Shaken, Not Stirred? Or one for the road...

Some British researchers with far too much time on their hands took to task a look at Ian Fleming's super spy James Bond, with particular regard to his alcohol consumption.  Postulating that his level of alcohol intake may have caused a tremor, they wondered if this might be the reason that he preferred his martinis "shaken, not stirred."  Never one to let a story such as this rest, MedPage Today asked me to contribute to a piece called

Bond's Martinis Shaken by Alcohol Tremor?

and here is the result, with some video clips of my, and others, responses to questions.  And you do want to view the video, it's the best part! This is just a perfect piece for the holiday season. Cheers!

It's That Time Of Year!

Yes, it's that time of year, again.  No, not the "Holiday Season," or anything like that, it's the time of the year for coughs and colds.  Covering your nose with a tissue.  Wiping off the doorknob with disinfectant.  You know, that time.  So, when a reporter from Health Magazine called me for some of the tips I follow when I get a cold, who would have thought this little tidbit would make it into the magazine?

20 Surprising Ways to Prevent Colds and Flu

And then I really was floored, when the same title popped up on the Fox News website!

20 surprising ways to prevent colds and flu

Who knows where I will pop up next?

Assorted bodily functions in combination

Some of the more interesting questions I have received of late have come from the readers of Maxim Magazine.  Here is one that occupied the featured slot of the Ask Maxim section of the October, 2013, issue of the magazine:

For the sake of completeness, here are some further thoughts on the subject:

I suppose that this is the kind of a question which might come up over drinks one evening.  So, let's have a look.... The same groups of muscles and reflexes are involved with both coughing and sneezing so, for all practical purposes, you cannot cough and sneeze at the same time.  But, these same muscles can increase the intra-abdominal pressure. And that increased pressure could encourage the expulsion of gas per rectum, a fart, if you will.  Coughing and sneezing, and even laughing for that matter, could all trigger a generous fart.  One would presume that the more vigorous the upper airway activity, the more vibrant the flatulence that would result.

Get It Going!

While physicians preach exercise as the cure for much of what ails you, getting up off your duff and putting it into practice does seem to remain an issue.  Here is an article I contributed to, even though they did spell my name wrong, which addresses just that issue!

14 Offbeat Workout Motivation Tips That Really Work!

Recommendation advice

Somehow, along the line, I have been on the employer side of hiring, and with patients needs at hand, I have also been involved in looking at caretakers.  This experience profile led to my being asked a few questions about the topic in this article:

How to Write a Letter of Recommendation

Combating Colds and Flu

I've been asked to comment on many topics by the Max Sports & Fitness website, this one is something we deal with every day this season.  Among others, enjoy my few comments in this article:

How to Combat Cold & Flu

Do you really need something for it?

One of the more common scenes in the office is the patient who has a minor illness and wants a major treatment.  The common cold is a ... well ... common scenario.  I had the opportunity to respond to a question about this from Oprah Magazine, and here is the link to my response:

Pop A Pill or See A Doc?

Safe Pregnancy Choices

As a physician in a primary care practice, I really do get questions from all over the block.  Well, here are some responses to questions recently posed about foods that are safe in pregnancy.  If there is any demand, I could post some of the background material for these topics.

What's Safe to Eat During Pregnancy: The Facts You Need to Make Your Own Decision

Another marker passed

On March 1, 2013, this blog hit the 1000 page view mark.  That took almost four years since the start of the blog in August, 2009.  This week we hit 2000, making the second 1000 views in some four and one-half months.  Wow.  Thanks to all who have read this blog, and spread the information about the site to their friends.  Between television appearances, print work, and posts unique to the blog, I hope to keep posting, and you, I hope, will keep reading.  Thanks to you all for your support.

Making the Portable Potable

Water Bottle Woes

A simple question about keeping your summertime water bottle clean really has many streams of response.  Although there are those who never clean a bottle until it is grossly, and I do mean grossly, contaminated, prudent use would have the bottle cleaned regularly, as you would any other container or utensil.  A variety of bacteria, including E. coli and salmonella, can contaminate the interior of the bottle, as well as viruses such as norovirus, which is responsible for the bulk of viral gastroenteritis, or “stomach flu,” throughout the year.  Keeping the bottle clean is pivotal in preventing these types of illnesses.

Since organisms can secret themselves in the interstices of lids and spouts, these items, particularly, need cleaning attention.  Sharing the bottle with other can encourage contamination, and the spread of disease, and should be avoided.  Depending on the bottle’s material and construction, similar cracks may form within the bottle, itself, making cleaning that much more necessary, and difficult.

While many use the disposable bottle sold containing bottled water, these bottles are not really manufactured for reuse, and may be difficult to keep clean.  The plastic used may also not be suited to long term use, with the question of plasticizer and chemical leakage and the formation of micro-cracks in the material.  Except for the very short term, their use as a refillable container should be discouraged.

Commercial plastic water bottles are nominally more sturdy than the disposable variety, with better tops and spouts.  One should insure that the plastic used is BPA-free to avoid exposure to this potentially harmful inclusion.  Properly maintained, these should last until the seal on the top starts to leak, which seems to be the most common reason to discard the bottle.

Metal water bottles, with stainless steel and aluminum being popular, are quite rugged, and often feature a lining which retards microbial growth, enhancing potential safety.  They may weigh more, a factor in bottles being carried in sport; they tend to be more durable, which also may be decisive in sports use.

Cleaning any bottle should start with a thorough wash out with clean water.  Techniques commonly use range from a little soap and water, to baking soda, to denture cleaning tablets, to a dishwasher.  These all have their advocates, with the bottom line being to clean as well as the bottle will tolerate to provide the best result.  Many plastic bottles will not survive a trip through the dishwasher, while some metal ones may require such treatment to disinfect.  Guidelines provided by the manufacturer of commercial water bottles should certainly be reviewed and followed.

And, finally, a word about the water, itself.  Bottled water, in general, is not submitted to the stringent guidelines of the commercial water supply.  Be aware of the source of any water you buy, which may be purified tap water from your local community.  Your own tap water, perhaps run through a filter to remove excess chlorination or metallic tastes, should be fine, and less expensive as well.  But certainly take some when you are exercising, and stay healthy and hydrated.

Get the Gout Out

Very nice piece broadcast on our local NBC television affiliate today about gout in women, although men can certainly appreciate this as well.  One of my patients agreed to be interviewed, and the result is about a minute and a half of a light treatment of a painful problem.  You can watch at:

Gout increases in America, but treatment available

Energy Drink Dangers

I had an opportunity to comment on the dangers of those caffeine laden energy drinks to children in this little piece last night on WJZ television, our local CBS affiliate.  They spelled my last name wrong; at least they got the "Marc" right!

Lawmakers Question Energy Drink Execs

Weightism and Discrimination

An article was recently published looking at the effects of "weightism," discrimination of the obese, on the individuals being discriminated against.  Medpagetoday.com put together this look at the article, with my comments on obesity and its management in such a situation

Weight Bias Tied to Obesity

The Scourge of Epistaxis

So what does that mean to you?  Epistaxis is the fancy medical word for Nosebleed, and here is a piece I was interviewed for on the Everyday Health website:

Nose Picking and Five Other Causes of Nosebleeds

Okay, so it's not brain surgery.... but I bet more of you have faced this than care to admit it!

What is the future of medicine?

I was interviewed for this article in the July, 2013, issue of Newsmax magazine.  Don't tell anyone, but the patient I am pictured interviewing, wearing the yellow sweater, is my brother, Steve Leavey!

Summer question about cold hands

Was asked a question for the June, 2013, issue of Maxim magazine about painful injuries to cold hands.  Here is what they printed:

Obviously, they did a little editing for space and content.  But if you are really curious about this, here is a little more information on the subject.

There are several reasons that contribute to that awful pain you feel when you injure cold hands, or cold feet for that matter.  With cold temperatures, the body shunts blood away from the extremities, the hands and feet, to preserve warmth to the body’s core and brain.  This causes the hands to shrink ever so slightly, you notice it when your rings get loose, and, in doing so, put a bit of extra pressure on the many nerve endings in the hands.  That irritates them a bit, making them more sensitive, more likely to signal pain, than when warmer.  Also, the muscle fibers tighten with the cold, making the hands stiffer, and more likely to suffer injury if traumatized.  Now, if you are really cold, you might even start having frostbite, with direct injury to the soft tissues of the hands, but that would be an extreme case.  Certainly wearing gloves helps keep your hands warmer and more protected, but wearing a hat in cold weather is also essential.  The hat helps keep your head, and brain, warm, lessening the amount of blood the body has to shunt to the head to preserve the brain, and allowing a tad more to be available to the extremities.

Fighting The Boomer Bulge

I was called by Barbara Phillips, a writer who is interested in health and wellness, and asked to contribute a chapter to her book, A Balanced You for Baby Boomers
Taking on the challenge, I wrote the following piece, called "Fighting the Boomer Bulge."  As we approach the summer, with barbecues, picnics, and such, as well as just about any other time of the year when weight is an issue, the information here may provide some help and guidance for many of you.

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Are you in that group of folks in which your belt size is approaching your age? Gaining weight in early middle age is common, and results in that Boomer Bulge that allows you to fit in with your cohorts. Do you really want to lose it, and regain your svelte youthful profile? Remember four words: Eat Less, Exercise More.

There are all kinds of diets out there, limiting or emphasizing this or that food, nutrient, origin or color. But if you really want to lose weight, all that really counts are calories. Many studies have supported the principle that a calorie deficit diet, eating less calories than you require, is the first step towards losing weight. The trouble with going onto some kind of diet, like high protein, carb loading, liquid supplement, or pre-packaged foods, is that by going on, you presume you will come off. And that is the fallacy. You don’t want to go onto a diet; you want to change your approach to food.

Limit your portion size, eat a variety of foods. Meat, chicken, fish ... all good! Fruits, vegetables, grain ... fine! A little wine, a little caffeine, a little chocolate, why not? The key, if there has to be a key, is to eat appropriately sized portions to what your needs are, and to keep you diet varied. Have a colorful plate with a variety of food hues and textures. Use the protein as a condiment, patterning the meal after the Asian model. Big portions of brown and boring foods are out; an exciting small plate of tastes and variety is in.

Ultimately, that you limit your calorie consumption is the goal, how you accomplish that goal is up to you. Do you really enjoy a low carb diet? Fine, incorporate that into your daily regimen, keeping the other principles intact. If you need a little guidance, there are organizations, such as Weight Watchers, which can help you understand portion size and the values of different foods; or you can use any of a number of online resources, many of which are free. Whichever path you take to eat less, you can accomplish the goal of incrementally reducing your calorie intake. By doing so, in a consistent and conscientious manner, you can take those first steps toward the goal of a healthy weight.

Speaking of steps, the second half of the equation was to “Exercise More.” That’s really not a dirty word, you can exercise. You have to want to. If you want to join a gym, go there every day for a few hours, and develop those “six pack abs,” go to it. It’s not for most of us but if you enjoy it, who am I to stop you? No, here I go by the principle of “slow and steady wins the race.” Remember the hare and the tortoise? Who won? Just start doing something every day. If you are really out of shape, ten or fifteen minutes of walking may be all that you can do. Just do it. Do it every day. You eat every day, you need to move every day. Sure, it would be great to do an hour on the treadmill every day, but let’s be realistic. Start slow and build. If ten minutes is your limit this week, maybe you can do eleven or twelve next week. Stay motivated, work your way up slowly, and stay interested. You will do what you can do, and what you want to do.

So how do you do it? You can walk, you can jog, you can run. You can use a treadmill, an elliptical machine, a stepping machine, a rowing machine, or a stationary bike. You can ride a real bike, on or off road. You can go to a gym, or have a gym at home. You can use a video game exercise program, or you can pop in an exercise DVD or even an old VHS tape. More than how you do it, it is that you do it. If you don’t exercise, the effect of a calorie restriction is blunted by the body shutting down, trying to conserve energy in the face of a perceived shortfall of calories. You’ve got to push the system to burn calories, and burning calories helps you lose weight.

Let’s get serious for a minute. Obesity is epidemic in this country, and is responsible for illness and death when it could have been prevented. Do you want to enjoy retirement? Do you have children, and hope to see them grow up? Do you look forward to grandchildren? Do you just want to be able to reap what you have sown? Carrying those extra pounds makes you tired, and can make diabetes, high blood pressure, high cholesterol, heart disease, and more worse and worse. So start now, today. You did not gain the weight in a short time, you won’t lose it quickly either. But start, take the task to heart, and you can succeed. And that success can reward you far beyond your expectations.

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Summer time ... gross time?

Among all the fun things you can do this summer are some really gross things you might want to avoid.  Here is a little article I contributed to that describes, in a light fashion, some of the situations you might find yourself in.

Six Kinda Gross Summer Health Hazards

Teens don't take it seriously

Youthful bravado is one thing, and stupidity another.  Teens have always seemed to be able to find things to do that could harm them, but now, a disturbing trend has arisen among young football players that could have disastrous consequences.  See this segment, for which I was interviewed on our local CBS affiliate:

Teen Athletes May Not Take Concussions Seriously

Cinnamon - tasty but can be dangerous

Among the crazy things that young people have done through the years, from swallowing goldfish to a gallon of milk, the latest fad is dangerous enough to possibly cost a life.  Here is a segment I did for WBAL-TV on the

Dangers of the Cinnamon Challenge

Be aware what young people around you are doing.  This can result in anything from an irritated throat to a collapsed lung, asthma, and death.  That someone has done it successful once does not mean the next time will be safe, and you may not get a next time, either.

Medical Planning for Public Events

I was asked to write a piece for Sports Destination Management magazine about the medical aspects involved with setting up a major public event.  After some research, and discussion with some who were involved in local situations, I put together this article, which is published in their March/April 2013 issue:

Medical Support Planning and Prep: Medical Planning for Public Events

Thanks ...

Nothing dramatic in this post, just a thank you to all who have stopped by over the past few years.  Just passing the 1000 page view mark.  I hope to post more for you all in the future.

Chicken Soup will help that ...

It's cold, you have a cold, so what else do you turn to?  Why, chicken soup, of course.  While we have called it "Bubby-mycin" in my family, there is more to this golden broth than the taste.  Here is a little piece I did on WBAL-TV that highlights some of the value in this tasty offering:

Chicken soup can help alleviate colds, docs say

More on the flu

This year's influenza outbreak has been a significantly more active one than in years past.  And I have been asked more questions about it by the press.  Here is another media piece,

Seasonal Flu Q&A: Top Questions Answered

No, I'm not the only "expert" on board, but I do have some nice quotes in the piece.  In the interview, I responded to quite a few questions, here is some more of what I had to say...

Does this flu season appear to be worse than in recent years and does the flu shot seem to be effective this season? 

According to the CDC, this year’s flu season is among the highest in recent years.  Peak levels have been observed in the moderately severe range, similar to the 2003-2004 and 2007-2008 seasons.  It may yet worsen, as the season appears to still be on the uptick.  The typical flu season peaks in March or April, still several months away.  

The vaccine appears to be about 60% effective in preventing influenza infections, comparable to other years.  At this level, the vaccine clearly reduces morbidity and mortality from the influenza virus.

What constitutes a flu emergency? 

A region typically declare a flu emergency in consideration of the severity and number of cases in the area.  This year, both New York and Boston, among others, have felt the need to declare such a state of emergency.  Flu vaccination, increase awareness of hygiene, and curtailment of public assembly may be impacted by such a pronouncement.  

Which strain of flu is the worst and are different strains treated differently? 

The A(H3N2) seems to be a particularly severe strain, along with several other strains that have been around before, such as A(H1N1).  

How can I take care of a loved one who is suffering from the flu, without getting sick myself? 

First and most important, wash your hands!  The flu virus can sit on your hands, and gain entry when you eat, rub your nose, or eyes.  As much as you want to share each other’s company, try to stay apart when not necessary, and use disposable dishes and utensils or wash them promptly in a dishwasher.  Bathroom surfaces and the like which may be contaminated should be cleaned with a disinfectant cleaner.  Tissues and other such material need to be disposed of promptly in a sanitary manner.  And wash your hands!

If someone in my household gets the flu, is it likely that everyone else in the house will become infected? 

If appropriate precautions are taken, including influenza vaccination for all in the household, proper hand washing, avoiding undue contact with the ill individual and sanitary handling of contaminated material, you should be able to minimize your risk.

What types of complications from the flu occur? For instance, pneumonia, sepsis that type of thing. Who is most at risk? 

Pneumonia, bronchitis, sinus infections and ear infections are some complications of the flu.  People with chronic health conditions, such as asthma or congestive heart failure, may experience worsening of their underlying condition with the flu.  The very young, under 2 years old, older individuals, over 65, and pregnant women are at a higher risk for developing complications.  Any of a raft of medical conditions, including asthma, diabetes, heart or lung conditions, kidney or liver problems, many neurologic disorders, and immune suppression, such as with cancer, HIV infection, or organ transplantation all increase the possibility of complications.  Being morbidly obese, with a BMI over 40, also puts one at an increase risk.

In addition to a flu shot, how can the public protect themselves from the flu? 

Did I mention to wash your hands?  It is hard to underestimate how important that is.  Being cautious around people who are coughing or ill, insisting that ill co-workers or students stay at home until recovered, and observing common sense sanitary techniques won’t hurt, either.

How can you tell the difference between the flu and a cold? 

Briefly, a cold is an upper respiratory infection, with symptoms primarily above the neck; the flu is more systemic and severe.  Fever is rare with a cold, common and often high with the flu.  Aches, chills, and fatigue are more signs of the flu than a cold.  The secretions of a cold produce the runny or stuffy nose, sneezing, sore throat, and productive cough; all of which are rare with the flu.  A severe headache and chest discomfort, however, are more typical of influenza.

Are what point should you see your doctor if you have the flu? What are the danger signals? 

First of all, if you do have the flu, there are medications that, if started within the first few days, can lessen the severity and duration of the illness.  Contacting your health care provider early may be of benefit.  You can also review your symptoms with your medical professional, to be sure that you do have “just” the flu, and to be sure you are treating it correctly.  Signs of worsening include a very high fever that is not going away, a change in mental status, rapid breathing or trouble with breathing, decreased voiding, a bluish or gray skin color, or increasing cough and fever following some resolution of symptoms.  As always, anything which represents a significant change from the baseline should at least be reported to your health care provider.

Any other comments are welcome. 

There is a rare but reported complication of influenza called “Reye’s Syndrome,” which is associated with younger people taking aspirin while having the flu.  Current guidelines are that aspirin not be given to those under 19 years old with a fever-causing illness to lessen such risk.  A potentially fatal disease with widespread target organ pathologies, avoiding aspirin seems a small price to pay to help prevent this possible complication.

Chickenpox ... in adults?

TV personality Barbara Walters made news this week when she developed chickenpox after first having a bad fall.  It turns out that she never had the disease as a child, making her still susceptible even in her 80s.  I was asked to comment about adults getting chickenpox in this article:

Barbara Walters Hospitalized For Adult Chicken Pox Complications

Lots of topic covered, with the bottom line being, you really don't want to get this disease!

Another great reason to wash your hands

Along with the seasonal influenza, many have experienced what they called the "stomach flu."  Not a flu bug at all, the most common organism causing several days of nausea, vomiting, and diarrhea is the norovirus, which is currently spreading throughout the area.  Our local CBS affiliate had me on for an interview on Monday, January 28, with comments about the disease:

Dangerous Strain of Norovirus Spreads Through Maryland

Bottom line lesson:  whether for influenza, norovirus, or any of a number of other diseases, wash your hands with soap and water.  Sing "Happy Birthday To You" slowly while washing, to give adequate time for cleaning.

Eat well, sleep well, move well....

It's not rocket science, but you can do great things for your immune system and your health in general by following some simple principles:  Eat healthy, exercise the best you can, and get a good night's sleep.  Sure, there are more, and I might even be convinced to post more on the blog, if asked, but for now, enjoy this little segment from our NBC affiliate, WBAL-TV, broadcast today:

Foods, exercise key to boosting immune system

Let's be honest.  Isn't this the kind of advice your mother, or grandmother, would have told you?

Avoiding Germs Beats Fighting Them

The spreading of germs is clearly a hot topic these days.  Here is yet another article that I had the chance to submit some comments for, among the others cited.  Appearing in Health Magazine in the December, 2012, issue, the article is called Avoid Germs Wherever You Go.  I've posted it here for you to enjoy!

Flu-Mania and the media

I guess that "flu-mania" is all around us these days.  It's on the news and in the paper, and certainly in the blog-o-sphere.  A clever blog called "Free Range Kids" contacted me about a recent television spot and being overly careful about becoming infected, and the result was this post:

Take 2 Doses of Flu Hysteria and Don’t Touch ANYTHING

I do have a nice little quip in there, have a look at that entry, and wander around her blog, too!

Flu 411 : 2013 style

No doubt about it, influenza is sweeping the country.  The Baltimore Sun newspaper interviewed me for an article about the flu called

Flu 411

Check out the article, and let's see if it gets picked up on the syndicate!