Keeping Your Goals

Written by: Krista Reader

Making your resolutions is the easy part, it’s keeping them that is the tough part.

Now that you’ve made and shared your goals, it can often be difficult to keep them a priority when the stress of life kicks into high gear, if it hasn’t already. Here are some tips to keep it manageable.

Indulge, but don’t gorge!
It’s ok to indulge for the occasional birthday celebration or special event. Be careful not to over-indulge, though. Your body can surely recover quickly from a little bit of bad behavior, but several weeks of overdoing it may have you packing on pounds that will be tough to shed later. If you must indulge at the company party or enjoy an obligatory office treat, be sure to make your next meal as healthy as possible to balance things out. Moderation is the key!

Avoid the splurge-and-starve cycle.
Sometimes when we eat a large meal or overindulge, there’s a tendency to say ‘I overate at dinner last night, so I’ll just skip breakfast and lunch.’ Better to break the cycle right away by starting the next morning with a quick walk and light, nutritious breakfast, and fill up with a snack and a glass of water before you sit down to the next tempting meal.

Stick to your regular exercise program.
It can be very easy to break a workout habit, and especially when your bed is so warm during Southern California’s winter. But if you’ve got one, maintain it!

Keep Hydrated.
When celebrating a special occasion, we tend to drink more sugary drinks – soda, cocktails, etc. – and less water. Try to get at least eight glasses of water a day!

Wash your hands.
Germs spread very fast, so remember to wash your hands before every meal and avoid touching your nose, eyes and mouth with your hands to keep germs at a minimum.

If your set of resolutions is still a work in progress, there are a few things to keep in mind to help you out.

1. Write down your ideas and goals that you’ve thought about achieving.

2. Give yourself a completion date for each goal.
Each of the goals should be definable and achievable. If your goal is to be more healthy, instead of telling yourself that you want to “lose 10 pounds,” consider adding in things like “meditate every morning to get centered, 30 minutes exercise three days each week, eat (x) amount of fruits/vegetables/whole grains per day.” If you don’t have a plan to get to a healthy place, you’ll become completely discouraged when the 10 pounds doesn’t fall right off of your body (plus, isn’t long-term health more important than just being skinny?)

3. Work on only one of those specific goals at a time.
For instance, instead of meditating every morning, working out three times a week and increasing your vegetables, just start with exercising 3 times a week. As soon as that becomes a habit, add in the meditation and as soon as that becomes a habit, add in the vegetables and so on. By the end of the year, you’ll have at least a dozen new life-long healthy habits. Here are some shocking statistics: Your chances of success when working on one specific goal is more than 85%. However, when throwing in just one more goal, your chances of success drop below 35%. Adding a 3rd one in, you might as well just throw in the towel, because you have less than a 10% chance of succeeding. It’s no wonder no one keeps their resolutions past February, we’re setting ourselves up for failure!

4. Rewrite your goal as: “I will _____ by (date).”
Just by writing down your goal and giving yourself a date to finish it by, you are making your health life a priority. Be sure to make it doable and stay dedicated.

5. Share your goals.
Don’t be shy – even if your goals might intimidate you, it’s amazing the amount of confidence and encouragement you can receive by sharing your goals with others. If you have the courage to share your own goals, chances are, you’ll unknowingly motivate others to pursue and share their own.

Good luck and we’re there if you need us!

Special thanks to Dr. Lyndsay Elliott, clinical psychologist.

PSA Testing May be More than a Pain in the Ass

Written by: Dr. Jeffrey Barke

PSA testing has been the standard testing mechanism for the detection of prostate cancer for many years. It stands for prostate specific antigen and is a simple blood test that has been relied upon by primary care and specialty physicians alike. However, this standard test is under attack and rightfully so.

The U.S. Preventive Services Task Force (USPSTF) has recently published a draft recommendation AGAINST prostate specific antigen or PSA screening for prostate cancer in asymptomatic men. The USPSTF gave PSA screening in asymptomatic men a D recommendation, which means there is a moderate or high certainty that the test has no net benefit or that the harms outweigh the benefits. The benefit, of course, would be detecting prostate cancer early. The harm is that the vast majority of those diagnosed with prostate cancer will never be harmed by this mostly very slow growing cancer; you get the risks associated with treatment but no benefit.

According to Dr. LeFevre, a professor at the University of Missouri, Columbia, for every 1,000 men treated for prostate cancer, five die of complications from the prostate surgery; 10-70 suffer significant complications but survive; and 200-300 suffer long-term problems including urinary incontinence (think lifelong Depends), impotence (inability to get an erection) or both.

USPSTF noted that the majority of men who have asymptomatic cancer detected by PSA screening have cancer that either will not progress or is so slow-growing that it will not affect the men’s life spans.

So what to do? The USPSTF, although well respected, is but one authority that makes recommendations. The American Urological Association continues to support the use of the PSA test. At minimum you should have a conversation with your doctor about the USPSTF recommendation and how that applies to you. Family history, age and current symptoms all play a role in determining whether to screen or not. The art of medicine is in part, knowing how to apply the latest research and data to an individual patient.

5 Tips to Stay Healthy During the Holidays

Written by: Krista Reader

Personalcare Physicians would like to thank all of our patients, staff and friends for an amazing year. Those in our Healthfit 4 Life program have lost 650 pounds as of Dec. 1 and we want to encourage everyone to stick to their goals as the year comes to a close.

We’ve come up with five easy tips to help keep you healthy through the rest of the year.

Have a wonderful holiday season and we look forward to seeing you in 2012!

Dr. Jeffrey Barke
Dr. Kenneth Cheng
Dr. Marcia Whalen
Dr. David Bloom

5 Tips to Stay Healthy During the Holidays

Indulge, but don’t gorge!
It’s ok, during this brief hiatus, to indulge in the richness and pleasures of the holidays. Be careful not to over-indulge, though. Your body can surely recover quickly from a little bit of bad behavior, but several weeks of overdoing it may have you packing on pounds that will be tough to shed later. If you must indulge at a holiday meal or enjoy a holiday treat, be sure to make your next meal as healthy as possible to balance things out. Moderation is the key!

Avoid the holiday splurge-and-starve cycle.
Sometimes when we eat a large meal or overindulge, there’s a tendency to say ‘I overate at dinner last night, so I’ll just skip breakfast and lunch.’ Better to break the cycle right away by starting the next morning with a quick walk and light, nutritious breakfast, and fill up with a snack and a glass of water before you sit down to the next tempting meal.

Stick to your regular exercise program.
It can be very easy to brake a workout habit, and especially so during the holidays. But if you’ve got one, maintain it!

Keep Hydrated.
During this time of year, we tend to drink more sugary drinks – hot chocolate, egg nog, etc. – and less water. Try to get at least eight glasses of water a day!

Wash your hands.
Germs spread very fast during the holidays, so remember to wash your hands before every meal and avoid touching your nose, eyes and mouth with your hands to keep germs at a minimum.

Happy Holidays!

This Blood Test Could Save Your Life

Written by: Dr. Jeffrey Barke

If you can’t measure it, you can’t improve it. Measure the ratio of AA:EPA in your blood and you have an accurate account of your future health.

We all try to take good care of ourselves with the belief that if we do so we will reduce the chances of serious illness. We make attempts to eat healthy, we exercise, we don’t smoke, and we try not to drink too much. Our bargain is if we do these things we are less likely to get: cardiovascular disease, diabetes, and maybe even cancer. Are we sure? How do we know? What can we measure?

The answers to these questions are difficult and imperfect. Here’s my thesis. Cellular inflammation is the foundation upon which our genetic expression of disease occurs. Control inflammation and we reduce the chances of disease. Full disclosure: Much of my statements are supported by research. However, I take common sense liberty in broadening what the research shows.

Inflammation in our body can be seen by measuring fatty acids. Fatty acids are the building blocks of eicosanoids. Eicosanoids are hormonal messengers in the body that control inflammation, and are produced in every living cell in the body. Manipulating eicosanoids through nutrition and supplements can change cellular inflammation. The ratio of AA (arachidonic acid an omega-6 inflammatory fatty acid) to EPA (eicosapentaenoic acid an omega-3 anti-inflammatory fatty acid) is a measure of “Cellular Inflammation.” This term cellular inflammation was coined by Dr. Barry Sears. Yes, the Barry Sears that wrote the nutrition book “The Zone” and the more recent book “Toxic Fat.” Control cellular inflammation and you control the development of chronic disease.

The AA:EPA ratio can be altered by changing our nutrition and by taking fish-oil. AA (arachidonic acid) is found in processed foods, egg yolks, and animal fat. It can also be produced by the over-consumption of cheap refined carbohydrates and vegetable oils. If you minimize or eliminate these food sources you reduce inflammatory arachidonic acid in your body. EPA (eicosapentaenoic acid) is found in fatty fish such as salmon and sardines, and in fish-oil supplements. If you increase these food sources you increase the levels of anti-inflammatory EPA in your body.

The easiest way to reduce your AA:EPA ratio is to take fish-oil. A caution is in order however. Not all fish-oil is created equal. Fish, in general, is polluted. Eat too much fish and you are likely to get too much mercury and other pollutants like PCBs. Take too much impure fish-oil and the same is true. The fish-oil I take and recommend is the product produce by Zone Labs (Dr. Sears’ company) called OmegaRx.

I take this product for three reasons:

1. I believe it is the purest fish-oil on the market and every batch is verified by an independent 3rd party lab.
2. It has an EPA:DHA ratio of 2:1. Most of us get plenty of DHA but lack EPA therefore this ratio is important.
3. If I’m going to spend a fair amount of money on fish-oil I might as well support Dr. Sears as I believe his research into nutrition and inflammation is important work.

Control cellular inflammation and you control the genetic expression of disease. Measure the AA:EPA ratio in your blood to know your level of cellular inflammation. Most importantly, you can change it and your blood will tell within 30 days.

Coming Home from College for the Holidays: How to Handle the “Freshman 15″

Written by: Dr. Lyndsay Elliott

We’re happy to have a new guest blogger, Dr. Lyndsay Elliott. Dr. Lyndsay, PsyD, is a clinical psychologist who specializes in food and body image issues out of her Newport Beach office. We believe these topics are incredibly important as eating disorders are rampant in Orange County.

We’re excited to have Dr. Lyndsay’s expertise!

Starting college is an exciting but overwhelming time for most young adults. Learning how to balance academics, a new social scene, and any work obligations can leave self-care in a place of neglect. Even with the welcomed change of “leaving the nest,” transitions are a difficult time for most people, and learning how to nourish oneself without the conveniences of home can be a challenge.

You may notice that when your child comes from college for holiday break, that they have gained weight. Anxiety sets in because you’re concerned about how your child is taking care of themselves, what or if to say anything about the change, and yet not wanting to avoid dealing with possible issues that are associated with their changing body. Below you will find some strategies in dealing with such issues to help alleviate the stress as well as to provide support for your loved one:

• Don’t assume that the weight gain is an issue. Perhaps their changing body is reflective of self-exploration, new freedom and fun that they are experiencing at college. Creating independence and learning how to feed themselves appropriately takes time, and there is a learning curve associated with this new phase in self-care.

 

• Watch out for warning signs that your child is concerned about the changes in their body. How do they talk to themselves about the weight gain? Are they criticizing their bodies or complaining that they do not fit into their clothes? You may have to purchase a few new items of clothing during this time of transition so that they feel confident and comfortable, but you do not have to buy a new wardrobe. Once their weight settles out, you can decide what else, if anything, needs to be purchased.

 

• Have a body composition test done by a professional. Is the new weight reflective (and appropriate) of any growth that has occurred or an increase in age? Physical maturity usually completes during the college years, and weight gain/loss can occur during times of growth.

 

• Spend consistent time with your child, and be a good observer during meals. Are they eating intuitively, or are there new behaviors that cause concern?

 

• Continue to monitor your child’s actions following meals. Are they drinking a lot of water, then disappearing or spending long periods of time in the bathroom? If you suspect that your child is purging, you should confront them with any worries.

 

• State any concerns in a loving and clear, but firm manner. If possible, use the same descriptors that they are using themselves (i.e. “I’ve gained so much weight”) to prevent them from accusing you of believing they are “fat.” Any concerns that you have should be addressed directly in the context of what concerns your child is stating, or behaviors you have noticed.

 

• Ask questions. How is your child making the transition in college? What are their stressors in school? Have they developed friendships or when are they feeling lonely? Are they too involved with the social scene? Develop ways that you can best support them while also holding them accountable to take care of themselves (i.e. nourish themselves appropriately), and not be pushed away because your child is too embarrassed to admit any difficulties.

 

• Hold your child accountable for their actions, and any commitments they make to increase their self-care. If they are gaining weight because they are going out and drinking most nights, chances are they are neglecting other areas of their life (i.e. academics or sleep) and need to re-prioritize their commitments.

 

• Praise any positive behaviors during this time of transition. Remember that they are still learning, and continue to encourage in areas that are appropriate. The holidays are for spending quality time with loved ones, and celebrating new milestones (i.e. college). Do not allow the weight gain to take away from such special and infrequent experiences, but rather enhance and build upon this new phase of their life. Afterall, you are still their parent, able to offer guidance and support in times of need, while also holding your child accountable for self-care and without avoiding potentially destructive behaviors. Finally, if your child still needs more support, encourage them to seek out help from their college counseling center where they can receive (often free) support to cope with stressors, or specialized counseling in food and body image issues.

Lyndsay Elliott, PsyD, is a clinical psychologist and maintains a boutique practice in Newport Beach, California. Dr. Lyndsay specializes in food and body image issues, and has been an expert in the field since 1996. Dr. Lyndsay posts relevant information on her blog at www.DrLyndsayElliott.com, on twitter @DrLyndsay and Facebook at Dr. Lyndsay Elliott, Inc.

A letter from Skip

Written by: Krista Reader

Here’s what one of our patients said…thanks Skip!

Hi Mat . . .
I met you in later February, and signed up for the gym/personal trainer program, and have been coming three times a week ever since. Since I am 73 years old, I had no idea how long it would take, or  what it would cost . . . but I knew that I had to get back into  something to preserve my body and mind, or continue downhill.

I wanted to significantly improve my life.

Skip

Long-Term Care Insurance: Know the facts early

Written by: Leanne Flesch

Caring for an ill family member can be emotionally, physically and financially exhausting if your resources are limited and you are not prepared. No one really wants to think about a time when they may need assistance with care. Nonetheless, an estimated 43% of Americans will spend time in a nursing home and studies estimate that 50% of 65-year-olds will likely need nursing home care in the future.

What is Long-Term Care (LTC) insurance?
Long-Term Care (LTC) insurance covers someone with a prolonged physical illness, a disability or a cognitive impairment such as Alzheimer’s Dementia. It can pay for care in a patient’s home, assisted living, board and care and in skilled nursing facilities. Many people believe that Medicare will cover all of their needs should they become seriously ill and require daily assistance. However, Medicare and regular health insurance only pay for a very small percentage of nursing home costs and generally only when you are receiving medical or rehabilitative services. The average cost of nursing home care in California can range from $150 – $200 a day depending on need.

Before you purchase a policy there are many things you ought to consider. First and foremost, can you afford the premium now and in the future? Will you still be able to eat and pay your monthly bills? A big consideration is your financial health. If you own your home outright and have money in the bank, LTC insurance can help you protect it, should you become ill and need care. You should also consider your age, status of your health and any pre-existing conditions that could disqualify you.

What to look for in a LTC insurance policy

• What is the maximum daily and lifetime benefit?
• How long is the elimination period, and is there more than one?
• What services are covered? A good policy will cover nursing homes, assisted living facilities and some home care assistance.
• How is the policy activated and how are you reimbursed, once a claim is approved?
• What is the company’s financial standing and track record?

More information
Becoming informed on the issue is the best thing you can do to protect your future. Talk to more than one agent as well as friends and family about your options. The patient advocates at Health CPA offer low cost health insurance planning and selection.

In addition
The California Department on Aging publishes a booklet on long-term care called “Taking Care of Tomorrow” that provides detailed information on long-term care issues.

The Health Insurance Counseling and Advocacy Program sponsored by the Department of Aging provides free counseling on long-term care insurance.

Memory and Aging

Written by: Dr. Marcia Whalen

Does it seem like you’re always looking for your keys when you walk out the door now? Are you repeating yourself during conversations or can’t remember small details? Are you concerned that your memory is getting worse?

A certain amount of memory decline is to be expected as our brains age but when should you be worried about significant “cognitive impairment” that may need medical intervention? At Personalcare Physicians, we are utilizing a diagnostic screening tool that can identify this subtle memory loss and distinguish normal aging from abnormal memory loss.  By detecting any signs of mild cognitive impairment of the brain early, we can help you to find and treat the cause.

The MCI Screen is designed to accurately measure an individual’s memory function. This short, accurate memory test can be performed in the comfort of our office. Answers are analyzed by a computerized scoring method with results provided to your physician to review with you. This diagnostic tool enables a physician to distinguish normal aging from subtle memory changes due to other medical causes. It is about 97% accurate.

Conditions such as anxiety, sleep deprivation, ADHD, depression, thyroid gland disease, diabetes, metabolic encephalopathy, Vitamin deficiency, infections and medications can cause significant memory loss. The effects can often be reversed after finding the cause and with the appropriate treatment.

Alzheimer’s Disease, Parkinson’s Disease and dementia are the first culprits patients associate with memory loss, and usually the worst case scenario. Through early diagnosis and treatment, doctors can work towards a reduced rate of memory decline and often allow patients to continue living a good quality of life for a long time.

A complete list of what may cause memory loss is available here, but in the meantime, take the following short test for yourself. Check off any of the following if you have found you are having increasing difficulty with the tasks.

Symptoms of Medical Conditions:

• Forgetting important details of things you have done in the past few weeks.
• Forgetting to do things you said you would do.
• Forgetting recent events or conversations.
• Retelling a story or joke to the same person because you forgot that I had already told them.
• Completing complex tasks at work or home (i.e. balancing checkbook, planning projects).

Symptoms of Normal Aging:

• Forgetting the name of someone you know well.
• Forgetting what you were going to say in a conversation.
• Forgetting what you were going to do when going into another room.
• Finding things you have just put down.
• Recalling a specific word you want to use.

If you’re worried about memory loss, give your personal physician a call to speak about options and possibly taking the short MCI Screen.

Prostate Cancer Awareness Month

Written by: Dr. David Bloom

Prostate cancer is the most common form of cancer in men across the country. September is Prostate Cancer Awareness Month and it is more important than ever to be aware of the warning signs and protect yourself and those you love with regular screenings.

Prostate Cancer is second only to lung cancer in the number of cancer deaths in the United States. The prostate organ is only in men, about the size of a walnut and occupies the space just below the bladder in the body. It plays a role in the reproductive system, but when cancer starts in the prostate, abnormal cells begin to grow out of control and may cause pain or other inhibit other bodily functions.

Although some men may not display any symptoms, others may experience difficulty before, during or after urination, continuous pain in the back, hips or lower pelvis or painful sexual activity.

If you have any symptoms that worry you, please visit your primary care doctor.  Identified early on, five-year survival rates are upwards of 97%.  Most prostate symptoms that men will notice are usually not cancer and more likely from Benign Prostatic Hypertrophy (benign enlargement) or possibly Prostatitis (swelling, inflammation, possible infection).  But to differentiate and exclude cancer first is very important and thus a doctors visit or better yet, a complete full physical

A screening a fast and easy for patients and only have to be often as you and your doctor decide.   It is important to start screening early if there is a family history of prostate cancer, as well as with African-American men.  Most doctors begin the PSA blood test at age 50, but depending upon the indivdual patient’s histroy & physical, his doctor may begin younger – usually age 40.

Flu vaccines are in!

Written by: Dr. Marcia Whalen

Our yearly supplies of flu vaccines are coming in!  Please give us a call at (949) 706-3300 or contact us via this website to schedule an appointment.

Who Should Consider the Flu Vaccine This Year?

Infants and children 6 months and older should get a flu vaccine each year for  the 2011-2012 influenza season. CDC’s Advisory Committee on Immunization Practices (ACIP) voted for “universal” flu vaccination  last year in the U.S. to expand protection against the flu to more people.

Potential High-Risk Groups:  While everyone should get a flu vaccine each flu season, it’s especially important that the following groups get vaccinated either because they are at high risk of having serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications:

• Pregnant women
• Children younger than 5, but especially children younger than 2 years old
• People 50 years of age and older
• People of any age with certain chronic medical conditions
• People who live in nursing homes and other long-term care facilities
• People who live with or care for those at high risk for complications from flu, including:   Health care workers, household contacts of persons at high risk for complications from the flu, household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Vaccines We Have Available:

• Flu shot — an inactivated vaccine (containing killed virus) that is given with a needle, sometimes a micro needle, in the arm. The flu shot is approved for use in people 6 months of age and older, including healthy people, people with chronic medical conditions, and pregnant women.
• Nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). LAIV is approved for use in healthy* people 2-49 years of age who are not pregnant.
• High dose Fluzone –  sometimes indicated for 65 years of age and older

* “Healthy” indicates persons who do not have an underlying medical condition that predisposes them to influenza complications.