Tai chi, one pathway to a better life.

Posted on July 21, 2011 by drlesliegreenberg

I have seen groups of people performing tai chi in the park and wondered what was the draw to (what seemed to me)… arm waving.  I know, I am unenlightened.  A recent internal medicine journal cites a study showing tai chi significantly improves heart failure patients’ quality of life.

Tai chi is actually a gentle, meditative exercise of flowing circular movements, weight and balance shifting, visualization, breathing techniques and focused internal awareness.   In one study, patient’s performed tai chi for one hour twice a week with an instructor and were encouraged to practice three times a week.

After 12 weeks the tai chi patients had

  • better mood scores,
  • less depression and
  • better exercise tolerance than those in a heart health education program only.

These studies spurn me to learn about complementary practices that I know little about.

Hope this helps.

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Frogs do not cause warts.

Posted on July 19, 2011 by drlesliegreenberg

I see warts commonly, today in fact. They are caused by the human papillomavirus (HPV). There are more than 100 types of HPV.  HPV infects the skin where there are nicks in the skin and causes cells to proliferate and make a thickened, warty bump. Risk factors include using communal showers or changing rooms, being a meat handler for a job (interesting, huh?), and having a weak immune system.  The HPV vaccine given to adolescents is targeted against genital warts, not to the HPV types that cause common warts.

Do not pick or scratch the wart.  You may spread the virus and get more warts.  Warts are harmless and usually resolve spontaneously within months to years. There are very few, large, high-quality studies to show effective treatments for warts. In those few studies, topical salicylic acid and cryotherapy (freezing with liquid nitrogen) have been found to be most effective.  There are countless home remedies, but none have showed much promise in good studies.

What should you do if you or your child has nongenital warts? You can be patient– as natural immunity will help clear the warts over time in most patients. Or try a tried-and-true method as above.

Your doctor can help.

Posted in Dermatology, Dermatology, General Medicine- Adults, infections, infections, Pediatrics, Uncategorized | Tagged , , , , , , , , , , , , , , | Comments Off on Frogs do not cause warts.

Recurrent yeast infections?

Posted on July 17, 2011 by drlesliegreenberg

I have some women patients who fight frequent vaginal yeast infections.  There is a 6 month regimen of medication that will help eradicate recurrent yeast infections.

The definition of recurrent vulvovaginal candidiasis is at least four documented episodes within the last 12 months.  It affects 5 to 8 % of reproductive-aged women.  First, it is important to make sure that the patient does not have elevated blood sugars (diabetes), as this can predispose the patient to yeast infections. If elevated blood sugars are the problem, then treatment of diabetes is first order of business.

Randomized controlled trials show effective treatment involves weekly diflucan or itraconazole two pills a month for the entire six months.  This placed nearly 91% of patients into remission.

Hope this helps.

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Childhood obesity. How to help your kids. . .

Posted on July 15, 2011 by drlesliegreenberg

A recent study of obese 2-11 year olds reinforced some take home points that all of us parents with young children may appreciate. . .First the facts and then how we can change the culture in our own homes.

  • Limit sugar-sweetened beverages and give water instead.  Water is the best way to hydrate.
  • Offer healthy snack in lieu of cheese puffs or chips.  (This may mean that you need to purge the unhealthy snacks from your home).
  • Eat breakfast.  Like your mom used to tell you. . . it IS the most important meal of the day.

These three changes may greatly help your child build a healthy eating pattern and shed some fat, too.  Parents are gatekeepers of the foods kept in the home and offered.  Pick those foods responsibly.

Childhood obesity rates 2007

Childhood obesity rates 2007

Hope this helps.

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Are you doing what you are passionate about?

Posted on July 12, 2011 by drlesliegreenberg

Today I had the pleasure of teaching.  I routinely help teach my patients at office visits.  But, today, it was teaching physicians, new physicians.  I continue to teach at a local residency program, and a group of 16 interns just started.    All that inquisitive brain power is amazing!  Inquisitive.  Energized.  Motivated.

Today I taught the Advanced Life Support for Obstetrics course like I have for 13 years.  It is an intensive course –like a 16 hour CPR course covering high-risk obstetrics. . . ahhhh!  I appreciate reading new guidelines, learning improved techniques, hearing colleagues lecture, and performing hands-on workshops.

Word is that half of what is taught in medical school is later found to be wrong. . . I hope to replace THAT half of my knowledge.

Enjoy today!  Seek out what YOU are passionate about.

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Does your New Year’s resolution resolve need a booster?

Posted on July 9, 2011 by drlesliegreenberg

Over 13,000 women participated in a study which yielded some interesting information on what habits can increase or decrease  your cancer risk . . . and by how much.

  • In women with a family history of breast cancer, or “other factors”. . .Women who smoke for 35 + years have a 59% higher risk of developing breast cancer compared with those who never smoked.  Smoking 15 – 35 years had a 34% higher risk.
  • Colon cancer is four times higher among women with 35+ year smoking history and 7% higher for those who have smoked 15-35 years.
  • It was noted, and not too surprisingly, that one pack per day of cigarettes for 35 + years has a risk 30 times higher risk of lung cancer than did women who never smoked.
  • Are you a couch potato?  Low level of exercise raises risk of endometrial cancer by 72%.
  • Alcohol consumption was NOT found to increase cancer risk.  (This means moderate alcohol consumption which is up to one drink a day.)   This was shown to decrease risk of colon cancer by 65% compared with those women who did not drink.

Take home message?  Don’t smoke.  Or stop smoking.  Exercise.  Drink in moderation.

Hope this helps.

Posted in Cancer, General Medicine- Adults, Uncategorized, Women's Health | Comments Off on Does your New Year’s resolution resolve need a booster?

2.4 million swimmer’s ear visits a year! How to not get one. . .

Posted on July 7, 2011 by drlesliegreenberg

The Centers for Disease Control forwarded on this astronomical number in a bulletin on external ear infections.  There are simple steps to do before and after swimming (or coming in contact with water), to greatly reduce your risk of this painful infection.

Symptoms of swimmer’s ear are tenderness at the ear or around it, redness, and swelling of the external ear canal.  Cases peak during the summer months and children aged 5-9 years accounted for the most physician visits for this—although it can occur at any age.

Surprisingly, the cost per case was $200 for those not requiring hospitalization.  3% of those visiting an emergency department for this were hospitalized.

To prevent. . .

  • Use ear plugs or bathing caps to reduce exposure of the ears to water
  • Dry the ears after swimming–hopping on one foot, moving the ear lobe, and tapping the other temple with your hand, or gently blow drying your ear.  Some sound silly but these do help.
  • Keep foreign objects (like cotton swabs) out of the ear, as these may break the skin and create an avenue of infection.

Do not remove ear wax.  It is good for the ear and helps protect it from infection.

Swim in maintained pools as proper pH and chlorine levels decrease Pseudomonas aeruginosa and Staphylococcus species which are the usual culprits of external otitis infections.

For more information, visit www.cdc.gov/healthyswimming

Enjoy the water this summer!

Posted in General Medicine- Adults, infections, infections, Pediatrics, Uncategorized | Tagged , , , , , , , , , , , , | Comments Off on 2.4 million swimmer’s ear visits a year! How to not get one. . .

How often do YOU need a pap?

Posted on July 5, 2011 by drlesliegreenberg

The Pap smear used to be done every year. . . guidelines have changed.  Read on. . . We perform paps on women to screen for abnormal cells on the cervix.  Cervical cancer is a disease of sexually active women, related to infection with specific high-risk strains of HPV.  Risk factors are earlier onset of sexual activity, multiple partners, cigarette smoking, and immunosuppression.

Initial screening is not suggested (by most professional groups) until age 21.  We now know that adolescents who have intercourse and contract HPV may have transient cervical changes and most resolve spontaneously, without any treatment.  At age 21 a pap should be offered to all women, regardless if they have ever had sexual intercourse.

At the other end of the age spectrum, Medicare first started reimbursing for Pap smears in 1990 because studies showed 40% of elderly women had NEVER had a pap.  How amazing!  There are no studies to show the effectiveness of screening women older than 65.  Paps may be considered in patients with positive HPV status, current sexual activity, or recent new sexual partners.  Also, older women who have not been screened should have Pap tests annually until they have had three normal tests.  No more paps needed for screening in those with adequate previous testing and no risk factors.

Screening frequency intervals have changed for those 21 to 65.  Most US guideline-issuing organizations recommend screening every two to three years for women older than 30, more frequent for younger women or those with risk factors (HIV infection, immunocompromise, in utero exposure to diethylstilbestrol, prior abnormal paps, or prior cancer).

If you’ve had a hysterectomy for non-cancerous reasons, no more Paps are needed.

For more information the CDC has a great brochure:   http://tinyurl.com/6g8de6v

Hope this helps.

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New measles and whooping cough vaccination guidelines for adults!

Posted on July 1, 2011 by drlesliegreenberg

Changes! Changes! The governing body on immunization practices met last week. Many babies are becoming ill with pertussis and the pregnant mom can help. The pertussis vaccine is considered safe for pregnant women and may give immunity to their young babies before they can make an immune response to their vaccines at the 2,4, and 6 month well child check visits. Measles is coming home as a travel souvenir , so some adults may need a booster of that before international travel.

Read on …

http://www.addthis.com/bookmark.php?v=250&username=aafponline.

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What to do about unwanted hair?

Posted on June 29, 2011 by drlesliegreenberg

A patient of mine recently asked me to blog about female unwanted facial hair.   She has more facial hair than she desires and works with children (who frequently are inquisitive and vocal).  This is not a singular problem, most of post-pubertal persons in the world routinely practice some form of hair removal.  Plucking or shaving are common. . . here are a few others to consider.

The temporary methods are just that, temporary–although sometimes the dermal papilla are damaged by the removal, leading to permanent removal of hair.

  • Plucking is effective, often lasting for 6 to 8 weeks, and often painful.  Plucking is best for selective area with small numbers of unwanted hairs.
  • Waxing involves applying a layer of cold or hot wax to the area and when the wax is pulled off, the trapped hairs are pulled out.  For some, this is less painful than plucking.  This pulls the hair out down to the bulb.
  • Depilation is the use of a chemical to dissolve the hair, which is then wiped off.  Most contain sulfur which produces an unpleasant odor, and the results only last 2 weeks.
  • Shaving is common, only removes hair to just below the surface of the skin, and may need to be repeated every 12 to 24 hours.  Shave bumps are especially common in black men.  Shaving can cause infection of the skin with staph aureus or spread warts or molluscum.
  • Bleaching does not remove hair, but may mask its presence.  The hydrogen peroxide may cause irritation, itching and possible skin discoloration.  Try this on a small area of skin first to make sure you do not make a reaction.
  • Vaniqa (FDA approved only for the face) is a prescription strength cream which can reduce hair growth by inhibiting an enzyme the hair needs to grow.  This is my patient’s favorite (and the reason she asked me to blog on the subject).  Noticeable results in 6-8 weeks.  When treatment stopped, hair returns to pretreatment levels in another 8 weeks.
  •  Lasers are effective, multiple treatments are needed, and it works best on dark hair.  A dermatologists or plastic surgeon can help.
  • Electrolysis permanently removes hair, usually performed at spas and not physician offices.  Technicians are not required to be formally trained.

Hope this helps.

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