script: Ever imagine what effect holding a cigarette up to your face for decades has?  Here’s a depiction.

agesmoke

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Straight, No Chaser: The Week In Review

General Health and Wellness, The Week In Review, , , , , , ,

week-in-review-header3-589x237
Happy Sunday, everyone. In the midst another all-time best week here, I got to discuss the topics I spend most of my time discussing with patients in the emergency department: high blood pressure, smoking and obesity. What that triad has in common is how they manifest in many different disease presentations. Well, at least now you know. I guess drinking and STDs will have to wait for another time. Here’s your week in review. Feel free to click the underlined topics to access the original posts.
We started the week on Sunday reviewing how the nerve gas sarin, allegedly used against the citizens of Syria, creates death and disease. Someone actually asked me why the victim in the lead picture was wearing shaving cream. That’s not shaving cream, folks. Victims wallow in their own secretions from everywhere, including salivation, excessive tearing, runny nose, diarrhea, urination, vomiting and lung secretions before they die of respiratory failure. We certain wish the best for the people of Syria and the country as a whole.
We spent Monday reviewing high blood pressure (hypertension), also known as the silent killer because yes, it can cause you to drop dead without knowing what happened. Just remember to try not to poison the pump that delivers oxygen and nourishment throughout the body (That would be your heart!). In part two of our hypertension review, we gave you numbers to know for monitoring your blood pressure and cues as to when that high pressure warrants a visit to the ER. I’d suggest you commit a few brain cells to that information. That’s information that could save your life, given the time dependent nature of treating the strokes and heart attacks that result from high blood pressure.
On Tuesday, we began reviewing smoking cessation and the benefits associated with it. We also discussed best practices in achieving smoking cessation. It remains interesting that many more people use the patch to stop (and many do so successfully), but stopping cold turkey remains the most effective way of stopping, for those able to pull it off. Consider the 10 Quick Tips I offered and consider working with your physician on the START method. I know this is a struggle. Over two-thirds of smokers want to stop, and over half attempt to stop every year. I wish you the best if you’re in that group.
On Wednesday, we took a look at obesity in America. Based on the data, it’s clear more people are choosing the pursuit of happiness (in excess) over the pursuit of health. That said, we’re still doing something right, as our life expectancy continues to increase despite approximately two-thirds of us being overweight (although we’re living longer with more disease).
On Thursday, we reviewed the health risks of obesity and introduced you to the caloric equation, which largely determines if you’re gaining or losing weight. It’s actually a pretty simple concept that you might consider learning, because every bit you lose reduces the load on your heart (in particular) and other organs. These relative, incremental amounts do matter.
Friday was a fun day, because we discussed solutions instead of just problems. We talked about how to lose weight the good old-fashioned way, reviewing how to pace yourself, set reasonable expectations and lose healthily. Just remember it’s going to take a lifestyle change, not a fad. The tortoise always did beat the hare. On Friday, we also discussed how to jump-start your metabolism, regardless of age. The Quick Tips I gave you couldn’t be simpler and do make a difference.
On Saturday, we completely switched gears and reviewed the painful topic of hemorrhoids. Don’t forget the self-help tip ‘WASH’, and trust me, your goal is to stay away from the ER or surgeon with these. Deal with them sooner rather than later, before it becomes a pain for everyone involved! Saturday, we returned to smoking – this time of the cigar variety. I had to bring the Surgeon General along to point out the cigar smoking is not a safe alternative to cigarettes. Can you believe a single large cigar contains as much nicotine as an entire pack of cigarettes? Who knew?
Your comments, concerns and disagreements are welcome. My goal is always to provide you information that you incorporate into making your lives happier and healthier, not to be the ‘health morality police’. As the obesity posts noted, there is too often a crossroads between health and happiness. When you’re younger, you really are investing in your health to secure your future happiness, because as you age, there is a much higher correlation being your health and your happiness. My mental health colleagues will be quick to tell you how the lack of health as you age leads to higher rates of depression and suicide in the elderly. Your goal is to head down the road that offers both health and happiness. And speaking of aging…
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Cigar Smoking: Facts and Fiction

Cardiology/Heart, Hematology & Oncology/Blood Disorders/Cancer, Respiratory/Lungs, Health Prevention, , , , , , ,

Fidel-Castro-smoking-ciga-001 mouth_cancer_cr

It’s the latest, greatest, coolest past-time.  Endorsed and practiced by celebrities the world over, cigar smoking has clearly and successfully marketed itself as a convenience of the successful.  Even the notion that the ‘best’ cigars are forbidden fruit (i.e. come from Cuba) adds to the allure if and when you’re able to wrap your lips around one.  I wasn’t surprised, but it’s worth noting that beyond the success stories received from those of you who have successfully stopped cigarette smoking, the next set of questions involved whether cigar smoking is a safe alternative.
Since you have little old me taking on an $8 billion a year industry and the wrath of the very passionate, I have no recourse but to arm myself with some data – cold, hard facts.

  • 49% of all cigars sold are large cigars.  A single large cigar contains as much tobacco as an entire pack of cigarettes.
  • Cigar use is on the rise, with over 13 million people identifying as current users.
  • 15% of male students in grades 9-12 are current users.
  • African-Americans have the highest rate of cigar smoking (among ethnicities/races), with a 7.7% user rate.

You want to know the effects of cigar smoking?  Let’s cut to the chase.
Here are the five “SURGEON GENERAL WARNING” text-only labels, one of which must be displayed on all cigar packaging and advertisements.  This is done on a rotating basis.

  1. Cigar Smoking Can Cause Cancers Of The Mouth and Throat, Even if You Do Not Inhale.
  2. Cigar Smoking Can Cause Lung Cancer and Heart Disease.
  3. Tobacco Use Increases the Risk of Infertility, Stillbirth and Low Birth Weight.
  4. Cigars Are Not A Safe Alternative To Cigarettes.
  5. Tobacco Smoke Increases The Risk of Lung Cancer And Heart Disease, Even In Nonsmokers. 

Beyond what the Surgeon General requires, here are some additional facts:

  • All tobacco smoke contains more than 60 chemicals that can cause cancer, and cigar smoke is no exception.
  • Regular cigar smoking increases your risk for the following cancers: lung, esophagus, larynx (your voice box), and oral cavity (lips, tongue, mouth and throat).
  • Cigar smoking is linked to gum disease and tooth decay and loss.
  • In addition to lung cancer, heavy cigar smoking increases the risk for emphysema and chronic bronchitis.

The bottom line?

Cigar smoking is not a safe alternative to cigarette smoking.

There is no level of cigar smoking that does not pose health risks.

As always, it’s not my chore to convince you to do or not to do; freedom of choice is a beautiful thing.  That said, be advised that if you read this blog, you will be an informed consumer.  I welcome your comments or questions.
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Straight No Chaser: Got Hemorrhoids?

Gastrointestinal, Genital/Urinary, , , , , , , , , , ,

hemorrhoid Bath reading

Yes, you do.  I can hear you now.  Aww, doc!  Why are you talking about this first thing in the morning?  Well, a lot of you have them 24 hours a day, so now is as good as a time as any.  I know this topic is a pain (no pun intended), but you should consider reading this before your next bowel movement.
Let’s talk about hemorrhoids, and we’re gonna make this simple.
1. What are they?  Hemorrhoids are swollen veins either inside (internal hemorrhoids) or outside (external hemorrhoids) the anal canal.  It’s not uncommon for people to have both types at the same time.  You should wonder if you have them if and when you experience pain, bleeding and itching to the perianal area.
2. Why do you get them?  It’s all about pressure.  The blood that is circulating to the skin near the anus finds itself in outpoutchings when you strain and stretch the skin while having a bowel movement.  Pregnancy is another time when hemorrhoids become common.  I’ve literally seen hemorrhoids form before my eyes during the straining of childbirth.  The table is set for that in advance, as the pressure of the last two trimesters on the pelvic vessels also causes development of hemorrhoids.  The same goes for the obese.  Plus, you sit too much.
3. How can I prevent them?  You should start with ensuring that you’re eating a high fiber diet (fruits, vegetables and whole grains), exercising and drinking a lot of water.  Becoming constipated and having to strain is a sure way to developing hemorrhoids.  Does anyone remember Al Bundy from Married with Children?  Notice how he always took a newspaper to the toilet?  That’s the other part of prevention.  Allowing your bowel movements to occur on their time-table without you straining keeps you without hemorrhoids.
4. How can I treat them?  The problem with hemorrhoids is they hurt, and hurting causes a vicious cycle.  Because they hurt (and bleed), you don’t want to have another bowel movement.  If you’re not having bowel movements, chances are you’ll get constipated.  If you get constipated, you’ll have to strain and endure pain.  And the cycle continues…  So, in order to break the cycle – WASH yourself (like the young lady in the lead picture).

  • Water (sitz bath)
  • Analgesics (pain medication, either topically or by mouth)
  • Stool softeners
  • High fiber diet

5. How will your physician treat them?  Treatment in an emergency room setting is largely dependent on whether or not the external hemorrhoid has developed a blood clot (as shown in the lead picture).  These are the type that are especially painful and are called thrombosed external hemorrhoids.

  • Non-thrombosed internal hemorrhoids usually are initially treated conservatively as described above.
  • Sometimes internal hemorrhoids will need to be tied off with a surgical band, eliminating the blood supply to the hemorrhoid and forcing it to shrink or fall away.  Alternatively, the tissue around the internal hemorrhoid may be surgically scarred (ouch!) to the same effect.
  • Thrombosed external hemorrhoids need to have the clot removed.  This is done by the physician with a particular type of incision.

By this point, you should be thinking “I’ll take the prevention!”.  Trust me, that’s the correct choice.
As an emergency physician, I’m even more concerned about the possibility of something else being wrong.  Given that 10 million Americans are walking around with hemorrhoids anyway, that rectal bleeding could be due to something else, such as rectal, anal or colon cancer.  You may receive additional examinations specifically to rule out those considerations (they may involve tubes, probes and/or scoping).  Feel free to ask if you really want details.
Feel free to read this again as motivation during your next bowel movement.
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Straight, No Chaser: Quick Tips on Boosting Your Metabolism

Cardiology/Heart, General Health and Wellness, Health Prevention, , , , , , , , , ,

fat crying
It would be improper for me to have dragged you through the mud for three days and depressed you into thinking you can’t improve your situation. Hopefully, you’re not feeling that way. You should now have a better understanding of how the body works, how to count calories and how to compare yourself to a baseline for health. What left is giving your body a leg up on your efforts. Yep, I’m talking about boosting your metabolism. Any of you that have been with me for a while know that means I’m not promoting something you’ll find in a bottle, although there are many good supplements that can assist in that effort. I’ll refer you to your (or my) favorite personal trainer for those considerations. As always, I want to offer you the tools to be self-empowered. To that end, here’s five Quick Tips to boost your metabolism. Why five? Because five is easier to implement than six. Once you get these five down, let me know, and we can get a bit more intricate.
1. Eat smaller meals, and eat more frequently. It’s true. More meals more often is better, but only if they’re smaller. Calorie counting is still a major part of the equation. The point of more frequent meals is preventing the body from going into starvation mode, which slows your metabolism as the body attempts to conserve energy. If you do this, you’ll discover those meals are smaller and you will get closer to eat more appropriate portions than we typically do. Also, make those in-between meals healthy choices like a handful of fruits or nuts.
2. Prime your pump. Remember, it’s all about your heart’s ability to efficiently move blood around the body anyway. The healthier your heart is, the better your metabolism will be. You need aerobic exercise that increases your heart rate for 20-30 minutes at a time. Learn your target heart rate for your age, and exercise to get into that range. Your metabolism will better approximate that of a fine tuned machine rather than a sputtering old car.
3. Weight train. This is very simple. The more muscular you are, the more calories you will burn, especially relative to someone of the same weight who is obese. Not only will you become a finer calorie-burning machine, in this case you actually will look better! Add weight training to your exercise regimen.
4. Choose the fish (and not the fried variety). Fish oil contains substances called omega-3 fatty acids (EPA, DHA) which increases levels of fat-burning enzymes and decreases levels of fat storing enzymes. Daily ingestion has been shown to help by approximately 400 calories a day.
5. Enlist a personal trainer. Everyone needs help and motivation. Some of us need a lot of help and a lot of motivation. We also need expertise. There’s nothing more frustrating than working hard yet not seeing any results because you’re working incorrectly. A good trainer can put you on the path, supervise your regimen, and hold your hand through the process. The minutia of age, sex and body habitus considerations that also play a role in this can be managed by a good trainer. Your ideal trainer will have knowledge of nutrition, wellness and supplements that are tailored to your specific considerations. This will get your metabolism revved up!
By the way, if you’re into green tea, caffeine or spicy/hot peppers, enjoy them for their other benefits, but don’t expect them to contribute significantly to your efforts to improve your metabolism. At least that’s what the consensus in the medical literature points out.
Finally: yes, it’s true that metabolism naturally slows with age (starting as early as age 25); everyone has heard that fact. However, here’s what you don’t usually hear: that’s not inevitable and is more a result of your becoming less physically active than just aging. That demonstrates the need for you to be even more diligent in your efforts. Good luck, and I welcome your questions and comments.
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Straight, No Chaser: Healthy, Sustainable Weight Loss – Let's Get Started

Cardiology/Heart, Personal Training, Health Prevention, , , , , , , ,

obesity6obesity5
How to Lose Weight, and What is Healthy Weight Loss (AKA, How Much, How Soon and How)?
Let’s start with the How. Commercial voice: “You should contact your physician before starting any weight loss routine”. We ended things on the last post talking about the caloric balance equation, which (simplified) means you need to get off your derriere, and close your mouth. Without getting too technical, to lose weight, 1 pound equals 3,500 calories, so your net caloric intake must be cut by at least 500 calories per day to lose a pound a week. Here are some Quick Tips to cut calories (and I will not be discussing any of the popular diets or medical remedies (with one exception in the next post); you can see your physician or nutritionist about those. Besides, guess what? Most of you don’t need a fad diet. Keep it simple. And…more importantly, you should be more concerned with healthy regimens that help you keep the weight off, not drastic efforts that have proven to have quick short-term but unsustainable long-term outcomes).
1) Work out: If you can sprint, do so. If you can’t, jog. If you can’t jog, walk. I like working out while watching sports, because my heart’s pumping anyway. Weight training at the same time is even better. Once you hit a good exercise regimen, your metabolism will improve, making weight loss that much easier.  By the way, the next post is on metabolism; stay tuned.
2) Hungry?  Start counting calories.  Use this standard to determine what your daily calorie intake should be.  Meal plan so you don’t exceed that level.  Remember the caloric equation to lose weight: Amount expended minus the amount eaten should be 500 calories a day.  In the next post, I’ll give you a Quick Tip for an extra 400 calories a day you can lose.
3) Still hungry? Try brushing your teeth. Don’t laugh. It actually works. And it gives you nice teeth. Otherwise try drinking water or chewing calorie-free gum. All these are nice, simple inexpensive appetite suppressants.
How Soon? It’s natural for anyone trying to lose weight to want to lose it very quickly. But evidence shows that people who lose weight gradually and steadily (about 1-2 pounds per week) are more successful at keeping weight off. Healthy weight loss isn’t just about a “diet” or “program”. It’s about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits. Think health instead of weight, and the weight will improve.
How Much? If you were my patient (but you’re not!), I’d tell you to forget about ideal body weight and BMI – for now. Focus on a modest weight loss, like 5-10% of your current weight. Even this success will improve your blood pressure, cholesterol and blood sugar levels. Once you accomplish that goal, do it again. So even if the overall goal seems large, see it as a journey rather than just a final destination. Seek to learn new eating and physical activity habits that will help you live a healthier lifestyle. These habits may help you maintain your weight loss over time. To that end, I love healthy challenges. Try a 30-day water instead of pop (soda)/coffee, etc. challenge, or even better, give yourself a 30-day ‘fruit for dessert challenge’ or ‘salad of your choice for lunch’ challenge. When that’s done, immediately do it again.  Learn to integrate healthy habits into your quest to lose weight, and you’ll increase the odds of having sustainable weight lost. At the end of the day, it’s been well established that those who maintained a significant weight loss report improvements in not only their physical health, but also their energy levels, physical mobility, general mood, and self-confidence. Good luck, and check back for the next post on how to fine-tune your metabolism!
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Straight, No Chaser: The Adverse Health Effects of Obesity and Why You Gain Weight

General Health and Wellness, Health Prevention, , , , , , , , ,

obesity1Obesity.jpg
Earlier, we identified the differences between a ‘normal’ weight and being overweight and/or obese. Today’s goal is to help you understand specific risks of carrying extra weight.  We’ll also set the table for losing weight by discussing why weight gain occurs.  It bears repeating that none of this has anything to do with the perception of one’s physical attractiveness.
Let’s focus on three considerations.
1. What are the health risks?
As body weight increases, so does the risk for several different medical conditions and illnesses, including the following:
• Arthritis
• Cancers (breast, endometrial, and colon)
• Diabetes
• Gynecological problems (abnormal periods, infertility)
• Heart disease (heart attacks, heart failure, hardening of the arteries)
• High cholesterol
• Liver and gallbladder disease (gallstones)
• Sleep apnea and other respiratory problems
• Stroke
In the event that these risks are just words on a page, learning a little bit about some of them might provide the motivation needed to avoid them.
2. What is a realistic goal for weight loss?  What’s the balance between family predisposition and the foods I eat?
No matter what I tell you today, it’s unlikely to turn you into a supermodel. The goal (independent of your consultation with your own health care provider) is to get you to optimize your situation based on the things you can control. Yes, genetic factors do play a role in obesity, but beyond that you are more than able to close your mouth and get off your…couch. You are able to limit your fat and caloric intake and put down the salt shaker. Yes, genetics count, but behavior and environmental (culture, socioeconomic status) consideration play at least as much of a role. These latter considerations can even jumpstart your metabolism beyond your genetic predisposition.
3. Why do I gain weight if I’m still active?
The most simple way to answer this is that weight gain occurs from an energy imbalance.  You’re taking in too many calories, and/or you’re not engaging in enough physical activity. It’s an equation, and the weight gain occurs when you’re on the wrong side of the equation. It’s not much more complicated than this. Either do less of the eating, more of the activity, or both.  I mentioned in a previous post on caloric counts that you must have an excess of 500 more calories expended than you ingest daily every day for a week just to lose one pound.  It takes work.  This is the simple answer as to why fad diets don’t work long-term.  You can’t cheat the equation.  The moment you stop being diligent, you’re headed in the wrong direction.  Your weight loss plan must include lifestyle changes for the long-term.
In the next post, we’ll identify some very simple methods to combat obesity based on the information provided to this point. Feel free to ask any questions or submit any comments you have.
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Straight, No Chaser: The United States of Obesity – The Crossroads Between Health and Happiness

Cardiology/Heart, General Health and Wellness, , , , , , ,

obesity_trends_20092obesity4

Obesity in the United States places many at a crossroad between self-esteem and health.  Often, larger frames are celebrated as more desirable.  Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise.  Of course, our culture embraces and contributes to obesity.  Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport.  I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health.  If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed.  As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:
Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.
Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.
‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight No Chaser: The United States of Obesity – The Crossroads Between The Pursuit of Health and Happiness

Cardiology/Heart, General Health and Wellness, Health Prevention, , , , , , , , , , , ,

obesity_trends_20092obesity4

Obesity in the United States places many at a crossroad between self-esteem and health.  Often, larger frames are celebrated as more desirable.  Other times, they are celebrated because we must learn to ‘love ourselves’, which is seemingly easier than laboring to diet and exercise.  Of course, our culture embraces and contributes to obesity.  Consider the ramifications of “As American as Apple Pie” or “Coke Adds Life” or the size of our favorite athletes in our most popular sport.  I’ve previously discussed the calorie counts of soft drinks and desserts and their contributions to obesity. At the end of the day, we now have a culture that views what’s physiologically most healthy for our hearts as visually less desirable and a culture where one can ‘reasonably’ (i.e. based on evolved cultural norms) make the decision that having a permissive attitude toward obesity is a more desirable state of being than the pursuit of health.
Odds are, you’re overweight. It was a both a joke and a cause for celebration that Mexico just overtook the US as this hemisphere’s fattest country, but it did bring attention to the fact that more than one-third of U.S. adults (35.7%) are obese, and nearly two-thirds are overweight. Over the next three days, we’ll review various components of obesity that affect your health. To be clear, this is not about your perceived physical attractiveness (and while we’re at it, just because you’re slim, that doesn’t mean you’re anorexic). It’s about your health.  If you’re sensitive about your size or have made an educated decision to ‘love yourself as you are’, you don’t have to read through this. If you’re at all interested in how your body is affected by weight, and if you can handle a little truth, proceed.  As always, the goal is to educate and stimulate thought, discussion and action.
Let’s start today with making it clear what obesity is and who’s obese. Be reminded the heart is only a pump meant to move blood around the body, carrying oxygen and nutrients to cells in different parts of the body. The heavier you are, the more work your heart has to do and the more likely it becomes that this pump will not function ideally and will functionally ‘give out’ over time. It is this functional failure that produces many diseases.
Let’s start with Ideal Body Weight (IBW). For humans (not ‘Northerners’ or the ‘Small-Boned’ or the ‘Non-Athlete’ or ‘Women Who Haven’t Had Children’), the formula for calculating IBW is as follows:

Women: 100 lbs for the first 5 feet, then 5 lbs. for each additional inch.
Men: 100 lbs for the first 5 feet, then 6 lbs. for each additional inch.

Ideal body weight refers to health, especially heart health, not ‘grown and sexy’ or any other concocted notion of what looks good. So as an example, if you’re a 6 ft tall male, your IBW is 172 lbs. If you’re a female and 5’5”, your IBW is 125. Now before those of you ‘in the know’ tell me there are limitations to IBW and BMI considerations, I’ll stipulate the point and note that doesn’t change the point of this conversation one bit.

‘Overweight’ and ‘Obesity’ are about your risks for disease. We’ll talk about those risks tomorrow, but here are the definitions of each.
Being Overweight is defined as a body mass index (BMI) of 25 or higher; Obesity is defined as a BMI of 30 or higher. BMI gives you an indication if you’re over/underweight or at a healthy weight for your height.
If you’re interested in your BMI, use the following calculator:
http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm
Let’s talk about it. This is important for your health and longevity.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Here's How You Stop Smoking – Quick Tips to START Smoking Cessation

General Health and Wellness, Health Prevention, , , , , , ,

smokingcessation1

  • Don’t pick your birthday or NYE to stop. Do it now. Can’t do it now? Do it Monday. In fact, do it every Monday. It’s a fight. If you fall down, start it back up again. It’s the fight of your life (or should I say for your life?).
  • If you decide to quit after your current (last) pack, throw away one cigarette for every one you smoke.
  • Count (figuratively or literally) all the money you’re saving by not smoking.
  • Throw away (not give away) all cigarettes, cigars, matches, lighters, humidors, cigar cutters and anything else you associate with smoking. You’ll realize how sad it is if and when you find yourself rummaging through the garbage to get a fix.
  • Tell everyone (loudly) that you’ve quit. Empower them to help and hold you accountable. Enlist another smoker friend to go through the journey with you.
  • If you do fall off the wagon, smoke a different cigarette brand. Odds are you won’t like it as much, and that will help combat the natural ease you have with smoking.
  • Contact your physician, and ask for help. Here’s a marvelous best-practices schemata of appropriate interplay between a physician and a patient trying to stop smoking.

smoking cessation As

  • If your physician and you decide to place you on a patch or otherwise medicate you, follow instructions carefully and precisely.
  • Practice deep breathing. Part of the euphoria of smoking is nothing more than the physiologic sensations produced by deep inhalations.
  • Keep other things in your mouth. Mints and chewing gum (low-calorie) are great. Brushing your teeth also serves many purposes. Drinking water when you want to smoke will often remove the urge.
  • Make it past the first day. Then make it past the first week.

I personally love the START method, which includes several of the above methods. Let me know if it works for any of you.

S: Set a quit date.

T: Tell your friends, family and associates that you’re quitting, and enlist their help.

A: Anticipate and act on the plan you’ve set and challenges you’ll meet.

R: Remove (trash) cigarettes, cigar and other paraphernalia from your environment.

T: Talk with your physician about options and additional support.

For those of you affected (either first or second-hand), this is huge and important. I really wish you all the best. I welcome any comments or questions.
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Straight, No Chaser: Smoking Cessation

General Health and Wellness, Respiratory/Lungs, Health Prevention, , , , , , , , ,

smoking stop
You’ve all been asked what things you’d take with you on a desert island.  I’ll pose and answer the opposite question, but not on an island but regarding your life.  Getting you to stop smoking is certainly one of the three gifts I’d offer you if it was within my power.  This post won’t be about the dangers of smoking – I’ll continue to hit you over the head with those at every opportunity.  Given that I’m into producing positive outcomes, I’m going to discuss with you effective means of smoking cessation and the benefits of stopping.
The question on your mind is obviously how to stop.  Personally, I’m of the Yoda mindset.  You know, when he was teaching Luke Skywalker, he famously said “Do or Do not. There is no try.”  I can hear you now, “But Doc, I’m addicted…”  Sure you are.  There are many things in medicine about which I’m absolutely sure.  One of these is the most effective way to stop smoking is to quit.  Cold turkey.  The moment you’re motivated.  Not only is this premise supported by the data, which I’ll discuss momentarily, but here’s the benefit of over 20 years in clinical emergency medicine practice and having seen hundreds of people stop, stay stopped, and letting me know months and years later that they stayed stopped.  Despite being addicted, people are amazingly able to quit cold turkey, and they will do it in one of five circumstances.

When they develop the will

After the birth of their first child

After their first heart attack

After their first stroke

When they die

For those of you convinced that you can’t, here’s a fact: today there are more former smokers than current smokers.

I want to point out that I appreciate the difference between cigarette smoking and nicotine dependence.  My particular concern for your health lies in the delivery of smoke (containing over 7000 other toxins, approximately 70 of which can cause various cancers) into the airway system that is supposed to deliver oxygen throughout your body for the maintenance and health of your organ systems.  Still I want you to know I understand and appreciate the difficulty of smoking cessation.

  • Nicotine dependence in the most common chemical dependence in the U.S.
  • Quitting smoking often requires multiple attempts.
  • Nicotine withdrawal produces bothersome symptoms (e.g. irritability, reduced concentration, increased appetite with possible weight gain, and anxiety)

The good news is more than two-thirds of smokers profess a desire to stop smoking, and yearly over half of smokers attempt to stop.  That’s likely a result of knowing that no matter when you stop, you will improve your health outcomes.  Each incremental inhalation of cigarette and cigar smoke produces damage better left unproduced.  Let’s just hope you don’t wait until permanent damage has set in.  Consider a sampling of the following benefits that are sitting there waiting for you.

  • Reduction of the risk for cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach and cervix, as well as certain leukemias.
  • Reduction of the risk for heart disease, stroke and peripheral vascular disease.
  • Reduction of the risk for COPD (chronic obstructive pulmonary disease)
  • Reduction of the risk for infertility

In my next post, I’ll review specific methods and tips to help you and/or your loved one stop.  Today’s as good of a day as any.
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