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Vitamins You Need as You Age

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Vitamins You Need as You Age

senior man drinking milk


With age, you can start to lose more of this mineral than you absorb. That can make your bones break more easily (osteoporosis), especially for women after menopause. Calcium helps your muscles, nerves, cells, and blood vessels work right. You get most of it from your bones, which get it from food. Women over 50 and men over 70 should get about 20% more than other adults. Milk, yogurt, and cheese are good sources.
grilled striploin steak

Vitamin B12

It helps make blood and nerve cells. You get it naturally from animal foods like meat, fish, eggs, and dairy. Pills, shots, and “B12-fortified” foods, like breakfast cereal, are other sources. Most Americans eat enough, but age can change that. Up to 30% of people over 50 have atrophic gastritis, which makes it harder for your body to absorb it from foods. Antacids, some meds, and weight loss surgery can contribute to a lack of B12.

Vitamin D

Your body needs it to absorb calcium. So take them in tandem to help prevent osteoporosis. Vitamin D also helps your muscles, nerves, and immune system work right. Most people get some vitamin D from sunlight. But your body is less able to convert sun’s rays to vitamin D as you age. It’s harder to get this vitamin from foods, but fatty fish like salmon, mackerel, and sardines are a good source.

Vitamin B6

Your body uses it to fight germs and to make energy. It also helps babies’ brains grow. You need more B6 as you get older. Some studies have found links between high B6 blood levels in seniors and better memory. But the vitamin doesn’t seem to improve mental abilities in people with dementia. Chickpeas are an easy and inexpensive source. So are liver, fatty fish and fortified breakfast cereals.
mature couple eating salad


It helps your body make protein and bone, and it keeps your blood sugar stable. You can get it from nuts, seeds, and leafy greens. But older people tend to eat less of it. Plus, they’re more likely to have long-term health conditions or take many medications, both of which may leave you short of magnesium.


These “friendly” bacteria are good for your gut. You get them from fermented foods like yogurt or sauerkraut, or from supplements. They can help with digestive issues like diarrhea or irritable bowel syndrome, and may even protect against allergies. Probiotics are likely safe if you’re healthy. But talk to your doctor first if you have any medical issues or a weakened immune system.
salmon planks


These fatty acids are called “essential” because your body can’t make them. They’re important for your eyes, brain, and sperm cells. They also could help protect against age-related disease like Alzheimer’s, arthritis, and macular degeneration, which can cause blindness. Unless your doctor says otherwise, it’s best to get your omega-3s from food like fatty fish, walnuts, canola oil, or flaxseed.
oyster plate


Many American seniors don’t get enough of this underappreciated micronutrient. It helps your sense of smell and taste, and fights infections and inflammation — all important jobs in older bodies. Zinc also may protect your vision. Oysters are far and away the best source of this mineral. Otherwise, you can get it from beef, crab, and fortified breakfast cereals.
brazil nuts


It protects your cells from damage and infection, and keeps your thyroid working the right way. Selenium also can keep your muscles strong, and may help prevent age-linked illnesses like dementia, some types of cancer, and thyroid disease. Just one or two Brazil nuts a day should be enough. Don’t overdo it. Too much selenium can make your hair fall out and turn your nails brittle.
dried apricots


Potassium plays a part in almost everything inside your body, including your heart, kidneys, muscles, and nerves. It also may help protect against stroke, high blood pressure, and osteoporosis. Many Americans don’t get enough. Dried apricots, bananas, spinach, milk, and yogurt are good sources. Ask your doctor before you take supplements. They can interfere with medications for high blood pressure, migraine, and other conditions.
vegetarian salad


This natural form of vitamin B9 is in leafy greens, nuts, beans, and other foods. Pregnant women take a lab-made form of vitamin B9 called folic acid to help prevent birth defects. Folate helps with cell growth and may protect against stroke and certain cancers. Most Americans get enough. Folate found in foods is safe. But too much folic acid from supplements or fortified foods can raise your odds of having colon cancer or nerve damage.
oatmeal and raspberries


You probably know fiber is good for you. But did you know it’s even more important as you age? Fiber helps protect against strokes, helps you poop more regularly, and lowers your cholesterol and blood sugar — big benefits in older bodies. Women over 50 should get at least 21 grams a day, while men need 30 grams, but most people don’t get that much. That’s equal to about 6-8 servings of whole grains, or 8-10 servings of vegetables.

Where to Get Them

Whether it’s vitamins, minerals, or fiber, it’s best to get them from foods instead of pills. But that can be a challenge for some older Americans, especially if you don’t eat a balanced diet. You’re most likely to lack vitamin D, potassium, calcium, or dietary fiber. If you think you need more than you can get from food, talk to your doctor about supplements that will be safe with your meds, diet, and health.


There’s little, if any, proof that multivitamins benefit seniors who are otherwise healthy. The U.S. Preventive Services Task Force recommends against daily multivitamins to ward off cancer or heart disease. Multivitamins marketed at seniors may be tailored with higher doses of vitamins D or B12 or less iron. But unless you have a poor appetite or have conditions that keep you from eating a healthy diet, you probably don’t need them.

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As Americans get heavier, obesity-linked cancers may strike earlier

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As Americans get heavier, obesity-linked cancers may strike earlier
Linda Carroll

Increasing numbers of middle-aged Americans appear to be developing cancers that can be associated with obesity, new data suggest.

And the increase in these cancers among 50- to 64-year-olds parallels the rising rates of obesity, researchers say.

In their analysis of more than six million cancer cases, researchers found that obesity-associated cancers appeared to be shifting to younger people, including those under 50, according to the report published in JAMA Network Open.

Obesity creates a state of constant low-grade inflammation, as well as multiple growth stimulating factors, all of which can accelerate the development of cancer,” explained the study’s lead author, Siran Koroukian, an associate professor in the department of population and quantitative Health Sciences at the Case Western Reserve University School of Medicine and director of the Population Cancer Analytics Shared Resource at Case Comprehensive Cancer Center, both in Cleveland, Ohio.

It’s possible that people can impact their cancer risk by watching their weight, Koroukian said in an email. “There is some evidence that weight loss (among those who are obese) can prevent the development of cancer,” she added. “The most important strategy is maintaining a normal weight.”

To take a closer look at the impact of obesity on cancer risk, Koroukian and her colleagues turned to data from the Surveillance, Epidemiology and End Results 18 (SEER18) database, focusing on cancer cases diagnosed from 2000 through 2016. The database is nationally representative and covers geographically diverse regions of the country.

The researchers looked for trends in the percentage of cases diagnosed in three age groups: 20-49, 50-64 and 65 and older.

Obesity-associated cancers considered by the researchers included myeloma, female breast cancer and cancers of the colon and rectum, gallbladder, esophagus, stomach, liver, pancreas, uterus, kidney and thyroid.

Among the more than 6 million cases, 43.6% were obesity-associated cancers.

“There are so many other factors that could be affecting trends and movements in cancer incidence,” Labow said. For example, the trend could be explained by the kinds of foods people are eating, he added.

“A high animal fat diet and lots of processed foods certainly could be contributing,” Labow said. Nevertheless, “obesity is not good for many different things so we should be working on decreasing it and it would be nice if we also saw a downstream trend of reduction of cancers,” he added.

Dr. Jian-Min Yuan agrees that there could be many factors that changed over time besides obesity. “A person who was a teen in the late 70s to early 80s, might have experienced a lifestyle change,” Yuan said. “Maybe they were more stressed. Maybe they ate a lot more meat and consumed less fiber. They could have consumed more alcohol. Their sleeping patterns might have changed in that era because of a much faster modern lifestyle.”

SOURCE: bit.ly/309TASU JAMA Network Open, online August 14, 2019

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The Truth About Carbs

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The Truth About Carbs

carbohydrate rich foods

fatWhat Are Carbs?

They’re one of three types of food that give your body energy. The other two are proteins and fats. Together, they provide the fuel your body uses to build and repair itself. Carbs break down into glucose (sugar) that you can use right away.

Your Body’s Fuel

Your body runs on glucose. Your brain, in particular, needs it to work the way it should. Carbohydrates are an almost instant source of it. Your body can break down and use fat for some of the same needs, but not all of them. Plus, fat that’s used for fuel makes compounds called ketones that can raise the level of acid in your blood, and that can be unhealthy over the long term.

Workout Prep

Because carbs are a source of energy, they can keep you going strong while you exercise. Experts recommend fueling up 1 to 3 hours beforehand with a combination of carbs and protein, like oatmeal, Greek yogurt, peanut butter, or nuts and raisins.
fruits vegetables grains triptych

Full of Nutrients

The best-quality carbs — berries, vegetables, and whole grains — are packed with vitamins, fiber, and antioxidants that are important for good health and well-being. Whole grains have fatty acids, magnesium, B vitamins, folate, and zinc. Fruit and starchy veggies have some of those, plus phytonutrients like flavonoids and carotenoids that help prevent disease. If you skip the carbs, you lose out on those nutrients, too.
dessert tray

Simple Carbs

Think of table sugar as simple carbs in pure form. They’re very small molecules, which makes them especially easy for your body to break down and use. That means they raise your glucose levels (blood sugar) really fast. Things that sweeten any number of candies, pastries, and desserts are loaded with these kinds of carbs.
bread pasta beans potatoes

Complex Carbs

String together a bunch of simple carbs, and you get these larger molecules. Your body has to break them down into simple carbohydrates and then into glucose before it can use them. This takes longer, which means your blood sugar goes up more slowly and they’re less likely to be changed into fat. These kinds of carbs include multigrain breads and pasta, beans, potatoes, and other vegetables.
liver anatomy

Storage Tank

Before your body turns leftover glucose from carbs into fat, it stores what it can in your liver in the form of glycogen. This keeps your body going between meals. But your liver can only keep a day or so’s worth at a time. 
fat cells micrograph

If You Have Too Many

If you overdo the carbs, your blood sugar levels can get too high. This causes your body to make more insulin, which tells your cells to save the extra glucose as fat. That can be unhealthy if you’re already carrying a few extra pounds. It can lead to diabetes and other related health issues.

If You Don’t Have Enough

If there aren’t enough carbs in your diet, you could get constipated from lack of fiber and nutrients. Your body is also forced to use protein or fat for energy. Proteins are the building blocks of the body. If you use them as fuel, you may not have enough left to make more cells and keep them healthy.
healthy complex carbs plate

The Right Amount

The number of carbs you need can depend on your gender, size, and how active you are — and that can change as you get older. But as a general rule, about half your daily calories should come from carbs in fruits, vegetables, grains, beans, and dairy products. Just make sure to go with healthy, complex carbs and don’t overdo the simple ones.
ketogenic diet foods

Low-Carb Diets

In theory, fewer carbs mean less sugar. And “ketogenic” diets have been shown to help some people lose weight and control their blood sugar in the short term. But these diets include lots of protein, and your body may need to use stored calcium to digest it. Plus, digesting lots of protein can be hard on your kidneys over time. You also tend to eat more saturated fat to replace the carbs, and that can be unhealthy in the long term, too.

Diabetes and Carbs

If you have this disease, you need to watch your carbs carefully because your body has trouble keeping your blood sugar at a safe level. If you have too many, your body may not be able to bring your blood sugar down quickly enough. But if your blood sugar gets too low, a glass of juice or another simple carb might be just the thing to kick it back up again. If you have diabetes, talk with your doctor about the best way to manage carbs.
six panel food comparison

Where to Get Healthy Carbs

Look for unrefined whole grains like quinoa, rye, and barley instead of highly processed white bread and pastries. Whole unprocessed fruits and vegetables are better than clear juices (clear juice = the liquid part of the juice without the pulp and fiber). And it’s a good idea to pass on the high-carb potato foods, especially french fries, in favor of beans, chickpeas, and other legumes.

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Surgeons not good at predicting benefit from knee operations

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Surgeons not good at predicting benefit from knee operations
Lisa Rapaport

(Reuters Health) – Surgeons are no better at determining which patients might benefit from operations to treat torn knee cartilage than if they just flipped a coin, a new study suggests.

Researchers surveyed 194 surgeons to see whether they would recommend surgery or exercise therapy in 20 test cases with middle-aged patients who had tears in the meniscus, the cartilage that works as a cushion between the shin and thigh bones.

Researchers created test cases based on actual patients to see whether the surgeons could accurately predict who would benefit the most, or least, from surgery or from exercise therapy.

Overall, surgeons correctly predicted which patients would benefit from operations only half of the time. And experienced knee surgeons were no better at guessing correctly than other orthopedic surgeons.

These findings offer one reason these knee operations remain common despite a growing body of evidence suggesting many patients don’t benefit, said Dr. Victor van de Graaf, lead author of the study and a researcher at University Medical Centre, Utrecht, in the Netherlands.

“Orthopedic surgeons believe they are capable of identifying which patients may still benefit more from surgery,” van de Graff said by email. “Therefore, our findings may help to further decrease the number of unnecessary performed surgeries.”

During the operation, a surgeon makes a small incision in the knee and inserts a tiny camera called an arthroscope to view the inside of the joint, locate and diagnose the problem, and guide repairs. Sometimes surgeons remove all of the meniscus, and other times they only remove part of it.

While the procedure is minimally invasive, it’s not risk-free. Patients receive anesthesia, which in any surgery may lead to complications such as allergic reactions or breathing difficulties. In addition, this specific procedure might potentially damage the knee or trigger blood clots in the leg.

To understand how accurately surgeons could predict patient outcomes, researchers asked a series of questions for each of the 20 patient cases. They asked whether patients should get surgery or physical therapy; what amount of improvement or deterioration would be expected in function after two years; and what level of function patients would have if they went with the treatment surgeons didn’t recommend.

Surgeons were more likely to make correct predictions about who would benefit from knee operations or physical therapy, but more likely to be wrong about which patients would not benefit from the treatments.

Among patients who didn’t respond to surgery, only 39% of the surgeons correctly foresaw this outcome. And among patients who didn’t respond to exercise therapy, only 29% of surgeons correctly predicted this outcome.

For patients who did benefit from surgery, surgeons correctly predicted this outcome 60% of the time. And for patients who benefited from physical therapy, surgeons correctly chose this outcome in 72% of cases.

One limitation of the study is that the 20 sample cases presented to surgeons don’t reflect how surgeons would interact with patients and make treatment decisions in real life, the study team notes in the British Journal of Sports Medicine.

Very few surgeons asked to participate in the study agreed to do so, and it’s possible the results don’t reflect what would happen with a larger group of surgeons.

But given how poor the participating surgeons were at guessing who might benefit from surgery, it makes sense for patients to only consider this option when chiropractic or physical therapy doesn’t work, the study team writes.

In the same journal, a study published in June went further, concluding that it’s impossible to predict who might benefit from arthroscopic meniscus repair surgery.

Kenneth Pihl of the University of Southern Denmark in Odense and his colleagues built a model based on the real-world outcomes after one year for 641 patients who had undergone the surgery. Out of 18 preoperative factors that surgeons and the medical literature consider predictive of who will benefit, none predicted the actual results for these patients, Pihl’s team found.

SOURCE: bit.ly/2Mk7Dlk and bit.ly/2H819lC British Journal of Sports Medicine, online August 1, 2019 and June 11, 2019.

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Dr. Lane’s Thoughts XV

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1) A great writer wrote this “There is a cult of ignorance in the United States, and there always has been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that ‘my ignorance is just as good as your knowledge’.” —Isaac Asimov, January 21, 1980

2) The wellness advice revolution seems to be based on people telling you what is wrong with you, emphasizing that this is a dilemma you need to face up to and… selling you something to ‘cure’ this dilemma in you life.  As my brother would say ” creating a problem and solving it”.  Please tell me if I am naive but I must be honest about this blog – I have no agenda!  I have never considered selling anything to assist people in facing the health concerns that I bring to your attention.  I am just happy informing people so that they can make better health choices.

Much like the medical issues that I bring to the attention of my CDL holders – “I need you to live forever so that I can do your CDL medical exams.  Dead people almost never pay me!”  Yes, you should keep your diabetes and high blood pressure under control.  You should eat right and you should learn to take control of your well-being.  You should make choices about how you want to live.

3) Recently it was brought to my attention that one of my CDL patients had committed suicide.  You may be surprised that I am also going to tell you that this was a ‘silent suicide’ and will never be classified as a suicide.  He chose to let his body kill him by walking away from his constant vigilance about his blood pressure and his wife’s nagging him about making life choices.
Ostensibly, he died of a heart attack while driving his truck.  A more complete explanation: he left his wife and stopped taking his medication.  I recall that he needed multiple visits to pass the blood pressure exam in my office – a simple 140/90 was nearly impossible for him to achieve.  It would be speculation on my part but I imagine that the lifestyle changes he was required to do and his wife’s desire to keep him alive by forcing food changes and vigilance about avoiding bad food choices left him to desire to live out his life without constraints and, ultimately, this is what caused his heart to fail on some road in Florida.

4) Recently Trump’s ICE agents (I think of them as only his because their new-found level of brutality came with his presidency) picked up a bunch of illegal immigrant people working at some business somewhere in the United States.

I am being purposely vague here for a reason.  The details don’t matter!  It does not matter which business they were working at; it does not matter which state I am talking about here.

INS/ICE can always find these people because all they have to do is go to some business which employs many people from other countries who are willing to do a job ‘Americans’ won’t do: factories, farms, any job that pays poorly and has harsh working conditions.

And why do I make this point?  THESE PEOPLE ARE WORKING!!!

Can you imagine how hard it would be to find illegal immigrants if they were homeless and living on the streets?  The job of finding them is easy because they are all in the same place – HOLDING JOBS!!!

REMINDER: holding jobs that most Americans won’t do.

The USA is blessed to have these people doing these jobs, their employers will now have trouble filling those same jobs, and everyone will be harmed.

You want to know another job that these illegals immigrants are willing to do that most Americans won’t do?  Working for Donald Trump at one of his resorts [true:  it is all over the news how he had many illegal immigrant employees and he knew it].

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Conditions That Affect Men and Women Differently

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Conditions That Affect Men and Women Differently

illustration of heart

Heart Attack

The telltale heart attack sign of feeling like there’s an elephant sitting on your chest isn’t as common in women as it is in men. Many women feel upper back pressure, jaw pain, and are short of breath. Or they may feel nauseated and dizzy instead. Though heart disease is the leading cause of death for both genders in the U.S., women are more likely to die after they have a heart attack.
photo of multiple sclerosis at micro level

Multiple Sclerosis

Diseases that affect the immune system are often more severe in men. For example, MS affects many more women than men overall, but when it comes to the progressive form (PPMS), men get it in equal numbers to women. PPMS tends to be harder to diagnose and treat than the relapsing remitting form of MS.
illustration of stroke in brain

Heart Attack

The telltale heart attack sign of feeling like there’s an elephant sitting on your chest isn’t as common in women as it is in men. Many women feel upper back pressure, jaw pain, and are short of breath. Or they may feel nauseated and dizzy instead. Though heart disease is the leading cause of death for both genders in the U.S., women are more likely to die after they have a heart attack.
photo of multiple sclerosis at micro level

Multiple Sclerosis

Diseases that affect the immune system are often more severe in men. For example, MS affects many more women than men overall, but when it comes to the progressive form (PPMS), men get it in equal numbers to women. PPMS tends to be harder to diagnose and treat than the relapsing remitting form of MS.
illustration of stroke in brain


Nearly 55,000 more women than men have strokes each year in the U.S. Common symptoms are sudden weakness on one side, loss of speech and balance, and confusion. But women often have additional or different symptoms: fainting, agitation, hallucinations, vomiting, pain, hiccups, and seizures. Women typically have a worse recovery after a stroke, too. 
photo of intimate couple


Women are less likely to have symptoms with sexually transmitted diseases (STDs) like chlamydia and gonorrhea. STDs can also lead to chronic pelvic inflammatory disease in women, causing fertility issues. Men seldom have such complications. The human papillomavirus (HPV) is also the main cause of cervical cancer in women, but it doesn’t pose a similar risk for men.
photo of balding man

Hair Loss

Men are far more likely to lose hair as they age than women. Some 40% of women will have hair thinning or hair loss, but 85% of men will have thinning hair by age 50. Men tend to lose hair in the same pattern — their hairline goes farther and farther back. (This is called a receding hairline.) They may also get a bald spot on the crown of their head. Women have either thinning all over or random bald patches.
photo of acne on jawline


Hormones are often to blame for acne. Because women’s hormones shift during periods, pregnancy, and throughout menopause, they’re more prone to adult acne than men. Treatment can vary based on your sex, too. Doctors tend to prescribe meds that control hormones, like birth control, for women. Creams that you rub onto your skin are more common for men.
photo of woman crying


Women are more likely to say they’re stressed than men. Both sexes feel anger,  crankiness, and muscle tension at near the same rates from stress, but women more often say it causes a headache, upset stomach, or makes them feel like they need to cry. Men are less likely to feel physical symptoms during times of stress than women. 
photo of restroom sign


Although women tend to get urinary tract infections (UTIs) more often, men’s UTIs are more complicated. They have different causes, too. Women most often get them because of bacteria from sex or poop (their urethra is shorter and closer to that area). Men’s UTIs are more likely to arise from something that blocks their urine stream, like an enlarged prostate or kidney stones.
photo of woman sleeping in bed


More women live with chronic pain (pain that lasts longer than 6 months and doesn’t seem to respond to treatment) than men. Their pain also tends to last longer and be more intense. Doctors are still trying to figure out why, but they think differences in hormones between the sexes may be to blame. 
photo of doctor with xray


Because women are more likely to get osteoporosis, it’s often overlooked in men. But men who have this lack of bone density and break a hip are twice as likely to die than women with osteoporosis who break a hip.

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A Visual Guide to Sciatica

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A Visual Guide to Sciatica

What Is Sciatica?

Illustration showing sciatica location

Sciatica refers to back pain caused by a problem with the sciatic nerve. This is a large nerve that runs from the lower back down the back of each leg. When something injures or puts pressure on the sciatic nerve, it can cause pain in the lower back that spreads to the hip, buttocks, and leg. Up to 90% of people recover from sciatica without surgery.
Man suffering from sciatica

Symptoms of Sciatica

The most common symptom of sciatica is lower back pain that extends through the hip and buttock and down one leg. The pain usually affects only one leg and may get worse when you sit, cough, or sneeze. The leg may also feel numb, weak, or tingly at times. The symptoms of sciatica tend to appear suddenly and can last for days or weeks.

Sciatica or Other Back Pain?

Up to 85% of Americans experience some type of back pain during their lives. But this doesn’t always involve the sciatic nerve. In many cases, back pain is the result of overextending or straining the muscles in the lower back. What most often sets sciatica apart is the way the pain radiates down the leg and into the foot. It may feel like a bad leg cramp that lasts for days.

Who Gets Sciatica?

Most people who get sciatica are between the ages of 30 and 50. Women may be more likely to develop the problem during pregnancy because of pressure on the sciatic nerve from the developing uterus. Other causes include a herniated disk and degenerative arthritis of the spine.

Cut away of slipped disc

Cause: Herniated Disk

The most common cause of sciatica is a herniated disk. Disks act like cushions between the vertebrae of your spine. These disks get weaker as you age and become more vulnerable to injury. Sometimes the gel-like center of a disk pushes through its outer lining and presses on the roots of the sciatic nerve. About 1 in 50 people will get a herniated disk at some point in life. Up to a quarter of them will have symptoms that last more than 6 weeks.
Spinal stenosis

Cause: Spinal Stenosis

Natural wear and tear of the vertebrae can lead to a narrowing of the spinal canal. This narrowing, called spinal stenosis, may put pressure on the roots of the sciatic nerve. Spinal stenosis is more common in adults over age 60.

MRI of spinal tumor

Cause: Spinal Tumors

In rare cases, sciatica may result from tumors growing inside or along the spinal cord or sciatic nerve. As a tumor grows, it may put pressure on the nerves that branch off from the spinal cord.
Compressed piriformis muscle

Cause: Piriformis Syndrome

The piriformis is a muscle found deep inside the buttocks. It connects the lower spine to the upper thighbone and runs directly over the sciatic nerve. If this muscle goes into spasm, it can put pressure on the sciatic nerve, triggering symptoms of sciatica. Piriformis syndrome is more common in women.
Man removing his wallet

A Fat Wallet Can Trigger Piriformis

You might not think of too much cash as a source of pain, but a fat wallet can trigger piriformis syndrome. The condition can affect men who wear their wallet in the back pocket of their pants. This puts chronic pressure on the piriformis muscle and can aggravate the sciatic nerve over time. You can avoid this problem by keeping your wallet in a front pocket or jacket pocket.

Cause: Sacroiliitis

Sacroiliitis is an inflammation of one or both of the sacroiliac joints, the spot where the lower spine connects to the pelvis. Sacroiliitis can cause pain in the buttocks, lower back, and may even extend down one or both legs. The pain can worsen with prolonged standing or climbing stairs. Sacroiliitis can be caused by arthritis, injury, pregnancy, or infection.

Cause: Injury or Infection

Other causes of sciatica include muscle inflammation, infection, or injury, such as a fracture. In general, any condition that irritates or compresses the sciatic nerve can trigger symptoms. In some cases, no specific cause of sciatica can be found.

Sciatica exam

Diagnosing Sciatica: Exam

To determine whether you have sciatica, your doctor will ask you how the pain started and where exactly it is located. You may be asked to squat, walk on your heels or toes, or raise your leg without bending the knee. These muscle tests can help your doctor determine if it is the sciatic nerve that is irritated.

Diagnosing Sciatica: Imaging

Your doctor may order imaging tests, such as an MRI, to get more information about the location and cause of the irritated nerve. An MRI can show the alignment of vertebral disks, ligaments, and muscles. A CT scan using contrast dye can also provide a useful picture of the spinal cord and nerves. Determining the cause of sciatica can help guide the course of treatment. X-rays can help identify bony abnormalities but can’t detect nerve problems.

Complications Related to Sciatica

If you develop a loss of bladder or bowel control, contact your doctor right away. This can be a sign of a medical emergency that requires surgery to avoid permanent damage. Fortunately, this complication is rare. Most cases of sciatica go away within a few days or weeks and cause no lasting harm.
Pain relieving compress

Sciatica Relief: Ice and Heat

There are steps you can take at home to ease the pain of sciatica. A heating pad or ice pack may be especially helpful. Apply the heat or ice for about 20 minutes every two hours. Experiment to see which provides more relief, or try alternating between the two.

Sciatica Relief: Medication

Over-the-counter pain relievers can provide short-term relief from sciatica. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen are options. Your doctor may give you a steroid injection to further reduce the inflammation.
Woman stretching out

Sciatica Relief: Stretching

While sciatica is healing, try to remain active. Motion can actually help reduce inflammation and pain. A physical therapist can show you how to gently stretch the hamstring and lower back. Practicing tai chi or yoga can help stabilize the affected area and strengthen your core. Depending on your medical condition, certain exercises may not be recommended. Your doctor may also recommend taking short walks.
Physical therapy after sciatica surgery

Complementary Therapies

There is evidence that chiropractic adjustments , acupuncture, massage, and yoga can relieve typical lower back pain. 

Sciatica Rehab

After back surgery, you will generally need to avoid driving, lifting, or bending forward for about a month. Your doctor may recommend physical therapy to help you strengthen the muscles in the back. Once recovery is complete, there’s an excellent chance you’ll be able to get back to all your usual activities.
Steroid injection to help with sciatica pain

Sciatica Relief: Injections

In severe cases, a doctor may recommend injecting steroids into the spine area to reduce inflammation. It delivers the medication directly to the area around the sciatic nerve.
Sciatica surgery in progress

Sciatica Relief: Surgery

If your sciatica is due to a herniated disk, and it’s still causing severe pain after four to six weeks, a last resort could be surgery as an an option. The surgeon will remove a portion of the herniated disk to relieve the pressure on the sciatic nerve. About 50% of patients get immediate relief from this type of surgery but this is because it is delicate surgery.  90% of the operations bring relief for many years afterward. Other surgical procedures can relieve sciatica caused by spinal stenosis.

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Get your vaccines!

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Get your vaccines!

I have been reading a great deal about people being wary of vaccines.  I have heard many unscientific people with no credentials (or questionable credentials) stating their “truth” about vaccines being dangerous.  The worst was a recent article (August 2019) in the leading chiropractic journal, Dynamic Chiropractic, called “Why We Worry About Vaccines” citing “1,200” anti-vaccine studies (the writer does not cite a single study of any merit or from a peer-reviewed journal which is considered the ‘gold standard’ of professional authorship).  He utilizes exclusively the writings of self-published ‘professionals’ and websites.

I agree with only a sliver of what he has written which is this: the way vaccines are made may be an issue that needs to be explored and safety should always be the greater goal.  In brief: vaccines are good and safety in their preparation should be the most important factor.

Most of his exhaustive writing (*sir, please consider getting an editor and/or learning that ‘stream-of-conciousness’ writing only works for journals describing the impact of religion or hallucinogenic drugs*) does discuss the additive to vaccines that could be an issue without any discussion about whether vaccines work.

The hardest part of writing my thoughts about people getting vaccines is controlling myself from calling anti-vaxxers what they are: fools and idiots.

People – get your kids vaccinated!

You don’t need me to tell you to do something that you don’t believe in.  No, you are too smart to listen to me – I understand that.  Still, there is someone you should talk to – any poerson you can find who is over 75 years old.  That is all I ask – find any person, related to you or not, and ask them one question.  I am not even going to tell you how to phrase the question or the words to use.  All you need to ask is something about what life was like before most children were vaccinated in the United States.

How about something like this, “Grandma, what was the United States like before kids were vaccinated?”  You can even toss in the words that ant-vaxxers like, such as “forced to be vaccinated” or “vaccinated against their will” or “vaccinated against God’s plan” or however you want to word it.  Make the movement in the United States sound as evil as you think it is – the words don’t really matter in my request.

This is probably what you will hear” “it was horrible before kids were vaccinated!  I lost my (brother, cousin, neighbor, friend) to (measles, rubella, scarlet fever, polio)”.  Something like that.

Ask any person of any age from the countries of Pakistan, India, or parts of Latin America, or Sub-Saharan Africa, especially if they are from a small village.  Ask any of them, young or old.  You will learn that fathers would give up a month’s wages to ensure that his children were vaccinated from diseases – vaccinations that are included free under your health insurance!  Even where college is not the means to employment, where subsistence is a way of life they all understand how important vaccines are

Get your kids vaccinated!

I have heard every excuse from every angle – I am a chiropractor so I have heard my colleagues argue against vaccines as being medicine.  Befoe I became a DC I got a Masters in Public Health (MPH) and I know about the history of vaccinations and the lives saved.  I am also the last child of older parents so my mother recalled the stories of children in iron lungs from polio, neighbors who died from communicable diseases, and aunts and uncles who did not live beyond their teens.

Get your kids vaccinated!

I could be Darwinian here and tell people to do whatever they want to their children and let death be the final decider for the parents but I am a healthcare provider and spend my days counseling people to get  treated for diabetes and high blood pressure.  If I speak to adults about their own health it would be disengenous for me to not speak up for the children who have their health decisions decided by those same parents.

These are the same parents who keep their dogs vaccinated and their houses maintained so I think that their kids should be maintained as well.

Still, if you don’t want to vaccinate your kids then you should be proud enough to announce it to the world by having your kids carry a sign or wear a pin that says “I AM NOT VACCINATED”.

That way I can avoid you and your kids.

Get your kids vaccinated.  Please.  Give them a chance to live a healthy life.

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New Alzheimer’s Blood Test 94% Accurate

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New Alzheimer’s Blood Test 94% Accurate

A new blood test to detect brain changes emblematic of early Alzheimer’s disease (AD) has moved one step closer to reality and could be a “game changer” for the field.
Researchers found that measuring the ratio of β-amyloid (Aβ) 42 and Aβ40 in blood using a high-precision assay is 94% accurate in diagnosing brain amyloidosis, using amyloid PET or CSF phosphorylated (p-tau) 181/Aβ42 as reference standards.
“Right now we screen people for clinical trials with brain scans, which is time-consuming and expensive, and enrolling participants takes years,” senior investigator Randall J. Bateman, MD, professor of neurology, Washington University School of Medicine in St. Louis, said in a statement.
“But with a blood test, we could potentially screen thousands of people a month. That means we can more efficiently enroll participants in clinical trials, which will help us find treatments faster, and could have an enormous impact on the cost of the disease as well as the human suffering that goes with it,” he added.
The study was published online August 1 in Neurology.

As reported by Medscape Medical News, the study builds on earlier work by the same researchers.

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Cataract Surgery: What to Expect

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Cataract Surgery: What to Expect

What Is a Cataract?

It’s a cloudy area in the lens of your eye. It can make your vision dim, blurry, or cloudy, and colors might look faded. A cataract also might make you more sensitive to light, or you might have trouble seeing at night. They typically begin to form around age 40 as proteins in the lens start to break down. Most people don’t notice any vision changes until after age 60, but sometimes they can grow faster and cause issues earlier.

When Do You Need Surgery?

In most cases, the main question is whether the condition affects your day-to-day life. Can you work and drive safely? Do you have problems reading, using your phone, or watching TV? If the answer to these is yes, your doctor probably will recommend cataract surgery to correct it. If you need it in both eyes, you’ll typically wait for the first operation to heal before having the second.

Type of Surgery: Small Incision (Phacoemulsification)

During cataract surgery, a surgeon removes the lens of your eye and puts in an artificial one. There are two ways to do that. With phacoemulsification (or “phaco”), the surgeon cuts a small opening in the clear covering over your eye (the cornea), and a tool sends sound waves that break up the clouded lens into smaller pieces. A tiny vacuum then sucks up the pieces, and the new lens goes in. The cut is so small that it usually heals without stitches.

Type of Surgery: Extracapsular

With this, your surgeon makes a slightly larger cut to try to remove the lens in one piece. This type is typically used when the cataract is very cloudy because that can make it harder to break up with phacoemulsification. But your surgeon may still use phaco to get rid of any remaining bits of the lens. 

Laser-Assisted Surgery

Your doctor may use a laser instead of a scalpel (small knife) to do your surgery. It’s more precise, and some doctors think it’s safer. In addition to making cuts in the cornea, the laser also can help soften the cataract so it’s easier to take out. Your surgeon can use it to fix certain vision problems, too. One thing to keep in mind: Insurance policies don’t cover the “upgrade” to laser-assisted cataract surgery, so it typically costs much more than traditional surgery.

Type of Lens: Fixed-Focus Monofocal

Doctors can use several kinds of replacement lenses. This type can help you see one distance well, like far away or up close. Some people get one lens for distance and one for up close so they can see well without glasses (known as monovision). But that doesn’t work for everyone. Most people need lenses for distance in both eyes and use reading glasses to see up close. This lens is the one that’s covered by most insurance companies.

Type of Lens: Accommodating-Focus Monofocal

Scientists designed this newer monofocal lens to work more like the one you were born with. Tiny eye muscles change the shape of the “accommodating lens” so it can focus at different distances. With it, you should see well at middle and far distances, but you might have trouble up close. Special eye exercises can help, but you’re likely to need reading glasses after surgery. 

Type: Multifocal

This lens splits light into a distance image and a near image that you see at the same time. The upside is that you shouldn’t need glasses afterward. But it can cause glare or a halo effect, which can sometimes make it harder to see, especially at night.

Type: Toric

If you have astigmatism, your vision is blurred because your cornea is shaped less like a basketball (as it should be) and more like a football. That affects the way light focuses inside your eye. Scientists designed the toric lens to correct the shape and get rid of the blurriness.

Before Surgery

Your eye surgeon (ophthalmologist) will measure the size and shape of your eye and the curve of your cornea to set the right focusing power for your new lens. They’ll also ask about any medicines you take, because you might need to stop taking ones that could affect your surgery or recovery. And they’ll probably prescribe antibiotic or steroid eye drops to use before and after the procedure to prevent infections and swelling. 

During Surgery

Your medical team will wash the area around your eye and dilate (widen) your pupil with drops. They’ll give you medicine to make you sleepy and more to numb your eye. The surgery is typically painless and lasts less than an hour. You may see some light or movement, but you won’t see what’s happening to your eye. The team will watch you for about 30 minutes afterward to make sure you’re OK, then you’ll need someone to drive you home.

After Surgery

Your doctor will likely give you a protective eye cover to wear at night and eye drops to use for a few weeks to help you heal. They’ll also give you instructions for what you what you should or shouldn’t do over the next week or so, and you’ll schedule a follow-up visit to check your progress. Your vision may be a little blurry, but it should get better within a few days, and your eye should be completely healed within 8 weeks.

When to Call Your Doctor

Your eye might hurt a bit, itch, or leak fluid for a couple of days after surgery, and that’s normal. It also may be more sensitive to light, or you might see a red or pink hue over everything. Serious problems aren’t common, but call your doctor right away if you have any of these:
  • Loss of vision
  • Pain that doesn’t get better with over-the-counter pain relievers
  • Your eye is very red
  • You see flashes of light or floaters

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