To My Patients, October 2016

Autumn is upon us, but you may still find some days warm enough to walk outdoors; take advantage of the time you've got!

Please be aware that Sandy and I will be away for a few days, from Thursday afternoon next week, 10/27, through the following Tuesday. We'll be back in the office on Wednesday, 11/2. We'll be visiting our son and his family in Denver, Colorado. We miss them since they moved from our area over two months ago.

Janine will be in the office during our regular hours, and Dr. Sarfraz will cover if necessary. Please plan ahead, if you need an appointment before we're back, call us immediately!


→ Difficulty Falling Asleep or Staying Asleep?

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If this is your problem, you don't necessarily have to resort to prescription medication. Many patients have found the Relaxation Response, practiced at bed time, to be very helpful. It's a progressive muscle tension-relaxation routine that takes 2-5 minutes to complete. It's a proven stress management tool which works even better if practiced more than once a day.

Others have used one or more over-the-counter preparations. The most effective ones, according to some authorities, are Melatonin, valerian and L-tryptophan. They work better when combined with a relaxation technique, but are not very effective for severe insomnia.

Feel free to discuss sleep problems when you're in the office, even if it's not the main reason for your appointment.

If you want a copy of my preferred version of the Relaxation Response, please let me know by phone or email.


→ Banking Calories Before The Holidays

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The holiday season is around the corner, with parties, parties and parties. And with the parties comes eating and overeating, and then comes the weight gain. The average American gains 1-3 pounds during the holiday season. It doesn't sound like a lot of weight, but many people don't shed the extra weight, or take months to lose it.

"Banking calories" is not a great lifestyle, but if you find it hard to control your food intake during holiday time, the method may work well for you.

With calorie banking you cut down on what you eat, but not starve, for several days before the big feast. Many Americans consume 4,500 calories (or more) during the Thanksgiving meal, which is about 3000-3500 calories more than they should. This is enough for a gain of one pound at the Thanksgiving dinner alone!

It not too hard to cut 500 calories of food (that's about one and one half bagels) for a few days before an eating event, and it doesn't even have to be on consecutive days. A little increase in exercise will help too, and pushing away from the table is a good way to start.

The old Chinese saying still holds "He who takes medicine and neglects diet wastes the skill of his doctor." So help me not waste my skills.

Until next time, stay well,


Igal Staw, Ph.D., M.D.
www.drstaw.com
weightloss.drstaw.com
www.twitter.com/drstaw
Dr. Staw on Facebook 

To My Patients, September 2016

It's been a wonderful summer; fall is around the corner. It's a great opportunity to take advantage of the outdoors, walking hiking, apple picking, you name it...

It's also a good time to take care of yourself, make sure you are at optimal health.


→ My Take On Optimal Health

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I have been looking at US health and longevity data for many years and was very active in a niche organization dealing with health risk reduction.

By health standards, we are not doing very well in the US. But you, as an individual, can do a whole lot better.

In a 2015 survey, the US ranked approximately #43 in longevity, with a life expectancy of 79 years, at least 5 years below the top ranking countries such as Monaco, Japan and Singapore. Yet the per capita cost of medicine in the US is the highest in the world. Still, early detection of disease, and the treatment of disease is the most aggressive and advanced in the world (despite all of its deficiencies), and that's a good thing.

But the key to longer, healthier life is lifestyle. That's where you can do something for yourself beyond what the health system does not do for you.

There's no need to re-emphasize the danger of smoking. It's still the number one primary cause of premature death in the US.

Overweight and lack of physical activity, combined, is the number two cause of premature death in the US.

You can increase your physical activity and lead an interesting life even if you don't go to the gym. The fall season is a great time to take a walk by the beach, hike on a nature trail, visit the outdoors flea market (at least 10 of them in Fairfield County), or walk the long corridors of the museums. Apple picking is a great weekend activity in the fall. Are you into the Pokémon game? Good. People active in the game, "chasing" the Pokémon, have reported impressive weight losses of 30-40 pounds, and they are having fun doing it.

Healthier foods have now become common place in supermarkets and many restaurants. Organic and less processed food is much more available. There are an increased choice of low sugar, whole grain, and low saturated foods. But you still have to read the label carefully. Farmer's markets are offering fresher, tastier fruit and vegetables.

Even the fast food places now offer much healthier foods, including chicken that is not fried, and fresh salads (but please avoid those French fries and the heavy duty salad dressings-a little oil and vinegar will do).

With all of that, still don't forget early detection, which is the most important part of your routine physical examination, plus prevention, which includes immunizations and treatment of known health risks.

So there's a lot you can do for yourself to increase longevity. As a whole we don't have to be part of the "43rd ranking" of longevity. Individually we can do a whole lot better than that.


→ Keeping It Healthy

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If you need any help staying on track, or if you think there's something you can do better, please feel free to reach out by email or phone.

If you need any help, I'm here.


Stay well,

Igal Staw, Ph.D., M.D.

To My Patients - May 2016

Well, spring is here, really? Is it April showers or May showers? In any case, here are some important spring health topics you may want to think about while you're hiding from the rain. → Lyme Disease, It's The Season Lyme disease usually begins to show its ugly face in the spring, and this year does not appear to be an exception. It's too early for this year's official statistics, but last year showed a significant increase in the percentage of infected ticks, and a resulting increase in Lyme disease incidence in our area. Endemic in our area, Lyme disease is caused by the bite of an infected deer tick, which then injects the Lyme-causing Borrelia bacteria through the skin of the affected person. If a large enough number of bacteria is injected, typically when the deer tick is attached to the skin for 24-48 hours, Lyme disease may develop. To make things more complicated, the same deer may carry other bacteria, those responsible for Babesiosis, Ehrlichiosis, and Cat Scratch Fever, which have symptoms overlapping with Lyme. Symptoms may develop several days to several weeks after the bite, including fatigue, headache and stiff neck, fever and chills, muscle aches, joint pain, and swollen glands. But that's also typical of so many other conditions. So the diagnosis is not always clear cut. The typical "bull's eye rash" appears in a minority of the cases. When it does appear, the diagnosis becomes easier. Blood tests for Lyme detection may not become indicative for at least 2-3 weeks after infection, frequently after symptoms have already begun, and perhaps even resolved. According to many experts, false negative tests occur at an uncomfortably high rate, and the Lyme disease may go untreated for too long, which may lead to serious consequences such as chronic pain and neurologic damage. Don't forget to inspect your body for presence of deer ticks, every time you do an outdoor activity such as gardening or playing sports on grass. So, during this "Lyme season" and in our endemic area, if you have suspicious symptoms with no clear cut explanation, or an engorged tick is attached to your skin, seek medical evaluation (call us if you need some advice). Do so even if you are not sure you were bitten by the bug. Early treatment is key! → Ginger Root Has Value If you have mild nausea and/or stomach discomfort, ginger, rather than prescription or over-the-counter medication, may help. It comes in many forms, the actual fresh root, a dried root preparation, a root oil extract, and even as a candy. It's been used for thousands of years, especially in the far east, and is worth a try. For some people it even works to relieve arthritic pain. Need additional information? Call us, I've got plenty to say on the topic... → A Spring Check-Up Your car needs a tune-up, and so do you. Your physical exam is a gateway to better health. Why wait until the end of the year? Call today for an appointment. Stay well, Igal Staw, Ph.D., M.D. www.drstaw.com weightloss.drstaw.com www.twitter.com/drstaw Dr. Staw on Facebook

To My Patients - April 2016

Although the calendar says "spring," It may be a little too cold to walk outdoors. That's no excuse! Move around, go to the gym, don't be sedentary. Your body won't forgive you come summer! And on that happy note, a few medical thoughts... → Are You Due For A Colonoscopy Last month was National Colon Cancer Awareness Month, aimed at promoting colon cancer screening and reducing colorectal deaths. Colorectal cancer is the 2nd leading cause of cancer deaths in the US (after lung cancer), causing approximately 50,000 deaths a year. I can't stress it enough, early detection saves lives. Colonoscopy screening usually starts at age 50, earlier if you have risk factors. These include inflammatory bowel disease, colorectal polyps, a family history of colorectal cancer, smoking, overweight, eating a lot of red meats, and sedentary lifestyle. Not sure if you're high risk? Give us a call and we'll talk about it. So, if you are due for colonoscopy, don't wait until colorectal awareness month of next year. It's OK to have it done before that... → Exercise For The Brain? We all know the benefits of regular exercise, especially the heart. But does it help our brain and psych function? During regular exercise, the body produces endorphins. These beneficial neurotransmitters act in our bodies as our own natural antidepressants, pain killers, and promoters of wellbeing. But there's much more to it. A recent study published in online Neurology claims that regular, moderate-to-high-intensity exercise (running, jogging, aerobic) is associated with a slower rate of cognitive decline as we get older, namely, exercise protects the brain's cognitive function. The cognitive function (memory, thinking clearly) of the more intense exercisers was about 10 years ahead of those with minimal or no exercise. Just one more reason to join the gym! → A Great Salad Dressing Use about 4 oz. tahini (we like Al Wadi the best, available in some supermarkets and Amazon), slowly add water to the tahini and mix continuously. The mixture will first become increasingly thicker, then, as you continue to add water slowly, it will start thinning. Thin it to desired consistency, add salt, garlic and black pepper to taste. It will keep in the refrigerator for a few days. Please note this is not a low calorie dressing, but it has an excellent nutritional value, and will entice you to eat more salads. Stay well, Igal Staw, Ph.D., M.D. www.drstaw.com weightloss.drstaw.com www.twitter.com/drstaw Dr. Staw on Facebook

To My Patients

February is Heart Month

The month of February is best known for Valentine’s Day and Presidents Day, but more importantly, it’s American Heart Month. I think that, more appropriately, it should be labeled American Cardiovascular Month, which would then take into account not only heart attacks but also strokes, both of which are major cardiovascular events. 

The risks of developing a heart attack prematurely (or a stroke, for that matter) are well known.  They are divided into modifiable and non-modifiable risks.

Modifiable risks include smoking, diabetes, hypertension, high cholesterol, obesity and lack of physical activity.

Non-modifiable risks include your age, gender and genetic makeup (blame this one on your parents…).

The important thing is to identify your cardiovascular risks, and then do whatever is necessary to minimize or eliminate your risks.

You can get a risk estimate by using one of the many risk calculators available on the internet. Here are two examples:

1. A very simple risk calculator, takes into account very few risk factors, but will give you the general idea, at http://cvdrisk.nhlbi.nih.gov/
2. A more inclusive calculator, at  http://www.cvriskcalculator.com/ 

Want to better identify your cardiovascular risks? We can help (I’ve only been doing it for 35 years…). Don’t hesitate to call.

High Deductible?

High deductibles are frequently used in order to decrease the medical insurance premium. A recent study of patients with high deductibles was conducted at the University of Southern California. The study found that high-deductible patients spend less on medical care, and are perhaps denying themselves of some medical care in order to decrease spending.

From our own experience, we have seen that patients with high deductibles often try to “bundle” their care into a single year, in which they would meet their deductible, and have the insurance pay for the remainder.

If you have a high deductible, I urge you to not deny yourself medical care; it would be false economy to do so, and may affect your health.  At our practice, we try to keep your out of pocket cost at a minimum, even if you have a high deductible, or have no insurance at all.

Keep safe on your snowy walks, and in bad weather walk the mall.

Stay well,

Igal Staw, PhD, MD

istaw@drstaw.com

The Home Garden

What a great site it was (and ready for my birthday...)

 

Citron. The first fruit after 5 years. Started from seed. Indoors for the winter.

The Amaryllis did it again

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