Wednesday, May 15, 2019

How do Wellness, Mindfulness and Health Relate?

Wellness and Mindfulness are buzzwords implied to be associated with Health. The terms seem to be everywhere:  in print and social media, as labels of health and wellness centers, and as titles of corporate lectures geared to improving productivity.  Associated visuals include yoga, herbs, stacked stones, greenery, and water.  The words are often used together but what do they really mean, how do they relate, and, most importantly: what do they do for our health?

Wellness implies a lifestyle of overall happiness, good health and psychological fulfillment.  Wellness has been identified as components numbering between 5 and 8 depending on the source.  The most common five are listed here first:
Physical:  fitness, nutrition, sleep, activity levels and overall health
Intellectual:  creative and mental activities, learning, curiosity
Emotional:  the ability to deal with stress, be flexible, have relationships and a positive outlook
Social: having supportive friends and or family, giving back to the community
Spiritual:  prayer, meditation, religion including love and hopefulness
Occupational:  personal and career satisfaction from work, family, or volunteer responsibilities
Environmental: having pleasant, healthy, stimulating surroundings
Financial:  being satisfied with current and future financial status

Disease risks are suggested to go down as a benefit of wellness.   Longevity is implied, along with a generalized improved feeling of energy, less illness, better mental health, and overall fitness ability.  Wellness encompasses the non-objective measures of health that make you feel better internally.  Wellness measures are individual to each person and are only valid if acceptable to the person they are for. 

Mindfulness is the act of letting go of stressful, negative thought processes and slowing down to be more aware. It includes various techniques and practices such as:
Meditation: a technique used to calm the mind
Relaxation: being free from tension and anxiety
Self-reflection:  thinking about ones’ thoughts and processing
Awareness: consciousness and realization
Gratitude:  thankfulness and appreciation for the good around us

Mindfulness has been practiced for thousands of years as part of Buddhism, Hinduism, and yoga.  It has been brought into non-religious meditation practice and recognized by health providers as a key to stress reduction, stable mental health and overall positive outlook and attitude.  Memory, attentiveness, productivity, creativity, and empathy all benefit from mindfulness.

There are differences between wellness, mindfulness and health.  Objective state of health, as determined by a doctor, nurse or other medical professional can be measured:  blood pressure, blood sugar, blood chemistries, weight, and negative tests for diseases.  In contrast, wellness is a subjective state, thought of by some medical health professionals as counterproductive to overall health.  Wellness is even associated with holistic and alternative health as a contrast to standard medical care.  Mindfulness is often considered an aspect of wellness representing psychological health.

Unfortunately, statistics reveal that despite our new attention to wellness and mindfulness, the US population’s health has declined.  Rates of depression, diabetes and cancer have increased in the past 20 years by 10-30%.  If wellness is tied to alternative medicine, proceed with caution:  alternative medicine ignores all standard medical practice including prescribed medications or regular MD visits and exams. To be clear, wellness and mindfulness are not substitutes for health. 

Still, the ideas behind the words are valuable to living a fulfilling, peaceful and happy life.  Addressing the components of wellness may not actually improve health measures, but will likely keep you feeling grounded and less stressed.  Staying calm and focused through mindfulness techniques will reduce injuries and accidents.  Wellness and mindfulness lifestyles reinforce healthy habits including sleep, nutrition, relaxation, avoiding toxins, spending quality time with friends or family, getting exercise and feeling grateful.  These are unarguably a recipe for overall happiness, less stress and feelings of better health. 

Sunday, April 7, 2019

Taking Over the Counter Pain Relievers for Arthritis

Osteoarthritis is the most common cause of joint pain in the US, affecting over 30 Million adults. The first line of medication treatment recommended by physicians for osteoarthritis is either acetaminophen (Tylenol) or a Non-Steroidal Anti-Inflammatory (NSAID).  70% of people 65 and older take Over-the-Counter (OTC) pain relievers at least once a week.  Studies show that after 2 weeks of regular use, they effectively reduce pain by 50% and increase mobility by 60%.  They are inexpensive, relatively safe, and widely available. 

You can purchase 3 types of NSAIDS at the drug store:  ibuprofen (Motrin), naproxen (Aleve)  and aspirin (Bayer/Bufferin).   They are very effective to reduce pain, inflammation, and even fever.  They do not cause the side effects of prescription pain relievers such as addiction, dizziness, sleepiness, or constipation.  Because the over the counter doses are lower than prescription, they have less risk of stomach bleeds or cardiovascular events such as heart attacks or strokes.  Tylenol is another product sold for pain relief at the drug store, but it is not an NSAID and while it reduces pain and fever, it does not reduce inflammation.  All the medications work within 30-60 minutes. 

These medications are recommended for short term (10 days to 2 weeks) use.  They have been researched to provide their strongest pain relief in the first 2 weeks of regular use, becoming less effective after 20 weeks.  For some, Advil is more effective than Aleve and vice versa.  The only way to know what will work best for you is to try, so buy the smallest amount possible to start.  Generic is fine as long as the product is made in the US. 

Always start with the lowest dose, as you can add a second pill within an hour if no effect.  Make sure you follow the dosage recommendations.  Aspirin and Tylenol have the maximum dose listed in directions on the bottle;  ibuprofen and naproxen labels recommend over-the-counter doses that are half of the prescription version of these drugs.  It is never a bad idea to take the medications with food or milk; an empty stomach can get irritated as NSAIDS reduce the protective lining.  Taking the medication with an OTC acid reducer like Zantac, Pepcid or Prilosec will reduce the irritation to the stomach. If your symptoms persist, speak with your doctor who will likely prescribe another type of pain reliever. 
If you also are suffering from headaches, cold or flu symptoms, read the labels of combination products as they often contain pain relievers.  Most contain acetaminophen (Tylenol) which can be taken with NSAIDS.  Your daily acetaminophen dose should not exceed  2000 miligrams. Taking aspirin or salicylate products with ibuprofen or naproxen is not advised. 

Finally, if you are having trouble swallowing pills, you can try children’s liquid doses or a topical product such as aspercreme which has a form of aspirin in it.  There are NSAID containing prescription gels and patches which provide the least overall side effect risks.  If you notice leg are swelling, headaches, stop the NSAID, check your blood pressure if you can, and call your doctor. Some people develop life threatening allergic reactions to NSAIDS, so look out for swelling of the mouth or face, itching, rashes, or trouble breathing in which case you must call ambulance immediately and ask if anyone around you has an Epipen for immediate use. 

For most, OTC NSAIDS are wonderful, allowing the maintenance of an active fitness life which prevents other health problems such as heart disease or diabetes.  Taking 1 OTC dose once a day on active days is common and acceptable.  Just make sure you let your doctor know about these and any OTC products you are taking. 

Thursday, February 28, 2019

The Importance of Finding the Right Primary Care Provider

Everyone should have a primary care provider.  Even if you see doctors such as dermatologists or endocrinologists regularly you should have someone who serves as your health manager.  Establishing a relationship with a primary care doctor who is accessible, trustworthy, and a great listener and communicator will guide you to optimum health.  Your primary care doctor will help you recover from illness and keep you informed of the latest preventive medical techniques and treatments.  

Factors to consider in finding the right primary care doctor include:
Location- are they conveniently located?
Insurance- Do they take your plan? If not is it affordable?
Accessibility- Do they answer phones and return calls or emails promptly?
Hospital Affiliation- Is their hospital network one you like?  Do they have access to hospital records if necessary?
Referrals-Do they communicate and follow up with specialists if needed?
Comfort level-Do you feel able to communicate with the doctor and staff about any subject?

Your primary care provider does not have to have an MD behind his or her name.  S/he could also be a DO, NP or PA as described here:    
Medical Doctors (MD) go to four years of allopathic medical school followed by a specialty residency of several years depending on the type.  MDs follow standardized protocols of preventive care and treatment of diseases.  MDs make up the greatest percentage of primary care providers. 
Osteopathic Doctors (DO) attend osteopathic medicine school but may enter the same residency programs as MDs and often function with the same privileges to treat and prescribe that MDs do
Nurse Practitioners are highly trained nurses who can make diagnoses, recommend treatment plans and prescribe medications.  They function similar to a primary care doctor and in some states, like New York, can even practice without a doctor’s supervision.
Physician Assistants can evaluate, prevent and treat diseases but must be supervised by a physician.  They attend a 2-3 year master’s program after they complete a Bachelors degree. 

Still not sure where to look?  Ask around.  Listen to your friends’ recommendations;  better yet, ask you specialists who they like best.  Don’t use urgent care centers as your go-to doctor, that won’t provide good continuity. Your primary care doctor will get to know you and guide your testing and treatment options based on your individual risk factors and lifestyle.   See your primary care provider at least once a year and be rewarded with maximum health with healthcare customized to you.