Cyberbullying- Same Old Problem, Magnified Beyond the Schoolyard

What is "cyberbullying"? It's pretty much what it sounds like: bullying via use of technology, whether that is over a cell phone through texting, or emails or facebook or any other form of social media. The scary parts to me are that (A) the bully can feel or actually be anonymous, which promotes more vicious attacks and (B) the potential audience is unlimited.

We need to remember that true bullying exists when there is INTENT to cause harm or pain to the recipient. Unfortunately, there are many opportunities these days for kids (and adults) to unintentionally cause pain via the internet. With facebook or gmail alone, kids post their "status" as attending this or that party, or making an amazing grade, or simply noting an immediate change in relationship status. These comments are floating out in cyberspace and causing plenty of tears on their own, though they lack the malicious intent of true bullying.

What can parents do about cyberbullying? Most importantly, we need to be aware of what our kids are receiving AND sending- remember, your kid might be the bully or the victim. Let's teach them more "digital citizenship" so they really understand what is appropriate online etiquette.

Dr. Gwen O'Keeffe's new book, Cybersafe: Protecting and Empowering Digital Kids in the World of Texting, Gaming and Social Media, is a great place to start- read it now.

BOTTOM LINE: Let's teach our kids better online "digital citizenship" and make sure they can protect themselves from cyberbullies.

Stuffed from the Turkey?

Welcome to the Monday morning after the long Thanksgiving food festival-oops- holiday weekend! Did you step on the scale this morning? Well, if you saw higher numbers than you would like, you are not alone. Past studies have shown that the average American gains between seven to eleven pounds between Thanksgiving and New Year's Day!
I would much rather address this TODAY than after New Year's, though, because this weight gain is not mysterious nor automatic, and CAN BE AVOIDED or at the very least, reduced!

I think we all know that there seem to be a plethora of parties and increased social activities this time of year. Virtually every one includes high calorie treats and drinks. Often families dash from one kid recital, play, concert or sporting event to the next, zipping through fast food drive-throughs along the way.

Let me encourage you to PLAN AHEAD, and haul out your slow cooker from the back of the cupboard! Healthy food does not have to be a huge time commitment, but absolutely does require thinking ahead. Toss a pork tenderloin in the slow cooker with some salsa, and after work/school you're ready for easy pulled pork sandwiches or tacos, for example. Really, it's only TWO ingredients to toss in, so it's simple! Of course leftover turkey (or chicken or beef) along with some cut up onion, carrots, potatoes or other veggies will make a lovely meal as well. The point is not specifically WHAT to make as much as to remind you that you WILL be rushed, and planning ahead makes it possible to have "grab and go" healthier choices.

As for parties, start off with a large glass of WATER in your hand, rather than mindlessly downing that immediately offered alcoholic beverage (which not only adds calories, but often reduces your judgement/motivation regarding healthier choices along the buffet...)

BOTTOM LINE: Check your weight TODAY and PLAN AHEAD for your meals during December so you don't have the extra pounds to begin 2011!

Why Visit Someone with Alzheimer's?

Please, I am BEGGING you, if you have a friend or family member with Alzheimer's disease, STAY IN CONTACT with him or her! The saddest part of my mother's Alzheimer's struggle was that many of her friends seemed to drop off the face of the earth. I understand that they were uncomfortable, worried that she might not remember them. What would they talk about? What if they brought up something she didn't remember- would that upset her or make her feel bad?

So here is the real deal. Yes, it's awkward. No one wants to see a dear friend struggle for words, or looking at you with a blank stare. On the flip side, even once someone who has dementia no longer recognizes you for the relationship you once shared, he or she still can sense the so-human link of affection. A big smile and laugh as you are "reminding" them of an old story involving the two of you will bring a moment of joy and often a real connection. Know that in the early and moderate stages, when the Alzheimer's patient no longer initiates conversation, she may still have full recall of remote events.

Pictures and music are also very powerful bonds. Think of that commercial jingle you can't shake out of your head. Similarly, old songs from the radio or traditional religious or patriotic songs pop right back into an otherwise confused brain. Simply flipping through old photo albums or singing songs can also turn on that faulty switch in their brain.

Finally, if there is a spouse, keep in touch with them as well. Pick up the phone and give them a call, and don't worry about what you are going to say. Saying ANYTHING is a million times better than nothing!

BOTTOM LINE: This Thanksgiving week, reconnect with any friends or family members who have been struggling with the non-glamorous challenge of dementia, and give thanks if your brain is still healthy!

PS. Our family is TREMENDOUSLY thankful for all the friends and family who continue to love and support first our Mom and now our Dad in their battles with Alzheimer's and Parkinson's dementias. God bless you!

Thankful for My Mother-In-Law...Seriously!

Getting ready for Thanksgiving? I know I am. Today my mother-in-law was sharing her fabulous fresh yam and green bean recipes with me, so I can begin to make some of "her" dishes. However, I am SO grateful that she is still here on earth to be on hand as I prepare them, because as I was dutifully typing them into a word document, her quantities were "just enough", and "till it looks right", and "well, it depends!"

Isn't it amazing how dependent we've become on prepared mixes or at a minimum, google'd recipes? Truthfully, in the kitchen I tend to alter the vast majority of recipes that I use, even the first time. I substitute apple sauce for oil, or change up flours to make things gluten-free, or create some other "healthy" modification. When it comes to family traditions, though, I usually defer to the high-fat, full calorie version, which is FINE. Not EVERYTHING we eat needs to be pure nutrition! It's perfectly fine within the confines of healthy living to splurge on treats now and then. The trick is to remember that every day or week should not be "that" special occasion!

I have learned from my patients (by doing 24 hour dietary recalls) that what people believe is an unusual day is often a frequent occurrence. Do you grab fast food before every soccer practice or music lesson? Well, I'm guessing that is EVERY Tuesday (or whatever day or dayS your kids have that activity.) Look at your schedule now, and recognize those days that present a challenge every week, and then PLAN AHEAD. Sandwiches, slow cooked meals, and even "breakfast for dinner" might be healthier choices.

BOTTOM LINE: Enjoy your traditional holiday treats this season, but recognize patterns of unhealthy choices in your everyday schedule and make pro-active changes to improve your health!

Alcohol and Arthritis- Cheers!

Okay, after a week of discouraging one habit, I thought I'd start of Thanksgiving week with an interesting study about alcohol. As opposed to nicotine, which we know is NEVER beneficial, there is absolutely medical evidence that small amounts of alcohol can be beneficial for different aspects of our health. Now, the key words here are SMALL AMOUNT and BENEFICIAL. When we pour our own glass of wine, for example, chances are that it may not be that small 4oz glass that doctors recommend...
The new study I'd like to mention today is from the journal Rheumatology, and is entitled "Alcohol consumption is inversely associated with risk and severity of rheumatoid arthritis."There were around 900 patients with rheumatic arthritis (RA) in the study, along with around 1000 people without RA. Basically, with trying to account for other variables such as gender and age, those patients with RA who consumed more alcohol reported less severe symptoms of their arthritis.
Why is this? We're not sure, but possibly because of the role that alcohol plays in suppressing the immune system (and RA is basically a result of the body's immune system over-reacting.) Evidence already supports that small amounts of alcohol decrease the risk of heart attacks and strokes via similar anti-inflammatory and anti-blood clotting effects.
Keep in mind that this study is not suggesting people with RA need to drink heavily, but simply that patients who report drinking alcohol fewer than 10 days per month reported more pain.
BOTTOM LINE We can now add reduction in the severity of rheumatic arthritis to the list of potential benefits of consuming SMALL amounts of alcohol.

Quitting Smoking...a WEIGHTY Issue

Why do people who quit smoking gain weight? Does it always happen, or can it be avoided? Do we really care that weight gain is really less detrimental to our health than smoking?
As a physician, I have found that women in particular choose to keep smoking because they simply do NOT want to gain weight. Period. I will confess that I will occasionally try to appeal to their vanity by discussing the yellow teeth or bad breath that tend to accompany cigarettes, but the reality is that what is important in this situation is helping patients understand why smokers gain weight with quitting, and how it can be avoided. So here are some things to remember:

1. Nicotine is an appetite suppressant, so obviously, when you initially take it away, your appetite is up.
2. Smoking KILLS taste buds, so just about the time the extra appetite from quitting is going away (around a week), suddenly food begins to TASTE better, because now you've actually got healthy taste buds!
3. Happily, ALL FOODS taste better, not only the high fat/high calorie ones.
4. Yes, oral gratification is a habit, so STOCK YOUR FRIDGE with some low calorie, crunchy and delicious snacks like carrot sticks with hummus, or apple slices, or ANY fruit or vegetable. Additionally, suck on sour hard candies the first week or two.
5. Don't forget EXERCISE! Getting and keeping your heart rate up for 30 minutes per day is equal to a low dose of an anti-depressant medicine, so exercise will not only balance extra calories consumed, but will make you HAPPY and less irritable!

BOTTOM LINE: Be proactive with your available food choices and exercise, and you will NOT pack on a bunch of weight when you quit smoking.

Seven Tips to Quit Smoking!

This week I'm focusing on QUITTING SMOKING, the absolute most important thing you can do for your health if you smoke. I've talked about prescription aids, but what can you do on your end? Lots! Here are seven tips that patients have had the most success with over the years:

1. Set a QUIT DATE and TELL EVERYONE YOU KNOW (helps keep you accountable!)
2. Right NOW, only smoke the cigarettes you REALLY want (typically around 6 per day for a pack per day smoker).
3. Do NOT smoke the "trigger" cigarettes-phone rings, starting the car, turning on the tv or finishing a meal.
4. Have your car professionally cleaned the day before your quit date (if you smoke in your car.)
5. Clean out your "smoking area"- throw out or give away ashtrays.
6. Pick a splurge reward and earmark your cigarette money to pay for it! Cigarettes cost a ton of money, so toss those $5 and $10 bills into a large glass jar on a counter top each day and have a fun visual reminder of your savings, or post a picture of your prize and make a money "thermometer" that you can color in as the money grows.
7. Grab some really sour hard candy to suck on the first week as a non-smoker; the sour nature stimulates your salivary glands and really helps with the oral craving portion.

BOTTOM LINE: Start with these seven tips to insure that THIS time you will be successful QUITTING SMOKING!

SEVEN Ways to Leave Your Cigarettes

SEVEN seems to be the magic number for habits of successful people, right? SO...smokers, step on up to the SEVEN choices to help with QUITTING SMOKING! In alphabetical order, here they are:

1. Bupropion SR (Wellbutrin SR)- this is an antidepressant that works via unknown mechanisms to decrease your desire for smoking; you start it a week or two before your quit date, and it significantly shuts down that craving for a cigarette.
Common side effects- insomnia and dry mouth.
2. NIcotine gum- do NOT chomp it like regular gum! It's chew, chew, stash it.
3. Nicotine inhaler- used every hour or two during the day; may cause throat/mouth irritation and cough
4. Nicotine nasal spray- 2-4 sprays per waking hour as needed; may cause local irritation in nose and throat
5. Nicotine patch (now OTC, but ask your doctor which dose)- may cause skin irritation; remove at night so no sleep issues
6. Nicotine lozenge- may cause mouth soreness and nausea
7. Varenicline (Zyban)- blocks nicotinic receptors and sharply decreases cravings; Common side effects: very vivid dreams and nausea.

Are they expensive? Puh-lease! Are cigarettes expensive? YES! These aids are money well spent, and will pretty much equal what you are already spending on your habit.

BOTTOM LINE: If you think you've tried everything to quit, double check the list and head to your doctor for a new cessation aid!

Attention SMOKERS: Get Ready to QUIT!

If you found yourself anxiously scanning yesterday's blog about CT scans for lung cancer screening in smokers, hoping for reassurance that we now have means to detect lung cancer early enough that you'll have time to quit before it's too late, then read on...

If you are a smoker today, then the SINGLE MOST IMPORTANT THING you can do for your health is to QUIT. Period. While we are learning to detect and treat smoking-related cancers better each year, believe me, you don't want to count on a CURE. Often times the surgeries and chemo are devastating, though life-sparing.

I have met very few smokers who do not WANT to quit, though yes (my friend who shall remain nameless) there are some out there who simply enjoy smoking and hope they don't live long enough to end up suffering poor quality of life because of chronic bronchitis or emphysema. MOST SMOKERS WANT TO QUIT, but have not found either the right motivation, medical aid, or family/friend support to do so.

First of all, let me say that it takes the average serious smokers multiple attempts to quit. Have you quit for a month, a year, a pregnancy or two, only to restart? That is COMMON, and NOT a reason that you "can't" quit!

There are SEVEN different medical aids that your doctor can recommend or prescribe to help you from the pharmacy end of things! Have you really tried them ALL?
There are numerous behavioral changes YOU can make NOW that will help you quit, too! Stay tuned for more blogs this week with more details...


BOTTOM LINE: NO amount of nicotine IMPROVES your health, so make an appointment with your doctor to find out which method might work best for you!

Breaking News for SMOKERS

Last week we had an encouraging development for smokers- the National Cancer Institute prematurely stopped a study because they felt ethically obligated to let all the participants know that a low dose CT scan of the lungs as a screen for lung cancer was yielding a 20% decrease in mortality (as compared with screening chest xrays). What does this mean? Should every smoker get a lung CT scan?

Hold your horses- CT scans for all smokers is NOT the answer- though I wish it were that simple. What we know so far is that in this group of smokers, which was an older group that had a greater than 30 pack-year smoking history (smoking a pack per day for 30 or greater years), the CT scans apparently allowed earlier detection of lung cancers, enough that they had a significant (20%) decrease in deaths.

Over the years I have had many patients who smoke ask for annual screening chest xrays. I explain to them that this is NOT a good screening method, though often I have ended up ordering the xray, in the hopes that they might at least see some noncancerous damage from the smoking that might be enough to motivate them to QUIT. Now, however, we may be changing our recommendations, at least for the older smoker with an extensive smoking history.

Ultimately, though, the real answer is to never start smoking, and if you ARE smoking at ANY amount, find help asap to QUIT!
I'll spend more time this week discussing smoking cessation, but know that there are seven medical aids available through your physician that can help you quit for good.

BOTTOM LINE: Smokers with a greater than 30 pack-year history of smoking may indeed benefit from CT lung scans to detect early lung cancer- check with your doctor (and QUIT TODAY!!!)

Gluten-Free Decadence

After talking about gluten-free diets and celiac disease this week, I want to be sure no one is left with the impression that you need to feel completely deprived if you must be gluten-free (GF). Can you ever eat at a restaurant? Is every GF food expensive?
No worries, there are plenty of delicious and reasonably priced choices out there!

Primarily, I want to again encourage you to take advantage of EVERY SINGLE fruit and vegetable, all of which are completely and totally gluten-free! Have a banana smothered in ice cream and topped with whip cream for dessert- yummy! Gluten-free chocolates are a bit more challenging to find, but absolutely out there.

Dining out? Last night, I had a business dinner at a lovely French restaurant...where most dishes appeared to be topped with a white sauce (that usually has flour in it.) Yes, I had to pass up the fragrant loaves of French bread, but I simply enjoyed my glass of wine and ordered a salad by asking for lettuce, tomato and a vinagrette-no croutons- (which was delicious!) and trout grilled and topped only with butter and lemon. The waiter and chef didn't flinch a bit when I asked for these off-menu choices, and I think I was possibly the only one who left the table not stuffed to the gills! I also could have chosen the steak, and had a baked potato instead of the french-fried version. Admittedly, I passed up dessert, but could have asked for strawberries and whipped topping- but I was pleasantly full.

Craving pasta? This was challenging, but I found a spiral pasta that is a quinoa blend that I can truly say I PREFER to regular pasta. Pizza is still leaves a bit to be desired, but I have even found a delivery pizza service that has very passable GF dough for only $5 extra- well worth it for me, though I order regular dough for my family.

I have blogged earlier about some wonderful baking GF products and cookbooks, and without a doubt, you can find all sorts of GF bagels, donuts, cakes, cookies.

BOTTOM LINE: Never fear, you can consume deliciously decadent GF foods and drinks with a little thought and willingness to venture off the printed menu- ASK THE WAITER/CHEF!

PS. The chef in this picture, Michael Marchitelli, is ironically an ITALIAN chef in Crested Butte, CO- Eat at his Gourmet Noodle for some AMAZING food! I'm not promising GF pasta, but I can attest from my pre-GF days that every item on the menu is delicious, and there are definitely GF options!

Gluten-Free for Weight Loss?

Many people think going gluten-free is a great way to diet in order to lose weight. Not surprisingly, it can be a pleasant side effect if you are overweight and diagnosed with celiac disease. It makes complete sense that if you simply ELIMINATE breads, cakes, pastries, pastas, cookies and breaded or coated foods (think chicken nuggets, french fries, meatballs) your calories will shrink dramatically!

I would likely approve any diet that reduces processed foods and complex carbohydrates, but I am MORE excited about diets that not only decrease those items, but INCREASE fruits and vegetables. Here is the trick with not only a gluten-free diet, but a vegan or vegetarian diet. Keep it HEALTHY by upping the produce (veggies and fruit) and NOT merely replacing everything you are "giving up" with a manufactured version that is GF (or CF, or Veggie-free).

For example, there are many gluten-free breads, crackers, cookies and treats out there. Very few of them happen to be low calorie and/or "good" for you- BUT- saying gluten-free somehow implies healthy and nutritious, doesn't it? It's that health-food store seal of approval when we see labels proclaiming a food item is "free" of something "BAD".

Ultimately, however, in the battle of the bulge, it still comes down to calories IN vs. calories OUT, regardless of the quality of those calories. So, enjoy those GF pancakes and breads in moderation, but don't pursue the search for the GF Twinkie, okay? Push up the produce and reap the rewards.

BOTTOM LINE: Eating gluten-free CAN be an incredibly healthy diet, rich in nutrients from fresh vegetables and fruit plus a protein source and GF carbs in moderation, but gluten-free does NOT equal low calorie!

Gluten-Free Diet

This week I am talking about celiac disease, which requires a life-long commitment to a gluten-free diet. So, what the heck does that involve? Well, gluten is a protein found in all forms of wheat, as well as related grains such as barley and rye. What is made with wheat? At first glance, it feels like EVERYTHING has wheat.

Most cereals, breads, cookies, muffins, cakes, dough (think pizza), buns, and pastas, etc. ALL are classically made using wheat flours. Happily, though, there are more and more foods in these categories that are made with rice, corn and potato flours- all of which are gluten-free. In almost every grocery, there is a small (and ever-expanding) section of gluten-free "bread" products and mixes. Check out my "commercial" for delicious gluten-free pancakes, for example- yum! And rice-flour cereals such as Rice Chex are still on the menu, though ones like Rice Krispies that sound gluten-free (GF) may not be (because of additives like malt.)

More importantly, though, there are tons of delicious, healthy foods that are naturally gluten-free. Practically the whole perimeter of the grocery store: every fruit and vegetable (think MORE!), dairy, nuts, and meat are all GF. Our bodies don't NEED gluten nor any of the treats/sweets/doughs that our MOUTHS or minds may crave...

I think the biggest challenge of GF eating is baking. There does not seem to be a simple recipe substitute- at least not "replace one cup of wheat flour with one cup of brown rice flour" style. Because of the TEXTURE, you need to make blends involving rice flour, potato starch and tapioca flours, for example. I have found a great baking cookbook that I would recommend: Gluten-Free Baking Classics, by Annalise Roberts- try the delicious lemon pound cake!

If you are committed to a GF diet, make an appointment with a registered dietician to really learn all the nuances of this meal plan. Here in Austin, I recommend Daniela Knight, RD, to help you with this transition.

BOTTOM LINE: Gluten-free diets are rich in fruits, veggies and protein, and can be supplemented with carefully chosen gluten-free baked goods.

Celiac Disease: Do I Have It?

This week I am talking about celiac disease, a very common problem that affects 1 in 133 Americans. With non-specific symptoms such as fatigue and abdominal bloating, how can it be diagnosed? As is often the case, it is not as clear cut as you might think.

The first caveat is that you must EAT wheat (gluten) for the whole month before you are tested to get the most accurate evaluation. Blood tests are performed that check your antibodies, including the most sensitive test (meaning it will miss the fewest cases, but may have some false positives) anti-tTG (anti-tissue transglutaminase antibody.)

The doctor must also test your IgA levels (immunoglobulin A) because if you are not making adequate IgA, you could test negative for celiac disease even though you have it. Additional blood tests include anti-endomysial antibody (EMA-IgA) and anti-deaminated gliadin peptide (DGP – IgA and IgG).

Ultimately, the diagnosis will need to be confirmed not only with a blood test, but with a small bowel biopsy which is done through endoscopy. The biopsy will look directly at the lining of the gut and determine what level of damage exists.

Alternatively, you can choose to follow a strict gluten-free diet, and if your symptoms resolve, it is likely you have celiac disease (or at least gluten-intolerance.) This is obviously less specific and accurate, but is certainly a good starting place.

BOTTOM LINE: If you are concerned you may have celiac disease, talk with your doctor about getting a simple blood test to help determine if you should go gluten-free.

Celiac Disease and GF: What is it?

You may have noticed a new section cropping up on menus in restaurants these days- the gluten-free choices. What's up with that? Celiac disease. This disease is very common in the United States, affecting 1 in 133 people. In people with this disease, eating gluten (the wheat protein) causes an auto-immune reaction that damages the small intestine, causing poor absorption of food and nutrients.

What symptoms show up? Diarrhea is the classic symptom, but it turns out there are probably more cases of celiac disease without diarrhea. The symptoms are often rather nonspecific: fatigue, irritable bowel, anemia, vitamin deficiencies, and osteoporosis. There is, though, one symptom that is 85% specific for celiac disease-a rash called dermatitis herpetiformis, DH for short. This rash has nothing to do with herpes, however (nope, no STD talk in this topic!) This rash is intensely itchy, symmetrical eruption on the face, buttocks, elbows and knees.

The good news is that celiac disease can usually be treated with dietary changes alone-no medications required! The bad news is that gluten is found in many products beyond the obvious wheat breads and cereals, so to completely avoid gluten requires significant effort and education. Stay tuned this week for more about Celiac disease diagnosis and diet.

BOTTOM LINE: Problem: Celiac disease, a very common challenge. Answer: Gluten-free diet.

Vitamin D- the Sunshine Vitamin!

Vitamin D has long been known as the "Sunshine" vitamin, because we literally can obtain Vitamin D from the sun (it is converted to an active form in our skin.) We also are realizing that Vitamin D appears to play a role in MOOD- so that if you are deficient in Vitamin D, you may be more prone to depression.

A large study was done in England a few years ago and recently published: Relationship Between Vitamin D Levels and Depressive Symptoms in Older Residents From a National Survey Population. They looked at over 2000 adults over the age of 65, and assessed the incidence and prevalence of depression by use of a depression inventory scale- a set of survey questions. They also checked blood levels of Vitamin D. It turns out that in people with severe Vitamin D deficiency (levels less than 10ng/ml), there was a 35% prevalence of depression, while in the whole sample, the prevalence was only 25%.
So, does taking Vitamin D prevent depression? Well, we can't tell from this study, but it certainly looks promising enough to investigate.

BOTTOM LINE: Low Vitamin D levels play a role in a variety of medical problems, and now we can add depression to that list. Check your level and see if you need a little more "SUNSHINE" in your life!

Supplements for Alzheimer's Disease

Bummer- another study that shows a specific supplement does NOT, in fact, delay or halt progression of Alzheimer's Disease. This study is titled Docosahexaenoic Acid Supplementation and Cognitive Decline in Alzheimer Disease, better known as DHA. We believe that DHA, a fatty acid used in the brain, has beneficial effects when taken as a supplement in humans. The question was whether or not taking this supplement would help to delay the progressive memory loss and other dysfunctions in Alzheimer's.

The completed study involved around 300 people with mild to moderate Alzheimer's disease. They randomly received either a placebo or 2g of DHA daily for eighteen months (it was randomized and double-blinded- our gold standard in research.) Cognitive tests were given at the onset and a year and a half later. Unfortunately, the people in the trial who received the DHA supplements were no better off on cognitive tests nor on brain atrophy at the end of the study.

We have been through this same process with Vitamin E, estrogen, and a number of other over the counter supplements. I remain optimistic that there may be a dietary or behavioral modification that does make a difference, as well as new medications that will not only stop the progression but some day reverse the dreaded decline of dementia with Alzheimer's.

BOTTOM LINE: Let's continue to support Alzheimer research, as we now have yet another supplement (DHA) proven to NOT be successful.

Best Birthday Present!

Today is my 45th birthday (or the 16th anniversary of my 29th birthday, however you want to look at it ;0) Personally, I love my age, and am happy to celebrate the full 45! I am blessed with an amazing family and the opportunity to pursue my ever expanding academic interests. I'd like to share today, though, what I am giving myself for this birthday. I'm giving myself...a PUSH!
I always make it a priority to have some exercise each day, but due to our hectic schedules, I have slipped into a low level of either simply walking the dog a couple miles each day or maybe jumping on the exercise bike. Now, there is NOTHING wrong with that, and I'd be thrilled if every one of my patients would commit to exactly that routine!

However, like everyone in my decade and beyond, I'm waking up to more aches and pains and stiffness each morning. It's time for a shake up in my exercise routine, so I'm giving myself a PUSH to bump it up a level. For me, I purchased a set of DVDs from an infomercial that I watched while I was on my exercise bike last month. The set has a great mix of weights and basic calisthenics, in thirty to sixty second chunks (which appeals to my limited attention span.) The first week, I felt like a truck had run over me...multiple times! I'm now in my third week, though, and excited to see huge improvement as I go through the routines. I can actually do a REAL pushup for the first time in my life!

BOTTOM LINE: Give YOURSELF the gift of a PUSH and bump up your level of exercise!

Halloween Hangover

REMEMBER, GO EXERCISE YOUR AMERICAN PRIVILEGE AND VOTE TODAY!!!

Okay, tell the truth...how many times did you grab a piece of Halloween candy yesterday? If it's sitting out in a bowl (or in your kids' pumpkins) easily accessible, chances are you nabbed a piece or two each time you walked by. I will be the first to confess that I managed to top off my completely nutritious breakfast smoothie (yogurt, banana, and frozen strawberries, mangoes & peaches) with both a Reeses cup AND a "fun size" Milky Way. And all that before 6:30am.

Now, is it the end of the world that I had a breakfast dessert? Of course not! But, if that happens three or four times per day until that whole bag of candy is polished off, I'll be wearing several new unwelcome pounds around my belly. What's the solution? In our house, we let the kids have a few pieces of candy per day for a few days, then we donate the rest of the candy to a food distribution charity. I'm actually always surprised how this is really "NBD" (no big deal) to our kids, especially since we do not keep any candy in our house on a regular basis. Mind you, we always have homemade cookies on hand, but we do not stock candy.

Before I leave the whole Halloween scene, let me point out that candy now comes in a ton of different sizes, so beware of "serving size" when you are assessing calories! There is bite size, fun size, snack size, mini-size, regular, king and movie!

BOTTOM LINE: Enjoy the Halloween treats for a day or two, then if you don't need the extra calories, pass it on so your Halloween candy hang over doesn't increase YOUR "bottom line"!

Show Me Your Teeth!

Cheers! It's November 1st, the fresh start of a brand new month. Do you know what I love about the first of each month? I treat each one like January 1st, and choose new "resolutions" to work on for the next four weeks. Don't worry, I'm not making any resolutions that involve Lady Gaga, but what IS up for today? Well, with Halloween nipping at our heels, I think TOOTH CARE needs to head up our list!


I'll bet you don't know a single dentist that does NOT floss their teeth, right? Why is that? Because nothing replaces flossing for cleaning your teeth and promoting healthy gums as well. We are hearing more and more that oral hygiene has implications for the rest of our body's health, especially cardiac, so we really need to focus more on prevention.

Make sure that you are brushing your teeth with a pea-sized amount of flouride toothpaste, and TAKE YOUR TIME- you should brush for a full two minutes, at least twice per day. Add in flossing once per day, and that extra 30 seconds is very well spent! Limit carbonated and other sugary beverages, and when you drink them, try not to nurse them over several hours (this is a weakness of mine.) Dentists recommend drinking a soda in less than fifteen minutes- treating it like a dessert. Then, go at least rinse your mouth with water if you can't brush those teeth!

So, remember that it takes up to twenty-one days to create a HABIT. On the way there, find some way to record your progress- use an app for habit making, write it on your calendar or stick it in your day planner; whatever it takes! We know recording CHANGES behaviors, so let this work for you! Consider scheduling a dentist appointment for a month from now...that should help motivate you! And YES, dentists CAN tell when you start flossing like crazy just a few days before your appointment, so save your poor gums that trauma and start TODAY!

BOTTOM LINE: Make THIS the month you start flossing your teeth regularly!

PS. Like the first of every month, it's time to CHANGE YOUR AIR FILTERS!