Its 5 AM!
And so begins my self-inflicted adventure to Port au Prince in Haiti. I said goodbye to my worried husband around 7.15 am at BWI and boarded the flight to San Juan. I was very worried that my bags would be too heavy but we were able to include all the prenatal and kiddie vitamin bottles I had brought with me plus a 5 pound bag of candy for the kids.
What are my emotions? I am not sure, after having so many people,including my dear husband, tell me not to go, then the security advisories and disclaimers from the American Refugee Committee (ARC) the group I am going to work with,I feel mre anxious than I usually am when I leave for a volunteer trip. The positives include the possibility of perhaps making a difference to someone in Haiti and also the chance that I may actually get more rest there!
Apart from only getting 3 hours of sleep last night and getting up with a sore back, the past few weeks are starting to take their toll. In addition to organizing a women’s seminar and having to evict a tenant from a rental property, I have had to work through my son’s “senior pranks” and graduation plus get my practice ready to do without me for two weeks and prepare for Haiti, all the while reassuring everyone that I will be coming back alive! In retrospect its been a tough year so far – a sentiment I am sure that is shared by everyone in Haiti! That thought rapidly puts everything in perspective doesn’t it?
I am hopeful that I can maintain my enthusiasm but am a little scared of being overwhelmed by the squalor and misery. My other fears are another earthquake or hurricane making orderly functioning impossible, plus I am claustrophobic so I will not be one of those surviving for days under the rubble- and then there's security.
Clues to the security situation have been provided by ARC: a casual mention that I will be picked up from the airport by an armed guard and their repeated requests that I fill out a “proof of life” form. “What is that?” I finally asked. “Just a form that lists answers to questions only you would know in case you get abducted” Aaah, yes of course!
I am anticipating up to 12 hour work days and I wonder if arriving exhausted is really doing a disservice to my potential Haitian patients.
Enough about you, what’s going on in Haiti you ask. Well I don’t know yet, I’m on a little plane on the way there from Puerto Rico. The captain says it is 33 degrees centigrade at the moment – what is that?
I will write about my initial impression and emotions shortly. Meanwhile where are my tissues……..just in case!
Sunday, June 6, 2010
Shout out to sponsors!
I wanted to acknowledge those who sponsored our seminar:
Northern Pharmacy with a special shout out to April!
Vien clinics of America
Spectracell
Northern Pharmacy with a special shout out to April!
Vien clinics of America
Spectracell
Monday, May 31, 2010
Happy 90th birthday Ms. B! News about our great seminar!
Here is a picture of me with a patient of mine who turned 90 this month. Doesnt she look great!Happy birthday.
Last weekend I held an anti-aging and hormone replacement seminar entitled: looking good and feeling good after 40! It was great and very inspiring for me personally to see women so receptive to receiving new information.
The seminar opened with Claudia Salomon a renowned Nia (and Zumba) teacher helping us claim the space that we were in. What I thought was going to be a mild stretching exercise had me breathless when called upon to speak even though we performed the movements right where we stood. After lunch she gave us another 7 minute workout and for those who wished she did a full class at the end. So invigorating and energizing, after Claudia the excitement was palpable, the room was electrified.
The first discussion was about Bio identical Hormone replacement and evaluating what hormones need to be replaced. Over 40, the most important hormones to get in harmony are: Estrogen, Progesterone, Cortisol, Thyroid and Insulin. Many people were surprised to discover that all steroid hormones are derived from cholesterol and there is such a thing as a too low cholesterol.
We also talked a lot about women's sexual dysfunction, how to manage it, how hormone replacement can help and what Herbs maybe useful. Its interesting that "erectile dysfunction" is all over the airwaves now and is considered a socially acceptable topic of conversation but more women than men suffer from sexual dysfunction yet no one feels comfortable talking about it.
Wow! No one knows unless they ask. "Is this normal?"
Dr Kanter followed with a very concise presentation on body contouring with plastic surgery. He got rave reviews from all the participants. He covered the body from head to toe and kept the audience spell bound with his before and after photos.
After lunch Claudia's routine helped with digestion and then we were back to talk about Anti-aging and Telomeres.
Three scientists were given the Nobel Prize for medicine last year for their work in this amazing field. Its implications are profound for understanding the aging process.
(Call our office if you would like to get your telomere length measured).
I was able to discuss a full and comprehensive Anti-aging workup such as the one we perform, in great detail. A very important component being neurological testing.
Dr Comeau a local physician talked about Botox and Fillers and then did a demonstration on my office manager Cindy. Once again everyone was riveted with attention.
There wasnt a dull moment!
It helps to be a woman over 40 and with the number of women I see in my practice I know what subjects are of interest to Baby Boomers. It is my goal to keep bringing you seminars
that are relevant, interesting and exciting with the end result of bringing life to your years!
We shall be holding another seminar in early fall, if you would like to be notified of our events please call our office at 410 992 0011 and give us your email address or send it through the contact page of the website.
Next week I will be blogging from Haiti !
The seminar opened with Claudia Salomon a renowned Nia (and Zumba) teacher helping us claim the space that we were in. What I thought was going to be a mild stretching exercise had me breathless when called upon to speak even though we performed the movements right where we stood. After lunch she gave us another 7 minute workout and for those who wished she did a full class at the end. So invigorating and energizing, after Claudia the excitement was palpable, the room was electrified.
The first discussion was about Bio identical Hormone replacement and evaluating what hormones need to be replaced. Over 40, the most important hormones to get in harmony are: Estrogen, Progesterone, Cortisol, Thyroid and Insulin. Many people were surprised to discover that all steroid hormones are derived from cholesterol and there is such a thing as a too low cholesterol.
We also talked a lot about women's sexual dysfunction, how to manage it, how hormone replacement can help and what Herbs maybe useful. Its interesting that "erectile dysfunction" is all over the airwaves now and is considered a socially acceptable topic of conversation but more women than men suffer from sexual dysfunction yet no one feels comfortable talking about it.
Wow! No one knows unless they ask. "Is this normal?"
Dr Kanter followed with a very concise presentation on body contouring with plastic surgery. He got rave reviews from all the participants. He covered the body from head to toe and kept the audience spell bound with his before and after photos.
After lunch Claudia's routine helped with digestion and then we were back to talk about Anti-aging and Telomeres.
Three scientists were given the Nobel Prize for medicine last year for their work in this amazing field. Its implications are profound for understanding the aging process.
(Call our office if you would like to get your telomere length measured).
I was able to discuss a full and comprehensive Anti-aging workup such as the one we perform, in great detail. A very important component being neurological testing.
Dr Comeau a local physician talked about Botox and Fillers and then did a demonstration on my office manager Cindy. Once again everyone was riveted with attention.
There wasnt a dull moment!
It helps to be a woman over 40 and with the number of women I see in my practice I know what subjects are of interest to Baby Boomers. It is my goal to keep bringing you seminars
that are relevant, interesting and exciting with the end result of bringing life to your years!
We shall be holding another seminar in early fall, if you would like to be notified of our events please call our office at 410 992 0011 and give us your email address or send it through the contact page of the website.
Next week I will be blogging from Haiti !
Tuesday, February 9, 2010
Vitamin D the under represented vitamin
I first got interested in Vitamin D a few years ago when a professor of Dermatology at a high profile institution in the North East got kicked out of his job for recommending that people get more sunlight. I was a little curious as to what sparked such controversy as clearly, an Ivy League dermatologist would be unlikely to put his job on the line over a vitamin!
After that I started receiving emails from the 'Vitamin D Research Council' an organization apparently funded by a doctor who believed so much in the importance of vitamin D that he put his career and a fair amount of his own money into proving the point.
Initially I was a little skeptical of the apparently far reaching consequences of Vitamin D deficiency: from possible association with Autism and ADHD to an increase in Cancer and infections. Then my skepticism turned to concern, the more I read and the more I checked my patients' vitamin D levels. Almost 90% of my patients were vitamin D deficient and at least 50% severely so. As a result, I have been checking Vitamin D levels routinely in all patients presenting for an annual physical exam for at least 2 years.
Most patients are not aware that they are deficient and have no symptoms but sometimes people are markedly symptomatic. Fairly often I find that Vitamin B12 deficiency and Vitamin D deficiency go hand in hand.
Such was the case with a patient of mine who came in to my office complaining that she thought she was developing Alzheimer's. She was very distressed and told me a story of constantly forgetting things and her anxiety about this. She became emotional when she explained how she did not want her children to find out. I suggested she see a neurologist and get some labwork done while she was waiting for that appointment.
Apparently she was so demotivated and forgetful she didn't get the labs done, continued with the neurologist who told her she didn't have Alzheimer's but she could try some medicine if she wanted, in case it helped. She declined.
She came back to see me 3 months later more tearful and agitated than before, she could hardly get out of bed in the morning because she was so tired. Her legs hurt and everything was a struggle. This time she got her labwork done and both her Vitamin B12 and Vitamin D level were extremely low.
With replacement she is fine, two weeks later she was back working the garden she loves and now she laughs when I remind her that she was convinced she had Alzheimer's.
Most cases are not as dramatic but is Vitamin D deficiency another one of those 'silent killers'?
Andrew Weil recently wrote an article stating that he is raising his recommendation for Vitamin D to 2000 daily (something most of my patients are already doing) because of a recent study out of the University of San Diego California which suggested that raising vitamin D levels could prevent one-half the cases of Breast cancer and two-thirds the cases of Colon cancer.
Hello this is HUGE!! As Dr Weil points out: a 50 percent reduction in Breast cancer would have saved the lives of more than 20,000 American women in 2009.
Vitamin D is thought to affect the immune system, it controls the utilization of calcium by the bones and so is important for bone strength, lack of it contributes to fatigue, it helps seniors retain their balance. It is important for cardiovascular health, in Diabetes, Psychosis and every month a new article comes out with different attributes.
In short, we need it! You can get it through fortified foods like milk and cereals but the main way is either supplementation or the sun. The latter recommendation being what cost my dermatology colleague his job because he suggested patients go out in the sun for half an hour a day without sunscreen.
Bottom line vitamin D is beginning to be recognized as a critical vitamin, if you have not had yours checked, do it now and take the necessary steps to keep it above a level of 32 (ideally closer to your age).
As always wishing you good health
Dr Tuakli
After that I started receiving emails from the 'Vitamin D Research Council' an organization apparently funded by a doctor who believed so much in the importance of vitamin D that he put his career and a fair amount of his own money into proving the point.
Initially I was a little skeptical of the apparently far reaching consequences of Vitamin D deficiency: from possible association with Autism and ADHD to an increase in Cancer and infections. Then my skepticism turned to concern, the more I read and the more I checked my patients' vitamin D levels. Almost 90% of my patients were vitamin D deficient and at least 50% severely so. As a result, I have been checking Vitamin D levels routinely in all patients presenting for an annual physical exam for at least 2 years.
Most patients are not aware that they are deficient and have no symptoms but sometimes people are markedly symptomatic. Fairly often I find that Vitamin B12 deficiency and Vitamin D deficiency go hand in hand.
Such was the case with a patient of mine who came in to my office complaining that she thought she was developing Alzheimer's. She was very distressed and told me a story of constantly forgetting things and her anxiety about this. She became emotional when she explained how she did not want her children to find out. I suggested she see a neurologist and get some labwork done while she was waiting for that appointment.
Apparently she was so demotivated and forgetful she didn't get the labs done, continued with the neurologist who told her she didn't have Alzheimer's but she could try some medicine if she wanted, in case it helped. She declined.
She came back to see me 3 months later more tearful and agitated than before, she could hardly get out of bed in the morning because she was so tired. Her legs hurt and everything was a struggle. This time she got her labwork done and both her Vitamin B12 and Vitamin D level were extremely low.
With replacement she is fine, two weeks later she was back working the garden she loves and now she laughs when I remind her that she was convinced she had Alzheimer's.
Most cases are not as dramatic but is Vitamin D deficiency another one of those 'silent killers'?
Andrew Weil recently wrote an article stating that he is raising his recommendation for Vitamin D to 2000 daily (something most of my patients are already doing) because of a recent study out of the University of San Diego California which suggested that raising vitamin D levels could prevent one-half the cases of Breast cancer and two-thirds the cases of Colon cancer.
Hello this is HUGE!! As Dr Weil points out: a 50 percent reduction in Breast cancer would have saved the lives of more than 20,000 American women in 2009.
Vitamin D is thought to affect the immune system, it controls the utilization of calcium by the bones and so is important for bone strength, lack of it contributes to fatigue, it helps seniors retain their balance. It is important for cardiovascular health, in Diabetes, Psychosis and every month a new article comes out with different attributes.
In short, we need it! You can get it through fortified foods like milk and cereals but the main way is either supplementation or the sun. The latter recommendation being what cost my dermatology colleague his job because he suggested patients go out in the sun for half an hour a day without sunscreen.
Bottom line vitamin D is beginning to be recognized as a critical vitamin, if you have not had yours checked, do it now and take the necessary steps to keep it above a level of 32 (ideally closer to your age).
As always wishing you good health
Dr Tuakli
Sunday, January 3, 2010
Latest mammogram recommendations
I have been asked by some patients what my thoughts are regarding the new mammogram recommendations. Quite frankly they don't make sense to me and will not change my current management of patients at all. Why?
Well first of all they are exactly what they claim to be "guidelines", I can choose to follow them or not. In this case I would rather not.
Mammograms are problematic from the standpoint of radiation however I have seen MANY patients diagnosed with Breast Cancer as a result of them. One of the most concerning trends has been the discovery of breast cancer in younger and younger women, the idea that they would not be diagnosed because they would delay their mammograms to the age of 50 is scary.
The bottom line is, as with most things in medicine, tailor the recommendation to the patient. It is important to have an on going relationship with a physician who knows you and who will make recommendations based on his or her knowledge of you and your particular situation, not based on guidelines. For example prolonged use of certain contraceptives, family history, breast exam findings are all things that would change how often and when a particular patient should get a mammogram.
Remember guidelines come and go, they are not set in stone and neither is your wellness. It should be a dynamic process arrived at by rational thinking and on going education.
When insurance companies finally start paying for thermograms we will have alternatives that don't involve radiation that may be more appropriate for some patients.
Until then for most people mammograms are the best they can afford ......
If you are at high risk remember to avoid caffeine, take indole-3, do regular self breast exams, do not take Provera and follow your doctors screening schedule.
Wishing you a healthful 2010
Dr Tuakli
Well first of all they are exactly what they claim to be "guidelines", I can choose to follow them or not. In this case I would rather not.
Mammograms are problematic from the standpoint of radiation however I have seen MANY patients diagnosed with Breast Cancer as a result of them. One of the most concerning trends has been the discovery of breast cancer in younger and younger women, the idea that they would not be diagnosed because they would delay their mammograms to the age of 50 is scary.
The bottom line is, as with most things in medicine, tailor the recommendation to the patient. It is important to have an on going relationship with a physician who knows you and who will make recommendations based on his or her knowledge of you and your particular situation, not based on guidelines. For example prolonged use of certain contraceptives, family history, breast exam findings are all things that would change how often and when a particular patient should get a mammogram.
Remember guidelines come and go, they are not set in stone and neither is your wellness. It should be a dynamic process arrived at by rational thinking and on going education.
When insurance companies finally start paying for thermograms we will have alternatives that don't involve radiation that may be more appropriate for some patients.
Until then for most people mammograms are the best they can afford ......
If you are at high risk remember to avoid caffeine, take indole-3, do regular self breast exams, do not take Provera and follow your doctors screening schedule.
Wishing you a healthful 2010
Dr Tuakli
Wednesday, November 18, 2009
Is the fedex man delivering more than just packages?
There is a story that is told in medical history about a milk delivery maid who was dubbed 'Typhoid Mary' because she single handed contributed to the biggest typhoid epidemic in England. An interesting story often told to very green medical students as an introduction to the term "carrier".
A patient of mine came in recently with the Swine Flu H1N1) he was very sick and was still wearing his Fedex uniform. I advised him that the type of work he was doing and his exposure to the elements would only make him sicker, needless to say I put him out of work for a week.
As I looked at this poor person with bloodshot eyes, sweating and coughing up a storm, I had cause to rethink our (the Health Establishment's) definition of 'High Risk' patients i.e those who are eligible to recieve the H1N1 vaccine. Surely the delivery man innocently delivering packages from one establishment to the next and potentially picking up infection at one and depositing it at the next, is at high risk. Not only that, he (or she) presents a risk to the community at large as he proffers his pen with a grin and the instruction to 'sign your name!' before darting off to the next densely populated building.
In my office we have been lucky enough to have had the H1N1 shot throughout the 'shortage' and we have religiously followed the Health departments instructions to limit its use to high risk individuals; children ages 6 months to 24 years, healthcare workers and pregnant women. As of this week I have opened it up to many more people that I consider high risk such as teachers and metro workers.
I have been struggling with the idea from the beginning that students need to be vaccinated but not those who teach them. Maybe I am more sypathetic because my husband is a professor or just because I have NEVER seen my 17 year old son as sick as he was with the Swine Flu. He rarely gets sick but this bug made him as sick as a dog! (He came down with it 3 days before I recieved my supply of vaccines ...........).
Anyway to cut a long story short, come on and get your H1N1 vaccine, lets curb this epidemic. It takes 2 weeks to develop a good immunity so hurry in, next week is Thanksgiving and yes, if you drive a UPS truck ................ you are welcome too!
A patient of mine came in recently with the Swine Flu H1N1) he was very sick and was still wearing his Fedex uniform. I advised him that the type of work he was doing and his exposure to the elements would only make him sicker, needless to say I put him out of work for a week.
As I looked at this poor person with bloodshot eyes, sweating and coughing up a storm, I had cause to rethink our (the Health Establishment's) definition of 'High Risk' patients i.e those who are eligible to recieve the H1N1 vaccine. Surely the delivery man innocently delivering packages from one establishment to the next and potentially picking up infection at one and depositing it at the next, is at high risk. Not only that, he (or she) presents a risk to the community at large as he proffers his pen with a grin and the instruction to 'sign your name!' before darting off to the next densely populated building.
In my office we have been lucky enough to have had the H1N1 shot throughout the 'shortage' and we have religiously followed the Health departments instructions to limit its use to high risk individuals; children ages 6 months to 24 years, healthcare workers and pregnant women. As of this week I have opened it up to many more people that I consider high risk such as teachers and metro workers.
I have been struggling with the idea from the beginning that students need to be vaccinated but not those who teach them. Maybe I am more sypathetic because my husband is a professor or just because I have NEVER seen my 17 year old son as sick as he was with the Swine Flu. He rarely gets sick but this bug made him as sick as a dog! (He came down with it 3 days before I recieved my supply of vaccines ...........).
Anyway to cut a long story short, come on and get your H1N1 vaccine, lets curb this epidemic. It takes 2 weeks to develop a good immunity so hurry in, next week is Thanksgiving and yes, if you drive a UPS truck ................ you are welcome too!
Thursday, October 29, 2009
It really IS an epidemic this time!
Yes, we have H1N1 shots in our office and Yes, I recommend them!
We have been inundated with people who have flu-like symptoms as well as people coming in for the vaccine. It really qualifies as an epidemic this time around. The local school board is posting the percentages of absenteeism for every school that has at least 10% of the kids out sick and there are no schools that are NOT on the list! One school was recorded twice with almost 20% of the students out sick.
One of my patients came in today with a red eye, body aches, fever, headache and generally feeling yucky and mentioned that at her elementary school (she is a kindergarten teacher) 10 teachers were out sick on the same day which resulted in general chaos as they tried to move the teachers and volunteers around to fill in the gaps.
One anecdotal observation: I haven't seen a single patient who has tested positive for Swine flu on culture who doesnt have a cough and a fever. Interesting since with regular flu you dont always have a cough. Body aches and sore throat are also extremely prevalent symptoms.
What to do? Well, first of all if you have any of these symptoms Stay Home! Spray your door knobs and counter tops with Lysol or the equivalent. Cough into your elbow and put hand sanitizer on your hands frequently. Get treated early.
We treat all our patients aggressively with homeopathic remedies, vitamins and supplements along with prescription anti-virals. Almost all are better within 3 days ............... except for that cough! If you start treatment late that cough can drag on for weeks. Inhale steam as much as possible and avoid cold drinks.
Prevention: Always the best option.
Get your Flu shots, both regular and the H1N1 (call the office if you need one). Stop by and pick up your "Well Being" and Vitamin C and Cod Liver Oil take them thru the winter, its going to be a rough one.
Stay out of crowds.
Warning:
Beware The Flu is usually worse after Thanksgiving ( after all the hugs and kisses). This year it started really early and with a vengeance, and if it is going to get worse after Thanksgiving we all need to be pro-active!
We have been inundated with people who have flu-like symptoms as well as people coming in for the vaccine. It really qualifies as an epidemic this time around. The local school board is posting the percentages of absenteeism for every school that has at least 10% of the kids out sick and there are no schools that are NOT on the list! One school was recorded twice with almost 20% of the students out sick.
One of my patients came in today with a red eye, body aches, fever, headache and generally feeling yucky and mentioned that at her elementary school (she is a kindergarten teacher) 10 teachers were out sick on the same day which resulted in general chaos as they tried to move the teachers and volunteers around to fill in the gaps.
One anecdotal observation: I haven't seen a single patient who has tested positive for Swine flu on culture who doesnt have a cough and a fever. Interesting since with regular flu you dont always have a cough. Body aches and sore throat are also extremely prevalent symptoms.
What to do? Well, first of all if you have any of these symptoms Stay Home! Spray your door knobs and counter tops with Lysol or the equivalent. Cough into your elbow and put hand sanitizer on your hands frequently. Get treated early.
We treat all our patients aggressively with homeopathic remedies, vitamins and supplements along with prescription anti-virals. Almost all are better within 3 days ............... except for that cough! If you start treatment late that cough can drag on for weeks. Inhale steam as much as possible and avoid cold drinks.
Prevention: Always the best option.
Get your Flu shots, both regular and the H1N1 (call the office if you need one). Stop by and pick up your "Well Being" and Vitamin C and Cod Liver Oil take them thru the winter, its going to be a rough one.
Stay out of crowds.
Warning:
Beware The Flu is usually worse after Thanksgiving ( after all the hugs and kisses). This year it started really early and with a vengeance, and if it is going to get worse after Thanksgiving we all need to be pro-active!
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