Plantar Fasciitis – Oh My Aching Heel!

I have been in pain for weeks.  Possibly for months.  I don’t recall when the pain started, it’s been so long.  The pain in the bottom of my left heel has ranged from a twinge to severe enough to make me limp badly.  I have plantar fasciitis.

Credit: drmoy.com

What is plantar fasciitis?

Plantar fasciitis is a mechanical problem that happens where the plantar fascia attaches to the front of the heel bone.  The plantar fascia is a tough band of tissue that supports the arch of the foot and acts as a shock absorber when we walk.  It runs from the ball of the foot to the front of the heel bone.

When the mechanics of the foot don’t work right, that attachment place gets inflamed and painful.  Typically the pain is worst first thing in the morning.  In fact if someone tells me their foot hurts on the bottom and the first step out of bed in the morning is the worst pain they feel all day, I know it’s plantar fasciitis.  Nothing else does that!

What causes plantar fasciitis?

The most common cause of plantar fasciitis is wearing the wrong shoes.  Flip-flops and other shoes with no arch support are the most common cause.  I bought some super cute Converse sneakers some months ago, and I think that’s when the pain started.  Tight calf muscles and Achilles tendons also contribute to the mechanical problems that start and maintain the problem.

What can be done about plantar fasciitis?

The first thing is to start wearing proper footwear.  If you have a high arch (like me) you are especially prone to this problem and should be very careful to wear supportive shoes.  Several people have advised me to never go barefoot, even in the house, especially on wood or tile floors.  I’m working on that!  It’s hard for me to wear shoes in the house, and most house slippers have no arch support.

Aggressive calf stretching is important to keep the calf muscles and Achilles tendons loose and limber.  My personal favorite stretch is to stand on the edge of a stair step on the balls of my feet and let my body weight pull me down into my heels.  Be sure to do calf stretches both with the knee straight and with the knee bent.  There are two big strong muscles in the calf and to stretch them both you need to stretch both ways.

Another measure to help heal the pain is ice.  Ice, ice, ice, and then when you’re done  ice some more.  A frozen water bottle is a good way to both stretch and massage the bottom of the foot while applying cold therapy.

What if it doesn’t work?

If I have a patient that comes in with persistent pain in spite of doing all the above simple things, it is usually time for a cortisone injection.  I haven’t done that yet, because I’m chicken, LOL!  It might be time for it soon, though.

In extremely resistant cases patients usually need to see the podiatrist (foot doctor).  Splinting, injections, massage, physical therapy, and sometimes even surgery may be needed.

Trust me when I tell you, good supportive quality shoes are definitely worth the expense!  It’s an investment in good pain-free foot health!

QUESTION: Have you ever had plantar fasciitis?  What did it take to get rid of it?

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Wound Healing And Nutrition

One of the most devastating complications of diabetes is chronic nonhealing foot wounds.  I’ve had many patients in the hospital for chronic wounds that become infected.  Unfortunately many of them are unable to heal their wounds and wind up with partial or complete amputations of their foot and lower leg.

Diabetics and other chronically ill older patients often have diets that aren’t healthy.  They don’t get enough healthy fats, protein and micronutrients from the food they eat.  These problems contribute to ill health and complications like poor wound healing.

Vitamin deficiencies are more common in older adults, especially those who don’t have a varied, healthy diet.  Inadequate intake, decreased absorption and use of medications  are among the causes of nutrient deficiencies.  Protein, vitamin D, folic acid, vitamin B12 and water are examples of nutrients that older adults may not get in adequate amounts.

In the case of diabetics, elevated levels of blood sugar over time result in the formation of advanced glycation end products (AGEs) which damage proteins and increase levels of inflammation in the cells and tissues.  This is one of the main ways diabetes contributes to end organ damage in just about every organ in the body.  AGEs are thought to contribute to a number of diseases, from Alzheimer’s disease to end stage kidney failure to cataracts to atherosclerotic cardiovascular disease.

If someone develops a chronic wound, what nutrients are needed to help in healing?  Protein, carbohydrate, fat, vitamins and minerals are all needed.  The best sources of these nutrients come from a healthy balanced diet of course.  However, studies have shown that 95% of Americans are not getting enough of one or more vitamins or minerals in their diet.  Especially if someone is trying to heal a wound, getting enough nutrients is critical and the patient likely will benefit from a supplement.

Protein

People who are sick or have a wound to heal need extra protein.  Estimates are that such people need about 1.5 grams per kilogram of body weight.  So a woman who weighs 70 kg (155 pounds) would need about 105 grams of protein per day.  One ounce of animal flesh (beef, poultry, pork or fish), one cup of dairy milk or one ounce of cheese contains about 8 grams protein.  One egg contains 6 grams, 8 ounces of Greek yogurt contains 23 grams, one cup of navy beans contains 20 grams and 4 ounces of tofu contain 16 grams of protein.

Fat

Getting extra fat in the diet helps provide energy and calories for healing and also provides building blocks for making new cells.  Omega 3 fats help mute inflammation and encourage healing, and omega 6 fats balance things out.  Fish oil has been shown to be helpful in patients with pressure ulcers in the ICU setting.

Carbohydrates

Complex carbohydrates provide fiber which feeds the healthy bacteria in the gut, as well as calories for energy.  Our gut bacteria help support a healthy immune system.  Healing wounds and getting well is hard work!  Depends on how malnourished someone is (and how sick they are) a patient may need up to 40 calories per kilogram of body weight.  That 70-kilogram woman above would need up to 2800 calories per day, plus more if she is doing more than just lying in bed.

It’s important that these carbohydrates should be whole-food complex carbohydrates like fresh fruits and vegetables, beans and whole grains like oatmeal.  Refined carbohydrates like white bread, bagels, bakery and the like are NOT helpful and increase the production of AGEs.

Vitamins and Minerals

Vitamin A, vitamin C, vitamin D, zinc, selenium and antioxidants have been investigated as being helpful in wound healing.  While supplementation with high doses of single nutrients has not been shown to help, using a good quality well-balanced multivitamin is smart.  After all, if only 5% of Americans get all the nutrients they need from their diet, who doesn’t need a multivitamin?  And if deficiencies slow down wound healing, those with slow-healing wounds would benefit even more!

Unfortunately many Americans are badly malnourished.  Those with very low or very high body mass index (BMI) are most at risk of significant malnutrition.

How do you know if someone is malnourished?  They may or may not lose a lot of weight, especially if they were obese to start with.  Low blood albumin levels are a clue, as is swelling (edema).  The edema may be mostly in the legs, but the arms and abdomen may be puffy and swollen too.  They are weak, and there may be a big change in their strength and ability to take care of themselves.

People who are malnourished will have loss of muscle and fat tissue.  A good place to look is at the temples.  If the temples look bony and it’s easy to feel the skull bones and see the bones of the eye sockets, it is suggestive of malnutrition.

If you know anyone with a chronic wound, especially if they are diabetic, encourage them to see their doctor and work hard to get their blood sugar under control.  Good blood sugar control slows the production of AGEs and decreases inflammation.

Also, make sure they are getting plenty of protein and taking a high-quality multivitamin.  Antioxidants and fish oil may be helpful as well.  If your doctor isn’t able to make recommendations about specific supplements, you’re welcome to reach out to me or get a quick assessment at jenniferwurstmd.com/healthprint.

Chronic wounds are tough to heal.  In addition to careful wound care and avoiding pressure on the wound, attention to a healthy diet and smart supplementation are practical steps you can take to speed up the healing process.

QUESTION: Have you known anyone with a chronic wound?  What did it take to heal it?

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What Is Pneumonia Anyway?

Angela is an older woman who unfortunately several years ago was diagnosed with multiple sclerosis.  She suddenly became weaker and was having trouble walking, shortly after developing some cold symptoms and a cough.  When she went to the ER, she was found on Xray to have evidence of pneumonia.

I’ve had two patients in the office this week with pneumonia and found myself having to explain exactly what that meant.  We’ve got tons of folks right now with cough and respiratory congestion, and the majority don’t have pneumonia.  What IS pneumonia, anyway?

Parts Of The Lung

To help you understand what pneumonia is and why it is so dangerous, we have to start with knowing the different parts of the lung and how they work.  When you take a deep breath, the air goes into your nose or mouth, down your throat, between the vocal folds (or vocal cords) and into the trachea.  This is an enormous airway that you can feel below the Adam’s apple in the front of your neck just below the skin.  It’s got ridges because of rings of cartilage that make sure the trachea stays wide open.

From the trachea, the airway divides into left and right main stem bronchi, the main airways leading to the left and right lungs.  The bronchi divide into smaller and smaller airways like the branches of a tree until they reach the alveoli.  Here is a really excellent diagram I found on WebMD (they own the copyright, so kudos to them!) that you can use to visualize these different parts.

Credit: WebMD.com

Where’s The Infection?

Different lower respiratory infections affect different parts of the lung.  (Lung infections are called lower respiratory infections, as opposed to colds, sinus infections, ear infections and strep throat which are upper respiratory infections.)

Croup, or tracheobronchitis, affects the largest airways, the trachea and mainstem bronchi.  It causes a very hoarse voice, horrible sore throat, dry painful “barking” cough and fever.  In children with small airways it can cause a high-pitched noise called stridor when they breathe.  Usually the symptoms are worst at night, especially in children.  Croup is so scary!  My son had it twice when he was small, and we were in the ER both times.  I’m a doctor, I KNEW what it was, and it was still scary!

Bronchitis is very common, and is usually caused by a cold virus.  This affects the bronchi inside the lungs themselves and causes a “rumbling” sound called rhonchi when breathing, a (usually) moist productive cough and can have associated cold symptoms like runny nose and congestion.

Bronchiolitis is a specific form of bronchitis that attacks the very smallest airways right before the alveoli.  Its most common cause is a virus called respiratory syncytial virus (RSV) that can be very dangerous for small babies.  For older children and adults it causes a cold or bronchitis, but small babies can get very sick and need hospitalization with wheezing and trouble breathing with this illness.

Pneumonia is an infection in the alveoli.  The alveoli are the sacs where carbon dioxide is released and oxygen is absorbed by the blood.  The are extremely delicate and can be badly damaged and scarred by infection.  We can often see evidence of pneumonia on Xray because larger areas of the lung can be infected.

Credit: www.med-ed.virginia.edu

What Is Pneumonia?

Symptoms of pneumonia include cough, chest pain with breathing, fever, shortness of breath and generally feeling unwell.

If the part of the lung that exchanges carbon dioxide and oxygen is full of pus and not functioning, the body can have trouble getting enough oxygen.  This can be very dangerous, especially in people who don’t have good lung function to start with (like asthmatics and people with COPD), those whose immune systems aren’t normal (like Angela with her MS, or like my diabetic patients) and those who are very young or very old.

Pneumonia is the number-8 leading cause of death in the US (with influenza).  Preventing pneumonia starts with good handwashing and includes staying generally as healthy as one possibly can.  Getting plenty of rest, eating healthy and taking a good quality multivitamin, exercising and managing your stress are integral to maintaining a strong immune system.  Vaccination against influenza and Streptococcus pneumoniae (the cause of the most dangerous form of pneumonia) decrease your risk as well.

We haven’t even started in to cold and flu season and I’m already seeing cases of pneumonia.  With the Farmer’s Almanac forecasting a long, cold, snowy winter we’d better start now to reduce our risk of pneumonia this season.

QUESTION: Have you had pneumonia?

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Chagas Disease From “Kissing Bugs?”

There have been new reports of concern about rising risk of a parasitic illness in the United States.  The illness is called Chagas disease, and it is transmitted by a certain type of insect.  Chagas disease has typically been found in Mexico, Central America and South America, but the carrier insect has been moving into the southern United States.

Triatomine Map

Chagas disease is caused by a parasite called Trypanosoma cruzi which is carried by a number of insects of the triatomine family.  The map above shows the states in which triatomine bugs have been found.

Triatomine bugs are called “kissing bugs” because they bite the lips and faces of sleeping people, dogs and other animals while they are sleeping.  They are generally found in poorly-maintained homes especially those made of adobe or those that have thatched roofs.  Modern American homes with plaster walls and well-sealed doorways don’t have much risk that these insects will get inside.  (Although stink bugs are only a little smaller than these triatomine bugs and they still get in my house.  So there’s that…)

The insects are a little larger than an inch in length:

Triatomine Stages

Here’s a better close-up photo of the insect:

Triatomine close-up

These insects are spreading into the US, but documented cases of Chagas disease transmitted INSIDE the United States are rare.  There are estimated to be about 300,000 people with Chagas disease in the United States, and almost all of them were infected in Mexico or South or Central America.

Chagas disease is rare.  In almost 20 years I’ve only ever seen one patient with it.  It starts with a bite from one of these insects that is infected with the T. cruzi organism.  When the insect bites, it also passes feces, which contains the organism.  When the bitten person wakes up and scratches or rubs the bite, they often spread the infected feces into their eyes.  This can cause swelling of the eyelids, called Romaña’s sign.

Romaña’s sign

Most of the time the body clears the infection without any trouble or illness at all.  However, if the infection becomes chronic it can cause problems with the heart and with the digestive tract.  It’s estimated that 20-30% of infected people will have medical problems related to the infection at some time in their life.  The infection can also lie dormant and reactivate, like shingles or tuberculosis, if an infected person becomes immune suppressed.  This is a potential concern in HIV-infected people or those who undergo chemotherapy for cancer or an autoimmune disease.

Chagas disease is treated with medication.  Because it is rare, typically an infectious disease specialist would be involved with treatment.

So for those who are seeing alarming reports about this “kissing bug” invading the US, there’s no need to panic right now.  The vast majority of these rare cases of Chagas disease are not caused by triatomine bites here in the United States.  If you’re not worried about malaria or Zika virus, you shouldn’t be worrying about Chagas disease at this point.

PS – Most of the information in this post comes from the CDC website.  You can visit and read more about Chagas disease here.

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Back To School Health Concerns

It’s that time of year again!  Have you got kids going to school this fall?  Me too!  We’re shopping for school supplies and clothes and shoes just like everybody else.

Are your kids ready to go back?  There are a number of things you can do to set your kids up for success this school year!

Good Sleep

Did your kids get off their school sleep schedule this summer?  Don’t worry, if they did you should have plenty of time to get them back on-track before school starts.

Elementary school children need about 10 hours of sleep per night.  For instance, our kids’ bus came at 7:30 AM last year.  Since they got up between 6:30 and 7:00, that made our bedtime about 8:30 so that they were asleep by 9.

You will want to give plenty of time to adjust a child’s sleep schedule.  Move bedtime by no more than a half-hour per night, every few nights, to let your child adjust.  If they’ve become accustomed to sleeping in, start instituting a set wake-up time.  In the adjustment period if they seem tired let them take a short nap.

There are plenty of things to adjust to in the first few weeks of school.  Fatigue and sleepiness and battles over going to bed and waking up are things you just don’t need to deal with.

Doctor’s Visits

Are your kids playing sports this school year?  Summertime is a good time to get their sports physicals out of the way.  Don’t worry, the physical is good for a year and is covered by health insurance.  Make sure to bring along any medication administration forms (for asthma or other meds your child will need to take at school).

If your child will be heading into kindergarten or 7th grade, they will need vaccines prior to starting school.  You should have gotten paperwork from the school already if your child is affected.  Remember that although your rising 7th grader is required to have the DTaP, the meningitis and HPV vaccines are also recommended at this age.

I get a lot of questions about the HPV vaccine and dove a little deeper into that topic in this post.  Please discuss the vaccine recommendations with your child’s doctor in detail.

After the 7th grade shots, your child will be done with tetanus shots until after college (unless she hurts herself, gets bit by a dog, etc) but she will need a meningitis shot booster at age 16.  Other than annual flu shots those are all the shots your child will need.

Nutrition

My younger son participates in a summer day program every year that does not provide lunch.  We were a little concerned at the beginning that packing lunches would be a big hassle.  To our pleased surprise, it has been a very positive experience.

Our lunch planning guidelines have been that our child needs a sandwich (with deli meat and cheese) and a fruit, a vegetable, and a starch for his lunch.  We read labels and used a food scale to explore portions for the starch (often pretzels, corn chips or a granola bar).  Here’s a website with interesting school lunch ideas.

Now after several summers he makes his own lunches like a pro.  Even better, when we go to the market and our kids want to try a different food (like barbecue potato chips) we can look at ingredients and talk about what’s in there, portion sizes and how they’re manipulated, price versus value, and other good topics.  We’ve even gotten them to try some new vegetables!

From a health standpoint, heading back to school can be stressful from a health standpoint.  With a little planning your youngsters can transition into the school year happy and healthy.

QUESTION:  What back to school health concerns do you have that I didn’t discuss?  I can always talk about them next week, LOL!

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Teen Smoking And Alcohol Use Decreasing

When you talk to the teenagers in your life, do you feel like they don’t listen?  That your words go in one ear and out the other (or straight over their head altogether)? Don’t give up – there are positive signs that some kinds of substance use among our teens are on the decline.

FINALLY some good news about our teens!  There is evidence we are seeing teen smoking and alcohol use DECREASE in the USA!

There was a research article published last week in Pediatrics that found that high school seniors in 2014 were five times more likely to report they had never tried cigarettes or alcohol than they were in the mid-1970s.  Similar trends were seen for younger adolescents as well.

Why is this happening?  There are likely a lot of reasons.  First of all, it’s illegal for teens under 18 to buy or use tobacco products.  Granted, whether something is illegal isn’t a great deterrent for either teens or adults, but it does make it more difficult for teens to smoke cigarettes than it was in the 70s.

Same with alcohol.  Penalties for teenage drinking are increasing, as well as for parents who host parties where teens are drinking.

I’m seeing in my office that fewer and fewer teenagers report smoking cigarettes.  Even better, they will often tell me that cigarettes are “gross.”  I love hearing that!  Cigarettes ARE gross!  The social pressure to smoke cigarettes is definitely decreasing among teens.

The downside to this is that smoking hookah (tobacco in a water pipe) and vaping are hugely on the rise.  Both of these are also illegal to sell or provide to minors, but the social pressure seems to favor these behaviors over smoking cigarettes.

What really concerns me is the recent sharp increase in marijuana smoking.  More and more of my teenage patients tell me they smoke pot, and they often don’t see any problem with it.  It seems like high school social pressures have moved away from cigarettes and towards behaviors that seem safer but really aren’t.

Those of us who are parenting or have leadership roles with teens need to be aware of these trends and continue to work to educate our kids.  There is danger in ALL tobacco products, marijuana, alcohol, other recreational drugs, and electronic cigarettes.

QUESTION: Do you spend time with teens?  Would you agree that drinking and smoking are decreasing?

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The Best Way To Control Your Blood Sugar

Don’t eat fruit.  Don’t eat meat.  Don’t eat sugar.  Eat before exercising.  Exercise while fasting.  Don’t eat after 7 PM.

If you read books by the popular health gurus or look at Facebook posts you can get completely confused by all the conflicting advice offered for diabetics.  What is the best way for a diabetic to control their blood sugar?

Get To And Maintain A Healthy Weight

The most important thing to do to get blood sugar under control is to achieve and maintain a healthy weight.  Just that one thing will get most of our diabetics to good blood sugar control, even without medication.

It isn’t even all that critical to get to a “normal” weight for blood sugar to improve.  Even losing just 5% of body fat (10 pounds for those starting at 200 pounds) has been shown to improve glycemic control.

I have a lot of patients who ask me what they SHOULD weigh.  I tell them I’m not sure, but let’s start with 5 pounds.  The same skills that get rid of the first 5 pounds will get rid of the first 100 pounds, you just have to stick with it!

For those who are looking for a healthy, effective, simple weight loss program, I always recommend the Shaklee 180 program.  If you’re interested in more information, please click this link to check it out.  If you like to watch videos, here’s one on my YouTube channel that’s very informative.

Eat Real Food

A lot of people are afraid of eating carbohydrates.  So many people want to eat Paleo, keto, low-carb…  The list goes on!  There are a lot of problems with trying so desperately to avoid carbs that you swing the pendulum WAY in the other direction and eat more meat and dairy.  Any diet that gets you to avoid eating processed food is a step in the right direction, but plant foods are much healthier than animal based foods.

The only diet that has been shown to improve health in diabetics (blood sugar control AND heart and vascular health) is the plant-based diet.  That means fruits and veggies, root vegetables, beans, nuts, seeds and whole unprocessed grains.

I always laugh when keto and Paleo people try to say fruit is unhealthy.  Come on, now.  Anyone who tells you steak, bacon, sausage and cheese are healthy but apples will make you fat is either misinformed or outright lying to you!

A word on sweeteners.  Be aware that artificial sweeteners are not a good choice, and all sweeteners that contain calories are pretty much the same.  For instance, high-fructose corn syrup, table sugar, agave syrup and honey all impact the body about the same.  You should reduce ALL of them, and avoid artificial sweeteners altogether.

Smart Supplementation

There are a few nutrients that are helpful for maintaining blood sugar control.  For instance, chromium supplementation is well-known for helping to improve glycemic control.  In fact, there was a smallish study published out of Iran that found about 1/3 of diabetics actually have deficiencies in chromium.  (I think I might have to start testing my patients and prescribing a supplement!)

Other nutrients are helpful for diabetics, like vanadium and zinc.  The amino acid taurine also is protective and improves blood sugar control.  Magnesium is important for everybody but especially those with diabetes, high blood pressure, and increased cardiovascular risk.

Shaklee’s Glucose Regulation Complex is based on solid scientific research and formulated to promote healthy blood sugar levels.  If you’re interested, you can check this link to learn more about it.

Diabetes is getting more and more prevalent.  Two-thirds of Americans are overweight or obese, which seriously increases their risk of diabetes.  Losing weight, eating real food and smart supplementation are things you can do to improve blood sugar control.

QUESTION: Are you diabetic? What do you find helpful in controlling your blood sugar?

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Is Drinking Coffee Healthy?

Are you a tea drinker or a coffee drinker?  Both?  Neither?  I love both, depending on my mood.  One or two cups of coffee in the morning, one in the afternoon and usually tea in the evening.

A lot of people think coffee isn’t healthy to drink.  It’s acidic, it has caffeine, it stains your teeth.  Is drinking coffee healthy?

Photo by Kaboompics .com from Pexels

There’s a lot of evidence that drinking coffee is associated with a lower rate of early death.  Most of those studies are smallish, but an absolutely massive research study was just published out of the UK.  Over a half million people were asked about their coffee drinking habits.  What did they find?

In short, the researchers found that the more coffee a person drank the lower their risk of death over the course of the study.  Now this study was not designed to assess CAUSE, but when you look at such a large group of people for 10 years, it suggests pretty reliable patterns.

It was also very exciting to find that drinking coffee lowered the risk of type 2 diabetes.  Similar to the death rate, more coffee intake was associated with lower risk.  Since we in the US are having an absolute epidemic of diabetes, any little thing we can do to decrease the risk is very welcome!

Even more interestingly, it didn’t matter whether people drank caffeinated coffee or decaf.  The researchers took caffeine into account because there are genes that make it hard for people to metabolize that stimulant.  Even if you don’t like the buzz of caffeine that you can get from coffee, you can still benefit.

Why is coffee healthy?  Coffee is made by roasting coffee beans, then grinding them, then steeping them in boiling water.  Healthy plant compounds like polyphenols and antioxidants are probably the cause, although more research is needed to be sure.

Be careful what you put in your coffee, though.  Sugary syrups, artificial flavors and sweeteners aren’t good options.  Choose more natural flavorings and sweeteners like cinnamon, ground nuts, honey or a little table sugar.  One of my favorite treats when I’m not in the mood to drink my coffee black is a little brown sugar.  The molasses and caramel flavor is delicious!

If you have high blood pressure or other cardiovascular problems be careful how much caffeine you’re taking in – it can be hard on the heart.  One of the great things about this study is that it showed decaf coffee is just as beneficial as regular.

If you enjoy drinking coffee there’s no reason to stop.  There is plenty of research showing coffee to be healthy to drink.

QUESTION: Do you like coffee?  Will this study change how much you drink?

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Vision and Memory Loss

Imagine that you’re a 75-year-old woman living in a small house with your 78-year-old husband.  You’ve been keeping the house for your husband all your married lives while he worked to support your family.  Now you’re retired and while you traveled some in your early retirement, both of you are tiring more easily and generally stay closer to home now.

Recently you’ve noticed your husband hasn’t been interested in doing the morning crossword or reading his beloved mystery novels, and you have to work harder to coax him to go out for your evening walk.  He used to like puttering in the yard but this year the shrubs are a bit overgrown and he forgets to put out the birdseed and shoo the squirrels away from the feeder.  What’s going on?

If you said he is depressed, you might be right.  He may also have early dementia.  However, when you take him to the doctor to address these concerns, please make sure the doctor does a quick vision and hearing screen too.

A recent study published in the Journal of the American Medical Association reports that vision loss is associated with a 2-3 times increased risk of cognitive dysfunction or dementia.

We know that children have trouble learning if they can’t see properly.  One important thing we as parents can do is make sure our children get their vision checked regularly.  Turns out it’s as important for us to make sure our PARENTS are getting to the eye doctor too!

Vision loss is unfortunately quite common in older adults.  Macular degeneration, cataracts and glaucoma become more common with older age.  Vision loss can come on gradually and be difficult to identify without regular eye exam.

Vision loss contributes to cognitive dysfunction by decreasing stimulation to the brain.  Adults with vision loss may be more cautious about (or frankly afraid of) travel or participating in more adventurous activities.  Also, vision loss makes activities known to protect cognitive function (like reading, doing puzzles and working with the hands) less enjoyable.

There are also nutrients that can help protect vision.  First, it is important to eat leafy green vegetables regularly.  These are rich in lutein and zeaxanthin which may protect against the development of macular degeneration. 

Taking an eye health supplement in addition to a multivitamin may be helpful if a doctor identifies early signs of macular degeneration on exam.  A specific brand may be recommended by the doctor.

If you have older adults in your life, please make sure they are seeing the eye doctor regularly and maintaining their vision.  It makes a huge difference in quality of life and is likely to protect them from memory loss.

QUESTION: Do you have an older adult in your life with vision loss?  How has it affected them?

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Celiac Disease And Pregnancy Complications

I can think of few things more heartbreaking than infertility, repeated miscarriage and losing a child at birth.  Women in my family and in my close circle of friends have struggled with pregnancy complications and I know how difficult and painful it is.

There is a glimmer of hope that was just reported in the journal Human Reproduction recently.  Researchers in Denmark found that women who have undiagnosed celiac disease are at higher risk for infertility, miscarriage and stillbirth.

The good news is that if these women are diagnosed and treated with a gluten-free diet, their risk of pregnancy problems goes back to normal levels.  Knowing about this link between undiagnosed celiac disease and pregnancy complications may help women achieve the pregnancies and families they have always wanted.

So what is celiac disease?  Celiac disease is an autoimmune disorder triggered by eating the protein gluten, found in foods containing one or more of four grains.  The four gluten grains are wheat, barley, rye and spelt.

Eating gluten causes a reaction that harms the lining of the intestine and interferes with digestion and absorption of nutrients.  It increases the risk of cancer of the small intestine. Gluten intolerance also is associated with disorders in many other body symptoms, including the brain, skin, joints and cardiovascular system.  Turns out celiac disease also appears to affect the reproductive system.

Celiac disease is diagnosed by a combination of blood tests and endoscopy, and is treated with a strict gluten-free diet.  Even accidental intake of tiny amounts of gluten can trigger the disease.

I was diagnosed with gluten intolerance about 3 years ago and don’t know if I have celiac disease.  I might;  I’m not willing to eat gluten to confirm the diagnosis.  (Eating gluten-free can interfere with testing because antibody levels and changes in the intestine correct with avoiding gluten in the diet).

I probably have been gluten intolerant most of my life.  As I wrote before, major food intolerance (including gluten intolerance) is strongly associated with gallstone formation.  I had my gallbladder removed at age 19 because of gallstones.

Luckily I have not had any problems with fertility.  I was able to have my children when I wanted them and carried them without problems.  I want that for you and the women in your life!  If you or someone you love has been struggling with problems achieving and carrying a pregnancy please share this article with them.  Their doctor may not be aware of this newly reported link between celiac disease and pregnancy complications.

If you are considering getting pregnant please keep a few things in mind.  You need a prenatal vitamin BEFORE you are pregnant.  One that contains adequate amounts of folic acid, iron and iodine is crucial.  Don’t smoke, drink alcohol or use any recreational drugs while trying to conceive.  Also, you must manage your stress because too much stress can affect fertility.  (Heck it affects everything else, why not that, right?)

Please click this link for several articles about nutrition and pregnancy.

QUESTION: Do you know anyone struggling with infertility or pregnancy loss?  Would this information help them?

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