pain

A Doctor’s Tips For A Successful Diet

/ Thomas Cohn, MD

vegetable dietEating right has always been a challenge, and losing weight sometimes seems to be impossible. With everything in life, change is hard and finding the right path is never easy. There are more diets available and more advice than one can ever fathom. Being the right weight is not magic, but it is work and a lifestyle commitment.

If you want to be successful, one must commit to change. So many times people say they are unhappy with where they are currently but in the next breath they are comfortable with how everything is and are not willing to consider alternatives. Furthermore, most people who ask for advice do not trust anyone who might have legitimate information. If the advice is sensible and simple it seems even less trustworthy.

Steps To Take

So the first step in changing one’s weight is to understand whether you feel it is problem and whether what you are eating is affecting your life. If you are totally happy with how you feel and with your health, than you have no reason to change. Life is likely to stay the same for you.

A person’s weight is dependent on a complex array of variables from genetics, to exercise to what we eat. There are things we can change and things that maybe outside of our control like our genetics and medical conditions. However, we can control what we eat, how we perceive our food and  we can also control our activity level. So weight management is about our interactions with food.

The temptation is always for people to look for a quick fix. In pain management everyone just wants a pill or quick solution. Once people realize the answer may be complex, the light goes on. If the answer was simple, the problem would likely not exist. Education is one of the best paths toward the solution.

Weight gain was a slow problem that crept up on me. Every year my baseline weight increased. Initially it was ok. When my pants were no longer fitting in the waist and I needed a new wardrobe, it became something I needed to understand. The first issue was as we all grow older, our bodies change. For me I had reached a time when there was a hormone change in my body and that caused a slowing of my metabolism. The old school teaching was calories in and calories out must be balanced. So I just tried to exercise more. Initially that may have worked, but only for a short period of time. However, exercising for hours a day does not work to burn off all the calories taken in by eating more than needed. Running or walking a mile only will burn off 100 calories. The not so obvious answer then was I needed to change my diet, and I probably need to do more than I have already done.

New Dieting Goals

The new goals with dieting are to be sensible about eating. The important things to remember are the quality and quantity of food. There are a million diets with tons of rules. Most of the diets are complicated, require special foods, and are difficult to follow for a long period of time. In reality, simpler is better.

First, remember a portion size is a ½ cup for most foods. Measure out that amount and it is not very much food. A small size French fries at MacDonald’s is likely 2 portions. A ½ cup of pasta is the size of a single scoop of ice cream. If one sticks with appropriate single sizes of portions one will not be over eating – staying to the right quantity. Next buy your own fresh food and cook it to make your meals. Eat fresh vegetables, fruits, lean meats, fish, and try some vegetarian meals since the calories will be less and healthier. Keeping the refined sugar down, as well as limiting bread and pasta helps most tremendously.

Typical meals tend to change as one begins to improve your diet. Most dietitians recommend that everyone should eat breakfast. This prevents the body from thinking it is starving and turning all intake into fat for storage. Breakfast can be a piece of fruit, Greek yogurt for diary and protein, and oatmeal or granola cereal (for more protein, fiber, and a bit of carbohydrates). Lunch is a green salad with a low fat dressing, and 4 ounces of protein. Dinner is a portion of vegetables, 5-6 ounces of lean meat, and fruit or a salad. It is okay to have a small portion of brown rice, pasta or potato, but not with butter or a fatty sauce. If you have no recipes, get yourself a cook book. Lastly, donate or throw out all of the snacks and junk food that is sitting around your home and tempting you to eat. Also, stop buying lots of processed food, and when you eat out, eat the same types of meals that you would cook on your own.

Finishing Strong

If you are serious about making a lifestyle change, then you may be successful. Some people are very self-motivated and can change if they set their minds to do something. For most of us, working with a partner and holding each other accountable often is easier and more successful. Another couple of helpful keys are to record everything you eat daily and keep a record of how much you actually eat. You must weigh out your portions and be accurate with them, and it also helps to weigh yourself once a week. Tracking your activity with a fitness tracker will also help monitor about how much you are burning, but they are notoriously overly ambitious in how many calories they are estimating that you are burning.

Starting a diet does not need to be complex. It requires one to shop from the outside edges of the grocery store.  Eat fresh fruit, vegetables and lean protein sources in controlled portion sizes. Reduce the amount of simple carbohydrates – sugars, pastas, and breads. Track your portion size, your intake, and weight. Increase your activity level and move moderately for at least 30 minutes a day. Drink more water also, as this may decrease your appetite. Lastly commit to change and keep at it.1-2 lbs of weight loss a week is excellent progress.

The Overall Health Benefits Of Exercise

/ Thomas Cohn, MD

exercise benefitsExercise isn’t just a way to stay in shape or calm inflammation, it also has enormous benefits for our overall health. In fact, new research shows that it doesn’t really matter whether your walk or run, so long as you are getting regular exercise.

According to new research, if you want to improve your overall health and reduce your risk of all-cause mortality, make sure you get some type of exercise on a regular basis. It doesn’t really matter whether it’s bi-weekly kickboxing classes or a 30-minute walk around the neighborhood with your dog, so long as you’re moving and working muscle groups.

The findings come on the heels of a study of more than 4,800 adults by the Journal of the American Heart Association. For their study, researchers sorted activity into two different categories – total minutes of activity per day and total minutes of intense or concentrated activity.

The Benefits Of Activity

You may assume that individuals who participated in more concentrated exercise would fare better than individuals who just walked or moved around, but that wasn’t really the case. The study found that neither type of activity had a significant edge over the other. According to researchers, individuals who clocked roughly 30 minutes of moderate to vigorous exercise a day were significantly less likely to die from any cause than people who got none. Participants who exercised an hour or more each day fared even better.

“The key message based on the results presented is that total physical activity (i.e., of any bout duration) provides important health benefits,” the study authors wrote.

Cardio workouts not only help with your overall health, but they can provide some other benefits as well, like increased blood flow, enhanced memory and improved mood. The overall message from the study is that the more you move, the healthier you are likely to be.

Apitherapy – Why All Alternative Treatment Options Aren’t The Same

/ Thomas Cohn, MD

apitherapyIf you’ve been following our blog for some time, you know that our goal is to help everyone find a solution to their pain problem. If you find something that works for you, then stick with it. That being said, not all alternative methods are created the same, and some can be downright dangerous.

That’s the lesson we learned when a 55-year-old woman recently died due to complications from apitherapy. For those of you who know your word origins, you might be able to figure out what apitherapy is – bee therapy. More specifically, apitherapy is known as live bee acupuncture.

Apitherapy Gone Wrong

We’re not saying the therapeutic technique is bonkers, because some people swear by it, and as is our motto, we want everyone to find a solution to their individual pain problem, so if it’s working for you, more power to you. That being said, even if it seems safe, it’s clear that we don’t know as much as we thought we did about the therapy technique.

According to the news reports, the 55-year-old woman had been undergoing apitherapy for more than two years without problems. However, during her most recent session, she developed a severe reaction and began wheezing, coughing, and suffering from shortness of breath. She eventually lost consciousness and was taken to an emergency facility. She died a couple weeks later of multiple organ failure. Medical researchers are saying it’s the first documented apitherapy death where the individual had previously been tolerant of the bee stings. Medical researchers who studied the woman’s case concluded that apitherapy is an “unsafe and unadvisable” treatment option.

Like a lot of things in this world, apitherapy has become more popular after being championed by an uninformed celebrity. In 2016, Gwyneth Paltrow touted the “thousands-of-years-old treatment” as something she tried for an old injury. Gerard Butler also said he received a bee sting injection in an attempt to calm inflammation from stunt work, but he ended up hospitalized after having a poor reaction to the injection. He said he felt like his heart might explode and it was as if he had ants crawling under his skin.

What Doctors Are Saying

The theory behind apitherapy is that bee stings cause inflammation, which in turns leads to an inflammatory response from your body. The hope is that the inflammatory response will address both the inflammation from the bee sting along with other local inflammation in the joints.

Doctors say patients considering the therapy should be fully informed of the dangers of apitherapy prior to treatment. They also recommend that measures be taken to identify if someone could have a bad reaction before receiving a full injection, and that practitioners should be trained in how to manage severe reactions and that they should have specific reaction medications on hand. There should also be a system where the patient can receive emergency response care in a quick manor if needed.

“The public need to be very aware of the unorthodox use of allergens such as bee venom,” said Amena Warner, Head of Clinical Services for Allergy UK. “This will come with risk and, in susceptible individuals, can lead to serious life threatening reactions.”

Want To Improve Your Core and Spine? Try This One Exercise

/ Thomas Cohn, MD

plankPlank exercises are a simple way to work on core strength. They can also be used as part of an overall program to build strength and can even be used as part of an aerobic conditioning program. The nice part of this exercise is that they do not require any extra equipment. As one makes them more challenging, weights and balance balls can be added. The most common planking position is holding the position of the body straight while balancing on bent arms at the elbows, and the with the legs stretched out on your toes.

Muscles Used In Planks

Planks look easy but it takes a lot of muscle strength to keep the body in a good position for even 30 seconds. The muscles used include abdominal, back, arm and shoulder. Specific primary muscles are the erector spinae and abdomimal wall muscles. Secondary muscles, or stabiliziers, include the trapezius, rhomboids, rotator cuff, deltoids, pectoralis and serratus anterior, and in the lower body the gluteus maximus, gastrocnemius, and quadriceps. Regular planks use muscles all along the spine, shoulders, abdomen, pelvis and legs.

Once the regular basic plank is routine, it can be made much more difficult to keep things challenging. The next level is doing side planks. This is holding a plank type position on either side of the body. Side planks activate abdominal muscles, some of the spine and shoulder muscles, and a lot of the pelvic, gluteal, hip and upper leg muscles. The nice thing is this a whole different set of muscles that can be strengthened, and again one needs no special equipment.

Planks can still be made even harder with a variety of techniques. In a standard plank, a person has four points of supports using the arms and legs. Move to three points of support and the exercise becomes significantly harder. Balancing on the feet and one arm at time stresses more upper body strength. Lifting off one leg requires more abdominal, back and arm stabilization. Maintaining good form for even 30 seconds is extremely difficult. With side planks, one has two points of support in general, so increasing the workload can be achieved with raising and lowering the upper leg, strengthening the hip muscles even more.

For true punishment, planks can be made even more difficult in two ways, decreasing the stability of the platform for the feet or arms, and adding weights to use with the arms or legs. Doing planks with the use of a wobble board, movement ball, half sphere – Bosu, or balance platform adds the challenge of maintaining position without tipping over or falling. Adding light weights of a few pounds to the arms or the legs can add more to the strengthening.

Controlling neck, back, shoulder, and pelvic pain all involve improving your core muscle strength. Working on strengthening does not take a fancy gym with expensive equipment, it can be done simply at home. Start a program with planks and see how difficult working on the core muscles can be.

Words To Live By From Stephen Hawking

/ Thomas Cohn, MD

This week marked the passage of Stephen Hawking. He was one of the most well-known physicists across the globe. He was a remarkable physicist who described theories on the origins of the universe. He worked on explanations of the Big Bang theory and on black holes among other things. He has been considered one of the world’s greatest thinkers and geniuses.

One of the most striking things about him was that at 21, he was diagnosed with ALS and only given two years to live, but he reached the age of 76. For most of his life he was paralyzed completed, and for years unable to talk, communicating through a computer with only eye movements.  Since his twenties he lived his life from his wheelchair.

Words To Remember

Some of his more profound quotes have been published in the last week in tribute to his passing. Two of them are worth thinking about for everyone. The first one is on living with his crippling ALS:

“I accept that there are some things I can’t do. But they are mostly things I don’t particularly want to do anyway…I seem to manage to do anything that I really want.”

The second quote is on life in general:

“One, remember to look up at the stars and not down at your feet. Two, never give up work….Three, if you are lucky enough to find love, remember it is there and don’t throw if away.”

These quotes say a lot about life and having a disability of any sort. Sometimes it is better to let someone else deliver a message. Spend some time thinking about all of what Stephen Hawking said in the above quotes and maybe reflect on how it might impact on your own life.

Have a wonderful week. All the best,

Dr. Cohn.