Boost your good cholesterol.

Posted on November 26, 2013 by drlesliegreenberg

Yes, there is good cholesterol.

Good cholesterol, HDL (high-density lipoprotein) , helps shuttle artery-clogging LDL to the liver for removal from the body. 

There are a few ways to increase HDL. 

  • Exercising daily (even walking 10,000 steps per day counts) and muscle-building workouts (like lifting soup cans during commercial breaks) two to three times a week.
  • Eating heart-healthy oils and fish. 
  • Eating an ounce of nuts—daily and unsalted. 
  • To a smaller degree, certain statin drugs may also modestly increase HDL (namely rosuvastatin and atorvastatin).

If you don’t know what your cholesterol panel shows (the good, the bad and the ugly!), ask your doctor!

Posted in Cholesterol, General Medicine- Adults, Uncategorized | Tagged , , , , , , , | Comments Off on Boost your good cholesterol.

Tanning beds illegal for youngsters?!

Posted on November 22, 2013 by drlesliegreenberg

Yes.  Illinois is the sixth state to ban tanning beds for youth younger than 18 years.  This law will take effect on January 1, 2014.   The Dermatology Association  said in a news release that the law is based on “significant scientific evidence that links indoor tanning to increased risk of developing melanoma and other forms of skin cancer.” 

In June, the Internal Revenue Service issued the final regulations on collecting a 10% tax on tanning salon receipts.   Lobbying groups such as the Indoor Tanning Association and the American Suntanning Association continue to lobby against tanning ban laws. 

Illinois joins California, Oregon, Nevada, Texas, and Vermont in passing age-related restrictions on the use of tanning beds.  New Jersey, Connecticut, and New York have bans for youth under age 17.  West Virginia and District of Columbia have bans for tanning beds for those younger than 14.

Posted in Uncategorized | Comments Off on Tanning beds illegal for youngsters?!

Flu vaccine decreases heart attacks!

Posted on November 14, 2013 by drlesliegreenberg

JAMA recently combined the results of many studies which in over 6000 patients it was shown that  receiving influenza vaccination lowers the risk of cardiovascular events ( like heart attacks or strokes).  The benefit was even more pronounced in patients with known coronary artery disease.  In those patients, it decreased cardiovascular events by half.

It is estimated that less than 1/3 the general population in North America and less than 1/2 of those at “high cardiovascular risk” currently receive the annual flu vaccine.  The researchers said that the flu vaccine “could address a sizable component of residual cardiovascular risk not addressed by current therapy, and provide yearlong coverage through a simple innoculation.”

Please get your flu vaccine today!

Posted in General Medicine- Adults, Uncategorized, Vaccines | Tagged , , , , , , , , , , | Comments Off on Flu vaccine decreases heart attacks!

FDA suggests hydrocodone be changed to a more restrictive drug class

Posted on November 11, 2013 by drlesliegreenberg

How does this affect you? Maybe it doesn’t.  But, if you’ve received a prescription for medication like Vicodin, Norco, or Lortab (as 131,000,000 prescriptions were written in 2011) this will affect you.

The FDA’s decision to increase the restrictiveness of these prescriptions comes out of years of controversy over epidemic-scale abuse and misuse of prescription pain medicines.  It is speculated that if hydrocodone medications were placed on the market today that they would firmly be within the Schedule II classification and that the change is justifiable and expected.

There is a need to balance safety with continued access to these drugs.

What is the prescribing difference between schedule III and schedule II?  Schedule II drugs require handwritten prescriptions.  No refills are allowed.

What is coming down the pike?  The FDA plans to submit formal recommendations by early December  2013 to the US Department of Health and Human Services to reclassify hydrocodone combinations into Schedule II.  The Drug Enforcement Administration (DEA) has the final decision.  The decision is complex and far-reaching both for patients and physicians.

Posted in General Medicine- Adults, medication issues, Uncategorized | Tagged , , , , , , , , , , , , | Comments Off on FDA suggests hydrocodone be changed to a more restrictive drug class

Myths about diabetes

Posted on November 7, 2013 by drlesliegreenberg

Myth:  Diabetics need to eat special diabetic foods.

Truth:  Diabetic foods generally offer no special benefit.  Healthy foods are what diabetics should eat.  This includes foods low in fat, moderate in salt and sugar, whole grains, vegetables, and fruits.

Myth:  Fruit has natural sugar, so it’s okay to eat as much as you’d like.

Truth:  Fruit is a healthy food and because fruits contain carbohydrates they need to be included in your meal plan.  No food is without limits.  Talk to your dietitian about the amount, frequency and types of fruits you should eat.

Myths: Overweight or obese people will eventually develop type 2 diabetes.

Fact:  Being overweight is a risk factor for developing type 2 diabetes.  Many overweight people will not get diabetes, and you can be normal weight and develop type 2 diabetes.

Myth: Diabetes is not a serious disease.

Truth:  It is a serious disease with important, serious complications if blood sugars are not managed properly.  Two out of three people with diabetes die from heart disease or stroke.

Myth:  Diabetes is contagious.

Truth:  Diabetes is not contagious.  Genetics and lifestyle play a part—especially in type 2 diabetes.

Want more information?  Go to www.diabetes.org/

Posted in Diabetes, General Medicine- Adults, Uncategorized | Tagged , , , , , , , , , , , , | Comments Off on Myths about diabetes

Three types of diabetes. Do you have one?

Posted on November 4, 2013 by drlesliegreenberg

flickr.com/photos/ petahopkins/ 10113965984Type 1, Type 2 and gestational diabetes are three types of diabetes each with different risks, all with increased blood sugars.

Type 1 diabetes is an autoimmune disease, when the body’s immune system attacks itself.  In this case the body destroys its insulin-producing pancreatic beta cells.  Type 1 diabetics must take insulin everyday to survive.  This type usually develops in children and young adults, but can appear at any age.

Type 2 diabetes is the most common form with 90% of diabetics having this type.  The risk factors for type 2 diabetes are

  • older age,
  • being overweight,
  • family history of diabetes,
  • physical inactivity,
  • history of gestational diabetes.

This type of diabetes may be controlled with weight loss, diet, exercise, medication and insulin.

Gestational diabetes develops only during pregnancy.  Women with a history of gestational diabetes have a 20 to 50% of developing type 2 diabetes within 5-10 years.  Pregnant patients routinely have a glucose tolerance test (drinking a sugary drink) and then checking blood sugars to confirm that body can control blood sugars well.

Symptoms of diabetes include increased thirst, increased frequency of urination, constant hunger, weight loss, blurred vision, extreme fatigue.

To test for diabetes, fasting blood sugar is the preferred test.  See your doctor if you have risk factors for diabetes or any of the above symptoms.  It’s best to know early so treatment can be instituted to decrease long term diabetic complications.

Posted in Diabetes, General Medicine- Adults, Uncategorized | Tagged , , , , , , , , , , , , | Comments Off on Three types of diabetes. Do you have one?

Wanting to conceive?

Posted on October 26, 2013 by drlesliegreenberg

If you are a woman wanting to conceive, there is no evidence that taking antioxidant supplements will improve your fertility.

Research was compiled from 28 trials with over 3500 women attending fertility clinics.  Women who took antioxidant supplements were no more likely to become pregnant than those who took an inactive placebo or received standard treatment, including folic acid.  It was difficult for the researchers to assess whether one antioxidant was better than another.

Consider more information at www.nichd.nih.gov/

A good book to read is Taking Charge of Your Fertility–very informative, an easy read.  More at www.tcoyf.com/

.flickr.com/ photos /themikebot/ 233440718

.flickr.com/ photos /themikebot/ 233440718

Posted in Obstetrics, Uncategorized, Women's Health | Tagged , , , , , , , , , , , | Comments Off on Wanting to conceive?

Electronic cigarettes

Posted on October 22, 2013 by drlesliegreenberg

Electronic cigarettes, or “e-cigarettes” were reportedly invented by a Chinese pharmacist who wanted to “find a safer way for smokers to inhale nicotine” after his father, a cigarette smoker, died from lung cancer.  The e-cigarette is designed with a lithium battery attached to a heating element.  This vaporizes a solution of either propylene glycol or vegetable glycerine and liquid nicotine.  Vaporization allows for inhalation, also referred to as “vaping” instead of “smoking.”

Smokers have access to these products.  They are unlikely to be  banned in the near future.  There may in the future be an age restriction.

We have two questions to answer as health professionals:

1.  Are e-cigarettes safe?  Truly, we have no idea.  There is no long-term safety data on the impact of repeated inhalation of propylene glycol or vegetable glycerin on lung tissue.  Some short-term data suggests that e-cigarettes may cause airway irritation.

2.  Are e-cigarettes effective at helping stop smoking?  There is a 2013 Lancet Journal study which compares e-cigarettes to nicotine patches to placebo pills.  The research showed that there was not a statistically significant help with e-cigarettes compared to the other two options.

We, clinicials, do know that e-cigarettes are not clearly superior to FDA-approved medications for smoking cessation, e-cigarettes are not FDA approved for smoking cessation, short-term safety data suggests that e-cigarettes cause airway irritation and NO long-term safety data exists.

.flickr.com/photos /rpmarks /4075285929/

.flickr.com/photos /rpmarks /4075285929/

My advice is to quit smoking and do not start vaping e-cigarettes.

Posted in General Medicine- Adults, lung conditions, nicotine, Uncategorized | Tagged , , , , , , , , , , , | Comments Off on Electronic cigarettes

Pre-teens and acne. Ugh! Starting already?

Posted on October 18, 2013 by drlesliegreenberg

What agents to start? Acne has long been viewed as a teen phenomenon, but we are seeing this earlier and earlier.  This may be due to a trend toward earlier onset of puberty, but regardless, as a clinician I see this in my office frequently.

A few questions to ask of your provider is which over-the-counter creams should be used.  Does my child need prescription medication?  Are antibiotics a safe additional medicine to use.  Typical preadolescent acne involves whiteheads and blackheads in the forehead, nose and chin region.  Scarring is rare, although often is a concern for the parents and patient.

The patient should be started first on over-the-counter benzoyl peroxide.  Washing the face twice a day with a nonabrasive pH-balanced cleanser is the cornerstone of acne care.  Close follow up with your physician is needed so that if oral antibiotics or an antibiotic gel are needed that this can be added on.

Hope this helps.

.flickr.com/photos /blushingmulberry/ 4001277317/

.flickr.com/photos /blushingmulberry/ 4001277317/

Posted in Dermatology, Pediatrics, Uncategorized | Tagged , , , , , , , , , , , | Comments Off on Pre-teens and acne. Ugh! Starting already?

Babies need extra Vitamin D.

Posted on October 15, 2013 by drlesliegreenberg

To prevent rickets and vitamin D deficiency in healthy infants and children, 200 international units (IU) of vitamin D is needed daily.

Who needs this?  All breastfed infants unless they are weaned to at least be drinking 500 mL per day of vitamin –D fortified formula or milk.  All nonbreastfed infants who are ingesting less than 500 ml per day of vitamin D fortified formula or milk.

Children and adolescents who do not get regular sunlight exposure, do not ingest at least 500 mL  ( 2 1/2 cups) per day of vitamin D-fortified milk, or do not take a daily multivitamin supplement containing at least 200 IU of vitamin D.

.flickr.com/photos/kaozkz/ 8391950499

.flickr.com/photos/kaozkz/ 8391950499

Posted in food, Pediatrics, Uncategorized | Tagged , , , , , , , , , , | Comments Off on Babies need extra Vitamin D.