Saturday morning hours for 2017………….start this Saturday!

Happy New Year! I am going to make a concerted effort to blog more this year, not just about 'health' but about 'life' in general. Things that I find interesting and want to share. One subject is travel, whenever a patient asks me where I went and I tell them they always say "did you like it?" or "what is it like?" Last year I went to England (my birth place), Spain, Italy, Portugal and St. Lucia and I have so much to tell you about these exciting places. Where better than my blog? If you like to hear about this kind of thing please remember to give it a thumbs up and I will keep it up :) Anyway,stay tuned, I will talk about that in my next blog but the purpose of this one is a little more mundane: Don't forget that we are in the Laurel office on the first Saturday morning of the month………..which means I will be there this weekend. Give us a call for an appointment so you don't have to miss work or get stressed trying to commute.Warm regards and Best wishes for 2017. Dr. Tuakli

The true lesson of Prince and his death

Since the untimely death of the great musician Prince, a lot has been said about how much his estate is worth and which relatives are lining up to get a piece of his mega millions. Unfortunately, I have not heard a word about the real lesson we should learn from his death: What is the point of being rich if you don’t put a premium on your health? As the old folks say “you can’t take it with you” and I say: you will be leaving it even sooner if you don’t make your health a priority. It boggles my mind that someone can have so much money and still be unhealthy. My feeling is that Prince was not as self destructive as some of those like Michael Jackson, Whitney Houston and Amy Winehouse who preceeded him, but still it is clear that being healthy was not top of his priority list the way it should have been. How many times have I harped on the old “Prevention is better than cure” song? When you have that much money and you still don’t look like the picture of health, what is wrong with this picture? Enough said, make your health a priority no matter what your age or income. If you have to skip a little purple rain and glitter to invest in your health then so be it.

Lack of sleep can kill you!

I gave a talk on Sex, Sanity and Sleep yesterday and wanted to share some of the amazing information I found out about sleep. Sleep is one of those wonderful things that we take for granted but it can increase not just the quality of your life but the QUANTITY of it too! One extra hour of sleep a day can decrease your mortality by 50%. Do you forgo leisure and sexual activities and sacrifice exercise because you are "too tired", gulping down caffeine to keep up. Stop! Besides making you tired,lack of sleep severely impacts your health. One in five auto accidents involves drowsy driving. Lack of sleep increases your blood pressure, your tendency to diabetes, arthritis, weight gain,heart disease and premature aging.When you are sleep deprived you are cranky and your decision making skills are reduced which affects your social relationships among other things.Improved sleep improves your thyroid function and immunity which controls your ability to fight off infections and cancer. So insomnia is no joke! Make sleep a priority. As I mentioned in yesterday's blog: It takes great sleep to make a great life. Check out that blog for tips on how to get better sleep and if that's not working, seek help.

Getting more sleep

Here are some tips on how to get better sleep: #1 Make it a priority Allow time for 7 to 9 hours of sleep Exercise regularly (no less than 4 hours before bedtime) Avoid caffeine in the PM and alcohol within 2 hours of sleep Warm bath before bed Sleepytime and other teas Manage stress Watch diet Make your bedroom quiet both noise wise and activity wise Only use the bed for sex and sleep: don’t use it for eating, reading, watching television, studying, work, hobbies Remove clutter Sleep alone, no pets, children, other Try Yoga and Acupuncture TRY HERBAL SUPPLEMENTS: Clinical Sleep, Melatonin, Holy basil, Passion Flower Lower lights change the bulbs outside the door if necessary Keep a regular sleep schedule • Go to bed and get up around the same time • Limit naps Limit stimulating behaviors before bedtime • Limit caffeine after 2 pm • Limit alcohol after dinner • Limit large or spicy meals • Limit vigorous exercise 4-6 hours before bed – De-stress, learn relaxation techniques – Physical and mental – Maintain a regular physical activity routine – Physical activity helps with stress – Do not go to bed hungry or full – Light snack of carbohydrates and foods with tryptophan – Practice stimulus control: – Go to bed when you are drowsy – If you don’t fall asleep within 10-15 minutes • Get up, leave the bedroom • Read or watch something dull • Make your room and bed comfortable • No pets on/in the bed • Temperature Cool • Lighting low, expose yourself to bright lights during day • Bed, sheets, PJ’s comfortable and not binding • – Treatment of underlying problem, with menopause that is the hormonal imbalance (estrogen deficiency) Treat medical conditions like restless legs, sleep apnea and obesity • Obstructive Sleep Apnea treatment options include: – Mouth appliance – Surgery-tonsils and/or adenoids – Weight reduction if obese – CPAP-Continuous positive airway pressure

Management of erectile dysfunction (ED)

Here is a brief synopsis of treatments available for erectile dysfunction and what tests should be done. As always start with history, issues like how long you have had the problem, whether your partner is interested in correcting the problem. What medications do you take that could be aggravating the problem. Are you a smoker of cigarettes or marijuana, abuser of alcohol all these cause ED. Have you had Diabetes or Hypertension and so on. The history should be extensive. Next is the Physical exam and lab tests for hormones and diabetes. Six hormones are tested for as well as standard blood tests.If you are physically normal and have no problems with desire then your doctor may prescribe the PDE5 inhibitor drugs like Viagra. If your hormones, such as testosterone are found to be low these can be replaced. Medical issues can be addressed and any offending medications removed. If these don't work there are medications like "Muse" which the man can put directly into his penis, this will give him an erection that could last 4 hours. A variety of medications can be put into the urethra or injected directly into the penis, by the patient or the doctor. If these are not satisfactory or unacceptable there are surgical remedies which include inserting rods into the penis some of these are firm in consistency and some have to be inflated. My urology colleagues tell me that for the people that have to get implants the satisfaction rate is 90%. If you have more questions please call for an appointment, I would love to go into more detail.

Bringing sexy back!

Last weekend I gave a talk on men's sexual function, actually men's sexual dysfunction to be precise. A lot of couples don't realize that men's sexual function does decrease with age even when the desire is still strong. Hence the immense popularity of Viagra and Cialis kinds of drugs. My talk involved the natural decline in sexual function and how to restore it even if these drugs don't work. Before I switch subjects, many are not aware that if a man has had Cialis within 48 hours he cannot take nitrates for a heart attack or chest pressure. I want to give that little piece of information so that people remember to mention the use of these medications should they find themselves in an emergency room. As it happens the conference called 'Bringing Sexy Back' was for married women only and they had a myriad of concerns about their husband's sexual function. The rest of the 2 days was spent 'getting sexy' with workshops and advice that I think would be hard to find elsewhere. Suffice to say it was 'live' and pretty wild (by my standards at least). I would certainly be happy to discuss either female or male sexual dysfunction with any patients who have an interest in the subject. This conference underscored the very important role that sexual intercourse plays in a marriage and how it reinforces bonding, intimacy and even friendship between the spouses. Here's a heads up: On April 30th at 11 AM I will be speaking at the Howard county Womanfest on "sex, sanity and sleep". The subject matter in this case will be strictly about women and it is free.. More on that in future blogs, in the meantime put some thought into spicing up your sex life and if its not working come and see me.

Happy New Year! Another year has rolled around and we are once again making resolutions. Don’t worry I am not going to talk about weight ☺ suffice to say our patients lost a total of over 500 pounds last year and we are hoping for more this year! I don’t generally believe in resolutions because they seem to be so easily broken, instead set yourself some targets that you can achieve at your own pace. Continue to be positive and try to achieve what you find self fulfilling regardless. I would mention that no one can achieve their full potential if they are not healthy, so hopefully one of your goals will be to strive for optimal health. But no pressure, enjoy the New Year and may you achieve all your heart desires. Stay well. Sincerely, Dr Tuakli