Separation of Religion and Medicine? I Hope NOT!

Lately there has been quite a buzz about the separation of church and state, but I'd like to share what I enjoy about COMBINING religion and medicine. In particular, I LOVE the season of LENT! Yesterday, we had Ash Wednesday, which marks the beginning of a 40 day (or 47 day, if you count Sundays) beautiful time of reflection, growth, and personal discipline in the Christian faith. Many people, particularly Catholics, have a tradition of giving up a dietary luxury of some sort- often chocolate, alcohol, desserts, or sodas. Today that list has expanded beyond dietary items, and many give up electronic activities such as Facebook, Twiiter, iPad, apps, or- gasp!- all non-school or work-related computer-based activities. How does this affect me as a family physician?

If I ask/suggest for a patient to give up, say, caffeine or alcohol- because it is causing him or her heartburn- patients are only moderately invested in committing to this change. Truthfully, they'd typically rather have a prescription for a pill to fix their symptoms, and not make any difficult lifestyle changes. If, however, this same conversation occurs after a Mardi Gras excessive celebration, and the patient CHOOSES to eliminate one of these substances from their diet as a form of religious discipline and self-sacrifice, the success rate skyrockets! I can't adequately express how often a Lenten "observance" has been an excellent kick-off for weight loss programs for my patients. Whether it is giving up a high calorie dietary staple, or freeing up time to exercise by giving up electronic play time, all of these changes work in a positive forward spiral, with the added benefit of personal religious fulfillment as well.

Of course, Lenten commitments aren't all about "giving up" treats, and I do not in any way want to minimize the religious implications of spiritual discipline. My point is simply that when we make positive health choices augmented with a higher purpose behind them, we can amplify our results.

BOTTOM LINE: Our personal religious beliefs can be a powerful source of motivation to make positive health changes- let's use them this Lent!

Drug Abuse in Teens- from YOUR Medicine Cabinet

Prescription drug abuse is at an all time high- no pun intended. Sadly, studies have found that 1 in 5 high school students say they have taken a prescription drug without a prescription. What are they taking? Pain killers, stimulants, and anxiety medications. Specifically, the most common drugs are OxyContin & Percocet (narcotic pain pills), Ritalin & Adderall (ADD stimulant drugs), and Xanax (an anti-anxiety sedative like valium.)

It frankly terrifies me to hear of kids swapping prescription medications, particularly ones as potent as these. Add in that the pain and anxiety pills are usually combined with alcohol, and you now have a recipe to take your breath away- literally. Both narcotics and alcohol can suppress your drive to breathe, and they are additive when taken together. Accidental overdose is the second leading cause of death for teenagers, and inappropriately used prescription drugs are believed to be major culprit. There is often a false feeling of security with getting a buzz from a prescription drug. Surely, if a doctor prescribed it for her, then it is safe for me, right? Wrong.

What can parents do about this alarming trend? Number one, TALK to your teen and ask (in a non-threatening, conversational tone) if they are aware of anyone borrowing prescription medications from friends. Let them know this is dangerous, even when someone else is using the drug for the same reason it was prescribed in the first place (like friends sharing ADD meds to be able to focus better in class.) The reality is that although there is plenty of "altruistic" sharing of medications, most "sharing" is for side effects- the buzz of the narcotic or sedative, or the appetite suppressant effects of the ADD drugs. At any rate, talking with your teen lets them know you are aware of this risky behavior in general. Next step? Take a close look at your medication cabinet. Throw away expired drugs, and keep close inventory of any potentially abused medications. Finally, if you realize that you are using prescription drugs inappropriately, it's time for a difficult conversation with your physician. You can't abuse it if we don't prescribe it, so this is a problem we need to tackle together, and there are solutions beyond simply cutting you off.

BOTTOM LINE: Prescription drug abuse is out of control. Learn the facts and protect and educate your teens. Get more info at the National Institute on Drug Abuse.

iPads to Prevent Dementia?

When I speak about Alzheimer's disease, people often ask what they can do to help prevent this debilitating illness. Although scientists have looked at innumerable medical interventions such as hormone replacement (estrogen), ginkgo biloba, anti-inflammatory drugs (like ibuprofen), Vitamin E, and many others, we have yet to find the right answer. The best evidence medical trials today suggest that our primary prevention lies in all the health maintenance strategies that prevent heart disease, high blood pressure and diabetes- namely a healthy diet high in vegetables and fruits & low in "junk", plus regular aerobic exercise.

Additionally, many studies have shown some benefit from "cognitive activities", meaning brain exercises, through puzzles such as word games (crossword puzzles or word searches) or number challenges such as sudoku. Is there a way technology might help? Why not? I believe the act of learning new skills in any format will help, regardless of whether it is an old-fashioned crossword puzzle from the Sunday paper, or learning to use... well, yes, an iPad. Let me say now that no, I do not have stock in Apple, though perhaps I should. And, I'm sure any electronic tablet will fit the bill. That being said, let me share our family's personal experience.

We gave my mother-in-law (who looks amazingly younger than her actual age, which I am not allowed to reveal) an iPad 2 for Christmas so that we could "face time" (video chat, for those uninitiated) with her, which would feel more intimate than just a phone call. Although she is very educated (a former RN), she has never had a computer or a cell phone, so we were uncertain how much use she would get beyond this function. May I brag that she is now texting like a teen? She is able to read and follow her favorite blogs, listen to Bible verses, enjoy interactive Rosaries, and best of all, "chat" with us throughout the day. We can text her pictures on the spot, and engage her in our daily lives more easily. As she is eagerly learning these new skills, I can picture those neurons firing up like crazy, and I have to think that her brain is reveling in the new stimulation.

BOTTOM LINE: You're never too old to learn a new skill, and when you do- your brain will thank you!

Shingles Vaccine- Starts Now at Age 50

Shingles, also known as Zoster, or Varicella Zoster, is a delayed eruption from the Chicken Pox virus. The chicken pox virus is in the herpes family of viruses, all of which stay in your body after the initial infection, and then show up later along a nerve pathway. In the case of shingles, the secondary eruption typically only happens once (versus herpes simplex that can cause many recurrences for years.) Roughly 10-20% of the population will develop shingles at some point in their lifetime.

What does it look like? Shingles is a very localized rash that occurs in a band pattern that wraps around one side of your body, most often the face, back or chest. The rash is made of clusters of red bumps that turn into blisters, then scab over. There is often tingling, stinging or burning pain in the affected area, starting before the rash even appears. The pain can range from mild to severe, and unfortunately, the pain can persist long after the rash has resolved in roughly 15% of patients- this is called Post-Herpetic Neuralgia (PHN.) The good news is that early initiation of anti-viral medication can not only shorten the duration and severity of infection but also decreases your chance of developing PHN.

Additionally, we have a shingles vaccine available, and the FDA has lowered the age of recipients from 60 to 50. A study of 22,000 patients between the ages of 50-59 showed that receiving the vaccine reduced their chance of having shingles by 70%. Although the FDA has APPROVED it for use starting at 50, I should note that our current guidelines from the ACIP (Advisory Committee on Immunization Practices) still recommends the vaccine be given starting at age 60, so please discuss this with your family doctor.

BOTTOM LINE: Consider adding a Shingles Vaccine to your your health prevention list when you turn 50!

New Treatment Approved for Head Lice

Nothing makes your head itch like hearing someone has head lice! Immediately, we all cringe and reach up for a quick scratch. Who gets lice? Primarily grade school aged girls (5-11 years old). Girls that age live with their heads tightly paired up with their best friends, sharing hairbrushes, pillows, headbands and hats. Certainly boys get lice, too, and people of all ages are susceptible. In the United States alone, we have between 6-12 million cases per year!

Lice come in two flavors- head lice and pubic lice- and they do not jump from one body part to another. Head lice stick to scalps, and pubic lice attach to the coarse pubic hair, or possibly coarse underarm, mustache, or eyebrow hairs. Lice are obligate parasites, requiring humans for their life cycle. The adults are 1-3mm long (so they are visible to the naked eye.) Most often, lice are recognized by seeing nits, which are the eggs that attach to hair near the base of the shaft. They look like tiny clear or white ovals stuck on the hair, and they will not be easily detached (as opposed to flakes of dandruff, which you can flick off easily.)

Lice can be treated with a couple different over-the-counter products- Rid and Nix. These products kill the adult lice, but not the eggs, so typically treatment is repeated one week after the initial treatment. There are also special combs that help to physically remove the nits from the hair. The FDA has recently approved another lotion called Sklice, with that active ingredient being ivermectin. (You might recognize this medication from your pet, as ivermectin is used to prevent heartworm.) The apparent advantage is that only one ten minute application resolves most lice infestations without the need to remove the nits.


Is Sklice better than the products we already have? Maybe, but we don't have any head-to-head comparison studies yet (pardon the pun.) Certainly, if it reduces or eliminates the need to "nit-pick", this will represent a very significant advantage over our existing treatments.

BOTTOM LINE: If you or your child get head lice, talk to your doctor about the treatment options, including the newly approved Sklice. (Note that Sklice will not be available in pharmacies for another couple of months.)

Traveling Out of the Country?

If your approaching Spring Break plans include traveling out of the country, NOW is the time to check in with your doctor to see whether or not you need any special vaccines or preventative medications before your trip. Immunizations take at least a few weeks to "kick in" and protect you, so start thinking about these shots at least a month (or preferably, two months) in advance of your trip. Additionally, there are some medications, such as those for prevention of malaria, that you need to start taking a couple weeks before your trip in order to be effective.

A great resource for medical travel planning can be found through the Center for Disease Control (CDC) at http://wwwnc.cdc.gov/travel/. Simply enter in your planned destinations, and a list of recommended vaccines as well as a plethora of extra information is readily available.

For example, let's take Mexico (think sunshine, beaches and...mosquitoes?) Of course, your routine vaccinations such as measles, tetanus and polio should be current. In addition, both Hepatitis A & B vaccines are recommended, as well as the typhoid vaccine- especially if you are visiting smaller or more rural areas. Rabies vaccine is only recommended for travelers who plan to be very involved with wild or stray animals, such as researchers, vets, or "high adventure" seekers. Besides the shots, travelers need to consider medications to prevent malaria, a serious blood-borne illness that is transmitted by mosquitoes. While not all regions of Mexico are at risk for malaria, people touring Chiapas, Oaxaca, Nayarit, and Sinoloa will need to discuss anti-malaria drugs with their doctors.

BOTTOM LINE: When your travel plans extend beyond our country's borders, check with your family doctor a couple months in ADVANCE of your trip to see if you need updated or additional immunizations or preventative medications.

True Gift of LOVE for Valentine's Day

Valentine's Day is already upon us- what happened to January? Are you still figuring out your New Year's Resolutions, or have you already forgotten the ones you chose? At any rate, we are indeed well into February of 2012, and the onslaught of high calorie holidays continues...with next week's Valentine's chocolates topping the list.

This year, why not show your love in a better way to support your loved one's health? I LOVE chocolate, but why not give a half-dozen chocolate covered strawberries, rather than a whole box of candy? Better yet, meet your sweetheart for a moonlight stroll around the lake (or city, or park). Write him a list of the top ten reasons he makes you smile, or send her a gift card for a pampering manicure!

If your honey is an award-winning athlete and truly heart healthy, knock yourself out sending high calorie treats or splurging on a five course meal. BUT, if you are like the vast majority of Americans, and you and/or your sweetheart really need to increase your overall fitness and decrease your waistline, show you REALLY love your partner by giving them a gift that will improve the quality and length of your lives together!


BOTTOM LINE: Let's support our loved ones and give gifts that spread joy, not waistlines!