- 27 May 2015
- Fitness Blog
Symptoms of dehydration include dry mouth, tiredness, headache, and dizziness. It can make your heart rate race and it can cause dangerously lower blood pressure. Our bodies cannot function without proper amounts of water. Each year, highly trained athletes die from dehydration. It is imperative that we take time to listen to our bodies’ response to the heat as well as take all precautionary measures to insure a healthy and hydrated work out.
Between 50% and 60% of the average body weight is made up of water. Our bodies need water to digest food, transport nutrients, and dissipate heat (sweat). A major component of our muscles is water, comprising about 73% of a muscle. To get the maximum benefits from a work out, it is essential that we don’t become dehydrated and allow other body systems to take the water necessary for muscle function to use elsewhere.
Luckily, during exercise our body does produce water as our muscles burn glycogen to help prevent dehydration, but there are many other things we can do to help ensure that our bodies are receiving the water that they need to replace the water lost through exertion and sweat. Sweat is our bodies natural defense to overheating, using its excess water to cool the muscles and organ systems of the body to keep them at healthy functioning temperatures.
Important things to know about remaining hydrated through hot summer work outs include realizing that drinking water is not the only adequate way to get water into your system. Plenty of foods and drinks also contain large percentages of water. Vegetables contain between 85 and 96% water. Yogurt and ice-cream contain a majority of water as well as coffee and low-fat milk. However, this being said, it is still imperative that you drink water pre and post work out along with consuming other favorites. To determine your individual water loss during a workout, weigh yourself before you workout, and then after you finish. The change in body weight you see is reflective of your sweat lost. 16 ounces of sweat lost is about equivalent to 1 pound of weight loss, 32 ounces equaling 2 pounds, etc. Drink accordingly during your exercise regimes to make up for the lost water. During extended periods of exercise it is vital to be aware that water is not the only thing your body is losing. Electrolytes, especially sodium, are lost as well. These can be replaced through meals or fitness drinks such as Gatorade or Powerade. These drinks however, are designed for highly active individuals and are not meant to drink daily without electrolyte loss.
Athletes who lose more than 2% of their body weight during an exercise lose their ability to perform optimally as well as lose their mental edge in a competition. While competing or just being active in hot weather, hydration is a key to successful training as well as safe training.
- 01 May 2015
- Internal Medicine Blog
By: Lauren O'Brien, M.D.
Spring has sprung. and soon those long, hot days of summer will be upon us. We are all ready to enjoy the warmer, days the sun has in store for us, so this is the perfect time to reflect on the potential hazards that can come with all of that UV exposure.
May is Skin Cancer Awareness Month, so let's review some important skin cancer stats.
As a group, skin cancers are the most common cancers of humans. Melanoma is the most deadly form of skin cancer. The overall lifetime risk of melanoma is 1:50, but it represents the most common cancer in women aged 25-29 and the second most common cancer in women 30-34.
WHO IS AT RISK?
Melanoma can affect ANYONE, but there are certain people who are at greater risk.
1) Caucasians have a higher risk than other races
2) If you have >50 moles, or large/atypical moles, you are at higher risk.
3) Caucasians with light skin, freckles, red or blond hair, and those with blue or green eyes are at higher risk.
4) Your risk is increased if you have had a previous melanoma, other skin cancers (basal cell, squamous cell) or other cancers such as breast or thyroid cancer.
5) You have an increased risk if you have a family history of melanoma.
6) Your risk is increased if you have a history of a sunburn, or if you visited a tanning bed prior age 30.
Now that we know more about skin cancer and melanoma, the best strategy is to prevent the skin damagebefore it occurs. Here are some ways we can prevent skin cancer:
1) Seek shade and avoid sunburns. It is most important to look for shade between l0am and 2pm when the suns rays are the strongest.
2) Avoid sun lamps and tanning beds- as we said before, this is linked to an increased risk of melanoma especially if used before age 30.
3) Wear hats with a 2-3 inch brim to protect your face, ears, and neck. Plain baseball caps leave your neck and ears exposed and straw hats offer less protection than those made with a tightly woven fabric. If possible, wear long sleeves and pants for added protection.
4) Don't forget the sunglasses with UVA and UVB protection to keep your eyes safe.
5) Use a broad-spectrum sunscreen with an SPF of 30 or higher. Use at least a palmful to cover arms, legs, face, and neck. Use a lip balm with sunscreen as well. Be sure to apply 30 minutes prior to going out in the sun and reapply every 2 hours. Remember, sunscreen acts as a filter and does not give 100% protection. If you stay out in the sun for many hours in a day you can still get burned.
6) Use extra caution near water, snow and sand as they reflect the damaging rays of the sun and can increase your chances of sunburn.
Many skin cancers can be cured if found early, so surveillance and early detection are key. If you are in one of the high-risk groups, seeing a dermatologist yearly for a full body skin check is a good idea. You can do your own surveillance at home in between visits by following these tips:
1) Look for any new growths or sores that do not heal.
2) Follow the "ABCDE 's of skin cancer when evaluating moles:
- Asymmetry- ½ of a mole does not match the other half
- Border- the edges of the mole are ragged, notched or blurred
- Color- the color of the mole is mottled or uneven
- Diameter- the size of the mole is unusually large, greater than the size of the tip of a pencil eraser (6mm)
- Evolving- a mole is changing in size, shape or color, or if a mole is new to you.
If you note any of these changes, make an appointment to see your doctor or dermatologist for further evaluation. With a little diligence, you can still enjoy the energizing summer sun and keep your skin safe at the same time!
- 27 April 2015
- Internal Medicine Blog
Although there are different types of skin cancer, melanoma is by far the most dangerous type. Melanoma is the most common form of cancer for adults ages 25-29 and, despite being highly curable if caught early, an estimated 1 American dies every 61 minutes because of this cancer.
What is Melanoma?
Melanoma is a type of cancer that originates from the cells in your skin that hold pigment – melanocytes. The majority of melanomas are black or brown, but they can also be pink, purple, red, white and blue! The primary cause of this type of cancer is intense exposure to ultraviolet light (typically resulting in sunburn)
ABCDEs of Melanoma
The biggest prevention tool for melanoma is knowing your skin and noticing any changes that occur. To help understand changes, you can use ‘the ABCDEs of Melanoma’:
Asymmetry – regular moles are more likely to be symmetrical
Borders – regular moles typically have smooth borders, whereas Melanoma can have rough, even scalloped borders
Color – regular moles tend to be uniform in color
Diameter – benign moles tend to be small – under ¼ inch
Evolution – regular moles do not change over time; any change in size, color, shape or unusual activity -such as bleeding, crusting or itching – is usually a sign of danger.
What can I do?
Other than monitoring your skin and having annual skin checks with a dermatologist, there are steps you can take to avoid the kind of exposure that causes melanoma:
· Stay in the shade, especially between the hours of 10am and 4 pm ‘peak sun hours’
· Avoid tanning, especially in UV tanning beds
· Use a broad spectrum sunscreen that covers both UVA and UVB with an SPF of 30-50. Sunscreens with an SPF of over 50 have been shown to have a limited benefit and can be more costly. Also – do not forget to reapply our sunscreen every 2 hours or after excessive sweating and/or swimming.
· Last but not least – make sure to keep your newborns shaded and out of the sun and make sure to use sunscreen once your baby has reached 6 months!
If you have any moles that you are concerned about, our physicians, Dr. Lauren O’Brien and Dr. Stephanie McKnight will be happy to see you and even remove the lesion if necessary! We can also refer you to a dermatologist if you do not see one regularly. So take care of your skin and have a safe and wonderful summer!
- 27 April 2015
- Nutrition Blog
Here are a few tips to help you purge your kitchen of the unhealthy items and replace them with whole, fresh, healthy foods.
Check the labels: As a rule, you should always check the nutrition label and ingredient list before buying any foods, condiments, drinks, etc. If the item is high in sugar, high in sodium, or has trans fat, get rid of it. Always check the serving size. Although a container may appear to be one serving, make sure you check to see just how many servings it contains. The following additives are a big red flag and a good indicator to purge that item from your pantry.
· High fructose corn syrup
· Artificial colors
· Artificial flavors
· Artificial sugars
· Anything with a number
· Enriched wheat
· Hydrogenated oil
· Monosodium glutamate (MSG)
· Preservatives (such as BHA, BHT, potassium sorbate)
Chuck the junk: Get rid of the foods, snacks, and drinks that are keeping you from sticking to a healthy eating routine. Here are some items to toss:
· Potato chips, pretzels, crackers, corn chips
· Ice cream, frozen yogurt, sorbet, popsicles
· Candy, cookies, brownies, cake
· Fried foods and snacks
· Soda, diet soda, juice, artificially flavored and sweetened drinks
· Artificial sweeteners
Check the expiration date: Make sure the food in your fridge and pantry has not expired. If it is expired, toss it out and replace it with a new, healthy version.
Donate your discards: After purging your kitchen of everything you no longer want or need, you may feel a little guilty about throwing it away. If you have a lot of unopened food, do some research to find a local food pantry, food bank, etc. and see if they will accept your unopened items.
Replenish your stock: Take inventory of what you got rid of and try to replenish your stock with the healthy alternative. For example, if you got rid of condiments containing artificial colors, flavors, and preservatives, find a natural alternative with minimal ingredients. A few great places to shop that don’t allow many, or any, of the unhealthy items on their shelves are Trader Joe’s, Whole Foods, and Mom’s Organic Market.
- 31 March 2015
- Internal Medicine Blog
Alcohol Abuse is an often and seemingly socially acceptable behavior that affects millions of people in the United States. In fact, according to the CDC, 88000 deaths per year are linked to excessive alcohol use.
WHAT is alcohol abuse?
Alcohol Abuse or alcoholism is a chronic disease recognized by the following 4 symptoms:
• Cravings (the urge to drink)
• Loss of Control (Not being able to stop once drinking has begun)
• Tolerance (The need to drink greater amounts of alcohol for the desired psychological effect.)
• Physical Dependence (Withdrawal symptoms after stopping drinking: nausea, sweating, shakiness, anxiety).
But everyone drinks alcohol! Why should I be worried?
Other than the emotional and financial impact alcohol abuse can have on your life, it also ravages your body; excessive alcohol use affects ALL of you organ systems!
The most commonly known outcomes of alcohol abuse are:
• Liver diseases - hepatitis, cirrhosis
• Gastrointestinal complaints – gastritis, pancreatitis
• Neurological impairment – dementia, neuropathy
• Cardiovascular problems – hypertension, heart attacks
• Unintentional Injuries – motor vehicle accidents, drowning, falls
• Alcohol abuse can even lead to the development of diabetes!
What can I do?
Although there is treatment for alcohol abuse, there currently is no ultimate cure. Preventing the development of this condition is the best course of action for anyone. In order to play it safe, the U.S. Department of Health recommends that women do not imbibe more than one drink per day.
If you feel that you may have a problem with alcohol or are uncertain, discussion is the first step. Schedule an appointment to talk to your doctor as soon as you are able. Your physician can help determine whether your habits need correction and, if necessary can help you find an optimal treatment program which can include counseling and/or medications.
If you are not ready to talk to a doctor, please explore the following resources:
www.ncadd.org - National Council on Alcoholism and Drug Dependence
www.niaaa.nih.gov - National Institute on Alcohol Abuse and Alcoholism
www.recovery.org - Connecting people and their families with the information and resources to help them recover from substance abuse and behavioral disorders.
Don’t allow your life and health to be washed away – talk to your Primary Care Provider today!
- 25 March 2015
- Fitness Blog
Spring has finally arrived and it is the perfect time to spring clean your workout routine. After the long winter months, this time of year is great to reevaluate and revitalize your workout! Here are some of the best and easiest ways to make sure you are getting the most out of your routine.
1. Footwear: First and foremost, make sure you are wearing the proper footwear for your workout. Depending on your goals, there are many sneakers to choose from nowadays. The best choices are lightweight and flexible. Make sure you are not wearing a shoe that is too heavy as it will tire you out and slow you down a lot sooner than a lightweight shoe selection. You should also purchase your workout sneakers at least ½ size larger than your regular shoe size as this will allow you to have more flexibility and decrease any strain on your toes.
2. Plan your workouts: One of the main reasons people give up on working out is due to lack of planning. Each week you should draw up what your workout for the entire week will look like. Be sure to plan at least 3-4 days of cardio lasting for 30-45 minutes during each session. Incorporating weights is key. Strength training helps to build lean muscle and boosts your resting metabolic rate so that you will burn calories for hours after your workout!
3. Incorporate Interval Training: If you don’t already, you should incorporate interval training into your routine. By alternating your speed every few minutes helps to build cardiovascular endurance, improves speed and burns tons of calories. Before trying interval training, be sure to speak to your physician about the benefits and risks of this workout regimen.
4. Stop Spot Training: Exercising a specific area of the body with the expectation to eliminate fat in that particular location is almost impossible. Every person is an individual and has different genetics. To attack problem areas, many factors need to be considered including hormonal imbalances as well as diet. In order to properly tackle those problem areas, you must use a total body approach. You need to assess your exercise routine as well as nutritional intake and genetics. The more you know about these 3 things, the more you will see a change in those problem areas.
5. Cool Down: After a long workout the last thing most people want to do is a cool down. Cooling down your body is very important. It helps to bring your heart rate down and relax your muscles. It also helps to alleviate feeling sick afterwards. Be sure to stretch! Stretching also relaxes muscles but also helps to speed circulation to your joints.
- 25 March 2015
- Nutrition Blog
With the Broad Street Run coming up, it’s important to properly fuel your body. Everything you eat and drink leading up to the run has a direct impact on performance. In order to help you better prepare, our dietitian, Theresa Shank, RD LDN has outlined the best advice to strengthen your body for this year’s race.
Hydration: Because of the high level of exercise your body is about to endure, hydration is key to regulating body temperature throughout the race. Not only is body temperature a concern, but also without proper hydration your body may experience muscle cramping, which can make for a very unpleasant Broad Street Run.
Pre-exercise: Drink at least 16 ounces of water or sports drink an hour or two before the race.
During: Drink 5-12 ounces of water or sports drink every 15-20 minutes during your run.
*Don’t drink TOO much. If you start to hear “sloshing” in your stomach or nauseous then wait at least 15 minutes before drinking more.
Post exercise: Drink 16-30 ounces of water or sports drink.
*Because you are running 10 miles, a sports drink with 5-8% of carbohydrate (Look at Daily Value Percentage) is appropriate for achieving proper hydration and replenishing of glycogen stores.
Pre-Exercise Nutritional Goals: It is important to prepare your body with adequate nutrition in the hours leading up to your 10 mile run. Two-three hours before the race, eat a full meal with at least 50 grams of carbohydrate.
Example: A bagel with a tablespoon of peanut butter
Pre-Exercise Fuel (30 minutes – one hour before): 30 grams of Carbohydrate
You want to eat a snack in at least an hour before the race that contains carbohydrates, protein, and a little bit of fat to power through your run.
· 6 ounces of Greek yogurt w/10 almonds and ½ cup fresh/frozen berries
· 2 slices of whole wheat bread with 1 Tbsp. of peanut butter and 2 tsp. of fruit preserves
· 1 hard-boiled egg, a slice of whole wheat toast and a small piece of fruit
· 1 English muffin with ½ banana and 1 Tbsp. of almond butter
· 8-ounce smoothie with 1-cup plain Greek yogurt, ½ banana, 1 Tbsp. peanut butter, ½ cup orange juice or low-fat milk, and ½ Cup ice. (blend together)
Post Exercise Fuel:
After the race, your body is continuing to burn calories. You must ensure proper nutrition after the event to replenish your body with the energy it lost. Focus on eating a small snack with a 4:1 carbs to protein ration within the first 15 minutes after your run. Choose a snack low in fat and fiber to insure proper digestion. Later, within two hours after your run eat a balanced meal.
Post Workout Snack Examples:
· 1 Cup of oatmeal with ½ cup frozen berries or ½ banana
· 8 ounces Greek yogurt with 1 piece of fruit
· 1 slice of whole wheat bread with 2 slices of turkey and 1 slice of low-fat cheese
· Sweet potato with lean protein
· 8 ounces low-fat/non-fat chocolate milk
- 24 March 2015
- Internal Medicine Blog
Spring is on its way! Along with budding trees and flowers comes pollen — a common trigger for allergies. Limiting the frequency and duration of your exposure to pollen can prevent or decrease symptoms and reduce your need for medications. For those who suffer from spring allergies here are a few tips to make the season more enjoyable.
- Limit outdoor activities when pollen counts are the highest, between 5am and 10am.
- Pay attention to pollen reports, available with the daily weather report and online, and stay indoors when counts are high. Dry, windy days are more likely to have large amounts of pollen in the air than damp, rainy days when most pollen is washed to the ground.
- Keep windows and doors closed to keep pollen from drifting into your house. Likewise, keep your car windows rolled up and sunroof closed when you drive and adjust your ventilation system to re-circulate inter-compartment air instead of drawing air from outside.
- Pollen can accumulate on your clothes and hair while you are outdoors. Remove your shoes at the door and change out of clothes you’ve worn outside. Shower to rinse pollen from your skin and hair. Your pet’s fur presents a similar problem. Though it is certainly not practical to bathe your dog every night, try to keep pets off of the furniture and out of your bed so that you will limit your exposure.
- Wash bedding often and always machine dry. Pollen may collect on laundry if it is hung outside.
- Rinse out your nasal passages once you are inside for the day or before you go to bed. If you can’t get the hang of a neti pot, pick up a reusable nasal irrigation kit available at most pharmacies.
- 02 March 2015
- Internal Medicine Blog
As spring comes along, some of us are starting to think about our summer vacation plans. If you are one of those people who is considering traveling to an area that requires updating your vaccines or getting vaccines that are not required growing up in the United States, it is never too early to get started with your Travel Visit.
There are a few things to keep in mind before traveling:
· Schedule your travel appointment as soon as possible. We recommend 4-6 weeks in advance.
· Have a list of your medical problems, medications, allergies and your doctors name and phone numbers.
· If you have artificial devices in your body.
· Insurance companies may or may not pay for the travel visit, vaccines and medications.
· Some vaccines require more than one shot.
· We do not carry the Yellow Fever Vaccine. You are able to do a travel visit with one of our doctors and then they will give you a Rx to get the vaccine injected at a local pharmacy.
· Check with your insurance company if you require more medication for extended vacations.
How to prepare for your travel visit:
· Have your travel itinerary with you at the time of your visit.
· Have a copy of your previous vaccines.
Scheduling a travel visit will help to ensure that you make the best out of your trip!
- 26 February 2015
- Nutrition Blog
With Memorial Day right around the corner, we asked Theresa Shank, our registered dietitian what she recommends clients to have in their kitchens to help them lose unwanted winter pounds. Here is what she had to say:
There are many items that are important to have in a healthy kitchen while trying to lose weight, but I won’t bore you with that and just keep it simple by recommending my “must haves.”
Fresh Fruit: Don’t over fruit. Even though fruit is loaded with nutrients and antioxidants, its natural sugar content can be troubling for weight loss. I recommend limiting fruit intake to 1- two servings per day. My favorite picks are apples, grapefruit, blueberries, strawberries, cantaloupe and pears.
Fresh seasonal vegetables or frozen vegetables: the more vegetables you eat the leaner you will be, so aim for at least 5 servings a day. * One vegetable serving counts as a ½ cup cooked or 1 cup raw.
Chia or Hemp Seeds: These seeds are good sources of Omega 3’s and fiber. Try adding to salads, oatmeal or smoothies. * Omega 3 fatty acids aid in decreasing cholesterol, depression, joint pain, diabetes and improve the health of your skin and hair.
Greek Yogurt: Fage and Siggi’s are my favorite brands. I always recommend Greek yogurt because it is higher in protein, making it more satiating than other yogurts. Siggi’s is the only flavored yogurt that I recommend because of its low sugar content in comparison to other flavored yogurts. For example, Siggi’s vanilla flavored yogurt contains just 9 grams of sugar, that’s only 2 more grams of sugar than Fage’s plain Greek yogurt. Can’t beat that!
Grains: Incorporate grains into your meals to help keep you feeling full longer. Grains provide nutrients such as B vitamins, folic acid, fiber and protein. I recommend limiting grains to 1-2 servings (think the size of your fist) per day. My go to grains are quinoa, black or wild rice and oats (make sure they are hand rolled, never instant)
Sprouted Bread: Sprouted grain bread vs. store bought whole wheat bread has higher nutrients such as niacin, B6, folate and protein. Some sprouted grain breads are also noted to contain less carbohydrate than the average slice of whole wheat bread because some of the carbohydrate content is lost in the sprouting process; making it an all-around better choice.
Lean Proteins: Organic poultry, eggs, and wild caught fish are a must in my kitchen. If you are a vegetarian, I caution you to leave the overly processed “meat substitutes” alone! Instead, try tofu, seitan or tempeh, which lend themselves well to various vegetarian dishes such as homemade burgers, stir-fry’s or veggie chili. The possibilities are endless! * I encourage clients to consume fish at least 3-4 times per week during weight loss efforts.
Olive oil and nut butters: Don’t let the myth that nut butters and oils make you fat, stop you from incorporating these essentials into your diet. Instead, limit you intake of added fat to 1 tbsp. per meal to insure your body the healthy fat it needs while preventing the excess intake that causes weight gain. If you are feeling adventurous try substituting coconut oil, cashew oil or grape seed oil the next time your dish calls for olive oil.