Archive for the ‘Simple Remedies’ Category

Athlete drink

I’m often asked by patients how much water they need to drink each day. The Institute of Medicine has calculated that men need about 13 cups or three quarts of liquids and women need about nine cups or two quarts of liquids daily. We also ingest approximately 2 ½ cups, or 20 percent of our daily intake of liquids from food, especially fruits and vegetables. In addition, beverages that we commonly drink such as coffee, juice, milk and soda are composed mostly of water.

Water makes up 60 percent of our body weight. Every cell and system of our body depends on water. Lack of water causes dehydration, a condition that occurs when the body receives an inadequate amount of fluids, which in turn slows down and eventually shuts down vital bodily functions.

Our bodies constantly lose water from perspiring, breathing, urinating and having bowel movements.

Various factors determine just how much more water we may need to drink, such as:

– Environment — Hot weather, especially with high humidity, increases perspiration. Even in frigid weather, water is lost from our bodies when breathing during activities such as skiing or hiking.

– Exercise —Also increases perspiration. The more prolonged and intense the exercising, the greater the fluid loss is.

– Illness — Intense or prolonged vomiting and/or diarrhea can lead to life-threatening dehydration. This is an unfortunate cause of death in many developing countries.

– Pregnancy and breast feeding — Increases women’s fluids needs.

After hours of prolonged exercise with heavy sweating we lose electrolytes, especially salt. This is when drinking a sports drink is recommended because it will not only replace the lost water but also the depleted electrolytes. Electrolytes lost through sweat from mild to moderate exercise, can be replaced from the food we eat.

Some liquids can act as a diuretic, which means they cause you to urinate more liquid than you’ve taken in. Caffeine is often implicated, but is really a weak diuretic. Alcoholic beverages on the other hand, especially at higher quantities, can be very potent diuretics causing dehydration which is a major cause of a hangover.

A rough guide as to whether or not you are consuming enough water is to check your urine color. If it appears light yellow, like lemonade, you’re probably well-hydrated but if it is very dark yellow, like apple juice, you need to drink more water.

To keep your body healthy:

– Drink a glass of water or other low or non-calorie beverage with each meal and between each meal.

– Drink water before, during and after exercise.

Bottoms up!

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From time to time, I’ll write about various vitamins and how they affect our health. But what exactly is a vitamin?

A vitamin is an organic substance essential in small quantities to normal metabolism. It is found naturally in various foods, but it can also be produced artificially. A lack of vitamins can produce certain diseases.

Vitamin D has received quite a bit of press these days both in medical literature as well as in newspapers and magazines.

Vitamin D is the only nutrient the human body makes itself. Ultraviolet rays from sun exposure interact with a chemical in the skin to form an inactive version of vitamin D, which is then converted in the liver and kidneys into an active version useful to our bodies.

Because people have been warned to wear sunscreen and to limit sun exposure, though, we might not be able to manufacture enough of this vitamin on our own and may need to look for other sources.

Vitamin D can be found in a limited number of foods, including fatty fish, fish liver oils, liver, and egg yolks. Commercial milk products, breakfast cereals and juices are often fortified with low levels of vitamin D. People don’t usually eat enough of these foods to consistently cover their daily vitamin D requirements, though.

The primary benefits of vitamin D for our bodies are these:

• Bone health: Vitamin D helps the body absorb calcium and phosphorus, which are two minerals needed for strong bones. People taking vitamin D have a lower risk of bone fractures and also have been found to have a lower chance of falling in the first place.

• Brain function: People with higher blood levels of vitamin D have higher cognitive performance, including memory and thinking skills.

Low levels of vitamin D, by contrast, have been associatedwith some increased risks: cancer of the colon, breast and prostate; arthritis; diabetes; and infections, such as tuberculosis.

The accepted recommended daily dose of vitamin D is 400 to 600 international units per day. Most common multivitamins contain 400 IU. Momentum is building within the medical community to increase the daily recommended dose to at least 800 to 1,000 IU. From what I can tell, this is a reasonable recommendation. The higher level should help to strengthen bones and muscles and hopefully prevent a variety of diseases, such as those I have mentioned.

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As we prepare to leave the old year behind and greet the New Year, I would like to propose the following health-related resolutions:

• If you smoke — quit.

• If you drink alcohol, do so in moderation.

• Develop a routine exercise program and stick with it.

• Improve your diet — increase fruits and vegetables and decrease fats and carbohydrates.

• Buckle up every time you enter your car.

• Don’t talk on your cell phone while driving. It’s not only very dangerous, but also now illegal.

• Get regular dental checkups and eye exams.

• If you are overweight, try to lose weight. If you can’t, at least remain physically fit.

• Use sunscreen when outside during the sunny months.

• Routinely examine your skin for any unusual changes.

• Keep your immunizations up to date — all the usual vaccinations that babies and children receive, as well as a diphtheria-tetanus booster every 10 years for adults and a yearly influenza vaccine.

• Have your blood pressure checked at every health care visit.

• Have a pap test for women beginning at age 20, continuing per doctor’s recommendation.

• Have a cholesterol level test starting at age 20.

• Have a clinical breast exam and mammogram for women beginning at age 40 per doctor’s recommendation.

• Have a blood sugar test starting at age 45.

• Have a colon screening (colonoscopy) beginning at age 50.

• Have a prostate exam for men starting at age 50.

• Do not climb ladders. (This is personal experience speaking.)

• See your doctor sooner rather than later if you have a strong family history of any significant medical problems, such as cancer, heart disease, diabetes, high blood pressure, etc.

• Avoid stress. Relax and honestly try to enjoy your life, whatever your circumstances.

After having practiced medicine for more than 37 years, I can assure you that following the above resolutions will very likely add years of healthy living to your life.

This month will mark the beginning of three years of writing this column. Reader feedback has been beyond expectations, for which I am very grateful. Please contact me if you have requests for medical topics that are important to you or that might have a broad reader appeal.

Happy healthy holidays!

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Over-the-counter cough and cold medications to alleviate cold symptoms in young children are being withdrawn from pharmacy shelves. This is because of unintentional misuse or of overdose of these medications, causing harm and, rarely, death, especially in children younger than 2.

These medications are frequently used in good faith, even though there is no scientific proof that these drugs are actually effective. This is a case where the risks outweigh the benefits.

Health care providers are now asked to advise not using these drugs for children younger than 6. Some of the most commonly used drugs in this category are PediaCare, Triaminic and Dimetapp.

I know this may sound discouraging when caring for a sick child, but there are very useful non-drug treatments for cold and cough symptoms:

  • Encourage the child to drink plenty of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus. The fat in milk does combine with saliva in the mouth, causing a slimy sensation, but that’s not harmful.
  • Fever or pain can be controlled using either acetaminophen (Tylenol) or ibuprofen (Advil), giving accurate and consistent doses every six hours.
  • Saline irrigations: For infants, use rubber bulb suction with saline nose drops to remove mucus. A saline nose spray can be used for older children.
  • Use a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water should be replaced daily and the machine cleansed regularly according to the manufacturer’s recommendations. Keep indoor relative humidity at about 40 percent to 50 percent
  • If a medication such as Tylenol or Advil is given, I do not advise the use of household silverware spoons to measure doses of medication. Common teaspoons can vary, holding anywhere from 2 to 10 milliliters (mLs) of liquid, which could cause either an under- or overdose of a medication. Proper measuring devices using units of milliliters usually come with the medicine or can be obtained from the pharmacist.
  • Honey can relieve coughs by increasing saliva, which coats the throat and relieves irritation. Suggested doses are half a teaspoon for children between 1 and 5 years, 1 teaspoon for children 6 to 11 years, and 2 teaspoons for children 12 years and older. Do not give honey to a child younger than 1 year old.

See your health care provider immediately for any of the following cases:

  • A child younger than 2 months of age with any fever
  • A child younger than 2 years with a fever that lasts longer than two or three days
  • A child who complains of an earache or a severe sore throat
  • A child who has thick green nasal discharge for more than 2 weeks
  • Mild symptoms that fail to improve after 10 to 14 days
  • Any child who seems very ill to you

By the way, for children who have been appropriately prescribed antibiotics, I am frequently asked whether the drug needs to be refrigerated. The two most commonly prescribed antibiotics, Amoxicillin (which tastes like bubblegum or occasionally is fruit-flavored) and Zithromax (which has a cherry-vanilla-banana taste), can be kept at room temperature for as long as 10 days. Refrigeration may improve the taste, but it isn’t needed to maintain potency.

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