Treatment of reflux in children…

Posted on March 23, 2015 by drlesliegreenberg

When stomach acid comes up the esophagus, this can cause symptoms of reflux.

Common symptoms in infants are feeding refusal, recurrent vomiting, poor weight gain, sleep disturbance, respiratory problems (like coughing and wheezing), and irritability. Symptoms in older children include heartburn, pain with swallowing, asthma, chronic cough or hoarseness, recurrent pneumonia, and recurrent vomiting.

What is first treatment? Lifestyle modification. If the infant is being breastfed, modifying the maternal diet may help decrease reflux symptoms.   A 2 to 4 week maternal exclusion diet that restricts milk and egg is recommended. If the child is formula-fed, reducing feeding volume while increasing feeding frequency or thickening the formula may help. Keep infants upright after feedings. In older children, losing weight (if overweight), not smoking or using alcohol and avoiding triggers may be beneficial.

Medications that help include antacids, histamine H2 antagonists (like zantac) and proton pump inhibitors (like prilosec). There are risks in starting young children medication or long-term use of any medication for reflux.

There is surgery. The stomach is wrapped around the esophagus. This is a last resort.

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Why do diabetics need annual eye exams?

Posted on March 16, 2015 by drlesliegreenberg

Because there are eye complications that diabetics are especially at risk for and , if found early, can be normalized.

I take care of many people with diabetes. As a family physician, I help manage their blood sugars. Standard of care is to see an eye doctor and have a dilated eye exam yearly. Diabetes can affect the eyes without causing symptoms or blurry vision.   Commonly diabetic eye disease is present when an adult first presents with diabetes (because elevated blood sugars may have been present for years).   Good news is that most mild eye changes are reversible with good control of blood sugar.

What is retinopathy? This is damage to the blood vessels of the retina (the back part of the eye) which can cause bleeding. If retinopathy is left untreated, this can result in blindness. If blood sugar remain high or fluctuates significantly, this can result in more damage to the delicate retinal blood vessels.   If the retina is not getting enough oxygen, new blood vessels may start to grow. These blood vessels are fragile and can break and bleed easily, leading to loss of vision.

What are concerning symptoms? Symptoms may include: spots or dark floaters, blurred vision, fluctuating vision, missing areas, vision loss, and difficulty with color perception.

Keeping blood sugars well controlled can help decrease your risk of all sorts of bad complications of diabetes. Watch your diet. Take your diabetes medication religiously. Take blood sugar readings as needed. See your doctor regularly.

Hope this helps.

IMG_3631

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Another few EASY things to do to live longer…

Posted on March 8, 2015 by drlesliegreenberg

Floss! We now know that plaque (bacterial film that covers teeth and gum lines) may be responsible for heart disease, diabetes, Alzheimer’s, some forms of cancer, and stroke). Oral bacteria can create proteins that are found in artery walls and in the bloodstream. These proteins can cause blood to clot more easily and may also cause inflammation in the body. Floss daily to help add six years to your life.

Be grateful. When you appreciate your life and things around you (even when your health may not be the best) this will help you live longer.   Appreciate something every day: sounds of birds, the glow of a sunset…

Cultivate healthy relationships. If you are involved in a negative relationship, you know– those people who pull you down– get rid of that relationship. Research shows that people with more friends and people in healthy relationships live longer.

Hope this helps. 

 

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Ways to curb office snacking…

Posted on March 2, 2015 by drlesliegreenberg

Opportunities for unhealthy grazing abound in most office environments. Keep your impulses in check with these tips…

  1. Bring your own munchies. Keep a healthy snack in your own desk. This way, when you are in the mood for a pick-me-up you’ll have a healthier option nearby. Ration them out by serving size. Do NOT eat straight from the bag.
  2. Brown bag it. Include a fruit, vegetable, lean protein and whole grain for your lunch. This will help you stay fuller longer and have more energy. Make your lunch the night before so that you have time to make sure it’s balanced (instead of out-the-door rushing).
  3. Keep crave-worthy foods out of sight. Research shows that if you are able to see inside a candy dish, you’ll eat 2.2 more candies per day than if you couldn’t see it.   If you swap from a clear container to a ceramic jar, this could save you thousands of calories in a year.
  4. … Keep snacks out of reach. Avoid the parts of the office (or the kitchen if you work at home) that have snacks. Some find that putting a sign on the fridge that reads “Kitchen closed” helps.
  5. And, do not walk near the vending machine. Even if you only have 10 minutes, it’s a great way to help you work through a challenging work project. Did you know that creative thinking increases by 60% when you’re taking a stroll? Even if you don’t go outside, walking up and down the hallways will help.
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What is the REAL benefit of family meals?

Posted on February 23, 2015 by drlesliegreenberg

IMG_3423There are nearly too many benefits to mention!  As a practicing physician and mother of three, I understand the stressors that make family mealtime difficult.  But, there are reasons to fight for more family mealtimes.  There is great impact on the physical and emotional health of kids and teens like

  • helping build vocabulary and conversation skills,
  • teaching others to wait your turn,
  • showing interest in others,
  • gaining a greater sense of safety and belonging,
  • lessening chance of depression
  • raising their self-esteem,
  • decreasing  likelihood of child using drugs, drinking or smoking

The meals do not need to be elaborate.  Try to make meals that everyone likes (or they can open a can of soup).  And, aim to be together for 15-20 minutes to share your days.  This time goes by too fast, enjoy it while you can.

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Want to live longer? Here are easy things to incorporate

Posted on February 16, 2015 by drlesliegreenberg

Many of these are common-sense suggestions… with research behind them.

1.  Get a colonoscopy.  This is suggested for everyone at age 50, unless you have a family history or GI symptoms necessitating one sooner.  The worst part, by far, is drinking the bowel prep and having 10+ stools.  You do this worst part in the comfort of your own home.  When you arrive at the endoscopy center the next day you will take “the best nap of your life” and if a polyp is found most every time it can be removed.  You won’t feel the procedure.  Nine out of 10 people whose colon cancer is discovered early will still be alive in 10 years according to the American Cancer Society.  Many will live a normal lifespan.

2. Stop eating before you are full.  Most Americans eat until we are full.  Know that it takes the body 15 to 20 minutes to realize that you are full.  Why is this important?  Obesity is rampant… If you are 100 pounds overweight, this can subtract a decade from your life, according to an Oxford University study.  So, eat until you are 3/5 full and add years to your life.

3.  Use sunscreen.  3.5 million Americans will get skin cancer this year.  76,000 more will develop melanoma per the American Cancer Society.  You may add 20 years to your life per a CDC study showing that those who die of melanoma died two decades prematurely.  Sun does not cause all cases of melanoma, but it does cause most of them.

3.  Stop smoking.  If you quit by age 30, you may increase your lifespan by 10 years.  Quit by 40, add nine years.  Quit at 50, add six years.  Quit at sixty, add three years. 

4.  Get more sleep.  Sleep deprivation has been linked to memory problems, anger, high blood pressure, stroke, depression, car accidents and obesity.  Aim for 7 hours of sleep per night to give your body back what it needs.

5.  Exercise.  Any level of exercise is valuable.  Walking gets you outside AND you get Vitamin D.  Even 15 minutes a day of exercise is beneficial.  One study on public radio reported that every minute you exercise adds seven minutes to your life.  Not bad, eh?

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Why should you see a family doctor?

Posted on February 9, 2015 by drlesliegreenberg

IMG_3426Your health is primary! See a primary care physician. Here’s a 2-minute video of why family physicians have an important role in your health … and what I’m trained to do:

http://youtu.be/TyR-C5hnJUA

 

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Babies need vitamin D

Posted on February 2, 2015 by drlesliegreenberg

IMG_3419Osteomalacia, also known as “rickets,”  is bone weakness resulting from Vitamin D deficiency.  We now know that breastfed babies and formula fed babies need Vitamin D supplementation.  Formula has Vitamin D in it, but not enough Vitamin D until the baby is drinking 500 mL (about 17 ounces) of formula per day. 

The National Academy of Sciences recommends a supplement of 200 IU per day of Vitamin D for the following:

1.  All breastfed infants unless they are weaned to at least 500 mL per day of Vitamin D-fortified formula or milk.

2.  All nonbreastfed infants who are ingesting less than 500 mL per day of Vitamin D-fortified formula or milk.

3.  All children and adolescents who do not get regular sunlight exposure, do not ingest at least 500 mL per day of Vitamin D-fortified milk, or do not take a daily multivitamin supplement containing at least 200 IU of vitamin D.

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New treatment for dry eyes

Posted on January 29, 2015 by drlesliegreenberg
.flickr.com/ photos/ bahkubean/ 1287879564

.flickr.com/ photos/ bahkubean/ 1287879564

Dry eye symptoms increase with age and may be as high as 30% in those older than 50. Women are more likely to have dry eyes than men. Other risk factor for dry eyes are contact lens use, medications like antihistamines (allergy medicines) or SSRI (common antidepressant and antianxiety medications), tobacco use, diabetes, and history of ophthalmic surgery.

What are symptoms of dry eyes?

Eye irritation, sensation of foreign body in the eye, excessive tearing, and altered vision.

What is first line treatment? Artificial tears.

Other than that… there was a recent study showing that fish oil supplementation may be helpful for the treatment of dry eyes. The study participants took 15 fish oil pills per day. 15 pills sounds a bit excessive, but certainly, the lowest dose that works for you would be best.

What to do about the “fish burps?” Fish oil pills often make the patients belch up fish tasting secretions. If you keep the fish oil pills in the freezer and swallow them frozen, this decreases the fishy burps.

Hope this helps.

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Do YOU (and your kids) really need the flu vaccine?

Posted on January 19, 2015 by drlesliegreenberg

The low-down on this is that influenza often kills those who are otherwise well. Also, the flu can be fatal to children.

The CDC found that 830 kids died from flu-related complications between 2004 and 2012 and most of those had not gotten a flu vaccine. Pneumonia was the most commonly reported complication among the kids who died 43% of the kids who died from flu complications were otherwise healthy and did not have high-risk medical conditions (like heart defects, epilepsy, diabetes, cancer, or asthma).

The CDC recommends that all children 6 months or older get the flu vaccine every year. Prevention IS the best strategy. Children younger than 9 who are receiving the vaccine for the first time need two doses. If they only get one vaccine the first year of flu vaccination, it’s as though they are not vaccinated that season.

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