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Оглавление“The physician heals. Nature makes well.”
—Aristotle
A Healthy Lifestyle Is the Best Medicine
I have devoted practically my whole life to holistic and homeopathic remedies, as well as healthy lifestyle approaches. Yet here I sit, with a stainless steel rod, a plate, and 10 screws in my lower-left leg, along with a brand new right hip. So I have also learned to have a healthy respect for the traditional and allopathic (symptom-based) work of the medical community. In fact, one of the points that I constantly emphasize is that traditional medicine offers a wealth of extremely important information and applications that simply cannot be ignored. And those who are open and willing to investigate nontraditional areas must do so knowing that medical research is the primary source of this knowledge.
After all, underlying all the advances that affect our health are the basic elements of biochemistry. Take trans fats, for example. That evil hydrogenation process that makes those little cream-filled cupcakes all the more hardy is the addition of hydrogen to the carbohydrate molecules. Like a stopper in a drain, it blocks the oxygen atoms in the air that lead to spoiling from getting in. Through “hydrogenation,” though, the fats and oils become inert—and the shelf life of the little cream-filled cupcake extends into the next century.
But do you really want those same molecules floating around your digestive tract and bloodstream? (Hint: The answer is “No!”) Commercial baked goods may not succumb to the ill effects of oxygen and sunlight, but your system won’t be able to break them down as easily either. In other words, trans fats remain just as inert in your gut as they are on the grocery shelves. On the other hand, it is well established that high-fiber foods absorb fat and cholesterol as they travel down your digestive tract, reducing the amounts that the body absorbs. So, traditional biochemistry helps us understand the problem—and the alternative therapy of good nutrition helps solve it.
A Multifaceted Approach
Platitudes abound these days as everyone seems to be getting on the health-and-wellness bandwagon, but whom should we believe? And, why doesn’t our healthcare system concern itself more with wellness than illness? That is a question I am often asked. Well, happily—and increasingly—today’s medical practitioners are becoming more aware and supportive of the concept of integrative medicine, which combines traditional medicine with complementary therapies to treat the mind, body, and spirit, with a focus on prevention.
Indeed, when I first started developing the Better Than Before Ladder for cancer survivors, many were confused about what to do once their treatment protocol was completed. After I explained my multifaceted approach to Dr. Rodney Sherman, a renowned New York City oncologist, I was heartened when he agreed with the concepts and even offered to help further develop the program. “We in the medical profession, and particularly in oncology research and treatment, are justifiably proud of the enormous strides that have been made in both extending the lives of cancer patients and making their protocol less debilitating,” he told me. “Our main goal is to provide patients with optimal cancer treatment while working with them to maintain a high standard for their quality of life. As a result of these efforts, more and more patients diagnosed with cancer are living longer with a much greater potential for returning to a normal life.”
“It is not an easy task to help survivors get back the satisfying quality of life they desire. Doctors cannot do it alone, and too often patients cannot do it either—it must be a team effort. Once their treatments are completed, it is up to the survivors to take over. We know they need to make certain lifestyle changes in order to achieve their goal—improved attitude, proper nutrition, easy exercises, renewed beauty and self-esteem, alternative medicine, family support, a heightened imagination, a connection to a higher power, and an opportunity to give back to others.”
—Dr. Rodney Sherman, Oncologist
Dr. Sherman was convinced that once survivors started incorporating simple changes, such as a positive attitude, proper nutrition, and family support, into their daily routines, they could better appreciate their second chance at life and enjoy it even more than they did before—further evidence that I was on the right track!
My personal journey over the past few years has made me eternally—or shall I say, internally—grateful to the miracles of modern orthopedic medicine. As for my husband, The Lawyer, he has three invisible drug-eluded coronary stents that undoubtedly saved his life. (He claims genetics are at fault, although I’m convinced it was his premarital diet.)
Yet those who know me realize that structuring my career around working with doctors—for my columns, radio show, and now this book—was perhaps ill-advised. You see, I am a confirmed hypochondriac who lives by a disease-of-the-day book. (But there is no guarantee, alas, that today’s disease—hives—won’t ultimately require a heart transplant.) Actually, I like to refer to myself as a “health alarmist,” although under either name it leads to the same emergency rooms. Every illness that a doctor (or a chance acquaintance) mentions to me, I either think I have or I start to immediately experience the symptoms. I am always certain that I have come down with something both life-threatening and trendy—like the Andromeda Strain. And every time I take a walk by a medical office, I am tempted to run in for a quick CT scan, cardiogram, or complete blood count—just to be sure.
However, my personal neuroses aside, I advise getting regular check-ups and preventive screenings, which can be life-saving. If you are currently suffering from symptoms, I strongly suggest your condition be appropriately diagnosed by medical experts and that you are on the appropriate protocol, if necessary.
Have Some Faith
Doctor’s Orders is the first rung of your climb up the ladder because it is the starting point from which most of us base our personal efforts toward better health and well-being. Of course, the odds of a doctor’s advice working for you often depend on your trust in him or her. Having faith in your physician will not only help you maintain a positive attitude, but you will also be more likely to follow the prescribed treatment. So, if you don’t believe in your doctor, find another one!
In order for you to develop that comfort level with a physician, come to the visit prepared with a list of questions and engage him or her in a two-way conversation. If you read an article or have information related to your condition, bring it to his or her attention and ask if it is relevant to your care. If you are unable or uncomfortable speaking up, designate someone who will advocate for you. Or have a friend, relative, or caregiver go with you and speak on your behalf. Also, the person you bring to your appointment can help you remember and digest all of the information provided. The more you know, the more you will be prepared to make the right decisions. Trust your inner voice and then act on what it tells you; because even when you have confidence in your physician, you must still be your own health advocate.
In Control
What makes a person at risk for illness? Some factors, such as age, ethnicity, and family history, are out of our hands. However, experts believe that up to 80 percent of illnesses, such as heart disease and type 2 diabetes, can be prevented by lifestyle changes. In other words, while genetics may load the gun, lifestyle pulls the trigger.
Even if you are receiving treatment and taking medication for a condition, adding simple disciplines to your everyday regimen can help you achieve optimal health. Not only will healthy habits make your medication or other treatments work more effectively, they may reduce or eliminate the need for medication.
Ultimately, following doctor’s orders and adopting healthy habits are the best prescription for wellness. We can find examples of how that “prescription” works in nearly every condition. While we can’t possibly cover every ailment in this book, let’s look at the top six maladies, starting with cancer, which is where I first began my professional odyssey so many years earlier.
When it comes to illness and longevity, there are some people who seem to defy the odds. Take, for instance, someone touted as the world’s oldest person—she is a member of the Kaxinawá tribe, found in the Brazilian Amazon. At 120-years-old, she believes her longevity is due to her lifestyle. She eats no salt, sugar, or processed food, but sticks to Amazonian staples such as monkey, manioc, and banana porridge. (Try finding that mix at your local Trader Joe’s!)
The Big C
Cancer is the diagnosis everyone fears, and there is no single remedy for survivors. However, Jackie’s story has much in common with many of the survivors with whom I spoke.
“I noticed an unusual lump during a breast self-exam,” she begins. “Although I knew something was different, I convinced myself it was nothing and pushed away any lingering fears. After all, there was no family history of breast cancer.” Eventually, the nagging feeling that followed her as she went about her daily routine won out, and she called her physician who referred her for a mammogram. That decision, along with the care she received, probably saved her life.
Her doctor was concerned enough with the results to suggest a biopsy. Jackie, though, was aware of what can go wrong in medical settings. So she insisted on a DNA-matching test to confirm that the surgical biopsy samples being evaluated actually belonged to her and that there hadn’t been any mislabeling or contamination. She was still shocked to learn that she had stage IIA breast cancer, but knowing that the DNA matched eased her worry that it might be someone else’s result.
Jackie’s medical team recommended immediate surgery followed by a chemotherapy protocol. It has been a few years since her diagnosis, and she is now cancer free. Still, to lower the risk of recurrence, she will continue to take medication for five years, which also serves as a daily reminder that she is a breast cancer survivor. Additionally, she started following a ketogenic diet (low carbs, no sugar) under the supervision of her doctor and has returned to the gym. Given this second chance, Jackie is determined to live as healthy a lifestyle as possible so that she can be even better than before.
Jackie hopes that others will learn that it is always best to take that extra step when it comes to your health. “Whether it’s making an appointment with your doctor or requesting a test that prevents medical errors that can typically go unnoticed, you’re worth it. And it could be a matter of life—or death.”
To that end, I asked a group of leading specialists for their advice on how to start the process. Dr. Andrew Kenler, an assistant clinical professor of surgery at Yale Medical School who specializes in laparoscopic surgery and treatment of diseases of the breast, suggests: “Before you have a test or procedure done, understand what steps your doctor should be taking to prevent medical errors.” When a patient comes into his office to get a biopsy taken, many are unaware that a standard biopsy process includes more than 20 steps, with multiple individuals in different locations handling the specimen. He explains that, at each step, human error can play a role, but a patient’s own DNA can ensure this doesn’t happen. “A Washington University study that was published in the American Journal of Clinical Pathology found that specimen contamination and mislabeling occurs in 3.5 percent of all biopsies.”
Dr. Deanna J. Attai, the president-elect of the American Society of Breast Surgeons, who focuses her practice exclusively on the care of patients with benign and malignant breast conditions, recommends researching your diagnosis but making sure that you are conducting directed research. “Many patients make the mistake of looking up their disease online, but they don’t really understand their specific condition, rendering much of the information irrelevant. Ask your physician to recommend reputable references, and be sure that you have enough information about your condition so that you spend your time reading articles most relevant to your unique situation.”
The doctor also says to never be afraid to get a second opinion, even if it simply reinforces what your physician has already told you. Most physicians do not take it personally if a patient seeks one, especially when it involves a serious illness or major invasive procedure. Remember to get another opinion not only on the diagnosis, but also on the treatment plan.
We also owe it to ourselves to improve the success of any treatment by adopting healthy habits. There is an abundance of evidence to support the fact that proper nutrition, exercise, and relaxation techniques can help cancer patients both during and after treatments. (We’ll talk more about these as we climb the Ladder.)
The Shape of Your Heart
People may not fear heart disease as much as cancer, but the prognosis is every bit as serious. It is, in fact, the number one cause of death due to illness in this country. And it affects men and women alike, although men generally develop heart disease up to 10 years earlier. For females, the onset often comes after menopause, in part due to the lack of estrogen, which has protective effects.
So when The Lawyer with the three coronary stents announced to the waiter, “I’ll have the steak,” I was understandably upset, even though he asked for a lean filet mignon. Judging by the look of self-satisfaction on his face, he was obviously proud of himself for not ordering what he really wanted—the marbled prime rib.
I couldn’t resist responding, “While you’re at it, dear, why don’t you have cheesecake for dessert, just in case you have any arteries left unclogged.”
I would be remiss not to mention that The Lawyer, dietary deviations aside, is in very good shape for a man his age and is extremely aware of what constitutes a healthy lifestyle. (Thanks to me, naturally.) But that doesn’t always mean he makes the wisest menu choices when it comes to his heart. He, of course, swears that a genetic predisposition—and my constant nagging—are the primary culprits for his prior coronary clogs. Therefore, I frequently remind him (always in calm, constructive tones), that he is just plain wrong.
Dr. Gordon Tomaselli, former president of the American Heart Association (AHA) and chief of the Division of Cardiology at Johns Hopkins University, backs me up on this. One in three Americans has some sort of cardiovascular disease, which can include hypertension (high blood pressure), coronary artery disease, heart failure, or arrhythmias (irregular heartbeat). He attributes a new uptick in coronary crises to a sedentary lifestyle, obesity, diabetes, smoking, and diets rich in processed foods.
Dr. Tomaselli stresses that we must turn our attention from risky to healthy behavior. For a start, that would include what the AHA refers to as Life’s Simple 7:
1. Get Active
2. Eat Better
3. Lose Weight
4. Stop Smoking (smoking damages your entire circulatory system and increases your risk for coronary heart disease, hardened arteries, aneurysm, and blood clots)
5. Control Cholesterol
6. Manage Blood Pressure (normal is less than 120 mm Hg systolic and less than 80 mm Hg diastolic or <120/80)
7. Reduce Blood Sugar
When it comes to getting active, there is a preponderance of evidence that shows exercise can strengthen your heart, lungs, and blood vessels. The AHA recommends 150 minutes of moderate-to-vigorous activity a week, which can be broken down into sessions of as little as 20 to 30 minutes of activity five or six days a week.
Eat better to lose weight, control cholesterol, manage blood pressure, and reduce blood sugar. Fat—especially if a lot of it is around your waist—puts you at higher risk for many health problems and is especially bad for your heart. According to the AHA, if your body mass index (BMI, a measure of body fat based on height and weight) is 25.0 or higher, you will benefit by bringing your number down below 25. If your BMI is 30.0 or higher, you are at significant risk for heart health problems.
“If a person has had a coronary event in the first place, then clearly life changes need to be made,” says Dr. Suzanne Steinbaum, director of Women and Heart Disease at the Heart and Vascular Institute at Lenox Hill Hospital in New York City and a spokesperson for the American Heart Association. “Eighty percent of the time you can prevent a repeat performance by making healthy lifestyle choices. Start by incorporating fruit, vegetables, whole grains, legumes, beans, olive or canola oil, and fish into your diet, and getting rid of all the saturated fats and simple ‘white’ carbohydrates, such as rice, pasta, bagels, and potatoes. Know that exercise is the best medication, and don’t forget to smile and breathe. Believe it or not, perspective is everything, and being pessimistic and hostile can be damaging to your heart. On the other hand, having a positive outlook and a glass-half-full approach can help your heart’s vitality and spirit.”
Studies presented at a recent AHA’s Scientific Session confirmed that women who drank more than two sugar-sweetened drinks a day had increasing waist sizes but weren’t necessarily gaining weight, reports Dr. Christina Shay, lead author of the study and assistant professor at the University of Oklahoma Health Sciences Center. “These women also developed high triglycerides, and women with normal blood glucose levels more frequently went from having a low risk to a high risk for developing diabetes over time.” This put them at higher risk for a heart attack.
Lack of exercise and an unhealthy diet, along with smoking and genetics, are unquestionably the most important risk factors for heart disease. But stress is also a huge factor. So “it is critical to make the connection between your emotional health and the health of your heart,” says Harvard assistant professor of psychiatry Dr. Paul Hammerness. “At its extreme, heart injuries and heart failure can occur during severe emotional stress. This is called stress cardiomyopathy, or ‘broken-heart syndrome.’ Less dramatic but far more common examples,” he claims, “include the well-known impact of anxiety and depression on heart disease and recovery from heart disease.” And as corroborated by a major and well-regarded Danish study, he notes that the relationship between mood/anxiety and heart disease appears to be a “dose-response relationship,” meaning that greater sadness and anxiety lead to greater heart disease and/or worse heart outcomes.
Therefore, one key step in caring for your heart is caring for your emotional health and working diligently to reduce levels of stress in your life (see Rung 2). When all is said and done, a calm, organized life may actually save your life.
Of course, along with these lifestyle changes, it’s important to have your blood pressure, cholesterol levels, and blood sugar tested regularly. If you already suffer from hypertension, high cholesterol, or elevated blood sugar, more frequent monitoring is required.
Bone Up on Your Bones
Arthritis
Less fatal, but considerably more common, is the pain and debilitation of arthritis. About 50 million Americans have been diagnosed with one of the seven common forms. Yes, I am one of them. But it would take another book to tell you the stories about my recent hip replacement!
“Arthritis is a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions, divided into three major categories: osteoarthritis, rheumatoid arthritis, and juvenile arthritis,” says Patience White, M.D., professor of medicine and pediatrics at the George Washington University School of Medicine and Health Sciences and vice president of public health for the Arthritis Foundation. “Although common belief is that arthritis is a condition affecting the elderly, two-thirds of people with arthritis are under the age of 65, including 300,000 children. Also, arthritis affects people of all ethnicities.”
The vast majority of current sufferers, about 27 million Americans, have osteoarthritis (OA), which is characterized by a breakdown of joint cartilage. The rest of arthritis sufferers have the more severe form: rheumatoid arthritis. Per Dr. White, “rheumatoid arthritis (RA) is characterized by inflammation of the membranes lining the joint. Although it can strike at any age, women are typically diagnosed between the ages of 30 and 60, while male patients usually are older. There are about 1.5 million affected individuals in the United States. Finally, juvenile arthritis (JA) is a term used to describe many autoimmune and inflammatory conditions that can affect children ages 16 and younger.”
The disease takes a heavy toll. “Each year, arthritis accounts for 44 million outpatient visits and more than 900,000 hospitalizations. In fact, it’s the leading cause of disability in the United States and is a more frequent cause of activity limitations than heart disease, cancer, or diabetes. By some estimates, 67 million Americans will have arthritis by 2030.”
So what can we do? Knee, shoulder, and, of course, hip replacements are the drastic remedies. And they are really the only full cures, since bone spurs and lost cartilage simply will not dissolve or regenerate in our present state of technology. Most arthritis sufferers, though, are not there yet. As even my orthopedic surgeon, Dr. Roy Davidovitch, director of the New York Hip Center, NYU Hospital for Joint Diseases will agree, it’s only when your lifestyle is completely compromised and you can’t take another moment of pain that you have to bite the bullet and get the joint replaced.
However, there is much to do in between. Says Phyllis Crockett, DPH, in the Express Scripts Rheumatoid Arthritis and Inflammatory Disease Therapeutic Resource Center, “Each patient is different, and a physician can help determine the best treatment plan, including managing the symptoms and pain of arthritis, starting with exercise. It is a valuable tool in the fight against arthritis. Osteoarthritis and RA patients particularly can benefit from both endurance and resistance training.”
Maintaining a healthy weight and protecting against joint injury can help prevent OA. “Every pound of weight lost reduces the pressure on each knee by four pounds. Even a small weight loss can be a big help in fighting it.”
For patients who are already on medication to treat the condition, adherence—taking medications as prescribed—is critical to healthier outcomes. But never self-medicate! “Combining over-the-counter medications with prescription medications can be risky and can cause side effects, such as an increase in gastrointestinal (GI) irritation or a GI bleed. And don’t adjust doses or make changes to the medication regimen without checking with your healthcare team.” Watch for drug interactions. “Some common drugs like acetaminophen can have an interaction with arthritis medications. Limit intake, and remember that acetaminophen often is a component in common sinus, cough/cold, and pain medications.”
Diet can also play a role. Opt for an anti-inflammatory dietary regimen (see Rung 3—Nutrition) and go easy on acidic foods such as sugar, white flours, and alcohol. “Also, some foods and beverages can block the effects of arthritis medications,” Crockett adds. “These include grapefruit, apple, and orange juice, as well as milk and yogurt. Wait at least four hours after taking medications before eating or drinking these. Exact times can vary depending on the disease and the treatment. Check with a trained clinician.”
Arthritis, in its many forms, is a continuing challenge. But with continuing focus it is possible to manage it successfully.
Osteoporosis
While we are discussing bones, we need to talk about osteoporosis, literally porous bones. After you turn 50, it’s a good idea to measure your height every year, which will assess your posture and skeletal health. A decrease in stature can be as informative as a change in a bone density test for monitoring your overall bone health.
If your doctor determines that you have osteoporosis—or osteopenia, a precursor to it—it’s still no reason to stress. True, the diagnosis creates visions of shattered bones and rounded backs, but it may just mean that you have a higher risk for fractures. And in the past 15 years or so, doctors have learned a lot about how to prevent those breaks.
Says Ethel S. Siris, M.D., director of the Toni Stabile Osteoporosis Center of the Columbia University Medical Center at New York-Presbyterian Hospital, “We now know that bone density loss is tied to decreases in calcium and impacted by low levels of vitamin D. So just make sure you take enough calcium and vitamin D every day. I generally recommend 1,200 milligrams of calcium from food or supplements, and 1,000 to 2,000 international units (IU) of vitamin D.” Your doctor may also prescribe a bisphosphonate drug to lower fracture risk.
But don’t sit around in fear of breaking your bones, which can actually be counterproductive. Load-bearing exercise, such as walking, is good for all bones. An exercise routine can not only preserve bone mass, it can improve flexibility, strength, coordination, and balance—all of which can help a person avoid falls.
Don’t overdo it, though. And if you are close to someone with osteoporosis, try to sensitively steer her or him into sensible habits. As Dr. Hammerness advises: “Be clear about what concerns you, and get the facts so that you can have a reasonable conversation. Emphasize that you want your loved one to keep enjoying her favorite activities—as long as she makes her health an equal priority. If she’s a hiker, for example, propose that she go only in daylight, avoid areas known for unstable terrain, wear boots with good traction, carry a walking stick or trekking poles for balance, and take a hiking partner. Remind her that by minding her own safety, she can do what she loves for much longer.”
While for the moment, arthritis and osteoporosis may be incurable, the symptoms can largely or wholly be managed or even prevented.
Breathe Easy
There is nothing we take more for granted than breathing. Until we can’t! Many moons ago, working through weeks of intense negotiations in smoke-filled conference rooms, The Lawyer began to suffer from what he thought were allergies. He ended up in the hospital for eight days with pneumonia. Happily, antismoking rules and more powerful antibiotics lessen the incidences of that now. However, in its place, we have almost an epidemic of asthma and, whether you believe in global warming or not, seemingly the same for allergies, and the two can be related. So much so that 50 million Americans are affected by them, and the numbers are growing.
The first time I came face to face with asthma was when my daughter, Elise, was in ninth grade and I got an urgent call from the school nurse, who told me Lisi was having trouble breathing. I dropped everything and raced up to her school. When I arrived, her chest was tight and she was still coughing and wheezing—all classic symptoms of asthma. What possibly could have triggered this sudden attack?
The nurse had an answer: “It came on right after she ate a pear. Probably some chemical in the skin.”
As we drove off to the pediatrician, I noticed the nurse running after the car, frantically flailing her arms, a half-eaten pear dangling by the stem in one hand. She caught up and tossed in the offending fruit. “Here, take this with you,” insisted the nurse, no doubt a CSI devotee, “to be inspected.”
The good news? My daughter wasn’t poisoned. But we were faced with the diagnosis that she had childhood asthma. Fortunately, after a few years of needing an inhaler from time to time before she exercised, she eventually outgrew it. Nevertheless, to this day, she has never eaten another pear.
No one is certain what causes asthma—most scientists believe it is partly genetic, partly environmental—and while some children, like Elise, see symptoms resolve with age, there is no cure. It is known that inhaled allergens and irritants, such as smoke, pollen, dust, mold, and strong odors and fumes, as well as certain common products and foods, even a beloved furry pet, can cause the airways leading to the lungs to become inflamed and swollen. Furthermore, the difficulty in breathing experienced by asthmatics often leads to anxiety attacks. And when stress levels increase, so do asthma symptoms. It’s a vicious cycle.
Living with chronic asthma is challenging. So the first thing to do is to approach it head-on. “Managing asthma is a team effort,” advises Dr. Norman H. Edelman, the American Lung Association’s (ALA) leading medical authority. “Patients (or parents) should work with their healthcare provider to develop an ‘asthma action plan’ such as the one developed by the ALA, specifying medications and how to alter them if the condition worsens. For children, the action plan should involve teachers and school officials.”
It is important to know that asthma and allergy triggers can come from the unlikeliest of places. For example, our homes can carry five times more pollutants than stepping outside since we breathe the same air over and over again. And The Lawyer, who seems to be allergic to exercise classes, was thrilled to learn that triggers can also be found lurking in health clubs. Unfortunately, Richard Weber, M.D., former president of the American College of Allergy, Asthma, and Immunology Organization of America (ACAAI) confirmed his suspicions: “Not only can new workout routines be difficult for those with asthma or allergies,” he said, “but yes, many allergens that cause coughing, sneezing, wheezing, or rashes and watery eyes can indeed be found in gyms.”
So be wary of the following culprits:
• The Pool—If you are sensitive to chlorine and don’t have access to a saltwater pool that naturally disinfects the water, be sure to shower immediately after swimming.
• The Locker Room—A study published in the Journal of Environmental Health Perspectives found a link between triclosan, a common ingredient in antibacterial soap, and allergies. Since these cleansers are found in practically every locker room, bring along your own unscented products.
• The Mats (yoga or exercise)—According to the ACAAI, most rubber mats contain allergy-inducing latex and other available options could be laced with toxic PVCs. If you have had allergic reactions to either of these, it’s best to tote along your own mats made of hemp or organic cotton.
• Workout Outfits—The ACAAI recommends staying away from materials such as polyester and nylon, which can also be itch-inducing, especially anything that says it’s “odor-free” or “antimicrobial.” Better to look for natural fiber or naturally wicking wool.
Fortunately, allergies can usually be treated with over-the-counter antihistamines. If symptoms are more chronic, your doctor may prescribe medication to take on a regular basis or even desensitization shots. If you want to know what you are allergic to, you can see your local allergist and be tested.
Dr. Joan Lehach, an integrative medicine physician specializing in allergy, asthma, and clinical immunology at Montefiore Medical Center in New York City, offers a few suggestions on how those with pollen allergies can breathe a bit easier during the high-pollen times:
• If you live in a suburban area, keep your grass short and have someone else mow it. If you are going to do yard duty, wear a well-fitting allergy mask.
• Do not hang your wash to dry outside, because pollen bonds to fabric.
• Pollen counts are the highest early in the morning, between 5 AM and 10 AM, so do outdoor activities such as jogging in the evening or after 10 AM
• Pollen tends to stick to hair, so wash your hair more frequently.
• Keep your car windows and your windows at home closed, and put the air conditioner on. Use the recirculate button on your air conditioner so you are not bringing pollen in from outside.
• Beware of fruit. Because the proteins are similar, your body can mistake fruit for pollen and create some mild local reactions. Those who are allergic to trees should avoid apples, peaches, and pears. If you are sensitive to grass, avoid melons, celery, and kiwis because they can trigger an itchy mouth and throat.
Following these suggestions, along with carrying your inhaler if need be, will allow you to breathe easier wherever you go.
Forget Me Not
When my three kids were 4, 10, and 14, I took them on one of our weekly massive food shopping expeditions. We dutifully reloaded our shopping cart with the customary slew of bags at the checkout counter. Then off we went to load our SUV, which was parked on the street because the supermarket lot was full. After making sure that everyone was securely buckled in, we headed home.
As soon as we arrived, the boys jumped out and left me to tend to the bags in the back. (Typical!) However, there were no bags.
“Boys,” I said in the calmest tone I could muster under the circumstances, addressing the two older offspring, “what happened to the shopping bags?”
They simply shrugged disinterestedly, but my little daughter, obviously feeling bad at how frazzled I was becoming, finally chirped, “I think we left them on the ‘stweet.’” Great!
At the time, I chalked it up to my mind being overwhelmed, and therefore overstressed and forgetful. Of course, if anything like that happened today, I would fear more ominous implications. The older we get, the more we tend to worry about losing our minds—literally! And while I’m not yet at an age when statistically I should be concerned about either dementia or Alzheimer’s disease, there is a family history. So every time I can’t find my keys or I’m madly looking for my lost cell phone—only to discover that I happen to be talking on it at the time—I fear the worst.
“How do I know if I have Alzheimer’s,” I recently asked a leading Manhattan neurologist. “I tend to lose things, and it’s beginning to upset me.”
“Well,” he explained, “everyone misplaces their keys, for example, every now and then. It’s when you are actually holding them in your hand and you don’t know what to do with them that you should begin to worry.”
Alzheimer’s disease (AD) is anticipated to be the largest health crisis of our lifetime. Already, it is the sixth leading cause of death in the United States and more than five million (one in eight) older Americans suffer from it. Happily, there is new scientific research and evidence that suggest patients may be able to delay or prevent the onset of AD with a careful diet. At the helm of this research are Harvard-trained neurologist Dr. Richard Isaacson and nutrition researcher Dr. Christopher Ochner. They contend that targeted nutrients and aggressive dietary changes could improve memory in AD patients and those with mild cognitive impairment (MCI). In fact, following a brain-healthy diet will benefit anyone who’s over age 40, has a family history of AD, or is experiencing problems with memory.
The doctors believe that nutritional interventions can indeed buy time for AD patients and their families. And thankfully, scientists have found a predictive marker for AD, a protein called amyloid beta that can be detected up to 25 years before the onset of the disease. “This gives future AD patients time to implement neuroprotective measures,” advises Dr. Isaacson. “And new research shows that specific nutritional interventions may delay the onset of AD in memory-compromised patients by two years—potentially long enough for a cure to be discovered—and improve memory function in AD and MCI (or pre-AD) patients, a win-win for the patient, family, and caregivers.”
Here are the doctors’ 10 memory-boosting dietary recommendations, based on the latest scientific research and their clinical experience treating patients with AD and MCI:
• Portion Your Macronutrients—Every day, aim for 25 percent of your total calories from fat (but less than 7 percent saturated, or “bad” fat); 30 percent to 45 percent from complex carbohydrates (fruits, vegetables, and whole foods that are low on the glycemic index); and 25 percent to 35 percent from high-quality lean protein.
• Wean Yourself Off High-Glycemic Carbs—These include sugars, high-fructose corn syrup, processed cereals and grains, ice cream, crackers, salty snacks, such as chips and pretzels, and anything made with refined white flour.
• Have More Good Fat and Less Bad—Brain foods high in good fats include olive oil, avocados, natural peanut butter, and certain fish. Foods high in bad or saturated fat include most fast foods, anything hydrogenated, dried coconut, butter, animal fats, milk chocolate, and cheese.
• Boost Your Omega-3 Intake—Omega-3 fatty acids (DHA and EPA) are essential for memory function and brain health. Most of us don’t get enough from dietary sources (such as fish), so consider high-quality pure fish oil supplements that contain a minimum of 250 mg of DHA in each capsule, and aim for 1,000 to 1,500 milligrams (mg) of DHA daily if approved by the treating physician.
• Feed Your Brain Antioxidants—Antioxidant-rich foods are great for mental function. Some of the best are berries, kale, 100 percent pure unsweetened cocoa powder, mushrooms, onions, beans, seeds, sardines, trout, and Alaskan wild salmon.
• Consume Enough Brain Vitamins—Ensure adequate intake of folic acid, B6, B12, and vitamin D in particular. If you’re not eating vitamin-rich foods on a regular basis, it’s good to supplement as needed in pill or liquid form.
• Choose Whole Foods—In general, whole foods have only one ingredient—for example, strawberries or broccoli. If you must have a convenience (manufactured) food on occasion, find those items with the fewest ingredients, especially ingredients that you readily recognize and understand.
• Opt for Low-Fat or Non-Fat Dairy—Any recipe you make can be just as good with non-fat versions.
• Enjoy a Cup or Two of Coffee—Caffeinated coffee, one to three cups early in the day, may be beneficial over time to your brain. Studies done in Europe over several years demonstrate that men who drank coffee regularly showed less of a decline on memory tests than those who did not drink coffee.
• Fast 12 Hours at Night—If you routinely wake up at 6 AM, try to eat your last meal at 6 PM the night before. There is scientific evidence that substances called ketone bodies, which are produced when there are no carbohydrates to burn for fuel, may have a protective effect on brain cells.
It is important to note that just like the muscles in your body benefiting from a workout, exercising your brain on a daily basis is critical for successful aging. In fact, research now suggests that regularly engaging in activities that stimulate the brain, such as doing crossword puzzles, playing chess, or reading, may help improve memory, enhance motor skills, and reduce the risk of getting dementia. Above all, stop worrying that you might have Alzheimer’s! Stress takes its own toll. So relax! Just remember the next time you inadvertently place your iPhone on the roof of your car while you are fumbling for your keys and then drive off with it still there (who me?) that you can still have many memorable years ahead if you watch your diet and give your brain a regular workout.
Fighting Depression
Emotional well-being is the next rung on our ladder, but I wanted to talk about depression from a medical standpoint. Clinical depression is a serious, but treatable, illness that affects millions of people. In fact, one in eight U.S. workers has been diagnosed with depression, according to a recent Gallup poll. Many “look perfectly fine, yet are suffering tremendously on the inside,” says Massachusetts General Hospital’s Dr. David Mischoulon, also an associate professor of psychiatry at Harvard Medical School. “Even as more companies offer wellness programs to promote good health, depression continues to take a toll in the workplace.”
Interestingly enough, depression doesn’t always manifest as sadness. Indeed, some chronically depressed people may just feel empty and apathetic, losing their passion for life. Trouble sleeping, loss of interest in pleasurable activities, feelings of guilt or hopelessness, decreased energy, trouble concentrating, appetite changes, and even suicidal thoughts or attempts have all been reported. One in six people will develop major depression in his or her lifetime. Surprisingly, two out of three individuals with depression do not receive adequate treatment, but it’s important to realize that help is available and you can get better.
Clinical depression is generally caused by a combination of genetic, biological, environmental, and psychological factors. Furthermore, people with depression are more likely to have other medical conditions such as heart disease or diabetes, and they are also less apt to follow therapy for those problems, adding to their disease burden.
If you suspect depression, it’s important to be diagnosed by a physician and explore treatment options. If you and your doctor determine that taking an antidepressant is the best course of treatment, Callie Carter, a specialist pharmacist in the Express Scripts Neuroscience Therapeutic Resource Center, suggests a few important tips to keep in mind:
• There is usually a lag of two to three weeks before medications begin to relieve symptoms of depression. It may take up to six weeks to see the full benefit, so be patient.
• Discuss symptoms that have not improved with your doctor. A different dose or medication may be needed.
• Antidepressant medication generally should be taken for at least six to nine months after a first episode of depression. The duration may be longer for subsequent episodes. Talk with your healthcare provider about the length of treatment, since early discontinuation increases the risk of depression recurrence.
• When antidepressants are discontinued, they should be tapered over two to four weeks to minimize side effects associated with abrupt cessation of therapy.
Chronic depression may be a terrible disease to live with, but once you find the right therapy you will happily discover a life that is indeed better.
At the end of the day, it is important to follow your doctor’s orders. But be sure to be your own doctor, as well. I am a strong believer that taking your health into your own hands is not only empowering—it’s an essential part of your journey to improved wellness.
