Monday, May 13, 2013

Run or Walk?

Taking a walk offers the same health benefits as a run. The determining factor is the distance covered, not how fast one goes. A runner will complete two miles in one-half the time as a walker but the runner and the walker would end up with similar reductions in the risk for hypertension, high cholesterol, diabetes and heart disease.

According to Dr. Paul Thompson of Hartford Hospital, “the faster you are, the faster the results but slow and steady gets you to the same point.”

Running reduced the risk for hypertension by 4.2% and walking reduced it by 7.2%. Running cut the risk for high cholesterol by 4.3% and walking reduced it by 7.0%. Running reduced the risk for diabetes by 12.1% and walking decreased it by 12.3%
Running cut coronary artery diseased by 4.5%, it was cut 9.3% by walking.

These results show that even modest amounts of exercise improve cardiovascular health. It’s not necessary to run a marathon - you don’t need to push yourself very hard to see benefits.

Lace up those sneakers and get going – your walk will put distance between you and the hospital. 

Wednesday, May 8, 2013


When talking about heart disease, the conversation will turn to the blood cholesterol level. In a more sophisticated exchange, the ratio of ‘good’ to ‘bad’ cholesterol will be discussed. The neglected part of the dialogue is the triglyceride level.

Triglycerides are formed when you eat more calories than the body needs right away. Sugars (candy, soda, cake) and simple carbohydrates (bread, rice, potatoes) are major culprits in boosting triglyceride levels. High triglyceride levels are most often seen with pre-diabetes, diabetes, obesity and a sedentary life-style.

Elevated triglycerides, especially when combined with low HDL cholesterol (the ‘good’ cholesterol) contributes to hardening of the arteries. The arteries are the blood vessels that travel from the heart delivering oxygen-rich blood to the tissues that need nourishment. Hard and stiff (in contrast to soft and expandable) arteries don’t do a good job with blood flow and run the risk of causing heart attacks and stroke. Other factors that cause hardening of the arteries are elevated blood pressure, cigarette smoking and age. Age is the only risk factor that cannot be modified: every other risk factor is under our direct control.

Obese children have accelerated aging of their blood vessels. The good news is that children are resilient and embracing a good diet and getting regular exercise can restore health to their blood vessels.

In adults, the combination of high triglycerides and low HDL cholesterol is a portent of impending diabetes. Medication is not the answer here – cutting calories and getting daily exercise is. Make water the beverage of choice. Don’t eat manufactured sweets. Get off the couch. Make the triglyceride level part of the conversation. 

Wednesday, May 1, 2013


Especially in the springtime, patients will come to the office with sinus symptoms. Sinusitis is the medical term for inflammation of the lining of the sinuses and nose. The sinuses are the hollow areas within the facial bones that are connected to the inside of the nose. It’s not easy to determine if the patient is suffering from seasonal allergies or has an infection.
The most common cause of acute sinusitis is a viral infection associated with the common cold. Bacterial sinusitis occurs much less commonly, in only 0.5 to 2 percent of cases, usually as a complication of viral sinusitis. The correct antibiotic can seem like a miracle cure but antibiotics are only effective against bacteria. An acute bacterial infection can be suspected if the patient has been sick for more than ten days without improvement, has a fever greater than 102 degrees or was initially getting better and then got suddenly worse.
Patients who have symptoms for fewer than ten days without a fever should have supportive care. This includes pain relief with acetaminophen or ibuprofen, saline nasal irrigation and fluids. Breathing up steam can be very helpful. Medications to thin secretions (such as guaifenesin) may help to clear mucus. Decongestants are usually not helpful and can have side-effects. Antihistamines only work if there is an allergic component. Nasal steroids (steroids delivered by a nasal spray) can help to reduce swelling inside the nose. These prescription medications have few side effects and dramatically relieve symptoms in most people.

 The vast majority of patients will eventually get better without medical intervention, but we do have products that can make people feel better much faster. Usually a quick exam will point the patient in the right direction.