JustCare

Tag: Health and wellness

  • Should you take Vitamin C tablets?

    Should you take Vitamin C tablets?

    Many of my patients tell me that they are taking large doses of Vitamin C tablets to boost their immune system. If your diet is balanced, with all the food groups represented, you are likely getting enough Vitamin C without any reason to take additional tablets.

    According to the NIH, one medium orange contains more than enough vitamin C, around 117% of what you need daily. Adding oranges, grapefruits and lemons to your diet or broccoli and other fruits and vegetables that are high in Vitamin C, can help greatly. And, you can eat as much of these foods as you’d like without side effects.

    With Vitamin C supplements, in extremely high doses, there is a risk of developing kidney stones and severe diarrhea. Vitamin C supplements can potentially interact with your medications in harmful ways.  If you take iron pills or have an iron disorder, for example, a Vitamin C supplement could increase iron absorption and be really bad for you.

    What you may find hard to believe is that the scientific evidence shows that Vitamin C supplements are not as effective as you think. One reason people often take them is to prevent the common cold. The Natural Medicines Comprehensive Database found that claim lacks evidence and it is possibly ineffective. Other systematic reviews of the Vitamin C supplement also show that it lacks the efficacy that the public believes it has. For example, in a systematic review of 29 studies released by the Cochrane Collaboration in 2013, Vitamin C supplements did not reduce the number of colds of participants in the studies. If you think the Vitamin C supplement keeps you from getting a cold or shortens it, think again.

    The one evidence-based reason to take Vitamin C supplements is that they can treat scurvy. Scurvy is a condition caused by an actual Vitamin C deficiency. In all of my years of practice, I have had ONE case of scurvy. You might have heard of scurvy in the past being an ailment of those sailing for long periods of time without a varied diet, but it is not limited to pirates and sailors. To read more about the history of scurvy click here.

    If you are worried about needing more Vitamin C, make sure you are eating enough Vitamin C-rich foods, including oranges, red peppers, kale, brussels sprouts, broccoli, strawberries, oranges and grapefruit. Changing your diet could be a simple non-supplement solution. If you still have concerns, discuss them with your doctor before taking any supplements. That’s the smartest way to protect your health and to save money.

    [N.B. This post was originally published on January 10, 2017.]

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  • Vigorous exercise found to ward off dementia

    Vigorous exercise found to ward off dementia

    Vigorous exercise can help keep your brain healthy and ward off dementia. Rachel Fairbank reports for the New York Times on three recent studies confirming the value of vigorous exercise for your mental health. The good news: Exercise comes in a large variety of forms, including household chores.

    The studies involved hundreds of thousands of people over many years. They each concluded that ongoing exercise of myriad types can “substantially” reduce your risk of developing dementia. They further found that the benefit of exercise for brain health extends to people with a family history of dementia.

    The British study of more than 500,000 people published in Neurology took a deep dive into the kinds of physical activity people engaged in routinely. After 11 years, about one percent of the participants had developed dementia. Participants who worked out or played a sport had a 35 percent lower risk of developing dementia. Participants who undertook household chores for an extended period had a 21 percent lower risk.

    An appropriate goal is still 30 minutes of exercise five days a week or a total of 150 minutes of exercise that has you breaking a sweat.

    A meta-analysis of 38 studies of the effects of leisure activities on brain health was published earlier this month in Neurology. These studies, over at least three years, involved more than two million people who did not have dementia. During that time, 74,700 developed dementia. Researchers found that participants who walked, ran, swum, danced, engaged in sports or worked out reduced their risk of developing dementia by 17 percent.

    The third study followed young children over a 30-year period. The researchers found that kids who are active end up with greater brain health in midlife.

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  • How to avoid food poisoning

    How to avoid food poisoning

    Consumer Reports explains that food poisoning comes from sources other than food.  So, you might not be aware of several causes. Happily, in this era of the novel coronavirus, you are likely following protocols that minimize your risks. For your health and wellness, here’s what you should know.

    The risk of food poisoning can come from being with chickens and kissing or holding baby chicks, turkeys, ducks and geese, and then putting your fingers in your mouth. These birds often walk, peck and roll in their feces, which contain the food poisoning bacteria.

    Food poisoning can also come from hedgehogs, iguanas and turtles, which also can have feces on them.

    Perhaps, most shockingly, raw pet food can give you food poisoning. Raw pet food can have high levels of bacterial contaminants. Unless it is cooked, the bacteria remains alive. If the food gets on your kitchen counter or cutlery or dishware and you touch it, and then don’t wash your hands, you can end up sick.

    Food poisoning can also spread from children and other people who might not be symptomatic and who do not wash their hands after using the toilet. If they then touch you or food that you eat, you can get the bacteria.

    What should you do? You should do exactly what you are advised to do to protect yourself from the novel coronavirus. Practice good hygiene. Wash your hands frequently. Wash them immediately after being with chickens and other fowl, turtles and other people. Wash them before eating. Keep your kitchen clean. And, Consumer Reports advises, take your shoes off before you enter the house. That not only protects you, it makes for less dirt and less housework!

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  • Five things to know about gout

    Five things to know about gout

    Gout can be a painful health condition, often a type of arthritis, which generally involves swelling in the joints and can be extremely painful. About 9.2 million Americans live with gout. With gout, your body produces more uric acid than your kidneys are able to filter out. Fortunately, gout can usually be treated, and you can live a productive life. Here are five things you should know about gout:

    1. Who is likely to get gout?
      • About nine million adults experience gout at some point in their lives. Adults are prone to get gout, particularly men between 40 and 50. Current thinking is that gout runs in families, so whether you get it may spend on your genes. People who are overweight, who drink a lot of alcohol, or eat a lot of purines, such as high-fructose corn syrup, beer and scallops, are also more prone to gout.
      • Older people are also more likely to get gout because their kidneys are not working effectively to remove uric acid in their systems. And some medications, such as diuretics, also can lead to gout.
    2. What causes gout? When you have an excess of uric acid in your system, needle-like crystals of uric acid can build up and end up in your joints or soft tissues. There, they cause gout, an inflammation and swelling, redness, heat, and stiffness in the joints that can be very painful.
    3. What are the symptoms of gout? Often, people get gout first in the big toe, but not always. Sometimes, people get gout in their feet or ankles, knees or wrists, fingers and elbows. And sometimes the uric acid crystals end up in the kidneys and cause kidney stones. You can have an excess of uric acid without experiencing any symptoms, and then there’s generally no cause for concern or treatment. Treatment is needed when there is intense swelling or pain in the joints.
    4. What are the triggers for painful symptoms of gout? Alcohol, drugs and stress are often triggers for a painful attack of gout, which usually begins at night and can last for three to ten days. The pain will typically end on its own, without treatment, but the swelling and pain can return at any time. There is an advanced and disabling stage of gout, in which the joints are permanently affected. With proper treatment, however, most people with gout never experience this stage.
    5. How is gout treated? Gout is commonly treated with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), which are taken by mouth, or corticosteroids, which are taken by mouth or by injection. With proper treatment, most people with gout can live pain-free or close to it.

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  • Medicare covers physical, speech and occupational therapy

    Medicare covers physical, speech and occupational therapy

    Whether it’s because of an illness or an injury, or simply to improve balance, at some point in our lives, many of us will need therapy to regain or maintain our ability to function. Medicare covers physical, speech and occupational therapy in a variety of settings. Talk to the doctor about whether therapy would benefit you or someone you love.

    Medicare offers several outpatient therapy options. You can receive outpatient therapy services at a Comprehensive Outpatient Rehabilitation Facility, hospital, public health agency or from a private therapist, so long as the provider is Medicare-certified and you qualify for coverage. You can also receive outpatient therapy services from a Medicare-certified home health agency, so long as you qualify for the Medicare home health benefit.

    For Medicare to cover outpatient therapy, you must meet the eligibility criteria:

    • Therapy must be a safe and effective treatment for you.
    • A therapist must deliver the services or direct the delivery of the services.
    • Your doctor must certify you need the therapy to regain or maintain your ability to function and set up a plan of care for you in advance of your receiving services. And, if you need ongoing therapy, your doctor must review it and recertify your need.

    Medicare now covers as much outpatient physical, speech and occupational therapy as people need.

    Traditional Medicare pays 80 percent of the cost of these covered services. Supplemental coverage, such as Medicare supplemental insurance or “Medigap,” retiree coverage or Medicaid,  should pay the rest.

    Medicare also offers several inpatient therapy options. It covers physical, speech and occupational therapy in a nursing home as well as in a rehabilitation hospital. Coverage is limited. If you want inpatient care in a nursing home, you will need to have been hospitalized as an inpatient for at least three days in the 30 days prior to admission. You must receive care in a Medicare-certified skilled nursing facility. (Note: You can spend three nights at a hospital and the hospital may still deem it an outpatient stay.)

    If you simply need rehabilitation services–be it nursing, therapy, social worker help or psychological services–Medicare will cover care in a rehabilitation hospital under its hospital benefit.

    Medicare also covers cardiac rehabilitation care.  Click here to read more about this coverage.

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  • Five questions to ask your doctor to avoid overtreatment

    Five questions to ask your doctor to avoid overtreatment

    When your doctor suggests a particular test or treatment, it’s OK to have questions. (Overtreatment can be a problem.) These five questions, adapted from the book Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer, are intended to help you start a conversation and get the right care. If your doctor feels like there isn’t time to answer all of these questions in one appointment, it’s OK to ask for another.

    1. What are my options? For many conditions and illnesses, there can be more than one treatment. Sometimes changing your lifestyle, such as your eating or exercise habits, can reduce your symptoms or risk of a bad outcome enough to make additional treatment unnecessary. Sometimes, not getting treated at all is a reasonable choice. Ask your doctor what your options are, and to explain each one carefully.
    2. How exactly might the treatment help me? Sometimes patients have one idea about what a treatment can do, and the doctor has another idea.You need to know exactly what you stand to gain. A hip replacement, for example, might allow you to walk again with greater ease, but it won’t cure your arthritis, and you might need another replacement in 10 to 20 years. A drug might be able to relieve some symptoms and not others. Ask your doctor how the proposed drug or procedure is supposed to help you.
    3. What side effects can I expect, and what bad outcomes might happen? Every test, drug, surgery, and medical procedure has side effects, and some can be very serious. Simply being in the hospital exposes you to the possibility of bad reactions, medical errors, and hospital-acquired infections. You need to know the risks so you can decide if the danger or discomfort of your condition is more worrisome to you than the risks of the proposed treatment.
    4. How good is the evidence that I’ll benefit from the treatment? Many of the treatments and tests that doctors prescribe have never been adequately tested to find out if they work, or if they work in patients like you. You need to know if the treatment your doctor is recommending is a proven therapy. If not, your doctor should explain why he or she thinks it’s a good idea.
    5. If it’s a test, what do you expect to learn from it, and how might it change my treatment? If the test won’t change the treatment, ask your doctor if you really need the test.

    When you or someone you care about is in the hospital for a serious condition, such as heart failure, cancer, kidney failure, emphysema or any other advanced chronic condition, all of these questions are relevant. In addition, there is one more question and request you should make.

    • Do you have a palliative specialist in this hospital? If so, ask for a “palliative care consult.” Palliative care specialists are nurses, doctors ad other health professionals who are expert in controlling pain. They also help patients and their families with important decisions, such as whether or not to have surgery. For patients who are in the terminal stage of their disease, palliative care can explain various options patients have around end-of-life care, and help them and their families decide what kind of care they want and need. You should not have to pay out of pocket for a palliative care consult.

    _______________________________________

    This post was originally published on December 2, 2015

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  • Good news for anyone looking for help losing weight

    Good news for anyone looking for help losing weight

    Many of us are overweight, struggling to figure out how to shake off some pounds. And, it’s never easy.  The good news is that Medicare pays the full cost of weight-loss counseling for people needing help losing weight. The bad news is that only a very small percentage of the people who might benefit from weight counseling are taking advantage of it.

    The Centers for Disease Control reports that more than three in 10 people with Medicare are obese.  And, obesity contributes to chronic health conditions, including heart disease, some types of cancer and diabetes. Studies show that counseling can help people take steps to lose significant weight.

    Medicare covers weight-loss counseling for everyone with a body mass index of 30 or more, under Part B. To be covered, only primary care doctors or the nurse practitioners and physicians’ assistants who practice in their offices can provide the benefit.

    The Medicare obesity-counseling benefit includes a weekly session for the first month and a session every two weeks for the next five months.  Another six months of counseling, one visit each month, is covered for people who lose at least 6.6 pounds during the first six months of counseling.

    Medicare covers weight-loss counseling at no cost to you if you see a doctor who accepts “assignment,” accepts Medicare’s approved rate as payment in full. Medicare sometimes covers gastric bypass surgery or laparoscopic banding surgery for people who are morbidly obese.

    For reasons that are unclear, only a very small percentage of people with Medicare have taken advantage of the obesity-counseling benefit. They may not be aware of the obesity-counseling benefit or they may not be able to find doctors who will provide the counseling services. In sharp contrast, 250,000 people with Medicare have taken advantage of smoking-cessation counseling, which Medicare also covers.

    (This post, originally published on March 24, 2015, has been updated.)

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  • Do you have a sense of purpose?

    Do you have a sense of purpose?

    A variety of studies have found that social interactions, personal relationships, having friends and family on whom you can rely, contribute to longer and healthier life. New and past research also find health benefits for people with a sense of purpose.

    An August 2017 report in JAMA Psychiatry finds that people over 50 with a sense of purpose may be better able to maintain physical function as they age. Specifically, researchers looked at the grip strength of people over 50 with a heightened sense of purpose. They discovered these people were less likely to lose grip strength when shaking hands. They were also less likely to slow down their walking speed four years later.

    In May 2014, a research article published in Sage Psychological Science found that adults with a sense of purpose in life are more likely to experience healthy aging and live longer than adults who do not.

    Researchers have also discovered that residents of Loma Linda, California usually live considerably longer (eight to 10 years) than other Americans in part because most are Seventh-day Adventists and lead a life of service to their church and their community.

    So, if you haven’t already set goals for yourself and a plan for achieving them, you should consider doing so.  Of course, a good diet and exercise are also important!

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  • You likely need more sleep than you think

    You likely need more sleep than you think

    As we age, we experience changes in sleep patterns. You might think you can get by with five or six hours of sleep every night. Believe it or not though, adults need between seven and eight hours a night of sleep. Sleep benefits both your mental and physical well-being.

    According to sleep expert and NIH neuroscientist, Merrill Mitler, “Sleep services all aspects of our body in one way or another: molecular, energy balance, as well as intellectual function, alertness and mood.” A good night’s sleep also improves your reflexes and overall ability to think clearly. An hour or two less than you need makes a difference in your level of reasoning, attention to detail, productivity and more.

    Dr, Michael Twery, another NIH sleep expert, explains: “Sleep affects almost every tissue in our bodies. It affects growth and stress hormones, our immune system, appetite, breathing, blood pressure and cardiovascular health.” Some experts claim that sleep is good for the brain and can help extend your life.

    As many as 70 million adults in America suffer from chronic sleep problems and do not get the sleep they need. Many people have insomnia and lay in bed awake a good chunk of the night. And, many people have sleep apnea, which keeps them from sleeping soundly. Sleep apnea causes you to have a loud, uneven snore. And you may wake up gasping for air. Apnea can be dangerous, causing you to stop breathing for short periods and your blood pressure to spike. You are at higher risk of stroke.

    Talk to your doctor if you have insomnia or the apnea symptoms. Sometimes, exercising, losing weight or sleeping on your side can reduce apnea symptoms. Do your best to get a good night’s sleep. It matters!

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  • Another reason to exercise: It lowers your risk of stroke

    Another reason to exercise: It lowers your risk of stroke

    According to the National Institutes of Health (NIH), stroke is the third leading cause of death and a major cause of serious disability. Age is the greatest risk factor for stroke. After age 55, the risk of stroke doubles every ten years. But, exercise lowers your risk of stroke, as do other healthy behaviors.

    To lower your risk of stroke, the National Institute on Aging advises that you check your blood pressure and cholesterol and treat them if they are high. High blood pressure can double or quadruple your risk of stroke. To lower your blood pressure, eat lots of fruits and vegetables and other food that is low in cholesterol and saturated fats; eat less salt; and, don’t smoke.  (Medicare covers smoking-cessation counseling as well as nutrition counseling.)

    Also, exercise!  You can take a brisk walk several times a week, ideally for at least 20 minutes every day, or swim or ride a bike.  According to the NIH, you might want to try these balancing exercises, as well. It all helps.

    If you are overweight, try to lose weight. Even if you lose only a small amount of weight, it can seriously decrease your risk of stroke. Harvard Health recommends that you limit your daily calorie intake to less than 2,000 and exercise more.

    For more information from the NIH on how to get started exercising and the kinds of exercise you might try, click here.

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