To My Patients - emailed 1/2/2016

To My Patients, Hope you're doing well in preparation for the new year. Let's all look forward to a fresh start, and more healthy choices in 2016. → I'm Doing Something New I decided that for 2016, I'm not making resolutions, I'm simply going to bring back an old tradition of good medicine. I'm going to do what very few physicians are doing these days. I am going to make house calls. House calls will be limited to those patients who are home bound, or for other good reasons can't make into the office. So, if you really need a house call, give a call! → More About Fat We all know about the dangers of excessive weight, so I will not repeat it here. Excess fat is usually estimated by the BMI (Body Mass Index), where a BMI of 19-25 is considered normal, and a BMI of over 40 is considered to be morbid obesity. But recent research (Annals of Intern Medicine, Nov 10, 2015) confirmed that some people with a normal or near-normal BMI also have a similar risk to those with a high BMI. How is this possible? These are people with a high "waist to hip ratio," also referred to as "central obesity," and colloquially as "spare tire belly." Men with a waste/hip ratio of 0.9 or higher, and women with a waist/hip ratio of 0.85 or higher, are considered to be centrally obese. If you are centrally obese you carry the risks of obesity. If your BMI is high, this adds to the risk. → How to Calculate the Important Waist/Hip Ratio Measure your waist circumference at the thinnest part of your waist, usually half inch to an inch above the belly button. Make sure you take the measurement at the end of a normal exhalation. Measure your hip circumference around the widest part of the hips or buttocks. Divide the waist measurement by the hip measurement, and there you have it. → How to Calculate Your BMI You'll need to know your height and weight (honesty is important here). Now, go to my blog, www.drstaw.com, and use the calculator on the right hand column. Need help in getting your BMI or waist/hip ratio moving in the direction? Want to get rid of the "spare tire?" Call for an appointment today and make 2016 a banner year for your health! Have a great year and stay well, Dr. Staw istaw@drstaw.com

To My Patients - emailed 11/16/2015

Continuing Medical Education. Please be aware that I will not be in the office on Thursday and Friday on this week. I’ll be attending the Continuing Medical Education meeting of Pri-Med in NYC. Janine will be in the office during our usual hours, and I’ll be accessible.

It’s never hurts to validate what you know and to learn more.

A couple of medical notes;

1. Probiotics. Numerous probiotics preparations are now available over the counter. Studies found them useful in the treatment of a number of common conditions such as Irritable bowel syndrome, diverticular disease (recurrent diverticulitis), traveler’s diarrhea, vaginal infections, bloating caused by certain drugs and foods, diarrhea caused by antibiotics, and others.

But which probiotic is best suited for you? We can help.

2. Non-prescription sleep supplements. If you’re having “minor” sleep problems, either falling asleep, maintaining sleep, or both, you may want to try over the counter supplements and other ways to help with the sleep issue. Many patients report help from Melatonin (usual dose 1-5 mg), taken about 45 minutes before bed time, others report benefit from the use of Valerian root, or the combination of both. Using a relaxation technique (such as the Relaxation Response, transcendental meditation) helps a lot. The list of things you can do without prescription sleep medicines goes on…

Do you need advice? Call us at (203) 853-1919.

This holiday season, as we have done for many years, we’ll again run our food drive. Boxes will be available at our office to collect non-perishable food (has to be in the original package), and sundry items. They will be distributed in the name of our patients to home shelters in our area in time for the holidays.

Stay well,

Dr. Staw

istaw@drstaw.com

Back From Vacation

Sandy and I returned from vacation on Monday. Spent two great weeks in France and Israel, and have been back in the office since Tuesday.

The blog will become more active again, concentrating on contemporary health issues and special notices, keeping up with my practice motto: We help you live a longer, healthier life.

Did you get you flu vaccine this season? If not, you can still do it and be protected for the upcoming flu season. Looking for information about this year's vaccines? click here for the CDC information sheet.

A comment about our trip: fewer overweight people everywhere we visited. They walk!

Sent to my patients on 3/12/2015.

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Are you ready for spring? The snow is melting away about as fast as it fell. Enjoy the change in seasons, it's good for the soul...


→ Heart Health 

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February was National Heart Month. While February may be over, taking care of your heart is a year-round commitment.

This is a reminder that, while heart disease is the number one cause of premature death and disability in the US, the risks of developing heart disease can be reduced significantly by making important changes in lifestyles, medical treatment, and early detection.

The most important modifiable risk factors for the development of premature heart disease include: Smoking, overweight, uncontrolled high blood pressure, uncontrolled diabetes, excess alcohol consumption, high "bad cholesterol" and lack of physical activity.

Heart disease can be delayed by many years by paying attention to your particular situation, and by "doing the right thing." We recently adapted for use in our office a heart risk calculator, which can give you an estimate of your risk for developing heart disease. This can be used to see how the risk changes if certain changes were made, such as achieving better blood pressure control, losing weight, etc.

Give us a call today; we'll develop a personalized program to help you reduce your heart related risks.


→ Alpha Lipoic Acid 

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Does the alpha lipoic acid supplement, available over the counter, have any value? Several patients asked me about it, and the answer may interest you.

Alpha lipoic acid is an antioxidant that plays an important role in several bodily functions. It helps eliminate free radicals, which are the harmful waste products of metabolism and which are contributing to the aging process. Alpha lipoic acid also helps convert nutrients into energy within body cells. With these qualities, it is thought to be helpful in two important instances:

• In people with diabetes, it may help reduce the symptoms of peripheral neuropathy (burning, pain and/or numbness, usually of the feet), and lessen the detrimental effects of diabetes on the heart, kidneys and small blood vessels. It may also improve insulin sensitivity, which then allows the body to burn sugar more effectively. Alpha lipoic acid has been officially approved in Germany for the treatment of diabetic neuropathy for many years.
• In patients who are trying to lose weight, and who are already on a reduced calorie diet, alpha lipoic acid supplements may enhance weight loss, especially when combined with EPA, an omega-3 fatty acid. This has been shown in a small study of women, and probably holds for men, too.

As with many other supplements, don't just go and buy it. Let's make sure first that this is what you need, and that you take the right preparation and dose and minimize the chance of side effects. Call today for a quick an easy assessment.


→ High Deductables Got You Down? 

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As always, we're doing our best to make medical care affordable. Many patients now have a high deductible. In many instances you may have to spend $5,000-12,000 before your insurance kicks in, and you are charged "retail" fees for services such as office visits and labs. In order to make medical care more affordable, we limited our self-pay basic office visit to a minimum (usually $85-95, and scaled down in cases of financial hardship), and have made arrangements with two labs for very reasonable fees for blood tests that are not covered by insurance.

Please take care of yourself and don't deny yourself of necessary medical services!

Stay well, 
IS

Mediterranean Diet, Sugar-Sweetened Beverages, and Ashwagandha

A few pearls for December:

Are you taking an ashwagandha supplement? Ashwagandha is an Indian herb from the Nepal region. It has been used by many patients for the treatment of mild anxiety and insomnia, and also for enhancement of cognitive and physical performance. Some studies say it may work.

Consumer Lab recently tested several Ashwagandha preparations, and found some of them not delivering the advertised amount of the product. They recommend the Pure Encapsulations preparation as the best one. Click here for an overview.

Are you on the Mediterranean Diet yet? A recent study done at Brigham and Women’s Hospital in Boston inferred that sticking to the Mediterranean Diet increases your lifespan. This is not surprising; we already knew that with this Diet your weight decreases, cholesterol profile improves, and the risk of a heart attack is diminished. The essentials of the diet are: Lots of fruits and vegetables, legumes, fish (it’s the fatty ones), extra virgin olive oil, and unrefined grains. A glass of red wine is good, and dark chocolate is not bad. Meats and fat containing milk products are not part of this diet, and should be kept to a minimum. We have a good Mediterranean Diet summary in our office. You are welcome to it, just request it by email at istaw@drstaw.com, or call the office (make sure we have your email address).

Are you still drinking sugar-sweetened beverages? If you do – stop it.

Considered one of the most important studies published this year, this study, an analysis of studies on more than 170,000 people, shows that the consumption of sugar-sweetened beverages increases the risk of heart disease. This is more so among men and American populations. Water is the drink of champions!!!

Have a great holiday season and stay well.