Sleep On It

5 Sleep postures affect your health

 

 

Most patients in my clinic receive advice on sleep posture. I want them to put the six to eight hours they sleep to use healing, not exacerbating the condition for which they came to me in the first place.

 

1. On back. Arms to sides.

This is anatomic position, though applied to supine (face up) sleeping for our purposes.

Stand naturally/relaxed. Your arms are at your sides. No  head tilt. Feet are approximately at shoulder width. Exactly the position most recommended for spinal health.

 

 

Yep. That guy's naked. Let's try to be adult about this.

 

In this position there is muscular balance: no tension here, relaxation there. The spine isn't contorted. Joints aren't tensioned. Pillows are available to maintain the cervical curve. If those are not used, pillows should be thin enough so as not to bring chin toward chest to maintain the above position.

For those with low back complaints and also to aid in maintaining this posture, a pillow or bolster placed beneath the knees to slightly elevate is also a common recommendation.

This is most often my recommendation for a sleep posture. But one posture doesn't fit all.

If you snore, or-- worse-- if you have sleep apnea, this posture should be avoided.

 

 

On his back? Check.

 

2. On back. Arm(s) up.

Look at Snory up there. Right arm up. Put your arm up like his. Do you feel the tension that creates? Now hold that position for an hour. No, don't do that. Aside from muscle imbalance-- tension here, relaxation there-- the humerus is forced forward. For some, this will place unwanted traction on  nerves and vessels. The position above is actually an orthopedic test position for thoracic outlet syndrome.

Still a good position for the spine.

 

 

 

3. Side-lying

Over half of us sleep on our sides. This isn't bad-- but it can be.

I tell my side sleepers to try to keep as close to anatomic position as possible. That means pillows sufficient to keep the head/neck in a neutral position and arms as near as possible to the body's sides. It can be tough.

This is a good position for snorers. Spinal curves are maintained. Sleeping on the left may help relieve heartburn (If you have heartburn we need to do more than change your posture at night.)

But then there's troubles. Most will do one of several things. Roll shoulder in with arm out or down, or elevate shoulder with arm up or out. For arms up, see above.

The rolled shoulder bit is something I encounter continuously. It is often apparent on visual exam. The sleeper has trained their shoulder to be dysfunctional. The sleeping position becomes the default waking position. The scapula rides high and loses motion. The humeral head is rolled forward and inward, making the biceps groove face inward. This can lead to or worsen any of the following which motivates our sleeper to see me: decreased shoulder motion, shoulder pain, painful arc syndrome, bursitis, tendonitis, tender points and/or trigger points, thoracic outlet syndrome.

 

And what to do about legs? For those with hip or pelvic problems this can be a poor choice position.  For them I recommend a pillow between the knees to approximate anatomic position. A body pillow can help as well, for both arm and leg placement.

 

 

Nighty-night.

 

4. Prone

No, no, no.

Stomach sleepers do all sorts of contortionist tricks. The most obvious and universal is their head has to turn to one side. If they want to breathe.

 

Today's tip for happiness: Do NOT image search "fetus".

 

5.Fetal

On your side with knees slightly bent is good. Drawing your knees up to your chest is not. Unless you're still a fetus and then congratulations on your strides in literacy.

In the womb you had no need for spinal curves. Now life without them is pain. Also, ma was giving you your oxygen. Sleep like this now and you restrict deep breathing.

 

 

 

Over the years I have been asked repeatedly to recommend beds/pillows. Can't do it.

Those with low back problems often find the harder the better. Many will sleep on the floor when pain is acute. Some stiffen their bed by placing a board under the mattress. Some travel with their own pillow-- often found after much trial and error.

There is no simple answer. No golden rule.

 

Having said that, I will now shill for the mattress/pillow makers.

They say replace every five to ten years. Broad range. Not helpful.

If your mattress is no longer supporting you, no matter whether soft or firm, it is time to part ways.

Take your prospective new sleeping partner for a spin. Try them out right there in the store.

Buying a mattress is akin to buying shoes. You have to try them on and see how they fit.

For all the hokey my-life-was-changed-by-my-new-mattress commercials, there really and truly is something to it.

 

 

Doubt it? Sleep on this for a month and get back to me.

 

 

9 Meds To Kill Your Memory

 

 

They come in on a string of medications. The older ones carry a list of their medications in purse or wallet. And they are forgetful. They have "senior moments". 

Memory loss isn't an inevitable consequence of aging. If ma or pa are getting forgetful, consider their medicine burden.  After all, 7 of 10 Americans are on a medication of some sort. Meds such as...

Statins
Zocor, Crestor, Lipitor, et al.
Statins lower cholesterol. They are among the most prescribed drugs in the world.
Cholesterol is absolutely necessary for your existence. Monkeying with your cholesterol has undesirable consequences including memory loss.
A study here found that 75% of statin users "experienced cognitive ADRs (Adverse Drug Reactions)determined to be probably or definitely related to statin therapy". And, notably, the FDA has required labeling to include memory loss warnings since 2012.

Wonder why folks choose the sunny summer and tropical locales for vacay?

Antidepressants
Amitriptyline/Elavil, Nortriptyline/Pamelor, Desipramine/Norpramin, and other tricyclic antidepressants.
These are currently among the most prescribed meds in the US.
These drugs block serotonin and norepinephrine which are necessary to modulate memory formation.

This migraine brought to you by your painkiller.

Hypertension drugs
Metoprolol/ Lopressor/Toprol, Propranolol/Inderal, and other beta blockers.
Used to treat high blood pressure and arrythmias, but also to treat  migraines, chest pain, and glaucoma.

Gambling. The perfect partner to inappropriate sexual behaviour.

Parkinson's disease drugs-- dopamine agonists
Ropinirole/Requip, Apomorphine, Apokyn/Pramipexole, Pramipexole/Mirapex
Used for Parkinson's disease, but also restless leg syndrome. The wide range of side effects includes, curiously enough, inappropriate sexual behavior. I doubt being unable to remember the behaviour will be a benefit.

Antianxiety drugs-- benzodiazepines
Alprazolam/Xanax, Diazepam/Valium, Triazolam/Halcion, Lorazepam/Ativan,  Midazolam/Versed, Chlordiazepoxide/Librium and others
Used to treat anxiety, but also muscle spasm and insomnia.

Old line antihistamines
Diphenhydramine/Benadryl and others.
While used to treat allergies,  they may also be used for nausea, vomiting, or insomnia.

Ambien.

Sleep disorder drugs-- nonbenzodiazepine
Eszopiclone/Lunesta, Zolpidem/Ambien, Zaleplon/Sonata
Another class linked to curious and undesirable side effects beyond memory loss. You may recall these as an additional Kennedy curse.

Antiseizure/Nerve pain drugs
Gabapentin/Neurontin, Carbamazepine/Tegretol, Levetiracetam/Keppra, Topiramate/Topamax, Pregabalin/Lyrica, Valproic acid/Depakote and others
They were a hit as antiseizure meds, and now they've gained new life as nerve pain meds and to treat bipolar disorder.

Poppy seed bagel anyone?

Opioid painkillers
Fentanyl/Duragesic, Hydrocodone/Vicodin, Hydromorphone/Dilaudid, and Oxycodone/OxyContin/Percocet.
If you missed it, the feds have been cracking down on opioids for some time. Opioid overdose deaths have increased nearly 500% in one decade among US women.
Like others on this list they interfere with messaging within the brain.

Bonus edit: http://web.mit.edu/newsoffice/2013/neuroscientists-plant-false-memories-in-the-brain-0725.html

 

 

Five Benefits of Rocking a Beard

 

Used to wear one only in winter-- helped prevent wind chap while skiing. Now it's on full time and no more razor burn.
But there are other reasons. And so I give you...

Will this be the only ridiculous beard pic? No it will not.

This my take on an article by  K. Aleisha Fetters Published June 20, 2013.
She writes, "five doctor approved reasons to let your beard grow".
OK. Let's have a look.

1. Sun Block
Don't want to be the red-faced guy everybody points and laughs at? Well, why slather goop on your mug to avoid an embarrassing burn when you can sport a knit sunshade like Smirky up there.
Beards block 50-95% of UV rays. At 4/10" thick you get UPF 2. But grow a Billie Gibbons 3.5" thick face jungle and you get UPF 21.

Even their guitars are sunproof.

Basal cell carcinoma is the most common cancer. 1 in 5 Americans will develop skin cancer. Most lesions occur above the shoulders.  UV rays take the blame.
Beard pro-tip:  Grow a neck-beard for maximum coverage.

Nose ring optional.

2.  No-blemish skin
A top reason of mine.
When you ditch the razor you skip the rash and cut down on acne and folliculitis. Shaving is a great way to spread bacteria around and infect follicles.

See? No blemishes.

3. Beards are Butch
I only know one man named Butch. While he has a pretty tough history, he wears no beard.
Nonetheless, apparently both sexes perceive the bearded as more masculine than the shorn.
 "..an intermediate level of beardedness is most attractive..." (Sorry, no blemish dude. You're doing it wrong.) and "Masculinity ratings increased linearly as facial hair increased, and this effect was more pronounced in women in the fertile phase of the menstrual cycle..."

Seems to've worked for this guy.

4. Moisturized
This one plays to me again. I used to hate wind chap when skiing.
This is all about sebaceous glands. These glands are at the base of the hair follicle. They secrete fatty sebum which keeps the skin moist and so protects. A beard keeps sebum in place like kudzu keeps dirt on a bare slope.

Bare slope.

Kudzu.

Beard.

5. Pollen trap
You blow your nose after a manly day tossing hay bales and what comes out is enough to start a garden. Nose hairs (with an assist from mucous) works that well.
And so does your beard.
How do bees collect pollen? They wallow in the stuff and collect it on the tiny hairs of their tiny bee appendages. Your beard is like that, catching and keeping pollen and dust out of your face-holes.

Works for the ladies, too.

For the most erudite and exciting musings on pollen/allergies ever written on this blog, page down a couple posts.

SUPER EXTRA BONUS BEARD LINK
And one man's solution to the high costs associated with shaving.

11 Non-joys of Pet Ownership

What with the warmer weather, your pets will probably be spending more time in the great outdoors.
Then return to the great indoors. Lie on the bed, couch. Patter around your house. Tracking/spreading unpleasantness all over. Maybe you even kiss your pets. Ugh.

Here is my take on an article written by Leah Zerbe, Prevention & Rodalenews.com entitled
11 Diseases You Can Get from Your Pet.

1. Ringworm

Nice article on defeating the fungus here.

The delightful spores live for months unhosted. Highly contagious.

Doggy ringworm.

 

Article suggests washing bedding once per month in hot water. OK.

WebMD recommends changing your socks and underwear at least once per day.

I kid you not.

They also helpfully recommend putting socks on before underwear. So as not to spread the fungus to your delicate regions. Sparky up there must have missed that memo.

 

I should think the plain advice would run: Be aware of your pet's health. Immediately address lesions. Wash what Sparky-tainted surfaces/items can be washed.

 

2. Roundworm

Horrific. Forewarned.

 

One of the banes of kittydom, the most common cat parasite.

And here is why they were such a fright in ages past:

 

It  can actually be more stomach-knottingly nightmarish. Again, forewarned.

 

Yep. That's some poor devil's eye. Left untreated, roundworm infection could progress to blindness.

But don't think this is only a problem of yore.  And note in the link that over half of infections occurred in southern states, Georgia and Florida being singled out.

Wow, these nematodes are high on my unclean list.

 

Article suggests, that just maybe, "house cat" indicates cats should live inside houses. Worms outside. Cat stay inside. I'd add that maybe, just maybe, there are other excellent reasons to keep them inside.

They also suggest hand washing after tending the litter box.

Bonus from the article from the University of Maryland Medical Center:  eat bitter and spicy foods such as turmeric, cayenne, ginger, olives, and garlic to naturally deter infection.

 

3. Hookworms

 

They live on blood sucked from dog's intestines.

 

The problem here is poop. Scoop the poop promptly, according to the article, so the eggs won't hatch in your yard.

I must suppose common sense would indicate not walking barefoot were animals may be expected to tend to their toilette. Clean you and anything that comes into contact with the nastiness.

 

He has a thing for feet. You're feet.

 

4. Giardia

 

Looks kinda cool, actually. After the last two monsters anyway.

 

Most frequent gut parasite, and most frequent organism associated with waterborne infection in the US.  Responisble for 4,000 hospital admissions per year.

Giardia sets up shop in the gut and causes diarrhea.

The article mainly recommends taking water with on trips. Don't allow your pet to drink from open water sources.

Great recommendation. Probably difficult to enforce.

 

 5. Campylobacter

 

Puppies and kittens are the scourge here, according to the article.

The usual advice stands-- touch puppy, wash hands.

If the puppy has had diarrhea, be aware that it can shed germs for weeks after infection.

 

6. Salmonella

 

Just like those things in the Matrix.

 

The authors of the article have a bit of trouble with the difference between reptile and amphibian. Nonetheless, the point is taken that our more scaly/slithery pets can harbour salmonella. Chickens are another potential reservoir. And, yes, people keep chickens as pets.

Wash your hands advice.

Good advice I hadn't considered is to not wash tanks in the kitchen sink. You could disinfect afterwards, of course, but why chance the exposure and go to the trouble?

Salmonella causes tummy ache, fever, nausea, and vomiting.

 

7. Tapeworms

 

Still amazes me this was a thing.

 

If your pet is boot-scooting across the carpet it may be time for a visit to the vet.

Worms can be seen in stool-- pet or human-- as rice-like bits.

 

 

Useful bit aside from the now all too familiar wash your hands:  You can be infected if you ingest a carrier flea.

So don't eat fleas, I guess.

 

8.Cat Scratch Fever

 

You knew you'd see this guy.

 

Bartonella hangs out on cats' nails. 40% of cats are infected at some point in their nine lives.

This is another flea vector problem. If kitty has been flea (or tick) infested and has swollen lymph nodes-- off to the vet.

The advice: keep cat's nails trimmed, and, get this, don't let them lick open wounds. Seems to me if they are indoors they won't be facing a tick problem and less chance of a flea problem.

In humans the disease causes swollen and tender lymph nodes near the wound, fever, fatigue, joint pain, rash.

 

9. Bubonic plague

 

That hapless fellow with the black hands is Oregonian Paul Gaylord. He was infected July of last year. So, yeah, the plague is definitely still around. No word on whether the Gaylord's kept Charlie the cat.

Once again the flea is the vector, which I suppose everyone knows. But did you know there are seven cases per year?

Keep you pets flea free.

 

Update:

Saw this yesterday: http://www.newsmax.com/thewire/bubonic-plague-dogs-black-death-new-mexico/2013/06/24/id/511497

 

10. Toxoplasmosis

 

 

This one is the reason pregnant women are discouraged from cats, or at least unfamiliar cats. It is once again also a good reason to mind the "house" part of house cat.

If you must see the infected baby pics they are here.

Article says keep cats out of gardens and sandboxes. Of course that wouldn't be a consideration if they were in the house.

 

Edit:

Forgot to add this: toxoplasmosis and schizophrenia http://www.stanleyresearch.org/dnn/LaboratoryofDevelopmentalNeurovirology/ToxoplasmosisSchizophreniaResearch/tabid/172/Default.aspx

 

11.  Rabies

 

Untreated, rabies is going to kill. The article quite reasonably impresses that if you have any suspicion your pet may be rabid it is time for the vet. And if you have the slightest suspicion a rabid animal has bitten you seek medical attention right away. Symptoms won't appear until the disease has reached the brain, and by then you're two days from death. Imminent, irrevocable death.

Naturally this isn't really a cat problem as they only live in the house. Only and always.

Outdoor dogs should be vaccinated.

 

So there you have it.

Enjoy your little biological terror.

 

 

 

 

Hay Fever

 

 

Pretty. Destructive. 

 

As we are non-drug around here, folks ask what they can do with or instead of medication for hay fever.
If you suffer from hay fever, you likely already know some of these strategies to alleviate your
seasonal allergies.
Here are 5 recommendations you can use now, immediately, to fight your misery inducing allergic reaction.

1. Wash that pollen right out of your hair.
Shampoo when you come indoors, or at least in the evening, to wash away any clinging pollen. This way you keep pollen off your pillow and sheets. No need sleeping with the enemy, is there?
Keep your dirty, pollen laden clothes out of the bedroom. Change and leave clothes where you'll have the least contact with them.

"Khaaaaaan!!!"

2. Watch what you wear.
Don’t be a greaser. Anything you put on your hair/skin that is sticky (hair gel, bug spray, sun block) is going to catch and keep airborne pollen. On your skin. In your hair. Near your eyes.
Wear sunglasses. Really. Wraps or Jackie O's can go a long way toward pollen free eyes.
Wear a hat to keep pollen off your hair.  All the disaffected, ironic kids are doing it.

See? Less pollen. I'm so happy.

 

3. Avoid the pollen to begin with.
Exercise indoors.  If you exercise outdoors, do it in the morning when less pollen is likely to be airborne. Stay indoors on dry, warm, windy days, and avoid the outdoors in the afternoon when pollen counts are generally highest.

4. Don't bring your troubles home with you.
Your four-legged roommates' furry coats are just super for bringing pollen in the house.  Keep them in or out, as far as allowable.
Close windows, turn off fans, use your air conditioners. Home and car.
When using the AC, set it on recirculate to keep pollen on the outside.
A window fan will obviously suck pollen right into your home. Indoor fans get dust and pollen invaders already in the house airborne. Where they will find you.

You can't run. You can't hide. We are POLLEN.

 

5. Clear the air.

Keep AC filters clean in home and car.  
If you don't have whole house filtration, invest in a room size unit.

-----------

Changing behaviors to thwart the allergens works pretty well for most people I treat.
Change with  supplement/diet regimes works even better.

Unfortunately, for some out there, the reaction is too horrific.
If that's you, the above can be useful even though you must use meds to function.

I don't have a silly picture for that.

10 Best Foods

(According to Science In The Public Interest)

1. WATERMELON
They actually put sweet potato first...but come on.
Sweet potato?
Watermelon.
1/3rd daily requirement of vitamins A and C, along with potassium and lycopene, for only 80 calories from two measly cups.

2. Sweet Potato
This is their "nutritional all-star", "one of the best vegetables you can eat".
Full of carotenoids, vitamin C, potassium, and fiber.
They suggest.you "bake and then mix in some unsweetened applesauce or crushed pineapple for extra moisture and sweetness. "
Notice watermelon didn't need any advice to make it more palatable.



3. Mango
In one cup you get all the C and 1/3rd the A you need every day, plus potassium and fiber.
They helpfully mention it is likely to have very little pesticide residue.
I learned to prepare mango from Hecule Poirot.




4. Unsweetened Greek Yogurt
They go on about "a pleasant tartness that’s a perfect foil for the natural sweetness of" blah, blah.
Their important bit is the protein. 17 grams per six ounces.
They leave out the EVEN MORE IMPORTANT bit about beneficial bacteria.
I've blogged on and on about that topic.
Unlike the mango, the berries up there (while nutritionally wonderful) are likely plenty heavy with pesticide residue.




5. Broccoli
Dubya's least favorite food, wasn't it? Or was that Bush the Elders least fave?
Loads of vitamin C, carotenoids, folic acid, and vitamin K.
K is getting a lot of press lately.
The yogurt we just had? Providing the good bacteria we need to live?
They make vitamin K for us in our gut.
The CSPI folks give one line of cooking/serving tips.
Everyone knows broccoli won't sell itself. (See sweet potato above)


6. Wild Salmon
Just look at the color of that salmon.
They only mention fatty acids.
How about protein and iron?
At least they didn't freak out over the rather high cholesterol content.
They also mention wild caught has a lower pcb burden.
Could have mentioned many other troubles with farmed salmon.
If you eat it farmed, try this link.

7. Crispbreads
They say "loaded with fiber and often fat free".
That's really all they gots.
Why down on fat, anyway?
No fat is a disaster.
They did trumpet salmon fat, after all.
Once again, the likelihood of pesticide residue is high. On the grapes.



8. Garbonzo Beans
Seriously?
A world of food and they go with garbonzo beans?
They provide protein, fiber, iron, magnesium, potassium, and zinc.
So there's that.
And I do love hummus.
And they do say "all beans are good beans", which is fine.
But remember: "Top 10 Best Foods"
Inexplicable.


9. Butternut Squash
Now I know they're messing with us.
They tout vitamins A, C, and fiber. All to the good. Tons of vitamin A.
But they act like it's a convenience item.
"Steam a sliced squash or buy peeled, diced butternut squash at the supermarket that’s ready to go into the oven, a stir-fry, or a soup."


10. Leafy greens
How on God's green earth does God's green greens get the rear position?
Down the list from squash and crispbreads?
They say "don’t miss out on powerhouse greens like kale, collards, spinach, turnip greens, mustard greens, and Swiss chard.... jam-packed with vitamins A, C, and K, folate, potassium, magnesium, calcium, iron, lutein, and fiber."
Got it.
Now look back over the list.
Greens vs. garbonzos?
The greens are the superstars.
Go green!
Sorry watermelon.