Monday, May 18, 2015

To wake and greet the day

Are you one of those who tried to get up at a good hour, with plenty of time to get to work, but just can't seem to get out of the house on time, time and time again?  Here is an interesting article with some useful tips to help you get up early, and feel good about it!

While putting this article together, I was asked about several other topics.  Here are my thoughts and responses to some questions:

1. Getting up is hard to do. What's the biology behind it?
Believe it or not, your body has an internal clock closely linked to the earth's 24 hour day. Various hormone systems, blood pressure, and even brain waves rise and fall throughout the day in this cycle, called a “Circadian Rhythm.” Waking up from sleep depends on these rhythms all pointing to an awakening state, and the morning light is one of the more powerful triggers of this. While there are clearly people who rise in the afternoon or evening to work during the night, they have been able to reset their body clock to support this mode of behavior. As evidenced by the strange feeling most of us have on the first day that Daylight Savings Time starts or ends, short term disruptions in sleep timing can be quite jarring.
2. If you had to offer two tips for rising early, what would they be?
If you need to awaken earlier than normal, say to leave for a trip, you need to be sure that your body is ready to awaken at the prescribed time. So, first, be sure to have enough sleep. If you will need to wake at 4 a.m., and you normally wake at 6 a.m., you should retire two hours earlier than usual. But, if you do that only on the night before you leave you likely will not fall asleep two hours earlier, but lie there, tossing and turning, and wake up a wreck. So, for several nights before the event, start retiring about 30 minutes early, and wake up 30 minutes early. Push this over several days to adjust to the new time. A similar technique can be used when travelling across time zones, to be sure sure you are functional at the new destination. Another neat device works on the principle of light awakening you. There are lights that come on very dim at first, and gradually brighten, simulating sunrise. This triggers a natural waking response. Together, these two techniques can substantially help you wake early and function normally.
3. Most people are either larks or night owls, depending on their genetics and age. So, in theory, it would be difficult to change how one's body works. Is it really worth getting up early then? If it's worth it, what's the best way to do it!
Getting a good night's sleep is worth it, no matter what your genes. Many studies have shown significant medical issues from sleeping too little or too much. Getting your sleep patterns into order would begin with getting your environment in order. A comfortable bed, the right temperature, covers that are neither too heavy or flimsy, and bedclothes as much or little as you feel you need are all important. The room should be dark and quiet, although some seem to benefit from some “white noise” to cover up ambient sounds. Count back some nine hours from your anticipated awakening and prepare for bed. Engage in some quiet activity, like reading or a peaceful television program. Snuggle down and let yourself fall asleep. Use a gentle alarm, or the wake light, to waken you, and then get out of bed. Setting it in your mind that you will accomplish this helps to motivate you to the task. Don't try to change too much too fast; if you have been sleeping until 8 a.m. for years, changing to 6 a.m. likely cannot be done in one night, for most people. All of this applies as well for those who find themselves in a situation where being awake at night is required. Take a few days, shift the times, and it can often be accomplished without too much trauma. Light blocking curtains and cooperative family members may also be required.

It should be noted that all of these bits of advice presume normal sleep physiology. If you have sleep apnea, or other medical conditions which affect sleep, you really should seek the close guidance and monitoring of your physician for any issues regarding your sleep or sleep habits.

Friday, May 8, 2015

Something really disgusting ... your coffee maker?

You had to assume that with the convenience might come a price, and that just may be the case with those pod and similar coffee makers.  To make the coffee convenient, water has to be stored and piped around the machine, and that gives all kinds of microorganisms a chance to thrive.  Here is a little piece from WBFF television that looks at the problem.
To explain the last comments a bit, particularly in offices that use a carafe, many hands on the carafe handle, often unwashed, can leave a plethora of germs upon it to share.  So be careful, be sure to wash your hands appropriately, and encourage frequent and thorough cleaning of the office coffee pot, and any other shared food equipment.

Sunday, May 3, 2015

When modesty prevails, does Vitamin D suffer?

There are lots of opinions out there about Vitamin D.  Should you take it or not?  Do you need it or not?  Does it just help your bones, or are there other effects?  If you are out in the sun all day, is that enough?  With all of these questions, and more, there seem to even more answers, on many sides of the discussion.

Although we like to think that sun exposure is the primary way we get Vitamin D, in fact, even in average dressed individuals, the importance of sunlight is not as high as one would think.  The body makes vitamin D when skin is directly exposed to the sun by the conversion of cholesterol (you knew it was good for something!), and most people meet at least some of their vitamin D needs this way. Skin exposed to sunshine indoors through a window will not produce vitamin D. Cloudy days, shade, and having dark-colored skin also cut down on the amount of vitamin D the skin makes.  Not only that, as we age our ability to produce Vitamin D from sunlight exposure goes down.

Having said that, it is still prudent to limit exposure of skin to sunlight in order to lower the risk for skin cancer. When out in the sun for more than a few minutes, wear protective clothing and apply sunscreen with an SPF (sun protection factor) of 8 or more. Clearly, in the case of those dressed for tznuit, modesty, the potential for Vitamin D deficiency is increased.  Such people, both men and women, should likely include good sources of vitamin D in their diets or take a supplement under the direction of their physician.  The often stated recommended intakes of vitamin D are set on the assumption of and average amount of sun exposure.

What foods provide vitamin D?

Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American diets.
·         Fatty fish such as salmon, tuna, and mackerel are among the best sources.
·         Beef liver, cheese, and egg yolks provide small amounts.
·         Mushrooms provide some vitamin D. In some mushrooms that are newly available in stores, the vitamin D content is being boosted by exposing these mushrooms to ultraviolet light.
·         Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart. But foods made from milk, like cheese and ice cream, are usually not fortified.
·         Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and soy beverages; check the labels.

A few words about milk.  Children who worked in factories in the early part of the 20th century would develop a disease called rickets, with softening and bending of the bones, particularly in the legs.  In the 1930s, it was recognized that Vitamin D would prevent rickets, and it was added to milk, a likely vehicle to get the vitamin into children.  The amount added to milk then, and still today, is 400 units per quart.  We now know that this is less than the daily requirement of Vitamin D, which for most adults is about twice that amount.  That means that in order to get adequate Vitamin D from milk, one would have to drink a half-gallon of milk every day.  And that's why supplements make more sense.

What kinds of vitamin D dietary supplements are available?

Vitamin D is found in supplements (and fortified foods) in two different forms: D2 (ergocalciferol) and D3 (cholecalciferol). Both increase vitamin D in the blood.  Check with your physician to see if you are deficient in Vitamin D, and what level of supplementation you may need.  If food is not sufficient for your needs, either over the counter or prescription levels of Vitamin D may be prescribed.  

Some studies suggest that taking mega-doses of Vitamin D on an infrequent basis, such as monthly or even less often, increases the risk of side effects from the supplement.  Taking a nominal amount daily would be more physiologic, and may have better results.

Do not just take extra Vitamin D just because you think you need it.  Vitamin D is one of the fat soluble vitamins, which will accumulate in the body to toxic levels if taken to excess.  So the first thing to do is ask your physician to test your Vitamin D level.  Of course, one can never predict if your health insurance will cover such screening, it may not.  And if the level is normal, you likely don't need to screen it again for many years.  But if it is not normal, allow your physician to direct the dose and regimen of Vitamin D to replace your deficiency and keep you in the healthy level going forward.

Friday, May 1, 2015

Sleep - if more is bad, is less worse?

Is Insomnia Deadly?Lots of press recently about sleep.  In an earlier blog post, I looked at some of the evidence that sleeping for too long, over nine hours, makes you more prone to strokes and other ills.  Well, it turns out that short sleeping, sleeping for less than six or seven hours nightly, is not the best thing, either.  Here are some of my thoughts in another article, about the other end of the sleep spectrum, in a piece entitled:
I think that if there is a lesson to be learned here it is, as with many aspects of our lives, that health lies in moderation.  But if you are having problems with sleep, such as short sleep, insomnia, interrupted sleep, or extended sleep, see your physician.  There are many health problems that can affect sleep, and they may not all be apparent to the casual eye.  You may need a sleep study, or even more tests, but ignoring the problem will not mitigate its effects nor make it go away.  And not paying attention could have severe consequences. 

Friday, April 24, 2015

Homeopathy - is there a place for it in conventional medicine?

After a landmark FDA analysis of homeopathic practices, some serious questions have been raised about this form of therapy.  I was asked to participate in a discussion of the topic, and you can read along with this...

Monday, April 20, 2015

Is there still life ... Is there still hope?

No doubt about it, the continuing saga of Bobbi Kristina Brown tugs at the heartstrings of the world.  Now with a question of her showing signs of lightening of her coma surfacing, the question of just what that might mean, and how one could tell, was posted to me by Newsmax's Charlotte Libov.  Here are some thoughts on the subject:

Sunday, April 19, 2015

Attention to Dangers of Distracted Driving

Here is a short piece from the Quality Health website with a few of my thoughts on distracted driving.  You know, there is a lot of publicity about cell phones or texting as a distraction, but there's much more.  Here is the article:

And here are some more of my thoughts on the subject, responding to some interview questions:

What is “distracted driving?”
Very simply, distracted driving is driving without paying full attention to driving.  Distractions can be overt, like a cell phone, or more subtle, like singing along with a song on the radio.  Every driver is susceptible to distracted driving, and it takes skill and concentration to drive safely.

What tips can you offer for staying safe on the road?
Remember what they taught you when you first learned to drive?  Keep your hands on the wheel, watch traffic, listen for the sounds of traffic – sirens or emergency vehicles, pedestrians, and the like.  Watch your mirrors, and stay alert.  Don't pay attention to the radio or music player, the person in the next or back seat, and especially not to a cell phone or tablet.  Don't put on makeup or shave, or read the newspaper balanced on the steering wheel.  Don't change clothes or see if those sunglasses look hot by staring at yourself in the rear view mirror.  DRIVE!

Who is most likely to be a distracted driver? Teens vs. adults? Male vs. females?
While young people, particularly teens, are disproportionately represented among distracted driving incidents, people of all ages are known to drive distracted.  Mothers attending to their seat belted children in the back seat, businessmen looking at Email or the newspaper, salesmen checking the map to get to a client, and just about anyone you can think of can be a distracted driver

What are some of the consequences of distracted driving?
Traveling the length of a football field while checking a text, not seeing the car stopped front while turning around to chastise the child, slamming into a child darting into the street while reaching for the high note in a song – the consequences of distracted driving are pure and simple tragedy.  Death, property damage, profound injury, all from just not paying attention.