Loving St. Louis- and it's Gluten-Free!

Wow- what a city! But it really feels more like a town, because everyone is SO FRIENDLY! If you haven't visited here yet, make plans to include it on your next family vacation. What is there to do?
First, of course-The ARCH- yes, in BOLD- gotta ride the tiny pod (they call it a tram, but that implies space to me...) to the top and catch the magnificent view of the town. This will certainly cure (or cement) your fear of heights.
In the shadow of the Arch is the Old Cathedral (formally known as the Basilica)-thanks to them for playing my mother's favorite hymn on Mother's Day (Let There be Peace on Earth.)
The Zoo- can you believe it's FREE?? Trails wind around through lush foliage as you view the animals. I was impressed that the kids' meals come with a choice of a healthy sides such as broccoli or applesauce. AND you can buy FRUIT SMOOTHIES at the Zoo!
Say Hello to Spike the cat at Left Bank Books.
For the grownups, there are Casinos- who knew? Stop in at the SLeeK in Lumiere's and tell Rusty hello from me as you order up a fabulous, thick steak.
Enjoy Saturday night live broadcasts with Lance from Y98- he is "Mr. St. Louis".
I had a GLUTEN-FREE pizza to die for at Pi (like the number)- special thanks to Tuck, our perky waitress.
And SWEET news- Ted Drewes Basic Frozen Custard is...GLUTEN-FREE! (Simply ask for a clean spindle). I love this town!
Look out for Fredbird and cheer on the Cardinals.

Special thanks to Dr. Teresa Knight, my friend and amazing tour guide- you go, "Gyno-Gal"!
BOTTOM LINE: St. Louis is a marvelous town that manages to celebrate the past and focus on a healthy future at the same time.
Thank you, St. Louis!

Mom Knows Best!

Happy Mother's Day! Have you hugged your Mom yet today? If she is still on this earth, please take a minute and call her and at least give her a virtual hug if you cannot do so in person. I had a special video chat with our precious daughters today, since I am in beautiful St. Louis today. Stay tuned for pictures of my terrified face in the Arch "tram" as we ascended today!
In honor of Mother's Day, I thought I would applaud a few maternal bits of medical wisdom.
1. Chicken Soup for colds- you're breathing steam (which loosens up congestion), hydrating and NOT taking antibiotics- all the right treatment for simple upper respiratory viruses!
2. Salt water gargles for sore throats- use a BUNCH of salt (a couple tablespoons) in a glass of warm water; this makes it hypertonic and helps actually kill bacteria when you gargle.
3. Band-aids and love- a kiss and a band aid will heal 90+% of childhood injuries.
4. Don't forget to wash your hands! Enough said- washing hands helps stop spreading germs!

BOTTOM LINE: Thanks to MY Mom in Heaven, and all Moms out there for the love you give your kids.

The Perfect Diet- What Healthy Seniors Know

After doing 24-hour food histories on my patients for over 15 years, I have seen many different consistent patterns. The "unhealthy vegetarian" one that I shared earlier this week is a classic example that was a surprise to me when I first began this practice. The one I'd like to share today is my personal goal. The majority of my healthy, active "seniors" (usually 60+years old) patients fit this pattern. Of course, there are variances, but a few common themes dominate:
1. A BIG breakfast- eat your largest meal first, then a smaller lunch, and smallest portions at dinner.
2. Very little processed foods of any type
3. An afternoon snack, typically including nuts
4. A dinner that includes primarily vegetables
5. Dessert (often just a piece of rich chocolate) and/or a glass of red wine

What does this look like specifically?
Breakfast- Egg or egg-white vegetable omelette (peppers, onions, mushrooms, tomatoes +/- cheese), beans, a bowl of mixed berries, whole wheat toast, and sometimes a slice of bacon or piece of sausage, juice or milk and coffee
Lunch- chicken breast, asparagus, carrot sticks, brown rice and WATER
Snack- an ounce of cashews or almonds (often they'll tell me a number- 22 almonds, or some fixed amount) and a sliced apple and water
Dinner- a large green salad with tomatoes and other veggies and a small portion of fish, completed with a glass of wine and a chocolate truffle

Notice there are not lots of chips, no fast food, and plenty of water.
BOTTOM LINE: While there is no "perfect" diet, look at the mature people around you who radiate health and energy, and ask them to share their dietary pattern with you. Let me know what they say!

Unhealthy Vegetarian?

How can you be a vegetarian and NOT have a healthy diet? Take a look at this 24-hour dietary recall:
Breakfast: Chocolate Cheerios (yes, they exist!) with milk, coffee
Snack: Poptart
Lunch: Lean Cuisine Manicotti & Diet Coke
Snack: Microwave popcorn & tea
Dinner: Cheese quesadilla, refried beans and chips with a margarita & water
Dessert: Vanilla ice cream

Okay, we don't need to break out our calculators to add up the daily servings of fruits and veggies! This is a very typical example of an unhealthy vegetarian diet. What did I ask this person to do?
Primarily to ADD IN fruits and vegetables. Add some berries or slice a banana on those Cheerios; skip the poptart and substitute an apple; add a salad or carrot sticks to the lean cuisine entree; consider a taco salad; make it a banana split (use more banana and less ice cream!) ANY of those suggestions would improve the quality of this day's nutrition.

BOTTOM LINE: Remember that VEGETARIAN does NOT automatically = Healthy!

Pediatric Medicine Recall

Have you heard? Last week (April 30th), McNeil Consumer Healthcare initiated a voluntary drug recall because some of their products did not meet required quality standards. At this time, there have been NO REPORTED adverse effects from these medications. Apparently the drugs had variable amounts of active and inactive ingredients, as well as extra "particles" in them.
Which products are included? Tylenol Infant Drops, Children's Tylenol Suspensions, Children's Tylenol Plus Suspensions,
Motrin Infants' Drops, Children's Motrin Suspension, Children's Zyrtec Liquids and Children's Benadryl.

Please click on this link for more specifics:
http://www.fda.gov/Safety/Recalls/ucm210443.htm

What should you do if you've already given your child these medications? Relax. If your child seems fine, she is! Again, there have been no adverse events reported at this time- this was a voluntary recall.
BOTTOM LINE: Be aware of this large medication recall and check out the specifics on the link above.

Stuffy nose, itchy eyes, and sneezing?

There are so many allergy remedies out there. How do you decide what you need? Do you understand the difference between an antihistamine and a decongestant? And where does an expectorant fit in? It's often tough to figure out when to take which drug might help. Here are the basics:

1. Decongestants simply narrow the blood vessels in the lining of the nose, allowing air to pass more easily. Use these when your nose is "stopped up". Caution: do not use if you have high blood pressure, as they can potentially raise your pressure.

2. Antihistamines block the release of histamine, the chemical in your body that cause cells to swell and leak fluid, resulting in itchy eyes, sneezing, and runny nose. Use these to DRY UP (but not when you are simply "stuffy")

3. Expectorants are all medications that include guaifenesin. This drug breaks up mucus, allowing it to drain down from sinuses or be coughed up from your lungs. It wont work if you are dehydrated, so drink extra water- especially if you are also taking an antihistamine, because they DRY UP mucus and that makes it tougher to break up and clear. Use these when you have sinus and ear pressure, or if you have a cold "go to your chest." There is little evidence-based medicine to support the use of these, but clinically I have seen them help a great deal to relieve head congestion, and often avoid the use of antibiotics.

The AAFP a great website with more detail: http://familydoctor.org/online/famdocen/home/otc-center/otc-medicines/857.html

BOTTOM LINE: Don't always grab the "do everything" medicine for your stuffy, sneezy, coughy, itchy symptoms- understand which drug works for which complaint!

MAY DAY, MAY DAY!

Isn't it funny that "May Day" conjures up some very conflicting images? Do you think of children dancing around a May pole, or a plane crashing? Hmm...it's all about half-empty or half-full, I suppose.
Let's think about the positive image of children dancing, flowers in their hair, and beautiful sunshine. That image reminds me of EXERCISE, POLLEN, and VITAMIN D. Okay, I know- a bit weird, but hey, it's my job and my passion!

#1- Exercise. It's now the fifth month of the year. Have you kept up your New Year's resolution for "MORE"? (See early January blog entries). If not, or if you did, but fell off the wagon, START OVER! Make another resolution today and start moving MORE.

#2- Pollen. It's the first of the month, so change those air filters! (See Feb 1st entry)

#3-Vitamin D- Get that sunshine vitamin in your system! Most people are deficient, so add 1000IU of Vit D to your diet, or have your doctor check your level to find out if you need more.(See The Sunshine Vitamin blog entry of 3/13/10)

BOTTOM LINE: Happy May Day! Today's reminders are about exercise, air filters and the sunshine vitamin.