Better Sleep May Be Incredibly Important to Alzheimer’s Risk

Better Sleep May Be Incredibly Important to Alzheimer’s Risk.

Sleep disturbances are common. Sometimes patients have come in with sleep problems that are clearly related to temporal issues (such as stressors like a death in the family, work stress, etc).

It is the people that come in with chronic issues which I think are challenging. Some patients have come on while on medications chronically to help with sleep. One concern is that they end up being too dependent on medications to sleep. When seeing things like this, it makes me wonder if patients on sleep medications chronically are altering their sleep architecture enough that it still puts them at risk for things.

Some sleep issues, such as obstructive sleep apnea, do put one at risk for things like high blood pressure, irregular heart rhythms, etc. luckily for that things like weight loss, CPAP machines, etc can help without the use of medications. This article does make the case for getting good sleep regularly!

The Wide-Ranging Role of the Microbiome

What goes in your stomach can influence countless disorders, from cancer to asthma. Dr David Johnson surveys the latest data underlining the ever-increasing importance of a low-fat, high-fiber diet.

Source: The Wide-Ranging Role of the Microbiome

 

Anyone who’s been reading my blog probably won’t be surprised by my linking to this article (you may have to subscribe to medscape to read the full article).

Basically, the gist is that diet effects the kinds of bacteria in one’s GI tract. The good kinds of bacteria (that promoted by a low fat, primarily plant based diet) helps reduce risk of diseases like colon cancer, breast cancer (the former by producing short chain fatty acids and the latter by altering the reabsorption of estrogen that has been chemically altered by the liver and secreted into the GI tract).

 

Facilitating Story-telling Leads to Patient Growth | Sarah Monahan, RN, QMHA | LinkedIn

Facilitating Story-telling Leads to Patient Growth | Sarah Monahan, RN, QMHA | LinkedIn.

I came across this article in linkedin.  It’s an interesting idea because when a physician uses the term “challenging patient” (s)he is likely referring to one of two kinds of patients. One kind is one with a lot of health problems, some of which interfere with the treatment of others (or perhaps just a couple complicated health issues).  However it is often used to refer to patients who are hard to reach/not very compliant/have poor insight to how their behavior affects their health.

Many times I ask myself how did the latter kind of patient get to where they are.  I haven’t yet used this with any of my patients, but it does seem like an interesting way to help patients.

Sugar: Madness Over a Macronutrient – MPR

Sugar: Madness Over a Macronutrient – MPR.

This article is interesting to me for a few reasons. One is that the current fad of calling refined sugar ‘evil’ (as well the fad of considering high fructose corn syrup as even worse than Satan) is something that has come and gone. This is something that the article does point out repeatedly.

The other is that, as with  many things dietary and lifestyle related, perhaps caution with somethings is warranted but that for many things (like sugar), a moderate approach is better.  It’s perhaps wiser to avoid refined sugar as much as possible (no two liter bottles of regular soda, have candy only occasionally, etc), but not get upset if one does have a can of soda or a piece of candy on occasion. If having something with a lot of refined sugar once in a while helps someone eat in a healthy manner, it’s better than going overboard with too much refined sugar. A can of soda or a piece of cake isn’t going to undo one month, or one week for that matter, of eating a healthy diet.

I would no more suggest that people don’t exercise because they might get injured than I’d say cut out sugar entirely. Better you do both (exercise and have sugar) moderately. That way if you do have something “bad” for you then won’t beat yourself over the head when you do so.

Stroke

In this post I’ll be talking about Strokes (also known as Cerebral Vascular accidents). It is the fifth leading cause of death in the United States.  It also is a major cause of disability and in terms of treatment, missed work, etc costs an estimated $34 billion dollars a year in the U.S. alone. Although the risk for stroke rises as we age, according to the CDC website 34% of strokes were in people younger than 65.

There are two kinds of stroke. One is hemorrhagic, meaning that is caused by bleeding. The other is ischemic, meaning that it is caused by a a blockage in a blood vessel. The symptoms, however are determined by the location and size of the stroke. Symptoms include: Facial Droop, double vision, confusion, garbled speech, limb weakness (especially if it occurs on one side of the body), numbness, and headaches.

It is important that if one suspects he or she is having a stroke that medical care be obtained quickly. There is a 3 hour window of opportunity from the start of symptoms that ischemic strokes can optimally be treated with clot dissolving medications. More than three hours after the start of symptom and the likely hood of poor outcomes increases – and the riskier it is to use medications to try and unblock arteries.

An acronym used to keep in mind regarding stroke is the word FAST (Face – is the face symmetrical: is one side drooping? Arms – weakness in one arm. Speech – is it normal? Time – call 911 immediately if it seems someone’s having a stroke).

Ischemic strokes are the most common. Based on symptoms one can’t tell if a stroke is ischemic or hemorrhagic, so it’s better to get to a hospital quickly. At this point in time there may be fewer acute treatments to stop hemorrhagic strokes, but even then supportive treatment is available.

Sometimes symptoms resolve quickly (within a few minutes). This is called a Transient Ischemic Attack, or TIA. This should not be ignored because people who have had a TIA are at increased for having a major/bigger stroke.

Although there isn’t anything that can be done about some risk factors such as age, there are many things one can do to reduce the risk of having a stroke:

1) Control your blood pressure if you have high blood pressure.

2) Lower your cholesterol if you have high cholesterol.

3) Control your diabetes if you are diabetic.

4) If you smoke, stop. If you don’t smoke, don’t ever start.

5) if you have an irregular heart rate, talk to your doctor about whether you need to be on blood thinners as certain irregular heart rhythms increase your risk of ischemic strokes.

6) Exercise (this will help with numbers 1-3 above)

 

Talking with your doctor.

Since I’m coming up on my second anniversary here on wordpress (I joined in late December 2012 and first published this post in January of 2013), I thought I’d reblog it

doctorgladstone

As this is my first blog post I’d like to start of by saying a few of things. One is thank you for visiting my blog. The other is that I won’t be responding to specific questions on this blog, except perhaps in a relatively generic way. In other words, talk with your primary care physician before you act on anything you read in this blog. For that matter, it’s probably a good idea no matter where you get your medical information from. Lastly, I have yet to decide on a schedule for posting. I don’t know whether it will be once a week, once a month, something in between or even less frequently.

And now to the subject of today: suggestions for talking with your doctor and getting the most out of your visits.

As a practicing physician there are times when I think my patients and I speak…

View original post 1,061 more words