Sunday, May 31, 2015

More on travel with TV spot

On Sunday, 31 May 15, I visited the studios of WBFF, our local Fox affiliate, for a live segment on staying healthy while traveling.  Have a look at this informative segment:

Yesterday, while researching this topic, I put together a raft of information which looks at many aspects of healthy traveling.  Take a look back at the material I posted for more thoughts on the topic:

Saturday, May 30, 2015

Travel Well

If you are planning a trip, to the beach, the mountains, or across the globe, it is important to pay attention to your health through the process. Whether a vacation with family or the trip of a lifetime, having it impacted by health issues can sour a potentially sweet time. Here are some things to keep in mind.

Start Well

Get a check up. Many people will have their car checked before a long trip, looking at the tires, battery, oil and the like, but rarely do the same for themselves. Do you have any nagging complaints that have been going on just below the surface? Make sure that you are in the best of health before the trip. See your physician, if necessary, with enough lead time to take care of any issues. See your dentist if there are any concerns, or if it's been a long time since your last check. If you will be doing a lot of walking, or going to a high elevation, or plan to learn how to SCUBA dive, work with your physician to maximize your prospect of having a great time.

Review your medications, if any, and be sure to have enough on hand. It would be prudent to take double your anticipated supply, just to plan for any contingencies. You should keep your needed supply in your carry-on, and pack the extras in checked luggage, just to be safe. Medications should be labeled with not only the brand name, but also the chemical or generic name, even if the medication is not available generically in this country. If you run out, or need to see a physician in a foreign land, the brand name may not be familiar, but the generic, chemical, name will help the doctor understand what you are taking. Ask your physician for a list of your medications and doses, with prescriptions if possible, and also have a clear list of any medications or substances to which you are allergic, and carry it with you along with your travel documents.

Check for regional health concerns. The CDC website ( can tell you what may be present where you are going. If you are traveling to a place which requires vaccinations, be sure to contact your physician with enough time to acquire and administer the shots. Most travel vaccines are not a part of daily practice, and would need to be ordered special for you. Calling at the last minute that you need a yellow fever shot may not have the desired result. And some medications, such as for malaria, are started before you leave, so, again, leave adequate time for the process.

Are you insured? Review your health insurance policy and verify that you will have coverage for any medical matters on your trip, should you need it. If leaving the country, consider the purchase of medical insurance for travel, along with other travel insurance that you might obtain. This will be influenced by your health and where you are going, of course, and should be considered.

Bring stuff

Check meds and such. As noted above, make sure you have any prescription medication in sufficient quantities to allow for a delay in your return home, with labels and directions. Over the counter medications that you may take on occasion at home, for indigestion, aches and pains, cough and cold, or such may also be needed. There are often travel sizes of these medications at the store; although such packaging is a bit more expensive, it is convenient and well labeled. Although commonly supplied at many venues, pocket bottles of hand sanitizer or packaged wipes can come in handy while traveling. You may also need appropriate sunscreen, sleep aids, or even hemorrhoid medication, if such are your occasions. Depending on your destination, a hat, sunglasses, bug repellent, safety equipment, wet weather dress, or other location specific items may be needed. It's often a good idea to pack a small pair of scissors, tweezers, pocket knife and nail clipper, which, of course, should be in your checked baggage.

Do stuff

Schedule yourself. If your trip involves a significant time zone change, and you are on medication timed through the day or have problems with sleep, you may consider starting the transition to the new time zone before you leave. Try to move your medications no more than a few hours a day, and shift your wake – sleep cycle as well, so that when you arrive at your destination you will be less likely to lose a day or more acclimating. If you have any questions or doubts, check with your doctor about the best way to time shift into the vacation, and then back home again.

Stay well hydrated, particularly if you are flying or going to a warm climate or high elevation. Dehydration can be sneaky, and lead to all kinds of problems, easily prevented by drinking a bit more water. That water should be bottled if you are in a place where there are any doubts about the native water supply, and lay off the alcohol, which itself is dehydrating.

Be active. Walk, swim, bike, hike, and burn off those vacation calories. There is always that special dessert, the regional pastry, the sweet treat to tempt you. All things being equal, you can have a taste, a portion, of the treat, but be sure to remain active to burn off those calories. Even on cruises, where you may be tempted with a dozen meals a day, walking the decks can prevent a vacation bloat.

Take time to rest. We all know those “on the bus, off the bus, walk around and back on the bus” tours, and they can be exhausting. Just got back from the all day excursion and there's a midnight bonfire and dance-a-thon until dawn? Got up early this morning to climb the path and see a great sunrise, and now, at dinner time, you're beat? Know when to stop, when to say you've had enough, when to go to bed. Wiping yourself out can only lead to your missing the rest of the trip, and taking more time to recover at home.

Don't be afraid to ask. If you're in a restaurant and you don't understand a menu item, ask for an explanation. If it is something you can't, or don't, eat, ask for a change. In general, the better the restaurant, the more likely they will be willing to accommodate a special request. Be careful of regional foods which your digestive tract may not know. The best time to taste a new and exciting new food may not be when you don't have a ready support system available in case of a reaction. There are times that a little taste, rather than a chomp, may be the prudent thing to do.

Stuff when you get home

Reschedule. Just as you may have had to shift times going, so do you have to do the same, in reverse, when coming home. It may be easier, depending on the direction of travel, and you may be able to relax a bit more at home than you could arriving at your vacation destination, but going to work the day after you get back may not be a good idea.

Wash and rinse. Wash everything you took with you, even if you did not wear it. Wash out your suitcases and watch out for little critters that may have hitched a ride. Bedbugs have entered homes through luggage, luggage that may have become contaminated in the cargo hold of a plane or ship. So even if you think you're okay, some precautions never hurt.

Finish your medicines. If you are on a course of medication to prevent disease, such as malaria, that should continue for a time after you return home, finish the meds. Don't assume that just because you are home all is fine to stop it. If you have any concerns about your health from the trip, call your physician and discuss your issues. You may need to be seen to insure that all is well.

Relax. You had a great time, relax a bit while you let it all soak in. Look at your pictures, check out those souvenirs, wait for the packages of purchases to arrive, and just enjoy. Makes some notes of what you did right, and what you may have done wrong, so that next year's trip is even better!

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.