Monday, February 27, 2012

Advice...from a 99 year old.

Today was one of those "ah-ha" days. Kind of like an "ah-ha" moment, but the moment was so good, it lasted all day.
Today I had the pleasure of taking care of J, a 99 year old man who was not only sharp as a tack, but also in great physical condition, and not on one medication...not one. J proceeded to tell me how he gives lectures to medical students and at universities about how he has lived so long, and his outlook on life, over 99 years. He told me that he feels like he needs to "spread his wealth of knowledge" to the world, and share with others at a young age, what he has learned over his life.

Rule #1: Stay active.
 This guy bowls 3 times a week, and goes out for walks on the other days. He even brought his bowling score sheet, with his high score of 200-something. He cracked me up. Best part about this, is not staying just physically active, but also mentally and socially active. He makes sure to have a circle of friends that he can converse with, from things like the weather to the latest in politics. Anything to keep his MIND sharp as well. 

Rule #2: Do not stress.
Even he agreed with me when I said, "easier said than done". But, what J was saying is to be realistic about stress. Sure, some things are going to annoy you, and some days are WAY better than others, but overall, stress in and of itself does nothing good for you. Try to come up with solutions to problems. Learn to breathe. Sit down and evaluate any situation that you may be "stressed" about, and dissect what you may be able to do to fix or help the situation.

My favorite quote of all time goes along with this rule..."Let go of things you can’t change, build the perseverance to change the things you can, and acknowledge the wisdom you possess to know the difference."

Rule #3: Listen to your doctors. This is (obviously) my favorite. In his exact words..."All I know is my body, and how I feel. I can express those feelings to you, and you figure it out...I didn't go to medical school, what the hell do I know?"
Gotta love him.

I hope you all enjoyed this blog. This post lends itself to the "inspiration" voice of the site. We cannot know everything about everything, and sometimes we have to listen and take advice from others...:)

I hope everyone has a FANTASTIC week.

"All things splendid have been achieved by those who dared believe that something inside them was superior to circumstance...” – Bruce Barton


Saturday, February 25, 2012

I'm turning BLUE!

I have discovered my new favorite snack.
First, if anyone knows me, I HATE the taste of "artificial-ness". Also, I have an odd obsession for anything that "crunches" in your mouth.

....say hello to my new favorite snack.....

Relax... Give me a chance here. I know you are thinking..."really?". ...YES! I am serious! These things taste amazing (well, not if you hate blueberries), have LOTS of fiber (which is good for your poo-poo and hence, your colon), and the best part, they are lo-cal!!
I saw them BOGO at Publix ...and oh boy am I glad I threw them in my cart (as my husband rolled his eyes...I am a sucker for BOGO!).

Just do me the favor...and try them!

Menu De-Constructed....Cheesecake Factory!

You know I love you all when I went through over 200 items on this menu to bring you the best and worst. This was exhausting, but worth it for my friends who are trying to get, or stay..."skinnylicious"!

Appetizers (remember these are for 2-4 servings!)

Best: Chicken Pot Stickers- 377 calories
Tuna Ahi Carpaccio- 260 calories
Edamame- 323 calories (typically a good choice, no matter where you go!)

Worst: Factory Appetizer Favorites (or a mix of the worst appetizers for you!)- 3218 calories!!
Factory Nachos with Spicy Chicken- 1931calories (and 62gm of SATURATED fat!)
Guacamole, Made to Order- 1608 calories


Best: Small Vegetable Chopped Salad with Chicken- 390 calories
Luau Lunch Salad (Regular size)- 509 calories

AVOID the Caesar!
Worst: ALL of the pizzas and burgers. I couldn't even pick one because they are all horrible. Avoid.
Also, as a rule of thumb, avoid caesar salads. The dressing is loaded with calories. 
Oh! The FLATBREADS off of the "skinnylicious" menu are another option in place of the pizza. I recommend the mozzarella and tomato one!


Best: Skinnylicious Factory Chopped Salad- 570 calories (and I bet you can't even eat the whole thing!)- Delicious!!
Skinnylicious Grilled Chicken- 560 calories with lots of veggies and protein- GREAT option!
(Ok, lets just make it easy...these were the Best, but I would just go with anything from the Skinnylicious Menu options)

Chicken & Biscuits...:-/
Worst: Well, this was easy. Practically all of the Burgers, Pastas and "Signature Dishes". Just to name a few...Pasta Carbonara and Bistro Shrimp Pasta both rang in with just over 2100 calories. Gross.
Believe it or not, the Miso Salmon had 1681 calories. Avoid.
Chicken and Biscuits (some of my friends fav)- ::gulp:: 2262 calories!


Best: Duh. The "Goblet" of Fresh Strawberries! No additives, just the strawberries..:)
Also, The Low-Carb Original Cheesecake would be your best Cheeseckae option at 570 calories (not too bad if you share!)

Worst:  Peanut Buter Cup Fudge Ripple Cheesecake- 1326 calories
Brownie Sundae Cheesecake- 1265 calories
...and everyone's favorite, the Oreo Cheesecake- 869 calories..ouch!

Overall, unless you stick to the "skinnylicious" menu, which does offer tasty options, this restaurant is packed full of calories and foods that everyone should just be avoiding. No wonder it is "America's Favorite Chain Restaurant"!

Thursday, February 23, 2012

Heartburn...or Heart Attack??

Ok ladies, time to get a little serious. As you all may (or may not) know, February is American Heart Month, and it just seems like the perfect time to talk about women and heart disease, and with that, heart attacks.

Yesterday, USA Today published a huge article about women and how they are less likely to get appropriate care sooner for a heart attack then men. Find the article here. As the article states, women have a 15% mortality (or death rate) in the hospital compared to 10% of men. Why? Because women are less likely to get early treatment, mostly because our symptoms may be "atypical", or not the "common" symptoms of  heart attack, like chest pain, shortness of breath or cold sweats. Moreso, even when we DO have these classic symptoms, we are STILL less likely to be treated early on, as in men.

What are these symptoms that many women, and their doctors play off as nothing, or anxiety? Mainly, nausea, extreme fatigue (like cannot clean or vacuum a room suddenly without becoming faint or short of breath), pain in the back or in the jaw. Since these symptoms are usually disregarded as "nothing", these women tend to die MORE, because they are not seeking medical care soon enough, or not at all.

This article goes on to say how we, as doctors, and healthcare community as a whole, are doing an extremely poor job of educating women on their risk for heart disease and stroke.  Every woman is terrified of getting breast cancer (rightfully so!), but women have a 1 in 3 risk of dying of heart disease whereas only 1 in 25 women die of breast cancer.

Me! the American Heart Association
"Go Red forWomen" breakfast in Miami.
How can you help yourself? I'll write it again...KNOW YOUR NUMBERS!! ALL women should know their cholesterol, blood sugar and blood pressure. The American Heart Association has a fantastic tool on their website that is a "Heart Attack Risk Assessment". I suggest everyone take a look at this tool to know your risk!

In an upcoming blog I will actually talk about what heart attacks and strokes are, and why they can be lethal. Most people say "heart attack" and "stroke", but really have no idea what they are, or the different types.

PLEASE PLEASE spread the word about today's blog. You never know, you may just save a life!

Monday, February 20, 2012

Supplement Madness!

Marketing companies have done a fantastic job of making everyone think that they "need" to take vitamins to be healthy, or even that if they don't take them then they will get cancer, heart disease, their leg will fall off...etc...etc..

Well.  I'm here to give you the nitty gritty truth about supplements...and it just may surprise you!

First. Forget everything you have ever heard, read, or that Cosmo magazine had an article about. Purge all the stuff you have read and listen ( up!

Here are the biggies: 

1. If your doctor told you that you need a particular supplement/vitamin, listen to him/her because your situation may be different then the "generic" information I will be giving here.

2. A good old multivitamin is likely to be okay. Would you believe that there is even controversy over this in the medical community? There are a lot of studies coming out now that are saying taking a daily multivitamin may be harmful to your health! My take on this is the following: If you eat like crap and do not have a good, balanced diet, then you should probably take a multivitamin. If you DO have a balanced diet (you know, whole wheat, veggies, fruits, milk) then you probably do not need to take a multivitamin.

3. Any female of child-bearing age that is not abstinent, and has a uterus and ovaries, should take folic acid daily. Folic acid is essential for proper spinal cord and brain development in a fetus, so taking this daily will help you one day IF and/or when you do get pregnant. Also, this takes about 3 months to build up in your system, so its best to take it PRIOR to pregnancy.

4. Vitamin D IS your friend. The one vitamin that has probably been studied the most recently is Vitamin D. Due to increased use of sunscreen (YAY!) and the fact that not many foods have a lot of Vitamin D, many different medical societies agree that adults <70 years old should probably supplement with 600 i.u. of Vit D and adults >70 years old and post-menopausal WOMEN with 800 i.u. of Vit D daily.  These guidelines are especially true for women, who are more prone to osteoporosis (brittle bones) after menopause..(ugh, not just the hot flashes!)

5. All "anemias" are not created equal! Unless your doctor told you to take iron pills...don't! There is only one type of anemia which requires iron supplementation..."Iron Deficiency Anemia"..(see, and you thought this medical stuff was hard!)  Please, do not just take iron for the heck of it. Talk to your doctor first.

6. All of these recommendations are just that, recommendations. These are based on guidelines/recommendations from medical societies for the average, healthy woman. If you have any specific questions, or if you are unsure if these recommendations are right for you, please contact your doctor.

P.S. Just in case you were wondering, I take the adult gummy vitamins (I loathe swallowing multivitamins) and folic acid daily..:)

Saturday, February 18, 2012

Menu De-Constructed!

I am going to try my *hardest* to do this this once a week for everyone. My goal was to have this posted on Friday (you know, the night typically people go out to a restaurant and ruin their diets), but I figured Saturday was the second best. So, I am going to pick a chain restaurant...and completely SHOCK and AWE you at the calories that you may be consuming! I will help you to pick the healthiest meal option..and which ones to completely avoid!
This week...cue the music..."I want my baby back, baby baby, baby back...riiiibbbs"---CHILI'S!

WORST APPETIZER...weighing in at 2120 calories.....Texas Cheese Fries with Chili and Ranch. Ew.
Texas Cheese Fries

BEST APPETIZER.. Tripple Dipper Chicken Crispers with no dressing..only 340 calories! (this beat out chips and salsa!) Believe it or not, a close second were the dang mozzarella sticks! Who would've known?!

Jalepino Smokehouse Burger
WORST MEAL...there are so many! But, the worst in terms of calories and fat is the JalapeƱo Smokehouse Burger with Ranch. Just GUESS how many calories..::gulp:: 2210! That is more in ONE MEAL than you should be eating in a day! And it has 144 gm of FAT! GROSS!! Hands down, doing my research, it looks like their burgers are the worst items on the menu. I would also avoid the Quesadilla Explosion and Buffalo Chicken Salads (BEWARE...just because it is a "salad" doesn't make it good for you!)

BEST MEAL Margarita Grilled Chicken. This has 550 calories, has a lot of protein in the chicken and the beans and only 14g of fat. Other great options are the Grilled Chicken Sandwich with Broccoli & the Classic Sirloin with veggies (Lighter Fare Menu items).

If you **must** SHARE dessert (sharing is caring!) then go with the cheesecake. Believe it or not, it has the least amount of calories.

P.S. I felt REALLY good about myself while writing this blog. I can tell you all that I always get the margarita grilled chicken when I eat at Chili's. It is really good..and a good option! Just because you go out to eat does NOT mean you have to ruin your diet! Also, be sure to drink water or unsweet tea (or, if you must, diet soda). AVOID regular soda...what a waste of calories!

Please let me know what restaurants you would like me to review next...leave a comment!

Thursday, February 16, 2012

Beer, Wine, Vodka, Oh My!

"How much alcohol am I allowed to drink?". Ah. My LEAST favorite question.

Let's begin with the following...if you have any of the conditions listed below, it is best that you NOT drink.
     1. Personal or family history of alcoholism
     2. Liver disease
     3. High Triglycerides
     4. Pancreatitis
     5. Heart Failure
     6. Uncontrolled Hypertension (High Blood Pressure)
     7. Pregnancy
     8. Any medications that may interact with alcohol
     9. Your doctor told you that you have a medical problem in which you should not         drink alcohol
    10. If you will be driving or operating heavy machinery while drinking (You knew that one!)
(Thank you, American Heart Association for such easy to understand guidelines!)

Then, there were the rest of you. The recommendations are the following: 1-2 drinks per day for men, and 1 drink per day for women. Now, don't think that you are getting off that easy! I know you are thinking.."Hmm..well then I'll have a GLASS of vodka!" Nice try! A "drink" is quite clearly defined as follows..12 oz beer, 4 oz of wine, 1.5 oz of 80-proof spirit or 1 oz of 100-proof spirit. For those of you who need a ya go.

Next question..."Is one type of alcohol better than another?" can get similar pre-measured
glasses at FG Bradley's
This is  a toughie. I'd say statistically, no. HOWEVER, there are small studies showing that people who consume moderate amounts (refer to above) of RED wine have better cardiovascular health because of the benefit of an increased HDL (remember, I taught you all about that already!). So, in my humble opinion, if I had to choose, I'd drink the red wine. Too bad I don't like it..:-/

Next..and my favorite question of all time...."If I don't drink all week, can I save them up and have 7 drinks in one night?" I'm not kidding, I really get asked this. And the answer is a big...NO! Binge drinking is out of the question..sorry!

Finally, let me say that I am in no means advocating the use of alcohol. There are far better means of increasing your HDL than by drinking red wine (exercise, anyone?). However, I thought it would be nice to provide everyone with the facts!

Monday, February 13, 2012

LDL, HDL, Schmel-dee-el...What's it mean?!

Time to do some breaking-down of "Cholesterol Confusion". Let me get everyone up to date on the whole cholesterol issue.

Ok. There is "bad" cholesterol (the LDL), the "good" cholesterol (the HDL), Triglycerides, and some others that I'm not going to get into for simplicity's sake.

To start, the LDL, or "loser" cholesterol is the main culprit of heart disease. This is that number that we, as doctors, freak out about. The LDL should be less than 100, ideally. If you do not have diabetes or any other medical problems or family history of heart disease, we say less than 130. If you have diabetes, <100, for sure, and now we are saying <70 if we can get it there safely.

The HDL is the "happy" cholesterol. HDL cholesterol actually takes the bad cholesterol from the arteries and transports it to the liver to be processed and removed. So, HDL>60 is said to be "cardio-protective", while an HDL<50 in women and <40 in men may put you at a higher risk of heart disease. To improve your HDL, avoid smoking and maintain a healthy weight.

Triglycerides store unused calories, and high levels typically correlate with eating a lot of starchy foods (carbs) and fatty foods.Also, people with uncontrolled blood sugars also typically have high triglyceride levels. Triglyceride levels should be <150.

The "total" cholesterol is basically the total of these mentioned plus a few not mentioned. The total cholesterol doesn't mean too much without the breakdown of the components. So, focus on the breakdown, and "know your numbers"!

To summarize:
HDL >60 in women, >50 in men

Also, just because you are fit and in good shape does not mean you have nothing to worry about. A very large part of cholesterol a lot of times is genetic, and there is not much you can do about that, unfortunately. Regardless, whether you are thin, heavy, in shape, or not....get it checked!!

Rules to LIVE by!

The all-anticipated post! Here we go. This is what I tell EVERY patient that gives me the general question "So, Doc, what can I do to prevent cancer, heart disease, stroke, death...etc etc..". Well, here it is. My rules to LIVE by!!

1. Don't smoke. Ever. If you do, then go flush all of those cancer sticks down the toilet.
This is one thing I DO NOT EVER budge on. This is hands down the worst thing you could ever do to your body. Please, for the love of God, if you smoke, stop.

2. Don't lay in a tanning bed. And with that, if you go in the sun, wear sunscreen! You may think it's cute to be all tan now, but let me tell you, Botox will not be able to get rid of those wrinkles made from the sun, and it definitely can't get rid of skin cancer...ew!

3. Enjoy chocolate (or whatever other food you like) moderation! The key to any good diet is to allow yourself a treat every once in a while. If you eat ice cream everyday, it just doesn't taste nearly as good as if you ate it at the end of the week, as a reward for a week of eating healthy!
A young patient, learning her "numbers"!

4. "Know your numbers". This is a tip from the American Heart Association. By this I mean, know your cholesterol (HDL, LDL...I will get into this on a future post) and your blood sugar. Knowing your numbers will help you to make more educated decisions about your diet and what your goals are. Most women have no idea what their cholesterol or glucose you?

5. Exercise. Daily. The American Heart Association recommends 30 minutes of aerobic exercise 5 days a week. This is moderate intensity (think elliptical/stairmaster). This is also non-negotiable. And this tip is not just about exercising to look good, this is exercising to keep your heart strong.

6. Know your family history. Did your maternal grandmother pass from ovarian cancer? Did your father have colon cancer? I cannot express how important it is to know your family history. It can totally change the screening guidelines for you. For instance, a screening colonoscopy is done at 50 years old. But, if your father had colon cancer at 49, then you must have a screening at 39! Not just cancers, but knowing family history of heart disease, diabetes, etc will help your physician make the right decisions for your health.

This is the green tea I drink.
7. Drink Green Tea. Ok, I am not talking about the powdered stuff that you mix in water. I am referring to tea-bag or whole-leaf green tea. Green tea is packed full of antioxidants and also has weight-loss properties. I try and drink at least one cup a day, but I really aim for two. P.S. Green Tea lattes and frappes don't count...but nice try!

8. Ditch the Soda. Never. Never. Never drink regular soda. I'd prefer you not to drink the diet either, but if you MUST have the taste of soda, drink the diet. The amount of calories and high fructose corn syrup in regular soda is insane. If I were you (and I am) I would replace all soda with #7..

9. Make sure to visit your GYN for annual exams and do your monthly breast exam. Let's just say I had a 20-something patient die of cervical cancer because she never went for her annual pap. In this day and age, there is almost no reason as to why women should be dying of cervical cancer. Also, ALL women should be doing monthly breast exams (do it at the same time every month, preferably 2-3 days after your menstruation), as well as an annual mammogram after the age of 40 (these guidelines are variable depending on who you talk to. In my opinion, annually after age 40).

10. No White Food. Ok, so its a little wrong to say, but its true! Avoid white rice, white bread, and white pasta like the plague! Replace all white foods with their whole-wheat counterpart. White foods offer almost no nutritional value, and replacing these carbs with whole grains adds vitamins and minerals to your diet (and no, honey wheat does not count...I know that was the next question. It always is!)

I'd love to hear if you are already following these tips, or if any of these have had an impact on your life. Please, keep me posted!