Q:

Is there really a “best” diet plan for losing weight?

A:

The best diet plan is the one that works for you as an individual. Talking any diet over with a certified nutritionist or your doctor is an important first step, especially for patients with any other significant disease. I tell my patients that losing weight is not a sprint but a marathon, with the goal NOT being rapid weight loss, but finding a pace and diet to stick with for the long term. (I would rather see them lose 20 lbs. and keep it off versus losing 50 lbs. quickly, but gaining it back.) A steady weight loss of 4-5 lbs. in a month is a good goal for most people. Patients often ask me whether they should try a specific “low-fat” or “low-carb” diet to lose weight. While some people have success with sticking to low-fat or carbohydrate-restricted diet plans, they are generally difficult to maintain over the long haul. It is better to focus on reducing calories by making healthier food choices from a variety of food groups and combining that with a regular exercise routine to lose weight. The New Year is a great time to set up your goals for the future, but set them up realistically. A healthy weight and regular exercise can put you on the path to a longer, more enjoyable life.

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Q:

Why is Vitamin D so important to our health?

A:

Recent studies show that the right level of Vitamin D in our bodies not only improves overall health, but may also help prevent several serious diseases. It’s important to think about getting enough Vitamin D during the winter because even though it can be found in our food, Vitamin D is also processed by the body through exposure to sunlight. This wasn’t a problem when humans worked and lived outside more, but in modern society where we spend more time indoors, we can be at risk for Vitamin D deficiency. Experts feel that 10-15 minutes of sunshine at least 3 times a week will help most people produce enough Vitamin D. You can also add Vitamin D to your diet by drinking fortified milk and eating certain foods, like salmon and other fatty fish, fortified cereals, liver, and eggs. We know Vitamin D helps the body absorb calcium for bone and teeth health- and helps prevent osteoporosis– but what is exciting is that Vitamin D is now linked to reducing the risk of breast, colon and other cancers, as well as heart disease. Talk to your doctor to make sure you are getting enough of this important “sunshine” vitamin.

Q:

What’s the latest in ADD/ADHD treatment?

A:

We’ve learned that the best treatment of AD/HD combines several different approaches working together to help each individual child. This “multimodal” treatment should include parent and child education, behavior management techniques, school/education plans and medication, when necessary.
As soon as a child or teen is diagnosed with AD/HD, parents should learn as much as they can about the diagnosis and develop a teamwork approach with their doctor and school. The more the child understands, the better their involvement will be as well.
There are several behavior modification approaches that help children, depending on age. Setting goals, using daily charts and reward systems, and working on social skills are examples.
Most schools have allocated resources to help families and children with AD/HD to develop plans for success in the classroom and socially. Working one on one with teachers or guidance counselors is the best way to ensure your child gets the resources needed.
Your doctor’s role is to help assess your child’s specific symptoms, where to find certain therapies or help, and if/which stimulant medications may be needed. All of these treatment approaches, used together, will best help children with AD/HD succeed in all facets of life.

Q:

How can doctors detect early heart disease?

A:

“An ounce of prevention is worth a pound of cure.” That saying has never been more true than in the field of Cardiology today. While we have an amazing array of treatment options for heart disease, it’s much better to find out about any heart problems early to protect the health of this vital organ.
Heart scans to the rescue! A new radiographic CT scan (x-ray) of the heart can detect early, asymptomatic heart disease in middle aged adults who are at risk of a future heart attack or stroke. Unlike some other tests, this scan uses no IV, no injection and no dye. Instead, it uses x-ray tomography to detect coronary artery calcification. Diseased arteries, where cholesterol plaque begins to develop, will be lined with calcific deposits (hardening of the arteries). A Heart Scan (also called a Calcium Heart Score test or Virtual Scan) can detect these early deposits, allowing doctors and their patients time to develop an effective treatment plan to reduce heart disease risks.
CT Heart Scans are safe, economical, and an invaluable tool to screen appropriate patients. Talk with your doctor to see if you are a good candidate for this test to help determine your heart health.

Q:

What should I do if I think I’m depressed?

A:

The first thing I tell my patients is that depression is very common. It will affect over 15% of people at some time during their lives. And, most importantly, in most cases depression is very treatable. You may have depression if you have several of these symptoms lasting for more than two weeks: sadness or feeling “numb,” loss of interest or pleasure in things you usually like to do, trouble sleeping or sleeping too much, change in appetite, low energy, poor concentration, feeling that you are worthless or that things are your fault, or thoughts about death/suicide. We know that depression is a biologi - cal illness just like diabetes or asthma. It tends to run in families and sci - entists are now identifying some of the genes that may be linked to depression. But, depression is defi - nitely not caused by personal weak - ness or an unwillingness to think posi - tively. Therefore, it’s important to seek professional help if you think you’re depressed. Talk to your doctor about your symptoms. Often depres - sion not only affects you emotionally, but can cause physical symptoms as well, such as headaches, back pain and stomach problems. There are excellent medication options and/or psychotherapy that can help make you feel better fairly quickly -- and get back to living your life to the fullest.

Q:

What is the best way to treat insomnia?

A:

Insomnia -the inability to sleep is a very common complaint among my patients. On average, most adults need between 7 to 9 hours of good quality sleep, and many people aren’t getting close to that.
Insomnia can have several causes. Some are easy to change such as decreasing the amount of caffeine or alcohol you consume in the hours before bedtime. Other causes are more serious, such as sleep apnea, which can present as simple fatigue or complaints of loud snoring from a spouse.
The first step to treating insomnia is to identify the cause. Are you under an increased amount of stress at this time? Or are you on medications that may be affecting your sleep? Do you fall asleep fine, but have trouble staying asleep? All of these are issues you need to discuss with your doctor. Keeping a log of your sleep patterns can also help identify any trends in your sleep problems.
A wide array of treatments can help depending on the cause of your insomnia: from simple things like cooling the bedroom, to some herbal supplements, to more specific prescription medications and even sleep studies to determine the scope of the problem. Lack of sleep can affect all areas of your life, so talk with your doctor if you are spending too much time counting sheep.

Q:

What are the main risk factors for diabetes?

A:

There are two types of diabetes: Type 1 and Type 2. In Type 1 the body doesn’t make insulin, while in Type 2 the body can’t use the insulin it produces effectively. Over time either of these types of diabetes can cause damage to the kidneys, heart, nerves, eyes, and other organs. Type 1 (often called juvenile or insulin-dependent diabetes) can’t currently be prevented but can be treated with insulin. Type 2 (the most common form) can possibly be prevented when risk factors are controlled. Risk factors include:
- Obesity/Overweight. Sadly, this is the #1 risk factor for Type 2 diabetes, which is on the rise among American adults and children.
- Sedentary lifestyle. Inactivity and overweight combined can greatly increase your risk. Being more active keeps weight under control, lowers blood sugar levels and increases muscle cells.
- High blood pressure and high cholesterol. Both increase diabetes risk and damage to the body’s major organs. Talk to your doctor about keeping these controlled.
- Unhealthy Diet. About 90% of those diagnosed with Type 2 diabetes are overweight. Too much fat, too many simple carbohydrates and not enough fiber are dietary issues to watch.
While some risks for diabetes, such as age and family history, cannot be changed, you can do a lot to help your whole family by making healthy lifestyle choices.

Q:

What is “travel medicine?”

A:

Travel medicine is the specialty of medicine that evaluates medical risks for travelers to foreign countries. It’s estimated that 80 million travelers visit developing or third-world countries annually. There they are exposed to health risks not regularly seen in developed countries.
Before travelling internationally, you should discuss any health concerns with your doctor, review health warnings for the country you plan to visit on the Centers for Disease Control website (www.cdc.gov/travel), and schedule a visit with a travel medicine health provider.
Most health problems in underdeveloped countries are due to infections carried by mosquitoes or through contaminated food or water. They can be prevented by avoiding mosquito bites, eating properly cooked food, and drinking clean water. In addition to these precautions, immunizations and oral medications to prevent Yellow Fever, typhoid fever, meningitis and malaria are recommended.
Some countries or regions have special concerns. We know that there are several regions of the world where rare polio remains endemic: Africa, South Asia, Southeast Asia and the Middle East. The CDC recommends polio vaccinations (or at least a booster) for all travelers to these locations. For safer and happier travels, talk to your doctor or find a specialist in travel medicine.

Q:

What’s the best way to treat ongoing acid reflux?

A:

If you’ve been taking antacid tablets and refraining from eating lots of different foods but still have heartburn or acid reflux, you may have what doctors call GERD. GERD stands for GastroEsophageal Reflux Disease and while its symptoms are annoying, GERD can also be serious if left untreated.
At the entrance to your stomach is a valve called the lower esophageal sphincter(LES). Normally, the LES closes as soon as food passes through it. If it doesn’t close all the way, acid in your stomach can move up into the esophagus, irritating the lining. Symptoms include burning chest pain, or “heartburn”, a sour taste in the mouth, nausea and others. If you have symptoms more than twice a week, you should talk to your doctor. We now know that untreated GERD can cause damage and increase a person’s risk of esophageal cancer. Plus, newer treatments can make you feel better fairly quickly.
Among the latest treatments for GERD are a class of medications, called proton pump inhibitors. They are very effective and are sometimes combined with over the counter treatments, like antacids or foaming agents to coat the stomach. Other drugs, such as H2 Blockers, help some people. If medications don’t help, there are surgical options, but they are being used less today. Patients should also make lifestyle changes such as not eating trigger foods, not snacking before bed, losing weight, stopping smoking and evaluating other medications that could make GERD worse.

Q:

What are the symptoms of ovarian cancer?

A:

Symptoms of ovarian cancer are nonspecific and can mimic those of other more common conditions, including bladder and digestive disorders. Since ovarian cancer affects over 20,000 American women each year and early detection improves outcomes, it is extremely important for women to be aware of these symptoms.
Common symptoms include persistence of the following for more than a few weeks:

Abdominal fullness, swelling or bloating

Pelvic or abdominal pain

Urinary urgency

Additional signs and symptoms of ovarian cancer may include:

Persistent indigestion, gas or nausea

Unexplained changes in bowel habits, such as constipation

Changes in bladder habits, including urinary frequency

Loss of appetite or feeling full quickly

Increased abdominal girth (clothes will feel tighter around your waist)

Pain during intercourse (dyspareunia)

Persistent fatigue or lack of energy

Low back pain

See your doctor if you have persistence of the above symptoms, especially abdominal bloating. If a diagnosis other than ovarian cancer has been made, make sure you follow-up with your doctor if your symptoms do not improve.
There’s no simple test for ovarian cancer, but the initial evaluation should include a pelvic exam. If your doctor suspects a problem, or if you have a family history of this cancer, he or she may order a blood test (CA-125 test) and/or a pelvic ultrasound.
Remember these warning signs - early detection is key.

Q:

I’ve been told I have “osteoarthritis.” What is it, and how is it treated?

A:

Arthritis is a general term that refers to inflammation in our joints. “Osteoarthritis” is the most common type of arthritis and affects over 20 million Americans. It’s related to the breakdown of cartilage in the body’s joints, particularly weight bearing joints such as the hips, knees and spine.
Cartilage is a firm, rubbery substance that covers the ends of bones in normal joints to reduce friction and act as a “shock absorber.” Over time, cartilage can loose elasticity and start to wear away in key areas. In some cases, the bones can end up rubbing together, causing acute pain and stiffness.
If your joints frequently ache or are swollen, you likely have osteoarthritis. The main causes are age, heredity (some people are born with joint abnormalities or weaker cartilage), obesity (which puts more stress on the joints), injury (previous injury in or around the joint, increases chances of arthritis) and joint overuse on the job or in athletics.
Treatment of osteoarthritis can include a combination of physical therapy to strengthen muscles around the joint, oral medications, weight control, injection of medications in the joint or removal of joint fluid, hot and cold compresses, and support devices such as braces. There are several surgical options, including joint replacement, if osteoarthritis is severe and other treatments haven’t worked.
If you have ongoing joint pain, talk to your doctor about treatment options to help you maintain an active lifestyle.

Q:

What are the main risk factors leading to a stroke?

A:

A stroke is brain damage caused by interruption of blood flow to the brain. It is the third leading cause of death in adults.
May is American Stroke Month, so it’s a great time to review the major risk factors. Some risk factors that increase the chances of a stroke can’t be changed, such as increasing age, being a male, or of African-American descent. Family or personal history of stroke also increase one’s risk of having a stroke.
But, there are stroke risks you can reduce by treatment or lifestyle changes:

1. High blood pressure - The leading cause of stroke, it can be controlled with your doctor’s help.
2. Smoking - Quit now to reduce damage to blood vessels.
3. Diabetes - Work with your doctor to control diabetes with lifestyle and diet changes, and medication if needed.
4. Atrial Fibrillation - If you have this, blood thinners reduce the risk for stroke.
5. High cholesterol - A risk for stroke, it can be controlled with proper diet and medication.
6. Alcohol - Excess consumption can increase stroke risk.

Talk to your doctor about your stroke risk. More information about stroke is available at www.stroke.org.