Prostate Cancer Screening and Men’s Health

Photo from wordpress...representation of male patient afte he finds out there will be no prostate exam.
Photo from wordpress…representation of male patient afte he finds out there will be no prostate exam.

I see both male and female patients. Women are accustomed to some sort of yearly exam, typically related to women’s health.

I’ve found over my years of practice that men typically present at the ages of 30, 40, or 50 wondering what is required of their health. Unlike women, the average healthy man may not have a specific need for a physician. It’s not unusual for a male patient to go over 20 years without seeing a physician. After going so long without seeing a physician naturally, they are very nervous about the prospect of meeting a physician and getting a rectal exam immediately.

These medical headlines are extremely helpful. The current recommendations are that for the majority of men, prostate cancer is not recommended.

My approach is education. Every man should be aware of symptoms of prostate enlargement, such as frequent urination or trouble emptying the bladder. Men should also be prepared discuss issues with sexual health, as any issues with having an erection could signal issues with cardiovascular disease. Checking PSA or performing a prostate exam won’t be necessary UNLESS a patient wants to do this. Patients that want a more rigorous screening exam have the option once we discuss the risks and benefits it prostate screening.

Internal Medicine News

KHN Morning Briefing

Insomnia #2-How to talk to your doctor about insomnia

Handy list of questions for insomnia

Lunar Eclipse 2015 blogphoto

Discussing insomnia with your physician  is an important decision. Doing some analysis of the situation will not only help you resolve the situation, but will help your physician work with you more effectively.  

Here are a few questions to consider before going in to see your physician:  

How long have you had sleep issues?

If this started just a few nights ago, likely there is a cause the patient can pin down themselves.  If it has been over a month, we’ll need to dig a little deeper. If it’s been over 6 months, likely you will be diagnosed with insomnia but we still need more details.  

Do you have trouble falling asleep? Or do you wake up after a few hours?

There are different types of insomnia. Having some awareness of if rather your issue is trouble with initiating sleep, waking up frequently, or waking up very early.  You may want to consider keeping track of your sleep with a sleep journal. It can be a cell phone app, information from your activity tracker, or just a list of bedtimes and waking times.

Are you a shift worker?

Naturally, if your work requires you to work overnight, or change scheduled frequently, we’ll need to discuss how this affects you.  

What’s your medical history?

Are you diabetic?  Do you have a condition that’s causing pain?  Are you prone to depression?

Almost any medical condition can disrupt sleep. The muscle aches (myalgia) of the flu can wake you up. If your becoming short of breath when you lay flat that can be a sign of heart disease. Anemia sometimes presents as insomnia. Although one of the main symptoms of anemia is fatigue, many people often notice restless leg symptoms at bedtime. This is because as they lose iron,  the nerves of the legs to become increasingly sensitive to pain.

It may be your diabetic nerve pain (also called diabetic neuropathy) that’s causing pain at night.  Diabetic neuropathy can be one of the first symptoms on diabetes.

Are you reading this blog now when it should be bedtime?

I know my natural tendency is to be a little sedating, and I’ve been batting around the idea of using my blog as a sleep aid.  But screen time has a very strongly association with insomnia. The light coming from your screen (and this counts for cell phones, tablets and televisions) activates your optic nerve.  This stimulus will have direct effects on the sleep center in your brain, the Pineal Gland, which will lead to a wakeful state. By the way, you can find an excellent pineal gland meditation here

Are you going to be angry?

Are you laying down in a peaceful state?  Or are you plopping down in the bed after an 18 hour day in which you missed lunch, never stopped moving and multitasking.  Your state of mind can be a major source of insomnia that we definitely do not want to treat with prescription sleep aids.

What did  you eat before bed?

Your diet choices make a difference when it comes to your sleep.  Caffeine intake naturally will disrupt your sleep. Caffeine has many benefits, but it is a drug with many effects on the body.  You may be especially sensitive to the effects of caffeine, and a stop at the local coffee shop at work may guarantee you a long restless night.

Are you using alcohol to sleep?

Alcoholic beverages have an immediate sedating effect. Paradoxically,  alcohol disrupt the normal sleep cycle, leading to disrupted poor quality sleep.

Are you being treated for chronic pain with narcotics?

Opioids can disrupt normal sleep architecture.  You may fall asleep very quickly, but then you wake up within hours feeling tired.

Do you fall asleep during the day?

It’s natural to have periods during the day of fatigue or sleepiness. But if you’re finding your sleeping at inopportune times, such as on meetings, during conversations, or while  driving, this will require an in depth conversation with your physician.

I recommend patients jot down some notes prior to going to their physician as this can help.  Any information patients bring to the physician will help with a diagnosis and treatment.

In future post, I’ll dive deeper into what happens when humans sleep, as well as using the Chakra system to classify the causes of insomnia.

 

Kidney Disease and Thyroid Disease-health news update

I received a very interesting email update from Mayo Clinic. Medical research is now showing a clear link between kidney disease and thyroid disease.

Thyroid disease has been commonly associated with critical illness, but as far as I know there has been no clear link between kidney disease and thyroid disease.

The take away from this study is in addition to other checkups, kidney patients need an assessment of their thyroid status.

Insomnia

Photograph by Charlyce Davis

 

It’s only 2am….

You’re already awake…

… And your reading this blog thinking …I need to sleep tonight

So you lay there, wishing for sleep.

Then it’s 3am

Then it’s 4am.

As you finally drift off to sleep….your alarm goes off, letting you know your day is about to start, sleep or not..

Insomnia. Oh lovely blessing of long, endless nights. If your finishing an amazing novel you may not mind taking 2-3 hours to get to sleep. If your next day is demanding or high stakes such as a job interview, you need the rest.

Insomnia is a BIG topic in my clinic. My personal estimation is that nearly ⅓ of patients that I see suffer from insomnia. The prevalence of insomnia disorder is approximately 10-20%, with approximately 50% having a chronic course.¹

Insomnia is defined as trouble falling asleep, staying asleep, or getting up too early.

Sleep is frequently disrupted at some point in our lives. Most humans will experience sleep disruption from either a self imposed cause (due to schedule changes, wanting to be productive, socializing) or from an external cause (a new baby). While it’s not ideal, most of us will be okay with one or two nights of short sleep as long as we can get to bed within a few nights.

I have personally dealt with sleep issues. During my residency, overnight call in the hospital meant a few hours of sleep, and possibly no sleep at all. Later, after a stressful breakup I frequently found myself waking up hours earlier than I needed. I know the terrible brain fog patients speak of when you need to be at your best but you can’t be.

When most patients tell me about the insomnia they are suffering, they typically have had either insomnia one month of severely interrupted sleep, a chronic course of poor quality sleep, or a several years long history of frequent bouts of poor sleep.

Thanks to development of prescription sleep aids with great marketing material, including beautiful butterflies drifting you off to sleep,

Photograph by Charlyce Davis

 

most patient anticipate that once they tell the physician they can’t sleep, they will be prescribed a medication that will eliminate the problem. Many patients are surprised that once they discuss their insomnia with me, I’m likely not to write a prescription.

Why would I avoid writing a prescription for a real medical issue? Medical research has shown that the best treatment for insomnia is behavioral treatment. The ACP recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I), as the initial treatment for chronic insomnia disorder². Furthermore, “many medications used regularly and long term for insomnia disorders have an FDA indication only for short-term, as-needed use, in part because hypnotics are associated with dementia, fracture, major injuries, and possibly cancer.”³

One of my aims with this blog is to take an honest look at health. Insomnia is one of the topics that I feel somewhat hypocritical due to the pressures and time constraints of modern health practice. Patients present to me with insomnia, and for years, I treated their insomnia completely differently from how I treated my own insomnia. I’m so happy to have this venue to spend more time on this important topic.

Over the next several post, I’m going to cover the topic of insomnia in more detail. I’m hoping that my blog as well as other sources can start to shift the conversation from insomnia as a condition that requires a multicomponent solution. Thank you so much for visiting my blog, and please stop by soon on my next entry on insomnia.

1.   Buysse DJ.   Insomnia. JAMA. 2013 Feb 20;309(7):706-16. doi: 10.1001/jama.2013.193. Review.
2.  Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine,165(2), 125. doi:10.7326/m15-2175
3. Wilt, T. J. (n.d.). Pharmacologic Treatment of Insomnia Disorder. Annals of Internal Medicine.

Asthma and Hay Fever Linked to Increased Risk of Psychiatric Disorders — Neuroscience News Updates and Mind/Body Connection

According to researchers, suffering from asthma or hay fever may put you at an increased risk of developing a psychiatric disorder. The study reports over a 15 year period, 10.8% of people with allergies developed psychiatric disorders, compare to 6.7% of people without allergic diseases.

via Asthma and Hay Fever Linked to Increased Risk of Psychiatric Disorders — Neuroscience News Updates

This article appeared in my feed and I find it very fascinating. I thought I might use this in my own blog as a way to start introducing the logistics of the Mind-Body Connection.

Pathophysiology of Allergies (Allergic Rhinitis)

I see patients with some form of allergies throughout most of the day. This should be no surprise since allergic rhinitis is “the most common chronic disease in the United States, affect[ing]  between 10 and 30% of adults and up to 40% of children”¹.

The symptoms of allergic rhinitis start at Mast Cells;

Mast_cells.jpg

Mast Cells are an important part of the immune system that also play a role in allergies.  Mast Cells are equipped with receptors for antigens (a signal to the immune system that an invader is within the body).    Someone that has allergies produces antibodies  (IgE) which function to tag antigens as they enter the body.  An antigen tagged with IgE circulating in the blood stream will land on a mast cell, causing the mast cell to launch its weapons (histamine, cytokines and other inflammatory  chemicals),  These chemicals will land in the nasal passage, sinuses, and lungs leading to allergy symptoms.

Energy Imbalance leading to Allergic Rhinitis

One of my favorite books is by Margaret Ann Lembo’s Chakra Awakening. This is one of the first books I read when I became curious about energy medicine. This is a wonderful starter for anyone who is wanting to learn about the Chakra system, and as well as using  essential oils and crystals as part of their healing routine. I have adapted a chart from her book which summarizes each Chakra’s function, and how imbalances show up. I use this chart personally when I’m working with energy medicine and for myself and find it to be a very handy tool in energy medicine.

Chakra Chart from Margaret Ann Lembo’s Chakra Awakening

Chakra Chart from Mary Ann Lembo (1)

When I first started learning about the Chakra system, I was fascinated with how blockages within a Chakra could contribute to disease. Chakras comes from Ayurveda, and I think of it as anatomical representation of energy centers within the body.

Chakras_Demostration.png

Media by LordtNIS

Most people suffer allergies in their noses, sinuses, eyes, ears, throat and sometimes chest. Symptoms of allergies are usually runny nose, watery eyes, sore throat, sinus pain and pressure. These organs are within the throat, third eye, and crown chakra. These organ are also associated with psychological dysfunction, such as stress, anxiety, or depression. Additionally, allergies are generated within the body when the immune system becomes overactive. Knowing that these energy centers correlate with our physical and emotional health, it would be expected that a person suffering from allergies is likely at increased risk of a psychological issues.  In particular, if an individual is feeling like they can’t express themselves (blocked throat chakra) they may be particularly prone to allergies.

There are a number of ways to handle allergies.

Over the Counter Medications:

Naturally I’ll have to remind readers to consult with their personal physician if you are suffering from allergies. Most people can tolerate antihistamines such as Claritin, Zyrtec, or Allegra very well. The addition of a nasal steroid such as Fluticasone (Flonase) can also help to control symptoms.

Anyone suffering from severe symptoms, such as a rash or wheezing needs to consult with their physician.

Reiki for Allergies:

If you are already  Reiki  attuned, you can simply treat your sinuses.  Consider treating the neck and chest.  Your Reiki manual  from your attunement is also a good resource for a treatment sequence.

If you are considering seeking Reiki to treat allergies, you may opt for a shorter session, but understanding that a combination of stress and chemical cascades are leading to your  symptoms, you may be due for a full Reiki session.

Essential Oils to use:

Anyone with experience using essential oils to support their health can attest to how wonderful they can be to relieve symptoms.  There is simply no better pleasure than your first whiff of Breath from DoTerra when your suffering from allergies.

doterra-breathe-15ml.jpgdoterra-touch-breathe-10ml (1).jpg

 

DoTerra offers a wonderful line of products that can be used for allergies, and are good for colds, or to augment your meditation.  The essential oil  comes in a 15ml or a roller bottle, and either one is excellent.  A drop or two on your chest of neck quickly alleviates symptoms.  Consider a patch test on your inner arm before using routinely.  Of course, Breathe is amazing in a diffuser.

doterra-breathe-vapor-stick.jpg

dōTERRA Breathe® Vapor Stick

The vapor stick is neat, clean and ready to go.  You can quickly apply some to you chest or neck to soothe your sinuses.

doterra-breathe-respiratory-drops (1).jpg

The dōTERRA Breathe® Respiratory Drops are my personal favorite cough drops.  You get all of the benefits of the oils without concern of others being affects by your essential oil use.  You will still get the cooling sensation in your sinus passages that is wonderful.

You can find more information on essential oils here.

 

1. Goldman, L., & Schafer, A. I. (2016). Goldman-Cecil medicine. Philadelphia, PA: Elsevier/Saunders.

What Happens During a Reiki Session

pexels-photo-259810.jpeg

If you have chosen to pursue Reiki as a treatment likely your Reiki Practitioner has advised you on how to prepare. If you are still wondering if you should try it, I would like to address what to happens before, during, and after a Reiki session.

The day of your appointment, you’ll want to wear comfortable clothing. Similar to having a massage, it is usually best to wear something you’ll be comfortable laying down in for about an hour. I recommend carrying water with you. Your Reiki healer likely will have refreshments but it’s good to have something for your trip home. Because you’ll be laying down for several minutes, I would avoid eating a heavy meal.

Reiki Practitioners are very accomodating, so you have have special circumstances, you only need to let your practitioner know. In my clinic, we can accomodate for someone in a wheelchair or who has physical limitations that won’t let them lie on a table.

Once you arrive, you’ll be shown to the space you’ll receive your treatment. We use an exam room in my clinic that’s quieter than our other spaces.

The first few minutes I like to have clients complete a form that I can use for record the visit. I also like to talk for a few minutes prior to starting. One of the things I love with Reiki is that clients do not need to reveal more than they are comfortable with sharing. The treatment is intuitive, and even if a client wants to share nothing with me, I can still treat them effectively. I found in my years of practice, many patients have been traumatized by the healthcare system. Sometimes simply reviewing the timeline and details of an illness can be traumatizing in itself. We can proceed with a Reiki session with a lot of information or none at all.

Reiki can be channeled with direct touch or by simply hovering the hands over the area. This depends on what the client is most comfortable with. Depending on life experience, many people are not comfortable being touched and this is perfectly fine. Reiki is effective hands on or hands off.

Once the session begins, the practitioner will position their hands over an area of the body and leave them there for at least a few minutes.

My experience with with patients and clients is that throughout the session, the person will become progressively more relaxed. Some enter a meditative state. Most are deeply relaxed with very little tension in their bodies. Some clients will have a release of pent up emotions, so may feel a need to cry or even laugh. But every experience is individual. The same person may have a different experience with each Reiki session.

Once the session is complete, I like to let clients have a few minutes of quiet to center themselves. After the session, if the client likes, we can discuss their experience.

I typically advise everyone after a session to try not to schedule any rigorous activities. If you have things you must accomplish, try to plan so that you don’t have to do too much as you’ll need to rest.

I hope this description is helpful for anyone considering this healing modality. I hope you’ll try it if you haven’t. If you have already experienced Reiki, you should continue, and maybe become healer.

Thank you for visiting.

Past Life Meditation

pexels-photo-289586.jpeg

I frequently discuss meditation  at work and in my personal life.  This post is for those that are comfortable with meditation.

I recently started using Insight Timer  in my cell phone.  I discovered a past life meditation that was an amazing experience.

I recommend this meditation for those that are comfortable with meditation.  This is a longer session, around 1 hour.  The meditation will guide you through a deep relaxation then onto a past life.

My personal experience was unexpected.  I discovered many things about myself, including why I love astronomy in this life.

I hope others will try it as well.

Past Life Meditation