October 2010


I had already decided what I was going to write about in this week’s blog, and was going over it in my head while I was doing some routine shopping in Walgreens the other day. So, imagine my surprise when I got up to the checkout counter and the lovely young man at the cash register – not a day over 19 – seemed to have read my mind. (Or, read my blog inside my head?)

Here’s what he said to me:

“Hello, Ma’am. Did you know that flu season is already here? This year, everyone is supposed to get a flu shot – not like previous years when only certain people were supposed to. And, this year, you won’t need to get two shots like last year because this year’s vaccine works against both H1N1 and the regular flu virus.”

Other than hating to be called Ma’am (I don’t look that old, do I?), I was impressed that not only did he give me this important information, but that he seemed to understand it rather than just reciting a canned speech. So, kudos to Walgreens on their public awareness campaign about the flu shot, and on training their employees so well!*

In case you’re not going to be in Walgreens anytime soon, I’ll repeat these points, with a few additions, below.

·        It is recommended by the CDC that everyone over the age of 6 months receive the flu shot this year.

·        You only need to get ONE shot this year since it works against both the H1N1 virus AND the regular flu virus.

·        There is a “high dose” flu shot available for people over 65 that helps with immunity against the flu.  Ask your doctor about it.

·        Certain groups should definitely get the flu shot including people over 50 (that’s all of us!) and people with chronic diseases like asthma and diabetes.

·        There should be enough flu vaccine to go around this year unlike in prior years.

·        Flu season has officially started, so you can get your shot anytime now. But remember, it takes about 2 weeks to develop immunity against the flu after getting the shot – so don’t wait too long to get it.

·        If you haven’t had the pneumonia shot yet, ask your doctor about it. It is especially important if you have a chronic disease.

 For more info: go to www.flu.gov   

*I have not been paid, courted or otherwise enticed to mention Walgreens here. 

Keep An Eye On Your Health

Despite the fact that over 80% of Americans fear losing their eyesight more than any other sense, a recent study has found that an even greater percent do not get eye exams even though they may be at risk for eye disease. Unfortunately, due to hard times with the economy many people are skipping them.

Neglecting to have eye exams is a problem because they can easily pick up signs of glaucoma and macular degeneration two eye diseases that have no symptoms until they have caused serious damage. Glaucoma is the second leading cause of blindness in the world. Age related macular degeneration is the most common cause of blindness in those over 55 in the US. Early treatment can prevent blindness.

Glaucoma can be treated by drops or surgery to relieve pressure in the eye. There are treatments for both age related and wet macular degeneration that include injections, laser treatments and vitamins and supplements.

Regular eye checks not only help to prevent eye diseases but often times eye doctors can find other problems such as diabetes, autoimmune diseases, multiple sclerosis and even brain tumors. That is why it is so important to make sure that a trip to the eye doctor is on your health maintenance calendar.

The Power of Love

The new blush of love is exciting and can be all consuming. It turns out in addition it can reduce pain. Scientists at Stanford and The State University of New York at Stony Brook have been able to quantify the power of love as it relates to pain.

They took 15 students who were in romantic relationships within the previous 9 months.
They brought pictures of their significant other and a friend. When looking at the pictures they were given a painful stimulus. They also distracted the students. They found that distraction and looking at the loved one (but not looking at a friend) decreased pain but by different mechanisms. Distraction required the thinking part of the brain and love used opiate receptors to relieve pain.

Love stopped pain processing before it reached the brain. Pain reached the brain before the distraction stopped it. Love lights up the part of the brain that is triggered with cocaine or winning a lot of money.

It would be great if we could bottle that feeling, and it could happen some day. In the meantime, we might be able to access the benefits with hypnosis or guided imagery.


October is National Breast Cancer Awareness Month in the U.S., and this is our third year of celebrating/discussing it in this blog.  In the blog about this during the past two years *, I’ve given a general summary about what is known about breast cancer – risk factors, diagnostic methods, recommendations for screening and prevention – but this year, I’m going to give you some new information. Information that will hopefully clear up the confusion from the past year.

What confusion am I referring to? Since last October, the US Preventive Services Task Force (USPSTF) came out with some recommendations about screening for breast cancer that created outrage in the medical community and confusion in the non-medical community. We were very strongly against several of their recommendations, as were all of the expert committees and organizations specializing in breast cancer, from the radiology societies, to the surgical societies to the major universities to the cancer societies. The recommendation that offended the most was the one that advised women to start having regular screening mammograms at age 50, rather than at age 40. We also disagreed with their recommendation that women should stop doing breast self-exam. (See Robin’s blog about this**)

Now comes a study that breast cancer experts believe should end the debate of when a woman should start having screening mammograms. A large and well done Swedish study*** showed that mammography screening in women ages 40-49 resulted in a much greater reduction in deaths from breast cancer than previously thought.  Considered to be the largest epidemiologic study of mammography in women in this age group, the study found that there was a 29% reduction in deaths from breast cancer due to mammographic screening.

The USPTF stated in their report/recommendations that there was only a 15% reduction in deaths from breast cancer, and therefore, screening efforts were not cost-effective. Most experts questioned that estimate, and many more (including us) questioned the appropriateness of the argument.

So, to all of you out there in the 40-49 year old age group, experts in breast health and breast cancer agree: the confusion should end.  You should start getting your regular mammograms at age 40 (or younger if you have certain risk factors, and your doctor recommends it). If you’re in this age group and were relieved by the USPTF’s recommendations, and planned not to start mammographic screenings until you were 50, please discuss this with your doctor. We and experts in the field do not believe that this is a wise decision.


*To read our blogs from the prior Octobers on general info about breast cancer:


** http://www.smartwomanshealth.com/horn_miller_blog/?p=688

 ***Cancer. Published online September 29, 2010.




Food Glorious Food

Food is one of those things we cannot live without. There are those of us who are addicted to certain types of food. For some it is fat, and for others it is sugar. It is impossible to completely eliminate either of these from our diet and thus we cannot treat it like we treat other addictions. You just can’t avoid food. So, for those of us fighting the battle of the bulge, and our cravings for fat, sugar or other types of food what do we do? Diets don’t work. What we have to do is make small changes that we can maintain for life. That is what can make a difference.

For some it may be avoiding the “white” food such as bread, pasta, potatoes and rice. For others, it may be eliminating red meat. It may be as simple as only eating whole foods and skipping anything processed. It is important for anyone who is struggling to maintain a healthy weight that (as Curly said in the movie City Slickers) you find that one thing that can make a big difference, make the change and you will be amazed at the results.


We’re all aware of the importance of regular physical activity in maintaining good health.  Put another way, not getting regular physical activity can lead to many health problems, including heart disease, strokes, memory problems, and obesity, among many other health effects. 

But would it surprise you to find out that simply sitting – as opposed to standing and walking around  – for prolonged periods is also bad for your health?

A recent large prospective study* sponsored by the American Cancer Society of over 53,000 adult men and over 69,000 adult women – all disease-free at the time of enrollment – looked at the relationship between the amount of leisure time spent sitting and mortality over a 14 year period.  Women who reported sitting for over 6 hours per day had an approximately 40% higher death rate than those who reported sitting for less than 3 hours per day; men who reported sitting over 6 hours per day had a 20% higher death rate than those who reported sitting less than 3 hours per day.

These findings are consistent with those of at least three other studies that looked at the relationship of time spent sitting and mortality.

The researchers also looked separately at the amount of vigorous physical activity each of the participants got.  As you would expect, those participants who got the highest level of physical activity had a lower mortality than those who got little physical activity. Very interesting, however, is the fact that the association of increased sitting time and higher mortality was independent of how much regular physical activity the subject got.  This means that sitting for prolonged periods of time – even if you get in regular physical activity – can be damaging to your health. And the converse is also true: even if you don’t get in much regular exercise, your health can benefit by limiting the amount of sitting you do in a day.

As you might expect,  the combination of sitting more (greater than 6 hours per day) and being less physically active (less than 24.5 MET- hours per week)** was associated with the highest increases in death rates – 94% increase in death rates for women, and 48% increase in death rates for men – when compared to those who sat the least amount (less than 3 hours per day) and had the highest level of physical activity (greater than 52 MET-hours per week).

Do yourself a favor and notice how many hours per day you sit without getting up, including your marathon of watching your favorite television shows, sitting at your desk at work, or getting caught up in that book you’re reading for hours at a time. If you are sitting for longer than 3 hours at a time, change it! If in fact you can’t help how many hours you have to sit at work, do two things: 1) get up and walk around once every hour or two; and 2) know that it is even more important for you to get in regular physical activity in order to offset the damage to your health done by sitting.

Remember: you should be reducing your time spent sitting per day in addition to getting regular vigorous physical activity each week.


* Alpa V. Patel; Leslie Bernstein; Anusila Deka; Heather Spencer Feigelson; Peter T. Campbell; Susan M. Gapstur; Graham A. Colditz; Michael J. Thun. Posted: 09/14/2010; American Journal of Epidemiology. 2010;172(4):419-429. © 2010 Oxford University Press.


** “MET-hours” is a measurement of how vigorous physical activity is over a certain period of time.



How To Sleep On Your Own Steam

For many years I was having trouble both getting to sleep and staying asleep. Even though I am a doctor, I have a problem taking medications. So, I thought I would try hypnosis. My only experience with it at the time was watching hypnotists perform at my friend’s sweet sixteen parties. I wasn’t impressed.

However, as I got older I realized that there are some great hypnotherapists out there and perhaps one of them might be able to help me. I found a wonderful person who taught me the art of self-hypnosis. She made a tape for me that I listened to every night. In the tape she had me visualize myself going down ten steps. With each step I became more relaxed. The steps led to the beach that was calm and peaceful. I walked in the sand and felt the water on my feet and then relaxed in a comfortable lounge chair. At this point, I was asleep.

After listening to the tape several times, I no longer needed it. I could play the scenario in my head. Since that time I have had no problems going to sleep or staying asleep. In fact, I rarely make it down the third step. The funny thing is that despite the fact that it works every time, each time I do it I still have a moment of anxiety thinking that this might be the one time it doesn’t work. But, it does!

In this day and age it would be easy to get a pill to help with sleep. However, using self-hypnosis is self-empowering, safe and the price is right. I highly recommend it.


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