Archive for January, 2007

How To Treat A Sprain: Can We Use Warm or Cold Pack?

January 31, 2007

27470618731.jpgAfter an injury from sports or just a mere accident from a simple jogging exercise or walking, a sprain can be disabling enough due to pain.  So what needs to be done if this happens: can we put ice pack? or how about warm compress?

Here’s a Healthy Practice Tip:

Actually both can be applied to the injured site and can be used alternately.  The purpose of applying heat is to relieve the swelling to the injured site by relaxing the muscles and allowing blood to flow to the injured site.   It is said that moist heat is more effective than dry heat, so you can actually use a moist towel- make sure it’s warm rather than hot to prevent burns or rather still… take a hot bath or shower.  Apply warm pack to the area 2-3x a day.

On the other hand,  the purpose of using a cold pack to the injured site is mainly to reduce pain by numbing the injured area.  Likewise cold compress can reduce the swelling as long as ice is applied at least twice a day, for about 15 minutes at a time.  What I usually do is do is use pre-made ice packs that I always keep in my refrigerator.  Other alternative is to put some ice cubes in a plastic bag or a towel.

So the next time somebody has a sprain in the family… you know what to do….

Warm or Cold: Both Can Do The Job!

Read My Other Healthy Practice Tips:

Weight Loss Surgery: Is It For You?

January 27, 2007

2459156720.jpgIn one recent survey, weight loss surgery is now increasing as a preferred way of losing weight in the US especially among baby boomers.  In a report by  Zhao published in Healthcare Cost and Utilization Project Statistical Brief#23, Agency for Healthcare Research and Quality in January 2007, “more Americans are turning to weight loss surgery and that an increasing number of younger people are undergoing these procedures.” 

In my practice nowadays, our center is also getting more patients requesting for weight loss surgical procedures.  Cebu Doctor’s University Hospital has the required facilities to do the procedure.  But who are candidates of these procedures?

Ask Yourself These Questions:

  • Do you have a BMI of 40 or more?
  • Are you suffering from mechanical problems due to obesity like arthritis or difficulty getting employment because of your weight affecting your work?
  • Are you suffering form obesity related medical complications like diabetes, hypertension, sleep apnea or heart disease?
  • Have you tried unsuccessfully other non invasive techniques of losing weight especially behavioral therapy?
  • Are you well informed that the procedure may entail some risks?
  • Are you really determined to lose weight and improve your health and has thought about it for quite sometime?
  • Are you ready to change you way of life and some habits after the operation?
  • Do you know that you may need and be committed to life-long medical follow-up?

The most difficult part in weight loss surgery is if a patient does it solely for cosmetic reasons and not health and hasn’t focused enough to know the difference.   For me… I always tell my patient that…

 “To be Successful Requires More Than Want But NEED!… The need to promote, preserve and enjoy health!” 

It is also very important that the patient needs to understand that there is a difference between: “I want to eat but I cant! “and “I don’t want to eat because I’m full!”  Once you have undergone gastric weight loss procedures like gastric banding… you’re desire to eat remains but you cant because you feel full easily.  This is where discipline to stop eating or face the risk of vomiting complications come in!  I always tell my patients: it’s like having the desire but you cant because you are impotent.  If you are not ready to face this challenge then the procedure is not for you!

 If you have answers to each question and we deemed you as a candidate for surgery then off you go…..

Weight Loss Surgery: Another Option For Health!

Read My Other Related Posts:

Tips on How To Stick To Exercise

January 25, 2007

exerc1.jpgConvincing patients to exercise can be tough… not only does it need discipline and determination but the harder part is how to plan ahead that this patient will stick to the regimen. 

The idea of losing weight can be attractive but doing it is another story. Going through my recent posts on weight loss tips: a simple way to lose weight using the food diary, eating the right food choices and benefits of increasing physical activity…this time I thought it would complete the package by sharing with you some tips on how to stick to a regimen.  It is as important as having a goal and achieving that goal… so that all we need to do is to stay focus to be successful!

  • Make sure it’s a regimen you like doing.  Read, listen to music using your iPod or watch TV while while doing the treadmill.
  • Being with someone else can make the activity more fun and exciting.
  • Dont do the same routine everyday because it can get boring.
  • Check the weather… check the area where you plan to exercise.  Make sure its comfortable and you’re comfortable too…meaning- never exercise right after eating.

Remember…exercise for fun and health. Be focused and determined to make exercise a lifestyle more than just a habit!

Lastly… the American Academy of Family Physicians provided more tips  which I found helpful and simple:

Making exercise a habit

  • Stick to a regular time every day.
  • Sign a contract committing yourself to exercise.
  • Put “exercise appointments” on your calendar.
  • Keep a daily log or diary of your activities.
  • Check your progress. Can you walk a certain distance faster now than when you began? Or is your heart rate slower now?
  • Ask your doctor to write a prescription for your exercise program, such as what type of exercise to do, how often to exercise and for how long.
  • Think about joining a health club. The cost gives some people an incentive to exercise regularly.

Exercise For Fun and Health…Stick To It For Life!

Read My Other Related Posts:

Foods To Avoid If You Have Heartburn

January 23, 2007

3464601270.jpgDue to missed meals as a result of too many activities and too little time… most of us suffer from dyspepsia or ulcer like symptoms.  One other acid related symptom that can result from the acid from the stomach to splash into your esophagus is called heartburn.  This will feel like heart attack and occurs most especially while lying down or at night  An irony to this is that certain foods tend to trigger the onset of heartburn symptoms such that in a recent survey conducted by the National Heartburn Alliance (NHBA) : 92%  point to food as the primary cause of their discomfort.

So if you have symptoms of heartburn… before grabbing or ordering foods to fill your stomach, reconsider and think if in turn what you’ll be eating will trigger the onset of your discomfort.

  • Foods To Go: beef, chicken nuggets & buffalo wings and the yummy french fries.  And anything fried!
  • Sweets. Chocolate, Chips, brownies, doughnuts ( the tasty Krispy Kreme) .
  • Drinks and Fruits. Orange juice, and lemonade, cranberry juice, wine coffee and tea, carbonated drinks ( goodbye to soft drinks) 
  • Others: tomato, mashed potatoes( especially with butter), raw onion, potato salad, Macaroni and cheese, spaghetti with marinara sauce, and ice cream.  Meaning… anything creamy and fatty!

Last advise: eat smaller meals especially prior to bed.  By doing so, you decrease the tendency of the food to reflux from your stomach into the esophagus.

But… Make sure it’s really heartburn because your symptoms may actually signal a heart disease. 

Read My Other Related Posts:

Red Meat and Breast Cancer

January 19, 2007

3763834536.jpgBeef or Pork… are the main stays in most of the meals being served worldwide.  That’s the reason why Mc Donalds can be found anywhere in the world.  From kids to adults… we all love the burger.   

But while going through my journals, I came across this article published recently in the November Issue of the Archives of Internal Medicine.  This time, the association between red meat and breast cancer was analyzed and I thought since breast cancer is one dreaded but “curable” cancer nowadays is to share with you this tip to hopefully lower your risk to develop it and share this information to your wives or mothers and sisters.

The study involved the 90,659 women,  who participated in the Nurses’ Health Study II.  During the 12 years of follow-up, around 1,021 women developed invasive breast cancer.

Women who ate around 2 servings of red meat per day were more likely to develop estrogen-positive and progesterone-positive breast cancer ( 97% more)  than those who ate red meat only three or fewer servings per week.

What types of Red meats were the culprits?  The usual red meats we love…. including hamburger,beef or pork as a main dish, anda variety of processed meats.

Again… to prevent any ilness, we modify factors that can be changed in our lifestyle,  And dietary factors are one modifiable culprits of a disease.  It  requires both knowledge and discipline in our food choices to be successful.  It boils down to one’s determination to prevent a disease and a goal to remain fit through an active and healthy lifestyle.

Remember it’s the Sacrifice and the Determination that can lead us to Success….whether in business or in health….

So for your next meal….

Fish… Anyone?   

Read My Other Related Posts:

Are You At Risk For Cancer?

January 17, 2007

30837198761.jpgAm not sure if there is a season of cancer but just reading the local newspapers nowadays, you see obituaries of prominent people all with the same diagnosis of early death due to the Big C!  We fear cancer that we dread just hearing it as a diagnosis of our ailment.  So what can we do to prevent cancer and who is at risk? 

Actually everyone has some risk for cancer. In one survey in the US:” cancer is likely to affect 1 in 2 men and 1 in 3 women at least once in their lifetime.”  Meaning we all have that risk that we should know and try to change the factors that increase our risk.  So what are these factors that affect our risk?

  • tobacco use,
  • lifestyle choices (such as diet and exercise),
  • family history, and
  • factors in your workplace and environment.

The real question however is: How can I protect myself from getting cancer? Just like ones risk for diabetes, or other chronic ailments, some risk factors for cancer like the family history are non modifiable. But you can definitely modify some of the risk factors like:

  •  Your diet ( eating more red meat for example increases your risk for some cancers)
  • exercise habits ( sedentary lifestyle and obesity)
  • Too much sun exposure and
  • The use tobacco products. .. smoking 2 packs or more per day increases ones risk to cancer 20 fold. 

For most types of cancer, the sooner the cancer is found and treatment begins, the better your chances of recovering and improved survival.  We have screening tests already available.  So if you assessed yourself to be at risk then … better act early…

Know if You Are At Risk… Then Do Something About It! 

Read My Other Related Posts:

Is Chromium Good For You?

January 16, 2007

2922756499.jpgChromium as a metal is known but not as a supplement or a health drug.  The reports of chromium and improvement in sugar control started with a chinese publication and since then more reports of its benefits have been studied.  I see a lot of patients asking my opinion on this supplement and so far the best summary I’ve read was recently published in the January 2007 issue of Harvard Men’s Health Watch.

  • Chromium and cholesterol. With such scattered scientific information, it’s too early to recommend chromium supplements for cholesterol. But there may be an exception to that rule when it comes to low HDL (good) cholesterol. The best ways to boost HDL levels are lifestyle changes such as exercise and diet. But if those don’t help, chromium may be worth a try. Some clinical trials have reported a benefit.
  • Chromium and heart disease. A new study reports a link between chromium levels and heart attack risk: the lower the levels, the higher the risk. The association of low chromium and heart attacks was unrelated to diabetes or diet.
  • Chromium and diabetes. Chromium influences insulin action and glucose metabolism. However, studies have yielded conflicting results. The American Diabetes Association states that “at present, benefit from chromium supplements has not been conclusively demonstrated.” It’s an invitation for more scientific study.
  • Chromium and weight loss. Despite the popularity of chromium picolinate as a diet aid, scientists agree that chromium supplements are not effective in producing sustained weight loss.

Sources of natural dietary chromium includes: whole grains, nuts, broccoli, and green beans.  All are healthy and worth munching while benefiting your good cholesterol, improve your heart disease risk and hopefully lower the blood sugar level.

My advise for now is…2393097542.jpggo for the natural sources of chromium… stay away from the supplements as we dont know yet the exact dose that will provide you of the necessary benefits.

Be Informed…Eat Right!

Read My Other Related Posts:

The Food Diary: How It Can Help One Lose Weigth

January 14, 2007

4204617119.jpgObesity and overweight are becoming prevalent and more complicated. To be overweight gets you more complications of developing other illnesses like diabetes, high blood pressure and heart disease.  You’ve seen friends losing weight but then gain back their lost weight because of fad diets which really don’t work.  The basic requirement of maintaining ones weight is determination and discipline in changing ones lifestyle. 

While reading a post on How To Lose Weight, the article points out that just being conscious of what you eat helps.  And basically this is the purpose why we ask for a food diary on any patient who asks for obesity management.  By being more aware of what you eat … you end up avoiding habits that make you unconsciously eat when in fact you’re no longer hungry.  Likewise the diary helps you analyze later on the day… which servings were more than they should be with plenty of calories that you can avoid later on.

Basic Rules To Remember:

Write Everything You Eat:
From a simple gum, to a can of juice to a big piece of pie.  Write everything you eat everytime you nibble and don’t forget to bring your diary anywhere you go.

Be Specific:
Include the extra cup of added sauce when you ate steak… or the 4 french fries you ate while watching TV or the pack of popcorn while watching the movie.

Write The Amount To The Detail:
¼ cup of rice or 1 palm size of meat or a tablespoon of sugar to the exact number of chips

Again it’s not difficult…it’s a matter of doing it. The attitude should NOT be… I can’t lose weight because…BUT rather … I need to lose weight…and therefore how can  I lose weight! 

The Food Diary… Practical, Simple and Easy! Try  Doing It!

Read My Other Related Posts:

Body Pains You Should Not Ignore!… The Warning Signs

January 12, 2007

3582617281.jpgWe often wake-up with a headache or bodyache.  We complain of some kind of chest discomfort that we just disregard as nothing but heartburn. But these complaints may mean something else if they occur everyday or becomes severe overtime.  Let me share with you some warning signs that should not be ignored.

Severe Headache

If you developed the so called: ” Worst Headache I Ever Had“… this could be something that needs immediate help. Conditions like a bleeding brain tumor or an aneurysm could cause this warning sign.  Or it may just be a plain migraine or colds. In short…if the headache is severe and persistent… seek medical help! 

“An Elephant Sitting on my Chest!”

Majority of heart ailments will manifest as merely chest discomfort that may radiate to the arm or jaw!  It can even present as abdominal discomfort like an ulcer.  So if you have risk factors for heart disease like diabetes… seek medical help right away!. A heart attack can feel like an elephant sitting on your chest!  The discomfort may have been there for quite sometime, usually occurs when walking or dancing but goes away when sitting down. So if your discomfort comes with activity and goes away when you rest… seek help!

Severe Abdominal Pain

An aneurysm perhaps? or Gallstones or some people describe this as ” excruciating Pain”… the kidney stones.  Or it can also be your appendix about to rupture. 

Pain in Lower Back or Between Shoulder Blades

Two possibilities with this kind of pain: a heart attack or abdominal problems. You may just mistake it for plain and simple arthritis but one danger is the so called aortic dissection, which can present as either a nagging or sudden pain. Those that should be more conscious about this include people who have high blood pressure, those who smoke especially if with diabetes.

So the more informed you are of the warning signs… the better!

The earlier the disease is discovered… the better!

and…the earlier you seek help… the better!

Know Your Body Better!

Read My Other Related Posts:

Are Sleeping Pills Safe? Tips To Induce Sleep…

January 10, 2007

2265466448.jpgAnxiety, stress, too many things to think about, drinking too much coffee are some good reasons why people can’t sleep. Not getting enough sleep puts one at risk of chronic illnesses like diabetes and depression.  And if this happens almost everyday, then almost always one will need to seek medical help.  And the obvious immediate help given is the sleeping pill!  But how safe are the Sleeping Pills?

Below is the list of available sleeping pills noting its duration of action and more specifically the risk of developing dependence which can be disabling in the future.   The ones highlighted are available to us locally.


  Duration of Effects Side Effects Dependence
Diphenhydramine   4-6 hours (sleepiness may last longer) Daytime sleepiness; confusion and difficulty urinating in older people. Low
Selective GABA Medicines

  • Ambien or Stillnox (zolpidem tartrate)
  • Ambien CR (zolpidem tartrate extended release)
  • Lunesta (eszopiclone)
  • Sonata (zaleplon)
  6-8 hours Usually few. Memory disturbances, hallucinations, behavior changes possible. Med(usually low)
Sleep-Wake cycle Modifiers

  • Rozerem (ramelteon)
  4-6 hours Headache, drowsiness, dizziness. Uncommonly, problems with sex drive. Loss of menses or problems getting pregnant. Low

  • Ativan (lorazepam)
  • Halcion (triazolam)
  • Restoril (temazepam)
  • Valium (diazepam)
  • Xanax or Xanor  (alprazolam)
  Varies (from 4 hours to more than 12) Sedation, loss of muscle coordination, dizziness, habit-forming. Higher
Tricyclic Antidepressants

  • Adapin (doxepin)
  • Aventyl (nortriptyline)
  • Elavil (amitriptyline)
  • Pamelor (nortriptyline)
  • Sinequan (doxepin)
  • Trazodone (desyrel)
. Not well studied Low at usual doses for insomnia. Dizziness, blurry vision, difficulty urinating, cardiac arrhythmias possible. Trazodone can cause prolonged, painful erections. Low

 Remember….all sleep medicines have untoward side effect and the most problematic of all is their potential for causing dependence…mainly psychological dependence, not physical.  So if you have to use these pills, get the one with the low dependence risk.

Before resorting to pills…I outlined some remedies in my previous post: Sleepless Nights?.  But do take time to try some other natural remedies that may help induce you to sleep tightly:

  • Warm milk contains high levels of tryptophan known to be a natural sedative.
  • Aromatherapy especially with massage using jasmine oil, lavender oil, and other relaxing essential oils, may actually help induce one to achieve sleep.
  • Relaxation techniques such as meditation may help.
  • And more importantly, avoid mentally stimulating activities in the evening hours… that is… don’t bring your job to bed!

Weigh the Risk Before Resorting To The Pills!

Read My Other Related Posts:

  1. Does Melatonin Work?
  2. Sleepless Nights? Why and What To Do
  3. Are You Getting Enough Sleep?

The Risk of Being ANGRY….

January 8, 2007

4030644144.jpgYou woke up early in the morning… ate your breakfast hoping for a nice day at work only to find out that nothing has been done right!  The sudden surge of cathecolamines causes the feeling of heat that eventually results into anger…  Now… hold on… calm down… and take a deep breath!  Because Anger can be bad for your health!

A recent webcast form the American Heart Association Scientific Session showed a study funded by the National Institute of Health that ” acute episodes of anger may cause potentially fatal heart rhythm disturbances.”

This study involved more than 30 medical centers around the United States and patients were asked about their lifestyle habits and medical histories.  These are patients who have implanted defibrillator and were then asked to record anytime they receive a shock and to record circumstances during that episode.

  • 3.2 times more likely for irregular heart rate if pt is moderately angry, as compared to periods of no anger
  • 16.7-fold increased risk of having the arryhthmia if participants were very angry and furious.

In conclusion, the authors have this to say….“Our results suggest that emotions, particularly anger, can trigger dangerous rhythm disturbances.”  And therefore can be fatal!

“Next time you are about to blow up… ask yourself this question … 

Is the Cause of Anger Worth The Risk?

Read My Other Related Post:

Foods To Eat If You Are A Diabetic

January 5, 2007

23543096601.jpgAs an endocrinologist handling patients with diabetes during these holidays is a challenge.  Keeping them on the right path in terms of eating what is right can be a daunting task.  A simple diet regimen should keep them at bay and prevent them from overworking their pancreas lest they will require insulin as a treatment once their pancreas fails.

This recommendation also holds true to siblings and kids of patients with diabetes and those paitients deemed at risk.  The source of this simple regimen came from the book published by the Cleveland Clinic Foundation – Diabetes: Eating Right.

It is important that once you are diagnosed to be diabetic or prediabetic is to always keep blood sugar as close to normal as possible.  And to do this , it’s important to follow the right meal plan… it should be a well planned and a well-balanced diet.

You will need to keep close track of the carbohydrates you eat since they have the most immediate effect on your blood sugar. Carbohydrates are in these food groups:

  • Fruit
  • Milk and yogurt
  • Bread, cereal, rice, pasta
  • Starchy vegetables

You should eat plenty of fiber since it plays a role in the digestive process, reduces heart disease risk, and can improve blood sugars. Choose from:

  • Fresh fruits and vegetables
  • Cooked dried beans and peas
  • Whole grain breads, cereals, and crackers
  • Brown rice
  • Bran products

It’s important to eat foods that are low in fat. Good choices are:

  • Lean meats. Bake, broil, grill, roast, or boil – never fry
  • Low-fat dairy. That includes cheese milk, yogurt
  • Low-fat vegetable cooking spray
  • Low-fat margarines and salad dressings

Avoid high-sodium foods, which can cause high blood pressure:

  • Salt
  • Boxed mixes of potatoes, rice, pasta
  • Canned meats
  • Canned soups and vegetables
  • Processed and packaged foods (lunch meat, sausage, bacon ham)
  • Salty snack foods

 Simple… Concise.. And Practical…

Remember, it’s what you put inside your mouth that counts!

Eating Right Can Make A Big Difference!

Read My Other Related Posts:

Is Advil Safe? Know The Facts!

January 4, 2007

39985664971.jpgOne of the most commonly used and prescribed medications over the counter are the pain relievers.  And one of the most marketed pain relievers is Advil. We take them when we have headache, toothache, joint pains or back aches.  People from all ages and all walks of life cant live without the pain relievers to help us alleviate the symptoms and make us be more active.  But recent controversies came up with the pulling out from the market of the most prescribed OTC med- a brand of Non Steroidal Anti Inflammatory Agent or NSAIDs jolted the medical community as well as the consumers.  We still continue to have safe OTC pain relievers but before buying or using one I thought of sharing with you some of the common considerations you have to do before using one: 

  • Do not use them for more than 10 days.
  • Know the side effects which include gastric ulcers and allergic reactions.  Recently cardiovascular complications were noted especially if taken daily for a long time.
  • Most NSAIDs are present in other OTC products like colds and the flu medicines.
  • Be careful if you have either a kidney or liver disease.   If you need to take one then use the alternatives to NSAIDs like Tylenol (acetaminophen.)
  • Other non medical alternatives include physical therapy, biofeedback, yoga, meditation, and acupuncture can also reduce their pain. 
  • Most importantly… if you have joint pains and overweight… weight loss is the key!
  • Do not mix these meds with alcohol since once risk for stomach bleeding is increased with just 1 drink per week.
  • All NSAIDs have the potential to raise high blood pressure.  So talk to your doctor if you have high blood pressure.

My advise is simple:OTC pain relievers are safe as long as we take them short term like 2-3 days or occasionally because of headache or toothache.  If you have to take them daily for any reason then take it for 2-3 days then stop for few days before taking them again.

Better Be Safe… Know The Facts! 

Start Right After The Holidays: Tips To Prevent Weight Gain

January 2, 2007

3489305539.jpgThese post holiday blues… feeling guilty for having eaten too much and having gained a few more pounds… let me share with you some simple facts and tips from the American Academy of Family Physicians as to why we become overweight and what to do to help us shed those few pounds we’ve gained during the holidays.

  • Reasons Why We Become Overweight:

    • Eating when you’re lonely, sad, bored or stressed.
    • Eating because you feel pressured by friends or family to eat.
    • Using food for recreation, or eating just because food is available.
    • Taking medicine that makes you feel hungry.
    • Having hormone problems that slow your metabolism (how fast your body burns calories).

    Tips For a Healthy Lifestyle:

    • Eat breakfast.
    • Eat your biggest meal of the day at lunchtime.
    • Begin meals with a low-fat salad, soup, broth or a glass of water.
    • Eat more vegetables and whole grains at each meal.
    • Drink fewer sugar-sweetened beverages (such as regular soda and fruit juice).
    • If you drink more than one regular soda per day, replace one of them with a diet soda, water or skim milk.
    • Limit your alcohol intake.
    • Know what 1 portion looks like — and stick to it.
    • Eat slowly so your body has time to know when you are full.
    • Be more active in your daily life.
    • Replace some of the sugar in your diet with non-caloric sweeteners
    • Get support from family and friends. Support is very important for long-term success in adopting healthy habits.
  • Resolve To Do Better This New Year…Health-wise!