Make A Wish!

Thursday I was at my mother-in-law’s house for Thanksgiving and saw the turkey carcass sitting on the counter.  I saw the bones sitting there and got thinking about how important it is to have healthy bones (I know, I think about weird things at family functions).  From the wishbone to the leg bones to the spine, those bones supported Tom as he gobbled his way around the turkey farm getting ready for his big day.

Have you ever broken the wishbone with another person on Thanksgiving?  Two people each hold a side, make a wish, and pull.  The one who gets the bigger half (the half with the connector piece in the middle) gets their wish granted.  The one whose half of the wishbone is weaker, more brittle, goes without.

Ask anybody who’s ever had a broken bone and they’ll tell you it’s an attention-getting experience.  I have a lady in the hospital who just had her SECOND broken hip repaired.  I had someone in the office today who was recently taken off Fosamax because her bone density is now better and, for now, she doesn’t need it.  We spend a lot of our time talking about bone health, measuring bone density and checking for bone injuries.

Bones are amazing structures.  They form from cartilage before we’re born and gradually accumulate calcium, magnesium, phosphate and other minerals and salts which strengthen them.  They are a massive storehouse of these minerals, which are critically important to several major systems in the body including the heart and nervous systems.  The metabolism of the skeleton is impacted by the function of the endocrine system (hormones) and the kidneys, among others.  They keep us from turning into a puddle of goo, support the fingers of violinists and pianists while they make incredible music, and protect the heart, lungs and brain from injury.  Bones are cool!

This week I would like to talk about a few ways for you to keep your bones healthy.  There are a number of risk factors for decreased bone density, also called osteopenia (less severe) and osteoporosis (more severe).  Being a woman, getting older, having a close family member with osteoporosis, being of Asian or Caucasian descent, and having a slender bone frame are all risk factors for osteoporosis.

The major ways we can keep our bones healthy are by feeding them and stressing them!  We have to take in the nutrients the bones need to keep them strong.  We also have to put some stress on those bones, because impact is the major signal to encourage bones to get and stay strong.

Calcium, magnesium and vitamin D are the main nutrients the bones need to stay strong.  A low lifetime intake of calcium increases the risk of osteoporosis.  Magnesium is needed too.  Vitamin D is a nutrient we’re just starting to understand better.  In northern Ohio it’s really hard to get all the vitamin D you need from sunshine, so supplementing is important.  Calcium and vitamin D are found in dairy foods.  Those who don’t drink milk should take a supplement.  You should get 1000-1500 mg of calcium and about 1500 units of vitamin D daily, so check your intake and supplement if you need to.  Check here for my recommendation for bone-health supplements.

There are two opposing forces working on your bones.  One type of cells, called osteoclasts, break down bone matrix.  A different class of cells, called osteoblasts, build up the bone matrix.  Healthy bone requires both types of cells working together.  Exercise, particularly impact exercise (like walking, jogging, aerobics, anything that involves your feet hitting the floor) is an important stimulus for bone remodeling.  This stimulates the osteoclasts to remove old, tired or worn-out bone matrix and the osteoblasts to replace it with fresh bone matrix.

Hormones like estrogen and testosterone shift the balance towards the osteoblasts and promote healthy, strong bone.  After menopause a woman’s osteoblasts lose one of their stimuli and can get a little lazy, leading to the gradual loss of bone.  This can be offset somewhat by vigorous impact exercise.  It’s important to realize all exercise is not equal for the purpose of bone health.  Swimming and biking, while great for cardiovascular health, do NOT protect the bones.

It’s also important to know that smoking and alcohol use increase the risk of osteoporosis (scientists aren’t sure why this is).  If you smoke, PLEASE make a commitment to quit and talk to your doctor about it.  Limit your alcohol intake to 5-7 drinks weekly for women, 10-14 weekly for men.  There are medications, such as seizure drugs and steroids, that impact bone health too.  If you have specific questions about your risk factors for osteoporosis, please talk to your doctor.

My wish for your bones is that you feed them plenty of calcium and vitamin D, and that you work them out to keep them strong.  I wish that you NOT experience the fragility and fractures that come with osteoporosis!

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I Hate My Job!

No, not me 🙂  I just seem to be having a theme this week.  Patients are coming in a lot with job stress, asking for help with managing it.  One patient is so stressed he needs to take a leave of absence to get a break.

I realize not everyone is as blessed as I am, to have a job so relaxing, easy and stress free 😉  I wanted to give everybody a couple of pointers if you are having problems with job stress.

It seems to me that you have three choices if your job is stressing you out:

  1. Put up with it.  Decide that your job is not your life, that it’s just the way you earn money to pay for the things you need and want.  Personally I think that you spend way too much time and effort at work to just “put up with it,” but many folks are able to grow thick skin, shrug off the annoyances and get on with getting the job done.
  2. Quit.  Unless you win the lottery, most people aren’t able to go without at least one job in the family.  So unless the job is really intolerable or is making you sick, you won’t be able to walk away without having a backup plan.  You can investigate going back to school to retrain, or get new skills that will enable you to apply for a different position within your same company or a different company.  You could look into a side business that can add income and potentially grow into your main occupation.  Unfortunately right now the economy is such that in many segments of the workforce it’s really a “buyer’s market,” with many more people looking for work than there are jobs.
  3. Learn to look on the bright side.  This is how folks who are truly happy at work manage to get to and stay in that mental state.  Think about it:  you must like SOMETHING about your job, even if it’s just the paycheck at the end of the week.  Be thankful!  Do you like your coworkers?  Is your boss supportive?  Are you lucky enough to work from home or have flextime benefits?  Do you make a difference to others?  Enjoy and be grateful for the things you DO like about your job, and also be thankful that you HAVE one, because so many are out of work and suffering.

Obviously #3 is my recommendation.  I am not recommending that you not try to correct problems at work, such as talking to your boss about a difficult coworker or unsafe work conditions.  I am just saying that everybody has things they don’t like or would change about their job if they could.  If you are able to go to work every day thankful for the things you DO like and enjoy, it will go a long way toward improving your general outlook.

Remember the Serenity Prayer.  You must recognize those things you can’t change or impact, and have the serenity to accept them.  However you CAN change and choose your focus, your attitude and your approach to your job.  Do you have the courage to try something new, and change the way you think about your job?

PS – Happy Thanksgiving everybody.  I’m very grateful for all of you 🙂

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God Help Them Help Us!

Hi everyone.  I have really struggled this week with my response to the election on Tuesday.  I wanted to share some thoughts with you, if you don’t mind.

First of all, for those who don’t know, I am a fiscal conservative with a strong libertarian lean.  Many small business entrepreneurs have similar tendencies.  I have major problems with the direction our country is headed.  I was not at all excited about the candidates offered, but not voting is unthinkably disrespectful to those who fought and died for our right to make our voices heard.  So I prayed and thought and researched, then cast my vote.

Tuesday night I watched the election returns until 10 PM, then had to go to bed.  And lay awake all night worrying and praying (and answering pages since I was on call).  I got up Wednesday and found some of my votes went with the majority and some very important votes did not.

Many people are angry about the election results, but I was actually a little afraid.  We can’t keep on the road we’re going on.  Government spending can’t continue to increase, there’s just not enough money moving around to tax it when we earn it, tax it when we spend it, tax it when we invest it AND tax it when we save it!  And those that we have elected seem to be content to keep the status quo while making empty promises to fix it “if only the other party will get out of the way.”

Someone I respect very much made a great Facebook post that we must not pray AGAINST our elected officials.  We must pray for their health and safety, for their focus to be on the good of the people while respecting the limits placed on them by those who founded this great nation.  So I pray that God will watch over and protect everyone that we have chosen to lead, to speak for and to serve us, that their hearts will be touched and their eyes opened to see the plan that God has for the next four years of our collective future.  I pray they will leave their egos outside when they step into the Capitol and remember why they were chosen:  to serve us.

Speaking of serving, I have made a decision that I will NOT be afraid anymore.  No matter who sleeps in the White House, my mission will not change.  I am here to help YOU make your life better, however I can help.  Whether that is by treating your medical problem, connecting you to the right specialist, listening, explaining, coaching, cheerleading or kicking you in the pants, nothing will get in the way of that.  I love what I do, and that call doesn’t answer to the government. 

Thanks so much for letting me share your journey with you, and for walking a little way with me.  We each have a mission, for which we were specially crafted.  I know what mine is.  What’s yours?

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It Hurts When I Do This…

You’ve all heard this old joke, right?  Guy goes to the doctor and says “Doc, it hurts when I touch here,” poking the spot with his finger.  Then he says “It hurts when I touch here, here and here too,” poking other spots.  Doc looks at him and says “I know what’s wrong.  You broke your finger.”

Ha.  Very funny, unless you have fibromyalgia.  Fibromyalgia sufferers only WISH they could blame it on a broken finger.  They have pain in many places, all over their bodies, for no reason that we understand.  There are lots of theories involving nervous systems that are too sensitive to pain or misinterpret normal sensations as pain, elevated levels of certain neurotransmitters related to pain, and low levels of other neurotransmitters.  The evidence is mounting though that fibromyalgia really IS a real disorder and there are some medications that seem to make a difference to some sufferers.

Before you flame me for my statement above, please understand that I happen to be one of those that knows my patients with fibromyalgia suffer real pain.  The medical establishment is slow, however, to recognize newly described disorders and the jury seems to still be out for the medical system as a whole.  I know this is a source of endless frustration for fibromyalgia sufferers.

We don’t have any drugs that are great for fibromyalgia or that consistently relieve pain or restore function.  There are only 3 drugs that have been approved for the treatment of fibromyalgia:  Cymbalta, Lyrica and Savella (sorry but I don’t know how to add the nifty c-in-a-circle so please remember these names are copyrighted).  As anyone with fibromyalgia will tell you, they don’t always give fabulous results and have pretty significant side effects sometimes.

There aren’t any super-great supplements for fibromyalgia either unfortunately!  However, I do have some suggestions that have helped my patients.  First of all, the foundation is critical.  Please check here and follow the link for your age and gender to see the foundation multivitamin or pack for you.  Fish oil has anti-inflammatory effects and B-complex helps relieve stress.  Vitamin C is important for healthy soft tissues and healing after injury.  Boswellia has anti-inflammatory and pain-relieving properties too.

Stress relief is important for fibromyalgia patients, as are proper sleep and regular gentle exercise.  Weight management is crucial as higher body weight puts more stress on the joints and muscles.

Much as I wish it were otherwise, I don’t think we’re going to see one pill fix fibromyalgia.  Like so many other complex problems in medicine (and in life!), it’s going to require time, patience, persistence and a willingness to step outside the box and try different approaches before we finally get it right.

Thanks Michelle for the great topic suggestion 🙂

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