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Top Doctors 2012

This year's top health issues



CPR: Saving a Life

Each year, hundreds of thousands of Americans keel over, felled by cardiac arrest. Most die before help can arrive. However, with proper intervention by good Samaritans like Jennifer Ani of San Rafael and Miki Goralsky of San Anselmo, many more would live to tell their tale. Several months ago, these brave women saved the life of a man they’d never met.

As it happened, both were attending a birthday celebration for a classmate of their child. As the kids lined up for their chance to smack the piñata, Mike Ryan— the father of one of the six-year-old party guests — dropped to the ground. “I didn’t see him go down, but I heard someone scream ‘call 911,’ ” recalls Goralsky.

Without speaking, the two moms (who barely knew one another), jumped into action. “Miki sort of swooped in and started chest compressions,” recalls Ani, who then pushed her way through the crowd, knelt beside Goralsky and began mouth-to-mouth resuscitation.

The women kept at it until first responders arrived and shocked the man’s heart back to life with a defibrillator. Once the patient stabilized, a paramedic came over to the women and said, “Congratulations, you just saved that man’s life.”

According to the American Heart Association, effective bystander CPR, performed immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival. To be clear, cardiac arrest differs from a heart attack in that the symptoms usually come on more rapidly and the window of opportunity to be helped is much shorter. Both can benefit greatly by CPR. Sadly, most Americans don’t believe they’re up to the challenge, fearing their inexperience could make the situation worse. But Jeffrey Olgin, professor of medicine and chief of cardiology at UCSF Medical Center, says that’s flawed thinking. “You can’t make the person any more dead, that’s for sure,” he explains. Could you crack their ribs? Absolutely. “It can happen even if you do everything right,” he says, “but in the scheme of things a cracked rib is nothing worth worrying about.”  

Ideally, a person should be recertified in CPR training every two years. Goralsky and Ani, who drew from decades-old CPR training for their rescue, have organized a CPR class for all the first-grade families at their school to take together. If you’d like to organize your own CPR class, there are numerous organizations including SOS CPR (707.795.4444), CPR ETC (415.884.2720) and Safety Training Seminars (415.437.1600 ) that will come to your home or business to teach these lifesaving skills. Or, to join one of the American Red Cross’s regularly scheduled classes, go to redcross.org, click on “take a class” and enter your zip code to find out where and when classes are being offered.

Sharpen Your Memory

We’ve all been there: A familiar person’s name is on the tip of your tongue, but you just can’t recall it. Or you pick up the phone to dial a number and suddenly have no idea whom you intended to call. While you might be wondering if these so called “senior moments” are a precursor to Alzheimer’s disease, fear not. In most cases, memory lapses are a normal, albeit frustrating, part of the aging process. And although we can’t turn back the clock, we can slow it down. A number of studies suggest that there are specific steps we can take to improve our cognitive skills. What follows are a list of the best ways to keep your memory bank reliable.

Think Hard When it comes to brainpower, the term “use it or lose it” definitely applies. When the brain is stimulated, nerve cells sprout extra branches. And that means challenging yourself mentally will keep your mind limber. “Take up a new hobby, learn a new language or read a new book,” suggests Mark Kubik, a geriatrician, a family physician and medical director of the Tamalpais Clinic in Greenbrae.

Play Games A round of the computer games Fruit Ninja or Tiny Wings won’t help you grow brain cells, but games geared to brain development can help you improve recall, processing speed and your ability to multitask. Two well-studied programs are BrainFitness by Dakim (dakim.com) and InSight by PositScience (positscience.com). “I’ve seen good results with these programs,” says Kubik. “Any activity that challenges your brain — be it Sudoku or a crossword — can be helpful, but with these software programs there’s clear research to support effectiveness.”  

Get Moving It’s no secret that regular workouts can keep you physically fit. What you might not know is that exercise can also keep you mentally fit. Numerous studies suggest that moderate exercise can increase the delivery of oxygenated blood to the brain. This influx of oxygen means brains cells that might have otherwise died continue to thrive. In fact, at least one study out of Columbia University suggests that vigorous aerobic exercise can actually help a person grow new brain cells.

Feed Your Brain Extensive research from the U.S. Department of Agriculture has found that a diet rich in antioxidants — nutrients that protect cells from destruction — can reduce and even reverse age-related memory problems. There are hundreds of different antioxidants in fruits and vegetables, but the most potent sources include strawberries, blueberries, spinach, kale, Brussels sprouts and garlic. And, generally speaking, maintaining a healthy diet may ward off dementia. A diet rich in vegetables, fruits and lean protein is part of the prescription for reducing the odds of getting Alzheimer’s, according to the UCLA Center on Aging.  Stay Calm Stress wreaks havoc on the body, and it can exact a mental toll as well. “It can be equated to bathing your brain in battery acid,” says Kubik. “It results in elevated cortisol and reduced hippocampal neurons, which play a vital role in memory.” Of course, avoiding stress is easier said than done, but practicing yoga and learning the art of meditation are two great ways to mitigate its effects. Likewise, carving out a little downtime each day can also be quite helpful, as it limits your exposure to stressors.

Medical Myths Vs. Truths

Step on a crack, and you’ll break your mama’s back. Hold your breath when passing a graveyard or risk premature death. Certain old wives’ tales fizzle out as we outgrow childhood; others are so ingrained in our culture that they can even dupe physicians. Why do so many myths exist? “Myths are stories we tell ourselves to make the world make sense,” says Dr. Aaron Carroll, co-author of Don’t Cross Your Eyes or They’ll Get Stuck that Way: And 75 Other Health Myths Debunked (St. Martin’s Press). “Plus, we often hear them from people we trust, like parents, teachers or even doctors.” Below are some of the most perpetuated medical myths and why the science just doesn’t add up.

Myth: We utilize only 10 percent of our brains.
Truth: No part of our brain ever lies dormant.

This claim has circulated for decades. Some claim it was Albert Einstein who first made this declaration, though there’s no evidence that he ever said anything of the sort. Fortunately, we now possess the technology to view the brain in action, and one thing is certain: This claim is bogus. According to a paper published by the British Medical Journal, MRI scans, PET scans and other imaging studies indicate that no area of our brain ever lies dormant. What’s more, even when individual neurons are viewed, inactive areas are never seen.   

Myth: Drink at least eight glasses of water a day for optimal health.   
Truth:  For most people, thirst is your best guide.

Chugging eight glasses of water per day, as many health fanatics preach, is purported to yield a host of benefits, from improving skin tone to promoting weight loss. But it’s just not so. A 2008 study published in The Lancet concluded there’s no scientific evidence that for most people there is any benefit to drinking this much water. There are, of course, occasional exceptions. For example, eight glasses may be warranted for people working in extreme heat, or prone to conditions such as kidney stones or diarrhea. But, for the most part, those levels may even be harmful, resulting in a condition called hyponatremia, an electrolyte disturbance in which the sodium concentration in the blood serum is lower than normal. It’s hard to say how the eight-glass myth took root. However, in a 2001 Dartmouth Medical School study that also refutes the recommendation, the paper’s author suggests that perhaps the misconception began after a Food and Nutrition Board of the National Research Council recommended approximately 1 milliliter of water for each calorie of food, which would amount to roughly two to two-and-a-half quarts per day. In the next sentence the board’s report goes on to say that most of that quantity is contained in prepared foods. Perhaps a few important people missed that line. Either way, since then, an organization called Hydration for Health has done much to promote the eight-glass-a-day agenda. Is it just a coincidence that this research organization is funded by the makers of Evian and Volvic bottled water?

Natural Remedies for the Common Cold

We can restore 20/20 vision to the near-sighted, replace diseased joints with prosthetics and even transplant organs. A cure for the common cold, however, remains elusive. “Unfortunately, there are just too many strains to come up with a workable vaccine,” says Dr. Catherine Clark-Sayles, an internist with Marin Medical Group and Marin Internal Medicine, part of the Marin Healthcare District. “Researchers are working on it, but we’re just not there yet.” Until then, the best practice is to treat the symptoms and let the virus run its course. This protocol can include a variety of over-the-counter medicines such as nasal decongestants, Tylenol and cough syrup. However, if you prefer a natural approach, the following five home remedies (and a box of soft tissues) will help you muddle through the nastiest of symptoms.

1 Nasal Irrigation Flushing your nasal cavities to expel excess mucus is an effective way to relieve congestion and stuffiness. You can purchase a ready-made saline spray or make your own by filling a squeeze bottle with a solution made from one cup of distilled warm water mixed with ⅛ teaspoon baking soda and ⅛ teaspoon salt. Squeeze the saline solution one to three times into each nostril, inhaling through the nose as you squeeze in the fluid. For a more aggressive approach, consider a neti pot — a spouted vessel that allows for a greater volume of liquid to flow into the nasal cavity and thus provides a more thorough lavage. “It’s messier and clunkier than a saline spray, but when I can convince my patients to try it, they’re usually happy with the results,” says Clark-Sayles.

2 Humidity Cold viruses thrive in dry conditions. What’s more, dry air will further irritate your mucous membranes, leading to additional stuffiness and throat discomfort. You can alleviate this by using a humidifier to moisten the air. A long, steamy shower will also bring relief.

3 Zinc Supplements For years, the efficacy of this supplement to treat the common cold has been hotly debated. And there are still plenty of naysayers. However, according to Clark-Sayles, a recent review of the research suggests that perhaps zinc can reduce the duration of a cold — particularly if it is taken within 24 hours of the onset of symptoms. One caveat: “Too much zinc can interfere with your absorption of iron and cause anemia,” says Clark-Sayles. So don’t overdo it. According to the National Institutes of Health’s Office of Dietary Supplements, 40 mg daily is the maximum safe dose.

4 Salt Water It may not taste good, but a quick gargle with a little salt water — a ½ teaspoon dissolved in an 8-ounce glass of water — can bring temporary relief to a scratchy throat.

5 Chicken Soup No, we’re not kidding. Scientists have confirmed what grandmothers have known for years: Chicken soup can soothe a cold. Researchers at the University of Nebraska performed laboratory tests with this tried-and-true remedy and found that indeed the soup’s combination of ingredients (including chicken, onions and parsnips) does have an anti-inflammatory effect.

Bedbugs 101

For decades, the bedtime salutation “Don’t let the bedbugs bite” conjured up feelings of warmth and security. But now that these tiny bloodsuckers have returned with a vengeance, this lighthearted way of saying good night is likely to give pause. And while it’s true that bedbug infestations are most definitely on the rise, here’s something you may not know: According to a new report from the Center sfor Disease Control and Prevention (CDC), exposure to insecticides used to control bedbugs led to one death and more than 100 illnesses between 2003 and 2010. The reason: Improper use of insecticides. Ironically, bedbugs are harmless. “Unlike some insects, they don’t carry disease,” says Dr. David Laub, a dermatologist in Mill Valley. “They’re a nuisance but not a health hazard.”

Of course, paranoia has led many folks to assume the worst when a mysterious rash erupts. (The bites can resemble a number of other conditions.) So how do you know if bedbugs are the culprit? Check for tiny bloodstains on your sheets as well as dark or rusty spots, which may be bedbug excrement. Also, pull off your sheets, and with the aid of a flashlight, check the mattresses seams and ticking, box spring and headboard. “Look for small, reddish bugs about 5 millimeters in length,” says Laub.

If you find them, you’ll need to thoroughly wash down the affected space. This means that all bedding, curtains and clothing need to be washed in hot water. (Your washing machine is OK.) Items that cannot be washed, such as stuffed animals or shoes, should go in the dryer on your highest setting for 30 minutes. The mattress should then be brushed and vacuumed, along with the floors. Cleaning can minimize the infestation. However, to be sure you’re rid of the problem, it might be best to let the professionals, which includes most pest exterminators, handle the job.

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