November 2014

Turn Down The Noise! By Robin Miller, MD MHS


During a recent trip to New York City, I found myself becoming more and more annoyed. The noise was driving me crazy. That got me thinking. What is the problem with noise? What does it do to people who live in noisy places?

Here are some facts about noise:

  • It is the leading cause of hearing loss
  • It can lead to emotional problems including anxiety, aggression and fatigue
  • It can cause physical problems including coronary artery disease, high blood pressure, migraines, and reduced and poor quality sleep.

Loud noises such as those from factory machines, construction sight banging or even rock music can damage and destroy the hair cells in our ears responsible for relaying sound signals to the brain. Once the hairs are gone they cannot be replaced.

Whether the sound is scary or not, the body experiences a stress response which can cause high blood pressure (that can increase the risk for heart disease) and the continuous release of stress hormones if the noise continues.  Noise is associated with trouble concentrating, poor learning in children, reduced motivation and aggressive behavior when prolonged.

A study done in New York City in the 1970’s found that noise has a negative impact on learning. Unfortunately, urban development has caused the noise levels to go up and it is having a negative effect on the population exposed.  One of the places with growing noise issues is the hospital. There are beeps and machine noises and a continuous din in most hospitals.

Knowing this, it is key that we all find a way to be quiet. Getting out into nature is an easy way to escape the noise. Living with it, there are some things that can help.  Carpeting will dampen the sound.  Double paned windows help.  Planting trees around houses helps to cushion sound. If there is outside noise where you live, and it still gets in, then play soothing sounds and music to drown it out. If you work in a noisy environment or go to a loud concert then make sure you wear ear protection. If you wind up in the hospital, use your headphones, and drown out the noise with calming sounds.

The effects of noise pollution are subtle but substantial.  Being aware of the problem we can find ways to avoid the potential emotional and physical distress that can result.

“I like it where it gets dark at night, and if you want noise, you have to make it yourself.”
H. Beam Piper, Fuzzies and Other People



Make Sure The Only Thing You Stuff Is The Turkey On Thanksgiving

Every year there are blogs about how to avoid weight during the holidays. So, here we go again. I have some quick tips that I think will help.

  • Make sure to eat a good breakfast on Thanksgiving Day so you aren’t ready to eat the turkey all by yourself.
  • Go for a walk and relax before your dinner.
  • Choose a small plate and take small amounts of food. Talking can distract you and cause you to eat faster.  Fast music and being surrounding by fast eaters can do it as well. .  So, chew slowly and enjoy every bite.
  • Fill yourself up with veggies.
  • Dessert is OK but take small amounts and bites.
  • Watch the alcohol.  Many drinks are loaded with calories and those who drink tend to eat more.
  • Fill up by drinking plenty of water and staying hydrated.
  • Finally, move around and socialize rather than hang out on the couch after dinner.

Thanksgiving means different things to different people.  For most it is a time to express gratitude for our freedom, and to enjoy family and friends. It is important not to get so rapped up in the food and festivities that we forget the true meaning.


Have a healthy, happy and safe Thanksgiving.










I Love Coffee

I am addicted to coffee and proud of it. I look forward to the ritual of that morning cup of coffee to start my day. I felt guilty for many years with the thought that maybe it was not such a healthy thing to be drinking. However, as more studies have been done, I feel pretty good about my morning java.

In the early coffee drinking years there was a concern that it caused pancreatic cancer. That is because when the studies were done, they did not control for cigarette smoking and other risk factors for pancreatic cancer. It turns out that coffee drinking and cigarette smoking go together for many and that is how coffee got the bad rap. It was the cigarette smoke and not the coffee that increased the risk for pancreatic cancer.

Now we know that there are actual benefits to coffee drinking. There are many. Here are a few. Read on.

Coffee and the brain

Coffee helps with alertness and the ability to focus. A study done at Pennsylvania State University found that 1 to 2 cups of coffee a day improve concentration and memory.

A study done by the University of South Florida and the University of Miami found that in patients with mild cognitive impairment, those who drank three cups of caffeinated coffee regularly had a slower progression to Alzheimer’s disease by several years. Coffee may prevent dementia altogether.

Several studies have found that those who drink caffeinated coffee have a decreased risk for developing Parkinson’s disease. In addition, a recent study found that those with Parkinson’s disease who were given caffeine (the equivalent of between 2 and 4 cups of coffee a day) had significantly improved movement.

A research study of over 50,000 women found that drinking 4 or more cups of caffeinated coffee daily decreased the incidence of depression by 20% as compared to those who did not drink coffee. A smaller study done in Finland found that men who were frequent coffee drinkers were less likely to commit suicide.

Coffee and cancer prevention

Research has found that women who drank the equivalent of three or more cups of caffeinated coffee daily had a 20% decrease in the risk of developing basal cell cancer. Men had a 9% decreased risk.

Yet another study found that women who drank four or more cups of caffeinated coffee daily had a 25% decreased risk of developing endometrial cancer when compared to women who drank one cup or less daily.

Yet another study found that those who drank four or more cups of caffeinated coffee daily had a 39% decrease in oral cavity cancers.

Coffee and diabetes and heart disease

Several studies have confirmed that those who drink four or more cups of coffee daily have a 50% decreased risk of developing type 2 diabetes. Another study has found that coffee in moderation (described as 2 cups a day) decreased the risk of heart failure by 11%.


Of course coffee does have some risks. It can precipitate heartburn and gastroesophageal reflux. Some people may get jittery if they overindulge, and it can cause palpitations in others. Adding sugar, syrups and cream can turn coffee into a high calorie drink. The caffeine addiction is real for habitual coffee drinkers and withdrawl can cause a wicked headache. However, overall it is relatively safe.


I am not urging anyone to start drinking coffee, but I would like to ease the guilt of those coffee drinkers who have been worrying about its safety. Drink your coffee but remember (which will be easier for you to do if you drink coffee!) as in all things, moderation is the key.

November is Diabetes Awareness Month

November is diabetes awareness month. Why is this important? Because, diabetes (specifically type 2 diabetes) is a HUGE problem. Here are some quick facts: Of those Americans over 65 years of age, close to a third (26.9%) had diabetes in 2010.

Between the years 2005 and 2008, more than a third of those over age 20 and half of those over 65 had prediabetes for a grand total of 79 million Americans over 20 who had prediabetes.

Why is it such a problem? Diabetes is a major cause of kidney failure, limb amputation and blindness. It is also a risk factor for stroke and heart attack. Overweight and obese individuals are most prone to developing type 2 diabetes. Weight gain decreases the body’s sensitivity to its own insulin. This causes the body to kick out more insulin but eventually insulin stores run down. This whole process results in inflammation, and that is how diabetes causes serious damage to the body.

Type 2 diabetes, also known as adult onset diabetes in the past, is no longer a disease of adults. As a result of our obesity epidemic it is becoming a disease of children. Unfortunately all the complications that follow as a result are being seen in children including stroke.

The symptoms of diabetes can be subtle. When it becomes more pronounced with increasing blood sugars the symptoms that occur include excessive thirst, urination and an increased appetite. Some people may lose weight. Others may also note fatigue and tingling of the hands and feet.

Fortunately, type 2 diabetes is preventable. A recent study found that small amounts of weight loss (5-10%) can delay or prevent diabetes in those who are at risk. In fact, it was pretty dramatic. Diabetes was reduced by 40 to 60% over the 3 to 6 years that the study was conducted.

The solution to this growing problem sounds easy. But, it is not, because achieving significant weight loss is tough. Obesity continues to grow as an epidemic that is threatening to kill our children, crush our medical system and ultimately our economy. We worry about terrorism and weapons of mass destruction or WMD, but perhaps what we should fear most are the ultimate WMD; the knife and the fork.

Riding Beyond: An Amazing Experience By Robin Miller, MD MHS


Recently I was invited to attend a private horse experience that was designed to help women who are breast cancer survivors. I went, because I wanted to know how it could help my patients. What I found was something that would help all my patients and my colleagues as well.  Horses are intuitive beings that sense our emotions, our hearts and they are healers.


My experience started with an excellent orientation by Trish, the horse trainer and her assistants Jennie and Hannah. Then, I walked into the ring by myself with Mystic, the therapy horse.  She is small (for a horse), powerful and beautiful. She approached me and I allowed her to nuzzle my hand. Then for a brief moment she wrapped her powerful head around to the small of my back signaling that she wanted her back rubbed, which I did.  Then I was instructed on how to rock her hips ever so slightly and she became very calm.  After that I hugged her. I placed my hand on her back and pressed my body up against her side with my hand over her heart.


I felt like I could have stayed there forever.  I was overwhelmed by something that is hard to describe. My heart opened and I felt a sense of pure love and acceptance and then I started to cry. It was amazing.  What is really wonderful is that I remember the feeling.  I am able to recall it when I feel scared or sad or insecure, and it comforts me.


Horses have been used as therapy animals for centuries.  In more recent times, they have been used to help those with PTSD, children with autism and those with disabilities to name a few. They are highly intuitive, and their rhythmic movement is similar to the human walking pattern, which is soothing. Their reactions to touch, brushing, grooming and bathing can be very calming.


The Riding Beyond program has helped breast cancer survivors to feel accepted, strong and loved. For those that feel scarred and/or wounded, they feel whole. Mystic is quite a therapist along with her wonderful, caring trainers.


Therapy horses are amazing beings. They can help all of us ride beyond whatever obstacles we encounter in our lives. In my opinion, it would be a more peaceful world if we could all have a horse therapy session!


“Horse sense is the thing a horse has which keeps it from betting on people. ”
W.C. Fields









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