Public Health

From humble roots in Santa Cruz, CA, CrossFit has become a national (and now international) phenomenon with not only a viral spread of some 13,000 CrossFit “boxes” across the country, but also dozens of blogs dedicated to the movement, an army of loyal fans, and even a televised international Olympics-style games.

At the same time, medicine is having to undergo a seismic shift from being solely focused on disease management to the completely new task of health creation and prevention. This new endeavor requires a different set of skills, and here are my top four things that medicine can learn from CrossFit about health creation.

Community is powerful – and scalable.

CrossFit is delivered in a group format that not only allows one instructor to train many people simultaneously, but also draws on the power of the group to provide peer to peer encouragement, support and accountability.

To access these three powerful forces in medicine, more and more doctors are using a group visit format for chronic diseases, especially those driven by unhealthy lifestyles. New models are needed to empower behavior change, and if done right they don’t need to be expensive to run.

Lean facilities can keep overhead low.

Why is it called a CrossFit “box” and not a CrossFit “gym?” The answer lies in the amount of overhead needed to run each type of facility. When you think about a “gym” you probably think of tons of equipment and services, classes, employees and a huge floor plan. Sounds like a hospital doesn’t it? In disease management, a lot of equipment, technology, and “stuff” is needed to keep sick people from dying.

A CrossFit “box” is typically just a warehouse with very little equipment. By keeping overhead low, it’s exponentially easier for new franchises to set up a facility and start training people. Health creation does not need a lot of “stuff” either. One trend we are seeing in the space is the concept of a “micropractice,” a low-overhead practice perhaps just run by one physician with a health coach or nurse, replacing the need for office staff with online booking technology and the need for a team needed to bill insurance with new models like Direct Primary Care or memberships.

Look at some of the most progressive clinics like Parsley Health in New York City. Set up in a WeWork co-working space, it combines low overhead, direct primary care, and human centered design technology for a completely new medical experience at low overhead.

Making systems easy to reproduce fuels the movement.

Within the CrossFit world there are WODs or “Workout of the Day”s where, potentially anyway, all classes across all the CrossFit boxes could be doing the same workout, guided by headquarters.

There has been a lot of interest in integrative medicine in health creation, including modalities like clinical nutrition and mindfulness meditation. However, one of the drawbacks of training masses of doctors or other providers in these techniques has been that it isn’t always clear which of these modalities should be used in which patient in which order.

One of the core benefits of functional medicine, as a subsection of integrative medicine, is that is does have a reproducible system that make it easier to replicate across clinics, with the “Functional Medicine Matrix” at the center of it, as a way to prioritize care in complex cases.

A culture of health must start from within.

Beyond the four walls of the CrossFit box is a culture of health. At the CrossFit I attended last summer there were “extracurricular activities,” like picnics and classes and the food was always much healthier than your average 4th of July get together. The CrossFit and paleo movements are tied at the hip, encouraging less inflammatory foods and more community support.

In order to become forces for health creation, clinics and hospitals are going to have to play a part in creating, or reinforcing, the culture of health – and this will have to start with the doctors themselves.

From the very outset of the American College of Cardiology meeting, the hashtag #ACC16 began trending. Analytics from #ACC16 demonstrated that by the event’s end, there were nearly 3600 individual tweets, 35 million individual impressions, and roughly 1500 members participating via social media platforms such as Twitter. In other words, it’s quite clear that the ACC has embraced the digital space. And that’s as it should be. As cardiologists we are innovators and social media and digital engagement should be no exception. What follows is a look at how, in reflection of this, the ACC has folded this experience into its fabric.

There was an average of 155 tweets per hour and many participants “live tweeted” during important presentations such as the late-breaking clinical trials sessions each day. Leadership in digital engagement was spread among individual attendees, Twitter feeds from the college itself, and feeds from institutions such as the Mayo and Cleveland Clinics. (Interestingly, the “Top 10 Influencers” by impressions were not the same as the Top 10 by tweets – suggesting that what you say may be more influential that how much you say in the digital space.)

This investment in social media and mobile health extended to presentations as well. Researchers from Mayo clinic investigated whether or not patients undergoing cardiac rehabilitation would benefit from using specially designed health tools on their smartphones. In the study, 80 patients were randomized to a group having access to a smartphone mobile health tool with cardiac rehabilitation versus rehabilitation alone. Primary endpoint was total weight loss in the 12-week time period. The mobile tool group lost four times as much weight compared with those undergoing 12 weeks of cardiac rehabilitation alone. This randomized controlled trial is the first in the US to look at how using mobile and wireless devices concurrently with cardiac rehab might improve health outcomes – and clearly demonstrates the power of patient engagement via digital platforms.

Additionally, social media sessions were included as part of the Annual Scientific Meetings academic programming. I was honored to chair and participate in the session alongside many distinguished colleagues. The session was well attended and each talk was delivered in a TED talk style format – emphasizing audience engagement, interaction, and story-telling. Slides contained images rather than charts, and each speaker shared real-world experiences and examples of social media and digital successes. Topics included the use of social media for connectivity, engagement, and innovation. The expanding use of mobile tools for the advancement of clinical trials was explored as well as issues surrounding direct patient engagement.

What does this all mean? The future of social media in medicine is limitless – it is my hope that in 2017, we add to the numbers of active healthcare providers on social media. Ultimately, engagement can only help the people that we are pledged to serve – our patients. Through embracing our digital future in medicine, we can improve outcomes, improve disease awareness and access to care, and provide new tools for disease management. Let’s all be part of the leading edge of the bell curve. As Rogers shows us in Diffusion of Innovations, we must be the early adopters, not the laggards, if we truly want to maximize success.

What is Cupping?

Suction is applied to the skin using glass, rubber, or plastic cups. In ancient times, doctors used bamboo. The vacuum action rapidly facilitates the release of rigid soft tissues. It loosens and lifts connective tissues, it breaks up and drains stagnation, and increases blood and lymph flow to skin, muscles, and connective tissues. It does all of these things far more rapidly and effectively than any other type of therapy, including acupuncture, massage therapy, chiropractic adjustments, medications and sometimes even surgery.

What do the Colours Mean?

The colour change on the skin after cupping indicates many different things. Sometimes it turns orange or purple and, for others, it may turn red. The marks usually last from three days to a week; sometimes longer if a person is very sick or sedentary. The colour change on the skin after cupping also helps to determine the nature and the location of an illness but, for a healthy person with healthy skin, the tissue colour does not change at all after the cupping.

Since you can use the suction cupping almost anywhere on the body surface except in areas where large blood vessels pass, such as in the groin, you can check to see if you have internal troubles from the outside of the body. In areas where there is dead blood, lymph, cellular debris, pathogenic factors, and toxins present in the body, cupping will leave marks which indicate that the stagnation has been moved from the deeper tissue layers to the surface. The colour and pattern of the marks depends on the level of stagnation in the area. If there is no stagnation present, there will be only a light pink mark which disappears in a few minutes to a couple of hours.

Sites where there is old trauma or injury may require multiple cupping treatments to remove all stagnation. Patients will find, in follow-up treatments, that the marks will be lighter and lighter as the pathogens are systemically removed from the body. Cupping marks are not bruises and they are generally not painful. Although the cupping treatment itself can be slightly uncomfortable and the marks can look dramatic, the presence of colour in the cupped areas guarantees that the patient will feel immediate relief after the treatment.

Who Should Do Cupping?

Although cupping is a simple technique, it should only be performed by an expert practitioner. Although some massage therapists, chiropractors, or estheticians offer cupping therapy, they generally lack the in-depth training and experience that is required to apply cupping therapy safely and effectively. At best, cupping therapy performed by an untrained practitioner will be ineffective. At worst, it can cause burns, blisters, or scar tissue that result in further pain as opposed to providing relief.

Heartburn usually kicks in when you lie down to sleep, especially after a heavy meal.

You wake up in the middle of the night with a fire in your throat and a sour taste in your mouth. A blob of something vile pops up from your stomach and you have to spit it out.

After you get rid of it, your throat feels sore and you sound hoarse when you talk. Sometimes you start to cough or your chest sounds wheezy.

What you have experienced is heartburn… which has nothing to do with your heart.

It happens when stomach acids, which you use to digest your food, flow back into your oesophagus (the long tube between your mouth and your stomach). These acids irritate and burn the lining of your oesophagus and throat.

Everyone experiences some heartburn now and then. But it can become chronic, ie recur constantly. If you experience heartburn a few times a week, it is likely you have gastroesophageal reflux disease, otherwise known in short as GORD (or GERD if you are American).

The chronic condition should be treated with seriousness for several vital reasons.

What chronic acid reflux (GORD) does to your body

The constant backflow of stomach acid into your oesophagus can lead to:

[1] Dental problems… stomach acids in the mouth can wreak havoc on tooth enamel, requiring more trips to the dentist than usual.

[2] Voice and throat problems… stomach acid in the throat can cause hoarseness and laryngitis, and even changes in the voice. However these problems tend to resolve easily when GORD is treated.

[3] Asthma … studies have found that up to 80% of patients with asthma also have chronic acid reflux. Whether asthma causes GORD or chronic heartburn causes asthma is not known, but some medical scientists are of the opinion that acid that backs up from the stomach can get into the airways and damage them.

[4] Other respiratory problems… GORD has been statistically linked to other respiratory conditions including… chronic bronchitis, chronic cough, chronic sinusitis, emphysema, pulmonary fibrosis (scaring of the lung), and recurrent pneumonia.

[5] Narrowing of the oesophagus… chronic acid reflux can, over time, produce scarring (strictures) that narrow the opening of the oesophagus. This can make swallowing difficult. It can also cause oesophageal spasms that can mimic a heart attack (a frightening experience).

The weird thing is that people who develop strictures find a bit of relief from their heartburn… as the narrowing stops the stomach acids from refluxing into the oesophagus.

[6] Oesophagitis… the sensitive lining of the oesophagus can be injured by refluxing acid and this can cause a painful inflammation called oesophagitis. Eventually the acid causes bleeding which, if it is heavy enough, it can pass into the digestive tract and show up as dark tarry stools.

Oesophagitis can also cause painful ulcers on the lining of the oesophagus.

[7] Barrett’s oesophagus and cancer… in a small number of people, long-term acid reflux can lead to a condition (Barrett’s oesophagus) in which abnormal cells take the place of cells damaged by the acid. These cells have the potential to turn cancerous.

Persons with Barrett’s oesophagus have an increased risk of cancer of the oesophagus. This risk is increased if you smoke, are obese or are a white male over the age of 50.

A few decades ago, most cancers of the oesophagus were caused by cigarette smoking and alcohol. But over the last 15 years oesophageal and other cancers of the upper digestive tract caused by GORD have been developing into an epidemic. This is likely caused by changes in diets in the modern world.

Whatever the cause, it is obvious that putting a stop to the backflow is vital. There are many ways in which this can be done successfully once you understand what is going on.

What causes heartburn?

Your oesophagus joins your pharynx (at the back of your throat) to your stomach. A ring of muscle called the lower oesophageal sphincter (LES) controls the junction between the oesophagus and the stomach. The LES acts like a valve, opening and closing the entry to the stomach.

When you swallow the LES opens to allow the food or drink coming down the oesophagus to enter the stomach. The LES then closes to prevent the food and your digestive juices flowing back up the oesophagus. Each time you swallow, the LES relaxes and allows the food into your stomach.

Certain medical conditions can weaken the LES and prevent it from closing properly after you swallow. These include:

Hiatal hernia (an abnormality where a part of the stomach slides up into the chest cavity)
Obesity
Some asthma medicines
Pregnancy
Smoking
Diabetes
Delayed stomach emptying (a consequence of nerve damage, often due to diabetes)

Acid reflux statistics

In both Europe and America, chronic heartburn is becoming extremely widespread, affecting about one-third of the populations on both continents.

There is a strong link between chronic heartburn and being overweight. Research shows that people who are overweight are 50% more likely to have GORD compared to persons who are at a healthy weight. Persons who are obese are 200% more likely to have the disease.

Diabetics are also likely to suffer from GORD. A study published in 2008 in the World Journal of Gastroenterology found that about 40% of people with diabetes suffer from chronic heartburn.

The researchers also found it to be more common in people with diabetes who also had neuropathy or nerve damage due to diabetes. In addition, the study showed that people with both diabetes and neuropathy were more likely to have the disease, regardless of their weight, compared to people without neuropathy.

Medical treatments for heartburn

Conventional doctors have several approaches to treating chronic heartburn.

Antacids such as Tums®, Maalox® and Rennies® are very popular. These products come in the form of tablets that you chew or dissolve in your mouth. They work by using simple mineral salts such as calcium carbonate and magnesium carbonate to neutralize stomach acid.

You do get temporary relief from your symptoms… but they treat the symptom, not the cause. Using them, however, is unlikely to damage your health.

Some doctors prescribe H2 blockers (more properly called histamine H2-receptor antagonists) such as like Zantac®, Tagamet® and Gertac®. These medications block the action of histamine, which normally stimulates the secretion of stomach acid. Personally, I have found that Gertac®, which contains ranitidine, to be gently effective in reducing GORD.

Proton-pump inhibitors (PPIs), such as Nexium, Prilosec and Prevacid, also block the production of stomach acid. These drugs target the last stage in the production of stomach acid and the blockage is irreversible. These drugs are significantly more effective than H2 blockers and reduce the secretion of gastric acid by up to 99%.

With more than 100 million prescriptions written for these three medicines every year, Big Pharma makes a cool US$14 billion a year on just these drugs. Many professional organizations recommend that people take the lowest effective PPI dose to achieve the desired therapeutic result when used to treat gastroesophageal reflux disease long-term. In the USA, the Food & Drug Administration (FDA) has advised that no more than three 14-day treatment courses should be used in one year.

For good reason… here is why blocking the production of stomach acid is not a smart thing to do:

Why you should NOT use proton-pump inhibitors (PPIs)

The parietal cells in your stomach secrete the stomach acid used in the digestion process. The secretion of the acid is governed by proton pumps which provide energy for the process.

Proton-pump inhibitors prevent the proton pumps from working and so reduce the amount of acid produced by the parietal cells. This prevents acid reflux (no acid, no reflux!).

The problem is that proton pumps are present in just about every cell in your body, not just the parietal cells in the stomach. These proton pump systems are necessary for the production of the energy used in a wide variety of your body’s processes. Though this energy can be produced in several ways, without proton pumps them these processes could not work at their best.

While proton-pump inhibitors are designed to interact specifically with the proton-pumps in the parietal cells in your stomach, research suggests that it is likely that their effects are not limited to the specific acid producing cells of the stomach.

There are many other good reasons why you should not use proton-pump inhibitors:

(1) Stomach acid is a critical part of your immune system

PPIs reduce the acidity of your stomach. This is dangerous as certain harmful bacteria thrive in low-acid environments. Examples include H Pylori, which is a major cause of stomach and duodenal ulcers, gastritis and can even cause gastric cancer (according to a report in Drug Safety in 2003).

Several recent studies have shown that PPIs alter the micro-organisms in the gut by reducing its overall diversity. As a result, dangerous pathogens, such as Enterococcus, Streptococcus, Staphylococcus, and E. coli, tend to be more prevalent in the guts of PPI users.

As stomach pH becomes less acidic, many ingested microorganisms that get in through the mouth but which would normally be destroyed are able to make their way into the gut. Those who use acid blockers increase their chances of acquiring Clostridium difficile, Campylobacter, Salmonella, Shigella, Listeria, and pneumonia compared to persons using other medications.

(2) PPIs impair the absorption of nutrients

Stomach acid is essential for the digestion and absorption of food, both macro- and micro-nutrients. Studies show that persons who use PPIs have an increased risk of vitamin and mineral deficiencies, including vitamin B12, vitamin C, calcium, iron, and magnesium.

Persons who use acid blockers can also end up with achlorhydria (a lack of stomach acid). This, combined with atrophic gastritis (stomach inflammation), allows bacteria, which compete with the host (you!) for the consumption of micronutrients such as vitamin B12, to flourish.

Studies have found an association between the use of PPIs and the total number of bone fractures in the elderly. The association was significant enough for the FDA in the USA to issue a warning in 2010. A more recent study has shown a similar association between PPI use and bone fractures in young adults.

(3) PPIs damage the cardiovascular system

A study published in May 2016 found a link between proton-pump inhibitors and the premature aging of blood vessels, with the cells losing their ability to split into new cells.

Other recent studies indicate that PPI users have a significantly greater risk of heart attack compared to person using other antacid medications.

PPIs reduce the production of nitric oxide, a nutrient that increases lung power, helps your heart pump blood and oxygen to your cells, and even helps with erectile function by allowing blood vessels to expand and relax when you are on the job.

PPIs also affect lysosomes. Those are acid-producing cells in your body that clear up unwanted debris. Without enough acid to remove the waste, the cells protecting your blood vessels age rapidly. That can lead to a stroke, heart attack or kidney failure.

(4) PPIs harm the kidneys

Patients using PPIs were compared to patients using H2 blockers, another common antacid drug in a study published in 2016.

The study indicated that, over five years, the PPI users were 28% more likely to develop chronic kidney disease and 96% more likely to develop end-stage renal disease.

(5) PPIs harm cognitive function

A study published in 2015 that assessed cognitive function in users of PPIs compared to controls found statistically significant impairment in visual memory, attention, executive function, and the working and planning function among the PPI users.

Another study in 2016 found that regular PPI users had a 44% increased risk of dementia compared to non-users.

Why this is so is not known. However, communication between brain cells requires the action of proton pumps. It may be that the proton pumps in the brain are affected by PPIs that target stomach acid.

(6) Rebound reflux

When your body senses a reduced production of stomach acid, it produces gastrin, a hormone that stimulates the secretion of gastric (stomach) acid by the parietal cells.

As a result, the individual parietal cells expand in size. Larger parietal cells have more proton pumps and can produce larger amounts of stomach acid. An overproduction of stomach acid caused by PPIs is called rebound hyper-secretion.

Rebound hyper-secretion illustrates why getting off PPI therapy is so difficult once you start using them… long-term use fundamentally changes the physiology of stomach cells.

The basic problem with PPIs is that they treat the symptoms of a condition (the production of acid that flows back up the oesophagus) rather than the underlying cause (a weakness in the lower oesophageal sphincter (LES)).

There are two main approaches you can take to dealing with chronic heartburn that focus on the underlying causes:

Heartburn avoidance techniques
Natural remedies for heartburn

How to avoid heartburn

Here are some simple ways you can prevent heartburn:

Eat smaller meals… this makes digestion easier and reduces the pressure in your stomach that causes reflux.
Eat slowly … digestion starts in the mouth and chewing your food thoroughly reduces the likelihood of reflux.
Avoid tight clothes… tight clothes can put pressure on your stomach, pushing food back up into your oesophagus.
Don’t smoke… smoking irritates the membranes of the throat and oesophagus. Nicotine also weakens the oesophageal valve, allowing stomach acid to come up to your throat.
Avoid certain foods… chocolate, tomatoes, fatty or fried foods, fatty meats (choose lean cuts), synthetic dressings (use olive oil), spicy sauces (choose mild or avoid), alcohol, cola and other sodas as well as caffeine are all contributors to LES malfunction.
Avoid certain spices… hot spices as used in curries and other hot Eastern foods, as well as cinnamon, can irritate your stomach and oesophagus causing pressure that forces acid back up through the LES.
Avoid peppermint tea… as it tends to relax the LES and allow acid to flow back up the oesophagus.
Raise the back of your bed… use short planks of wood between the legs of the bed and the floor to raise the pillow-end 4 to 6 inches higher than the foot-end; by sleeping with your head lightly higher than your feet you will be using gravity to reduces the chances of stomach acid flowing back up to your throat… this really does work in my experience.

Persons who take these simple steps to prevent acid reflux experience fewer and milder bouts of acid reflux.

Natural remedies for heartburn

There are several natural remedies for heartburn that actually work:

D-limonene
Magnesium
Ginger
Baking soda

Some of these ‘cure’ acid reflux for a time at least if not permanently. Others provide temporary but effective relief.

D-limonene

D-limonene is an extract from orange peel which is safe to use as a food additive or supplement.

Research at WRC Laboratories in the USA indicates that a daily intake of one 1000mg capsule of d-limonene every second day for 20 days reduces or eliminates acid reflux in most people for at least six months. This is supported by anecdotal evidence among researchers and further research that has yet to be published.

D-limonene is a cell rejuvenator yet scientists don’t know why it is so effective. Researchers have speculated, however, that as d-limonene is lighter than water, it floats to the surface of the gastric juices in your stomach.

The minor burping you experience with d-limonene causes it to be carried directly into the oesophagus. By coating the oesophagus, d-limonene may protect it against the caustic contents that are regurgitated during acid reflux. This would help heal and strengthen the lower oesophageal sphincter (LES) and heal erosion in the oesophagus.

It is also thought that d-limonene may promote quicker movement of food and gastric juices out of the stomach so that these oesophageal irritants promote less reflux.

Scientists also suggest that d-limonene may provide a barrier in the oesophagus and stomach against bacterial infection, such as helicobacter pylori, which are ingested in food or water. H pylori attack the lining of the stomach eventually causing ulcers and even stomach cancers.

The generally accepted opinion (or shrewd marketing) suggests that the best d-limonene, which is available in health food stores, is the Jarrow Formulas D-Limonene.

I recently took a 1000mg capsule of the Jarrow Formulas D-Limonene (sourced online through Amazon) each day for 30 days. There were no side-effects and it appears to have cured my acid reflux.

Magnesium

Magnesium is a calming and relaxing mineral. It is an ingredient in several antacids.

This mineral helps your LES to relax so that it can close properly, thus preventing the backflow of stomach acid that causes heartburn.

Magnesium chloride is absorbed better than other compounds of magnesium and is thus more likely to be effective in relieving your heartburn.

Take 450 to 500mg once or twice a day to see if it helps. Each dose should contain about 150mg of magnesium and about 350mg of chloride.

Ginger

Ginger is prized for its health-giving qualities in Asia, Africa, the Middle East and the Caribbean. Most of the health benefits of ginger are in the woody root of the plant, the rhizome.

Ginger is absolutely loaded with antioxidants. It has antibacterial, antiviral, antioxidant and anti-parasitic properties. It can relieve the discomfort of heartburn without side-effects.

Fresh ginger is best, though you can use dried ginger. When buying ginger root, make sure it feels firm and fresh. Fresh ginger, provided it is unpeeled, can be stored in a refrigerator for up to three weeks or in a freezer for up to six months.

You can peel ginger with a paring knife and add it to cooked dishes, mix it into a stir-fry or drop it into homemade chicken soup. But taking it as a supplement is not recommended as the ginger in capsules is not easily absorbed or used by your body.

In Uganda, doctors and herbalists use ginger tea to treat heartburn. The root’s anti-inflammatory properties speed up the digestive process, preventing the build-up of gas, and helping to regulate bile and gastric juices.

Adding a simple ginger tea to your daily diet will tighten your LES and help prevent the backflow of acid from your stomach according to a report by the Thai Medical Association in 2010.

Here’s an easy recipe:

Remove the skin from a piece of fresh ginger root and chop it into small pieces or slices
Fill a small pot with two cups of water and boil
Add the ginger and cover.
Let it simmer for about 10 minutes
Strain the tea

You can drink it hot or cold. You could try adding a pinch of cinnamon to boost the flavour.

I make a batch twice a week, store it in the refrigerator and drink a chilled glass first thing in the morning.

Bicarbonate of soda

Sodium bicarbonate, aka baking soda, offers a very quick remedy when you are having an attack of acid reflux.

Just mix a flat teaspoon of baking soda into a glass of water, stir and wait for it to dissolve and then drink it down. Relief will be fairly immediate.

Baking soda works because it contains bicarbonate which neutralises the acid in your stomach.

This is not a permanent solution for chronic heartburn. But it works a dream for a quick fix and there are no side effects.

In July of 2017, the online journal Scientific Reports (Nature) published an article on diabetic retinopathy and the importance to people diagnosed with Type 2 diabetes of keeping on top of their blood pressure reading. Workers at the Federal University of Rio de Janeiro in Brazil studied five hundred and forty-four Type 2 diabetics who were at high risk for developing diabetic retinopathy, a severe eye disease. Over the course of six years, the participants had an annual eye examination. Their blood pressure reading was taken as they went about their normal routines. Their aorta (artery from the heart to the rest of the body), was examined for stiffness. By the end of the study, one hundred and fifty-six of the participants either developed diabetic retinopathy or saw the condition grow worse. They had…

a higher blood pressure measurement,
a longer duration of having Type 2 diabetes,
a stiffer aorta,
poorer blood sugar control, and
higher LDL (“bad”) cholesterol measurements.

than the participants without diabetic retinopathy.

Diastolic (lower number) blood pressure and high LDL were the measurements most strongly linked with diabetic retinopathy.

To lower blood pressure…

engage in physical activity several times a week.
take your dog to the park.
go swimming.
walk up the stairs instead of taking the elevator.
park at the farthest reaches of the parking lot and walk to the shops.
normalize your weight or keep it in a healthy range.
take the blood pressure medication prescribed by your doctor.

To lower LDL…

eat different fruits, nuts, vegetables, and whole wheat products.
avoid fatty foods such as meat and dairy products.
cook with extra virgin olive or other vegetable oil instead of butter.

Diabetic retinopathy develops when sugar in the blood damages small arteries in the back of the eye. New, weak, incompetent blood vessels proliferate. Sometimes there is bleeding into the eye’s center. The condition often goes unnoticed until it has advanced sufficiently to cause sight issues. Usually, dots or lines (floaters) can be seen, problems with different colors are noticed as well as loss of vision.

Diabetic retinopathy is diagnosed by an ophthalmologic exam, which is one reason why regular eye exams are essential. When retinopathy is diagnosed, laser surgery can cauterize or stop troublesome blood vessels developing.

One study put together thirty-five earlier individual studies showing how much diabetic retinopathy exists in the world. The results showed about 34.6 percent of people diagnosed with diabetes have the condition. Preventing or controlling Type 2 diabetes protects many important parts of your body, and your eyesight is one of them. Unfortunately, many Type 2 diabetics fail to take their condition seriously because it does not hurt. Your eyes are two good reasons to keep your blood sugar and body weight under control.

Although managing your disease can be very challenging, Type 2 diabetes is not a condition you must just live with. You can make simple changes to your daily routine and lower both your weight and your blood sugar levels. Hang in there, the longer you do it, the easier it gets.

For nearly 25 years, Beverleigh Piepers has searched for and found a number of secrets to help you build a healthy body

For an overall dental hygiene, an appointment every six months functions as a vital pillar. However, there are many instances where we feel that our mouths are not at their very best. And whether 6 or 60, dental visits become a must in such scenarios.

Be it your busy schedule or hectic social life, if you’re one of those putting off that much-needed dentist visit, you could seriously regret it later in life.

Additionally, here are a few sure shot signs that you should definitely knock your dentist’s door:

1. Tooth ache: Tooth ache is, in fact one of the most common, yet one of the most ignored indications that you immediately require a dental visit. Although it hits seriously hard, and is often too difficult to ignore, it could be something more serious than you perceive, and thus it’s mandatory that you seek dental consultation.

2. Inflamed gums: Medically known as gingival inflammation, gum inflammation is a condition wherein the gums are swollen and red. It has the potential to contribute to periodontal infection such as gingivitis. This is generally caused by hardened plaque that accumulates under the gum line. If untreated, it can also lead to altered teeth structure, tooth loss and cardiac problems.

3. Tooth sensitivity: This is another sort of tooth pain and occurs whenever you take in something colder, hotter or sourer. Further damage can be easily ruled out if one chooses to diagnose it on time. Sensitivity is indicative of tooth decay. The earlier you check out with your dentist, the better it is for your oral health.

4. Dryness within mouth: There are many reasons that can contribute to this condition. That said, there is, however, no explanation for a sudden dry mouth syndrome. Mouth dryness can contribute to tooth decay, and ultimately, to other oral disorders as well. It is, therefore, important to visit your dentist if the condition persists.

5. Oral Ulcers: Canker sores are quite a common sight, and often not a cause for concern. However, if it is one of those which doesn’t heal, you need to immediately seek dental attention. It could easily turn out to be an oral ulcer and is also indicative of oral cancer.

6. Headaches: Not most people know, but headaches and oral care are very closely related. Frequent headaches are often a sign of teeth grinding which, contrary to what most people believe, is a cause for concern. Grinding can cause additional damage and further expose your teeth to contamination.

Miniscule issues, if resolved early into their life, can prevent major oral diseases from forming up. Timely dental care is all you need.

Whoever said that a picture is worth a million words might as well have replaced the word ‘picture’ with ‘smile’. There is no denying that a beautiful smile speaks more about your personality even before you utter a word. While everyone would love to have a dazzling smile, a missing tooth can ruin all this. If you have a missing tooth, you will inadvertently find it harder to socialize freely while your dietary habits will also be affected. This is where dental implants come in handy.

Dental Implant Technology in Detail

A single missing tooth or several teeth on your gum can now be replaced using advanced technology in dentistry. The surgical procedure involves placement of a metal post mostly made of titanium into the jaw bone to form a strong foundation for a replacement tooth. This metal ossifies into the jawbone and has no side effects and once it has been fully integrated into the bone, an abutment is fixed on top where a crown is then screwed firmly.

The American Dental Association (ADA) has identified the following implant procedures as safe:

Endosteal: This is an implant that is fixed directly into the jawbone. A post is later connected before an artificial is fixed.
Subperiosteal: A metal post is fitted onto the jawbone just below the gum tissue. Posts will protrude through the gums where a crown is then fixed to give you a perfectly natural oral outlook.

Advantages of Implant Technology

There are many reasons your family dentist will recommend this procedure for improved oral health. These include:

Improved appearance: You will get back the look and feel of your natural teeth.
No more slurred speech once the replacement is in place. This cannot be said for other alternatives such as dentures, which can slip and cause embarrassments.
Better dietary habits: With missing teeth, you might find it hard to eat your favorite foods and drinks. Once you are done with the implant treatment, you can enjoy all meals that will boost your overall health.
Improved oral health: This procedure does not affect the rest of your gum and in fact serves to protect the jaw bone against exposure. Common oral complications such as bone loss are avoided.
Permanency: This is a permanent treatment that deals with the missing tooth conclusively. You don’t have to worry about special maintenance of the replacement.

These implants enjoy a high success rate and this has been rated as one of the best oral care procedure. If you are looking for a way to bring your beautiful smile back, it is time to talk to your dentist. A comprehensive evaluation of your jaw bone mass is done as well as an assessment of your health history before treatment starts.

Many people develop a fear of dentists early in their lives. This could be due to a combination of factors, such as wrong diagnosis, poor pain and discomfort management, embarrassment over teeth and mouth conditions, and previous negative experiences among others. A recent survey shows that 9 to 15% of Americans avoid seeing their dentist due to these fears and anxiety.

This means many families suffer silently while dental services today have advanced tremendously. Without proper oral care, you are exposing yourself to the risk of gum disease, tooth loss, poor dietary habits among other related health problems.

Sedation Dentistry to Overcome Anxiety

If you or someone close to you is suffering from dentophobia, it is high time you tried a whole new dental experience through sedation dentistry. This is a Godsend for anyone with an extreme fear of oral care professionals. To appreciate the importance of this approach in medical care, you need to appreciate how it works.

In the simplest form, you doctor will use sedatives to help you relax and reduce patina and discomfort during the procedure. The sedatives can be administered in different forms;

Oral: A pill is given to promote a high level of relaxation.
Gas: This helps you to relax throughout the procedure although you will still be conscious.
Intravenous: A sedative is administered through the veins into the blood.

Benefits of Sedatives in Dentistry

The advantages of using sedatives are enjoyed by both the patient and the doctor and they include:

Quicker procedure because the doctor is able to focus solely on the affected area as the patient lies calmly. More work is done in one sitting as opposed to numerous visits.
No fear and anxiety: The entire procedure goes on smoothly for the patient without any accompanying fears and anxiety.
Pain-free treatment: The mouth is one of the most sensitive body parts and no one enjoys sharp objects prodding inside. With sedation dentistry, you are assured of a pain-free experience, which is what everyone wants.
No painful memories: One major reason many adults suffer oral problems is the fact that they avoid dentists like the plague. This is understandable in cases where painful memories are involved. Luckily, your family doesn’t have to go through such horrendous situations because advances in dentistry will create only pleasant memories.
More effectiveness: It is possible to talk to your dentist even when under sedation and this can lead to better outcomes of the treatment procedure.

Still worried about your next dental visit? You need not be; with this advanced procedure, you will have a comprehensive diagnosis and treatment without any accompanying pain and discomfort.

Complete dentistry of Orland Park has successfully performed numerous implant procedures. Complete Dentistry of Orland Park offers top quality Dental Services and excellent patient aftercare. Sedation dentistry Orland Park is an advanced procedure, where you will have a comprehensive diagnosis and treatment without any accompanying pain and discomfort.