Hair, Skin and Nails

Hair tends to be less lustrous as we get older, Nails more brittle and Skin more saggy. Is there a common thread? Of course, not just the obvious generic aging syndrome but also deficiencies that we can actually point to (and replace). Here are some basic tips: Use an antimicrobial shampoo before you use the fancy, nice smelling, super conditioning stuff. make sure the producte you use dont cause build up. Consider massaging coconut oil into the scalp before washing, leave on for a minimum of 20 minutes. Get the supplements on our list for whichever is problematic for you, hair, skin, nails or all of the above. If you notice rapid aging check for hormone imbalances, thyroid etc and vitamin deficiencies. Maintain your internal anti-oxidant levels and of course use the Stop-Aging Skin therapy twice a day. This would be a good time to stock up on maintenance items for the New Year, if you were registered for today's seminar because of the 10% discount. Yours in health Dr. Nadu A. Tuakli

Dont discount doing a pap smear

A patient said to me last week “I do believe you saved my life for the second time Dr. Tuakli” And I thought Wow! You know what, she is right. People thank me for saving their lives from time to time and not to sound cavalier but I often think that it is nice to hear but I was just doing my job. Any qualified physician could have been credited with doing the same thing. But this time was different and very stark. This 50 something year old lady has been in my practice for perhaps 3 or 4 years. She has a variety of medical issues that we have been working on and from time to time I would suggest she have a pap. She had told me previously that she had been told that she didn’t need one because she had had a hysterectomy. Interestingly enough whenever I probed further she never seemed sure about exactly what had been done. Was the uterus completely gone including the cervix? How about the ovaries? Why was the surgery done in the first place? It never ceases to amaze me how many times I ask those questions and the answer is “I don’t know”, particularly in over 40 year old women. I eventually convinced her that it would be a good idea to just do a routine check up even though she had no symptoms and so I did a pap. As soon as I started her pap I knew from the look of the lesion in her vagina that it was cancerous. Putting cells on a slide and sending it to the lab quite frankly was a formality and I had her schedule an appointment with a gynecology oncologist pending the results. She told me when she came in last week that the specialist walked into the room and the first thing he said to her was “What is a women your age doing still getting pap smears?!” (I wont be referring any more patients to him). The arrogance dissolved when he saw the cytology report and the patient has since had the appropriate surgery. So why do I tell this cautionary tale? Well, for one thing, the current guidelines imply that she did not need a pap smear, simply based on her age. Secondly, I think that many women are walking around thinking that because they have had a hysterectomy they are immune to genital cancers. Thirdly, standard recommendations are just that, written for the common good but not by someone who knows you. Do not take them as gospel. You could argue that this is the exception to the rule and that is probably true but it also means that someone’s mother and sister will still be alive 3 years from now and she also managed to avoid the trauma of cancer therapy that would have resulted had she found it later. In medicine it is not always easy to argue with “official recommendations” and specialists who don’t know the patients. I believe that I taught myself something with this case, not everything has to be rational, and care must be individualized regardless. I am a strong believer in learning from past experience even if its not written anywhere. I derive no satisfaction from my patient being diagnosed with cancer but I am sure glad I followed my gut. When in doubt get a pap, it sure beats the alternative!

Mammograms and Breast Cancer prevention

The nice thing about blogging is that I can have an opinion and express it as such. This may be in direct contrast to the official 'recommendations' of the medical establishment.
A case in point are the new mammogram recommendations. Last year someone who was writing an article for 'Good Housekeeping' called me and asked how the new recommendations would change my practice. I told her honestly, they wouldn't.
My response must have been either uninteresting or not politically correct as it wasnt published!

Now that Breast Health awareness month is back (October) I get asked this question again quite a bit.
As far as I'm concerned the new recommendations dont make sense and I believe if my patients see the facts they will agree.
Some of the most egregious recommendations include: discouraging women from doing their own self breast exam and not starting mammograms until the age of 50. Do these jokers know how many of my patients would have been dead by now if I followed these recommendations?

While glancing through a recent edition of Family Practice News I noticed a reference to a study done in Michigan, with more than 5000 women, which agrees with me. The study was reported at the symposium of the American Society of Clinical Oncology. It found that many breast cancer patients would have more advanced disease and face harsher treatment if the recently updated screening guidelines of the US Preventive Services Task Force were widely adopted.
In women under 50, 48.3% of breast cancers were detected by mammography, 46% by palpation.
The speaker concluded that " you are better off if you can have your cancer detected by mammography .....you will have more options and likely need less aggressive treatment......we would support the societies that continue to recommend annual screening mammography starting at age 40"

Do not misunderstand me, mammograms are not perfect and there is some radiation exposure but if you have breast cancer they definitely beat the alternative! I think if you are under 50 you can work it where you can get more thermograms and less mammograms but you still need to get that baseline mammogram to know where you stand. They dont hurt anymore and can be life saving.
Breast cancer treatment has come a long way but we still have a long way to go to eradicate the disease.

Prevention is ALWAYS better than cure.

Stay Well

Dr Tuakli

Growth Hormone the mystery reparative hormone

The majority of my Anti-Aging patients are male but the reverse is true when it comes to Hormone Replacement. Its an observation that I find interesting, why the difference? I'm not sure.
This month I am going to focus on issues affecting Anti-Aging specifically and many of them are more male directed intentionally because I think that sometimes women's issues are overrepresented.

What is Growth Hormone exactly and why is it so popular? Growth Hormone is naturally secreted by the pituitary it affects almost every organ in the body, it is a master controller of metabolism and muscle tone.

In my opinion, Growth Hormone is a misnomer,oftened referred to as HGH (Human Growth Hormone) it was originally named because children without it didnt grow. In adults once the growth plates are closed there is no opportunity for getting taller no matter how much growth hormone a person takes.
The name gives the impresion of a substance that can cause strange things to grow like horns and cancer, it actually does not. It is in fact HGH a reparative hormone which helps the body repair damage and heal faster.

I recently had a patient whose company sent him to a leading hospital annually for an 'executive' physical. This, and the fact that he had formerly been a triathlete led him to believe that he was very healthy. After he had some arthroscopic surgery last year he became very frustrated because he could not get back to his prior level of fitness. A friend told him he needed to find an Anti-aging physician and he found me. I ran a series of tests on the patient and started him on therapy. We optimized his vitamin, and supplement levels in addition to short course of HGH.
At his 3 month follow up visit, the patient told me he was 'back to 100%'. It took less than 90 days to get him back in condition, something physical therapy and working out had not been able to achieve.
I had another patient who was 35, also an athlete and when he was offered his 5th knee surgery decided there had to be another way.
The first patient asked me an interesting question, one in fact that I couldnt answer: "Why doesnt every patient who is getting surgery get treated like this from the get go?"
I have no idea, but it seems to make sense. Why should this be 'the medicine of the future' when we have the information to help people now? Why dont more orthopedic doctors refer their patients to get 'tuned up' before undergoing the knife?
I put all the patients who come to me for a 'pre-operative' physical on a healing regimen, afterall, surgery is just self-inflicted trauma. We can anticipate the damage that will be caused and limit it.
(For more information on Growth Hormone please see my website).

Another interesting point that this case brings up is: Do you really want your preventive medical care managed in a place that is totally focused on disease? It is fine to go to the country's best hospital for 'Treatment' but the goal of Preventive Maintenance is different. Be clear about exactly what you want from your 'routine' physical exams and what your doctor's focus is. Primary prevention is the art of preventing something before it occurs, secondary prevention (for example a mammogram) is detecting a disease early enough to do something about it and then there is the third option: fixing a problem that is already entrenched.
You choose what works best for you.