Aging is no fun! ( However our seminar is will be!)

Let's be honest: the other title for this blog is "keeping it real".
Why? because aging, at least physically, really is not any fun. Aging is, after all a degenerative process and that is exactly why 'Anti-Aging' is so important.

With Anti-Aging, the process is not so daunting and we retard the rate at which our body degenerates,and slow the rate at which various organ systems become problematic.

On October 23rd 2010, I will once again be giving a seminar on how to feel good and look good as you age. It is about what YOU can do to help yourself maintain and reach new heights as you get older.

The goal is to maximize all our resources both inherent and external to contnue to feel vital, energetic and sexy as the years add up, at least on paper. In short we want to widen the gap between our chronological and biological age as much as possible.

Please mark your calenders:
Date: October 23rd 2010
Place: Turf Valley Golf Resort and Conference Center, Ellicott City, MD
Time: 10 am to 4pm (break for lunch 12 to 1)
Cost: $15 before October 15 $20 after October 16th

Its going to be even more fun than the last one with a Zumba/Nia class and lots of hands on demonstrations, Get all you questions answered. Hope to see you there!

Hi from Costa Rica

Hi I am in Costa Rica for a week. My husband teaches deaf students at Galluadet and he is here to oversee a summer project at the deaf school. It is the rainy season now, the season that is referred to as winter here and rain it does, everyday!
The terrain is incredibly lush and green and I am sure these rains are partly responsible.
I thought this country would have more of a Carribean flair but it doesn't, most Costa Ricans seem to take themelves very seriously!
Here are a couple of photos, unfortunately the volcano was shrouded in clouds this morning so I dont have good shots of that but plenty of other aspects of nature.

Watch for my 'Men's Blogs' and for our fall seminar which is coming soon.
As they say in Costa Rica "Pura Vida" (pure life)!

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.

The benefits of having your hormones balanced

For those of you who followed my blog from Haiti, thank you for reading it! It is amazing how stimulating an environment like that can be. With all the hardships the Haitians are AMAZINGLY strong people and I feel priviledged to have been able to go there and help in any small way. They say the first person to benefit from any service is the giver and it is so true! I will go back when I can.

In the meantime I shall refocus on what I specialize in and try to help more people here at home to feel better in a different way.
Everytime I meet with both new and old HRT patients I am inspired by how much good natural hormone balancing does for them. Professional people who are able to carry on with their busy lives without missing a beat, mothers who had babies in their forties but can still keep up with them as teenagers,and relationships that refind their zest. I see people who can come off anti-depressant and anxiety medications once their hormones are in better balance and young people throwing off PMS and bad periond cramps that used to keep them at home every month.

So this too, is a very gratifying field of medicine for me something that I enjoy practicing everyday.

My next blog will be about Telomeres,a fascinatng field of research in Anti-Aging.

Its good to be back .....do come and visit!

Devastated!

After two weeks of taking more pictures than I have ever taken in my life I lost my camera with the memory stick of 600 photos! I am truly devastated. I couldnt wait to get home and share them with you. Now I am really glad that I wrote a daily blog, that is how I will have to remember the small details of my trip. There will be others and as my insightful daughter (age 14) said, at least I am home safe and sound.
Thank you for reading my blog.
Now I will go back to Hormone replacement and Anti-aging and hope that in some small way I did some good.
Wishing you Good Health!

A new birth!

Day 10
Well here I am packed and ready to go! I was really starting to get into a groove at the clinic. It helps to have cooperation, I believe there are many staff members who actually enjoy what they do. Unfortunately they have little or no direction and no personal experience or education to fall back on.
I asked about the staff member who had fainted on Monday and was told she was fine however she had not returned to the clinic. After consulting Denise the clinic manager we decided to do a home visit (“visite domicile”), I needed an interpreter and another staff member decided she would like to tag along as well. So the 4 of us set off among the tents, boy it was hot! A few minutes later we were at the lady’s tent. “She’s in there!” I was told, so I pulled back the curtain and there was a new born baby on the floor barely a foot from the doorway! I guess it’s the coolest place to be.
The rest of the team was unfazed, “where is Madame F ? they asked loudly. They were advised that she was in the opposite tent and everyone turned in pursuit . Whoa! wait a minute. Ummh about the baby, I said not wanting to appear overly dramatic. I had several questions like who, what, why and when. We started to question the mother. No ,she hasn’t seen a doctor since she delivered. Yes, the baby was born in the tent. Amazingly everyone was so matter of fact, I was still stunned at this sleeping miniature person and the surreal surrounding!
I gave Mom prenatal vitamins and a lecture on the virtues of breast feeding and visiting the clinic for a check up, photos taken and onward!

Our next visit was almost at the top of the camp wow! Up and up and up! Great views of Terrain Acra. We went into a tent and a man was fixing some kind of wheel barrow-like contraption , I talked to him. He said he paints pictures he had some on display, my impression was so-so talent. I asked him about the tent : how many people in this tent , 7 he said. There is an open area in the middle of the tent where cooking is done. The latrines in this camp have no doors because people have stolen them to add to their tent space. I asked how people maintained some dignity and was told that when they go to the latrine they concoct some kind of cover.

As I followed the clinic director further into the tent I got my second shock of the day. A 57 year old paraplegic man who looked like an AIDS or TB patient. He was really cachexic (thin) and his legs went in two different directions and clearly had not moved in a long time. The skin on his legs was like something I’ve never seen before! You could count every rib! He gave me permission to post his pictures. Apparently he was paralyzed by a car accident before the earthquake but he says things got worse after that. I gave him the only thing I had, a bottle of prenatal vitamins,and advised his family members to try to do a little physical therapy. I told him he would sleep better if he was adjusted to a 45 degree angle. He seemed to appreciate that piece of advice.

I later had a discussion with the clinic manager. I suggested they have a meeting with him and his family and discuss amputation. This may be the only way for him to get on with his life, he cant use his legs and they are just going to be a major source of infection and ultimately kill him. It is not easy to suggest cutting off someone’s legs.

NEWS hot off the press:
Someone knocked on my door this evening and told me there is an outbreak of typhoid. Apparently the Ministry of Health randomly screened 15 stool samples and all tested positive. They might need even more help if this keeps up.

And finally the Corail latrine update :
The Corail camp manager met with Oxfam today and they have agreed to back pay the latrine cleaners however they are still philosophically against paying people to clean up their own waste. The compromise is to back pay but none going forward, they are going to build more latrines now so that only 5 families share a latrine. They believe this will help the people take ownership of the cleaning process. That could turn out to be a pile of S…tuff no pun intended. At least a riot was averted for now. They also handed out more food rations today but only to pregnant women, so pregnant women came out of everywhere, once again food to last2 weeks and no more.
The only down side of today is dealing with a colleague who is a pediatrician and insists on talking to me as if I am a child! It is starting to get to me but Voila! Its my last day!

As always Desiderata proves inspiration:
Go placidly amid the noise and haste, and remember what peace there may be in silence.
As far as possible, without surrender, be on good terms with all persons. Speak your truth quietly and clearly; and listen to others, even to the dull and the ignorant, they too have their story. Avoid loud and aggressive persons, they are vexations to the spirit.
There is literally a new baby born every minute, even in Terrain Acra one can see the potential for the future that arises from every birth.
With all its sham, drudgery and broken dreams, it is still a beautiful world!

From Home visits to Brazil Haiti Day 9

On the way in to the camp this morning I discussed strategy with the medical director. He seems to have bought into my idea of offering prenatal care at the clinic but after asking for a prenatal flow sheet form for the 10th time and still not getting it, I think the chances of pulling it off before I leave are pretty slim.
Once we get the form the process would be, to teach the triage staff what to do on each pregnant woman and to develop criteria for referrals. The staff at the camp have a very low level of education and it takes several repetitions of the same thing to begin to effect change. Today ,I believe, was the first time every patient I saw had been weighed (that’s another story), I am now attempting to get a last menstrual period date recorded on every female patient (50% yesterday, 0% today). And then there’s the protocol for reading pregnancy tests another challenge which I think would work out with a little more practice.
On the subject of criteria, we need to develop some for ‘home visits’. I like the idea of home visits it gives a warm fuzzy caring kind of feel and who doesn’t like the doctor to come to them? I went to visit a lady whose right arm was broken during the earthquake, her leg was injured also but that has resolved . She is left with chronic pain in her wrist and arm and minimal motion. I demonstrated some exercises for her, she really needs to do physical therapy and I think I convinced her that in spite of the pain she must force herself to start using it. I gave her some pain medication and tomorrow I will give her a wrist splint. I am a little leary of giving her a splint because it may cause her to use her arm even less. She promised to do the exercises 4 times a day, regardless, so we will see.
As I was finishing up with her 3 able bodied women approached and sat down to be ‘seen’. They were all in the early stages of pregnancy the nurse told me and they didn’t feel like coming down to the clinic! I really have a problem with this kind of healthcare, I think it is a mistake to end up having drive-thru clinics and creating a dependency on them purely for convenience. The clinic is less than a five minute walk from their tents but they prefer to tag on to home visits. I think a lot of people think that prenatal care is just a matter of handing out vitamins. It is not. The patient needs to be weighed, the blood pressure checked, the length of the uterus measured and the urine checked for protein among other things. None of them had had tetanus shots and Haiti has the highest incidence of neonatal tetanus in the western hemisphere. I told them to come down to the clinic tomorrow. They weren’t overly enthused but I told them if they care about their babies they need to come to the clinic every month. I hope all this Aid that is pouring into Haiti does not create a ‘fast food’ approach to preventative care, were people feel entitled to door to door service without any need for effort on their part!
Viva Brazil! There is a huge fan base for Brazil in Haiti, tons of people were wearing yellow and green and the Brazilian flag was flying everywhere. There was palpable excitement in the air today and everyone (who wasn’t working) was glued to the radio or TV for the world cup match between Brazil and North Korea. At the camp a gunshot rang out when Brazil scored and you could hear the roar of the crowd. I was doing the home visit at the time, my first opportunity to actually wonder through the camp and see inside a tent that people are living in. Incredibly the average number of occupants per tent is 5. The one i saw had a sheet hung in the middle to divide the sleeping area from the sitting area. I hope to see more homes tomorrow.