SPA Water- At YOUR House!

Over the holidays, I went to a gathering for teenage girls that included a fabulous cookie exchange. There were tempting gingerbread cookies, snickerdoodles, chocolate everythings, and good old-fashioned Christmas cookies to tempt every palate. Imagine my surprise and delight when I left this party with a HEALTHY idea! What was it? SPA Water!

In a large, beautiful, clear glass dispenser, the hostess (thank you, Toni Holmes!) had simply sliced up whatever citrus fruit she had on hand- oranges & lemons- and added them to water and ice. I found myself (as did the other moms and many of the girls) irresistibly drawn to refill my glass over and over! When I commented to the hostess that if I had this sitting out on my counter, I would never fall short of my water-consumption goals, she laughed and shared that several other moms had all told her the same thing. Being an all-in or all-out kind of gal, my first instinct was to head to Bed, Bath, and Beyond, coupon in hand, and snag myself a gorgeous water dispenser. I literally was standing in the store lifting the box to place it in my cart when I realized that this was overkill. Did I really need a gallon of water displayed for myself? Um, probably not. And until my cabinets are cleaned out, I am not allowing myself one more item. Though I still want one for my next hostess opportunity...

So, that afternoon, I started a new habit. A box of "Cuties" (small Clementine oranges) is usually less than $5 at my grocery store, and so I generally keep them on hand to pop in our girls' lunches. I grabbed the largest, most beautiful glass that we have, then simply sliced up (rind and all- gotta be quick) a Cutie and popped half of in the glass. I added ice and water, and voila! My very own personal "spa water"...in a glass. I actually drank three in a row that first day!

Since then, I have made a point of buying some lemons in addition to the weekly Cuties, just to vary it up a bit. Toni mentioned she likes to add grapefruit slices, which sound delicious to me. If it is citrus, toss it in!

BOTTOM LINE: We all know water is the best way to hydrate, but why not make it DELICIOUS and TEMPTING by slicing up some citrus fruit into your glass?

What about Tamiflu? Should you take it?

So if you GET the flu, should you take Tamiflu? Or less known, Relenza?

Ah, that's the million dollar question...literally, since Tamiflu and Relenza are the only drugs FDA approved and indicated for this year's flu. These drugs are flying off the shelves as the flu season kicks into full gear, and we are desperate to get over the flu as fast as possible. Much is being debated these days about the efficacy of these anti-viral drugs. What do we know?

We know that antiviral treatment typically shortens the symptoms of the flu by at least twenty-four hours. We know treatment is recommended for those with weakened immune systems or those with severe enough symptoms to be hospitalized. We know starting these medications when you have already had symptoms for more than two days is NOT helpful. We know that taking Tamiflu can help prevent getting the flu if you are definitely exposed to someone with the flu.

What else do we know? We know that there are no independent studies of the drug (meaning that the manufacturer of the drug has at least partially funded all the studies). That does not mean the studies are invalid, but certainly it calls bias into question.

Tamiflu and Relenza are not without side effects. In my own clinical experience, I have had patients who took one of these drugs because their family member was diagnosed with the flu, and the side effects of the drug were "as bad as the flu"- particularly nausea. That being said, I have also had patients who had zero side effects and happily did not get the flu despite obvious exposure.

What do I do clinically? If I diagnose you with the flu, and you've had symptoms for more than two days, I will not prescribe an antiviral. If you have a very sensitive stomach, I am unlikely to prescribe an antiviral. If you are a college student living in a dorm (translation, exposing a zillion other kids to your flu), I am likely going to encourage you to take an antiviral. So, it depends...on YOU and your symptoms and your risk factors.

BOTTOM LINE: If you have true flu symptoms, get in to see your doctor ASAP...and then have a DISCUSSION about whether or not an antiviral medicine is likely to help you (or your roommates.)

Flu Vaccine- It's Not Too Late!

Okay, it's January, and now EVERYONE you know is getting the flu! Is it too late for you to get vaccinated? ABSOLUTELY NOT! The truth is that now that we're all scared, it's tough to find somewhere that has the flu vaccine in stock! Call your doctor or your pharmacy and find out how many they have left, then jump in your car and head over.

This year is another one of those "really bad" flu years. Yes, if you are vaccinated today, you have to wait a couple weeks for your shot to protect you. BUT...the flu season is just catching its stride, so all you have to lose is a temporarily sore shoulder.

This year's flu seems to be bringing with it the added bonus of nausea and vomiting, as if muscles that feel like a Mack truck hit you were not enough. The flu is NOT just a stuffy or runny nose and cough- that's a cold. The flu is OMG, I can NOT get out of bed and function, because my head is splitting, my muscles are screaming, and yes, this year's bonus is the vomiting and diarrhea. Believe me, a sore arm for a few days is a happy trade for the flu.

Who should be vaccinated? Hello, it's EVERYONE. The CDC (Center for Disease Control and Prevention) recommends that everyone over the age of 6 MONTHS get a flu vaccine each year.

Wash hands, wash hands, and oh yes, wash your hands...for 20 full seconds! When you dash them under the water or take 5 seconds to apply hand sanitizer, you are nicely moving your germs around, so spend the extra 15 seconds and scrub a bit to be more effective.

BOTTOM LINE: FLU SEASON is in FULL SWING- Strike back by getting your FLU VACCINE and WASHING YOUR HANDS...for a full 20 seconds!

For more info, check out the current stats on this year's flu at the CDC at: 
http://www.cdc.gov/flu/about/season/flu-season-2012-2013.htm

2013- A Year for YOU!

Happy New Year! I love new beginnings- who doesn't? Whether it is the first of the month, your birthday, an anniversary, or yes, the NEW YEAR- give yourself the precious gift of a new start!
Since this is my blog about all things healthy, I wish for you specifically to give yourself the gift of a new start for health...whatever is most important to YOU.
90% of us struggle with our weight. Whether it is fighting that same darn 10-20 pounds that we battle every year, or perhaps the first time that our metabolism packed its bags and deserted us, Americans have big issues with weight (no pun intended.) What will you do this year?
Let me say right now, if you are not exercising at all, and eating out over half your meals, please do not commit to exercise every day & a brilliant, gourmet, healthy home-cooked meal three times per day! Whatever you choose, set yourself up for SUCCESS!
For 2013, I'd like to encourage you to pick ONE thing today to improve your health. Is it a goal of five servings of fruits and/or vegetables per day? Hooray! Choose it! Is it parking your car at the back of the lot? Awesome! Walking the stairs instead of taking the escalator or elevator? Buying a pedometer? Meditating 5 minutes each morning before you get out of bed? Amen!
My wish for each and every one of you is better health- spiritual, mental, and physical health. I am in the process of finalizing tough decisions in my own life to optimize not only my health, but my family's collaborative "health".
BOTTOM LINE: Start off 2013 with ONE simple step towards better health- choose it today!

Can't Get Rid of that COUGH?

This time of year especially, coughs seem to stick around forever. Here in Austin, the culprit may be seasonal allergies, but overall the major cause of persistent coughs is viral upper respiratory infections- from both simple "colds" and the big, bad flu. With these infections, after you get past the headaches, and stuffy nose part, you find yourself coughing- often up to SIX WEEKS after the initial illness. Sometimes it's a minor "clear your throat" type of cough, while other times, it's the crazy fits of coughing that keep you from sleeping.

Is there anything that can be done for a cough that wont go away? Yes, but a cough does NOT mean you definitely need an antibiotic- in fact, typically, you do NOT. However, a cough that is not managed with over the counter medicines should be addressed by your physician. Coughing all day long at school or work (or keeping up your spouse with coughing all night) is NOT a good plan!

What can your doctor do? First of all, she does need to rule out any secondary infection such as a pneumonia. If you are a week into your symptoms, and suddenly you feel a ton worse and develop a fever, this might be a bacterial infection setting up shop AFTER the virus cleared the way past your body's defenses. For this scenario, yes, you need an antibiotic. More commonly, though, you may have developed some over-reactive airways and may benefit from some inhalers or other asthma-style of medicines. A prescription cough syrup used at night may help with the nighttime exacerbations, and your doctor can remind you of some traditional home remedies such as cool mist humidifiers that may help. Finally, sometimes a cough comes from other sources, such as acid reflux or sinus drainage, which require different treatments.

BOTTOM LINE: See your doctor to evaluate coughs that get worse after a respiratory illness, or that wont go away- don't expect antibiotics, but know there are other treatment options!!

Feeling SAD? LIGHTen Up!

While everyone around you is humming Christmas songs, lighting their menorahs or making ski vacation plans , are you left feeling sad? Perhaps it's not the holiday blues, but SAD- Seasonal Affective Disorder. This depressive disorder was formally named only a few decades ago, in the 1980's. It affects over half a million people each winter, including some symptoms in up to a third of patients seeing their primary care physicians during this season.

Who gets seasonal affective disorder? It's most common in women (3:1 over males) and young adults 20-30 years old, but it is seen in across the board. January and February are the most common months that SAD is diagnosed.

What are the complaints? Often fatigue, weight gain and recurrent illness are the primary issues, rather than simply "sadness". The symptoms range from a mild case of "winter blues" to serious depression.

What is the cause? There are different theories, most of which are linked to hours of sunlight. There is disruption in our circadian rhythms as well as decreased seratonin secretion during winter months, and of course, less Sunshine vitamin (Vitamin D).

Prevention? Light therapy (using full spectrum light bulbs in your home and work) or consciously spending more time outside in the sunlight can help prevent S.A.D. Of course, moving to a more southern location can help, especially if you are far north, but that is not typically feasible for most people.

Treatment? Light therapy is the treatment of choice. Anti-depressant medications (Buproprion is the only one FDA indicated, but SSRI's such as prozac are also used), and Vitamin D replacement (if low) have also shown effectiveness in improving symptoms.

What is "light therapy"? Light therapy aims to artificially increase your exposure to light during the time of year when our natural daylight is limited. Typically light therapy is performed by sitting in front of a light therapy box, which simply gives off bright light that is similar to natural outdoor daylight (rather than standard light bulbs). During the session, the person may read, write or even eat- he or she does not need to focus on the light.  Although most people with SAD will require the therapeutic intensity of a light therapy box, many people with mild symptoms will respond to simple full spectrum light bulbs replacing their normal light sources at home.

Does light therapy work for other depressive disorders? Maybe. More studies are needed as we try to find depression treatments that do not carry large side effect profiles, and light therapy is a perfect example. One such study (Controlled trial of safety and efficacy of bright light therapy vs. negative air ions in patients with bipolar depression) published this year started looking at the effects of light therapy in bipolar disorder, but this small study (44 patients) did not yield statistically significant differences. However, bright light therapy has been effectively used to improve symptoms in chronic depression, post-partum depression (baby blues), premenstrual depression (PMS) and in disorders in the sleep cycle. 

BOTTOM LINE: If you recognize a pattern of feeling sluggish every winter and perking up in the spring and summer, consider purchasing some full spectrum lights and talk to your doctor and see if together you can change "S.A.D." to glad this year!

Flu Season 2012- Ready or Not!

While we are rushing around in December, take a moment to think about whether or not your family has received the flu vaccine this year. The CDC reports show that unfortunately, we are jumping into the season early this year, especially in TEXAS, Alabama, Louisiana, Mississippi, and Tennessee. In fact, this is the earliest in the flu season to reach this level in almost a decade (since 2003-2004). The good news is that the viruses identified with testing DO largely match the strains that are included in this year's vaccine. More good news is that they are susceptible to our antiviral medications, although I am not a huge fan of these drugs in otherwise healthy individuals.
Both types of influenza- A and B- are being documented, with the usual ratio of nearly 3:1 from A:B.

What is FLU? Influenza is not a simple cold, nor is it a twenty four hour stomach virus. The flu causes fever, chills, cough, runny/stuffy nose, muscle aches, headaches, fatigue, and sometimes involves vomiting and diarrhea (more often in kids). Colds and allergies tend to bother you from the neck up- stuffy, sore throat, headache- but don't knock you down for the count, and coughs are generally less bothersome.

How is the FLU spread? This virus is spread from infected people when the cough, sneeze or talk, via tiny respiratory droplets, and the scary part is that you are contagious a full day BEFORE you develop symptoms (as well as for about a week after you feel sick.)

How can you prevent the FLU? Get vaccinated. Get vaccinated. Get vaccinated. It's not too late for this year- get vaccinated. The flu vaccine is indicated for EVERYONE over the age of 6 months, EVERY YEAR.

Who should NOT get vaccinated? Those with severe chicken egg allergies; bad reactions to vaccine in the past; younger than 6 months; history of an uncommon disease called Guillain-Barre. If you are sick with a fever, wait till this illness is over before getting the vaccine.

BOTTOM LINE: It's FLU SEASON again- get vaccinated!