Nap On You Crazy Diamond

One of my guiltiest pleasures is napping.  I tell myself that my napping habit is reprehensible for a number of reasons. Napping is for babies, college kids, and elderly people. Napping is self-indulgent – something one does on vacation. Time spent napping could be spent cleaning house, exercising, studying, or writing a blog.  All of these statements are true, but you know what else? Napping can be really good for you. For those of us suffering from excessive daytime sleepiness napping is a must to keep us from falling asleep at the wheel. 

What’s so great about napping? Well, besides taking off my shoes, putting up my feet, clutching my snuggly-wuggly pillow, and closing my eyes to drift away to dreamland, lots of stuff. A short burst of sleep can relax you, help you better cope with stress, and allow you to push the reset button in the middle of your day. It can improve alertness and performance and reduce mistakes made at work or more importantly while driving.

What are the risks of napping? There aren’t many, but you can suffer excessive grogginess, called sleep inertia, if you sleep for too long. You can also impair your nighttime sleep schedule if you nap too late in the day. The ideal power nap is from 10-30 minutes in duration. Beyond that and you may make yourself sleepier than before.

If you struggle to stay awake in the late morning or early to mid afternoon, you might benefit from a short siesta.  If you’re fighting to stay awake while out on the road, you can augment your nap by drinking a cup of coffee just prior to drifting off to sleep – it takes 20-30 minutes for the stimulant effects of caffeine to kick in. 

What we’re really pointing at with the emphasis on napping is the extreme importance of sleep. Your brain needs to rest in order for you to think clearly, deal with your emotions, relate to people in a healthy way, maintain balanced hormones and be at your best. If you can find the place and the time to carve out a snooze during your day, indulge. There’s no need to feel guilty – you may be doing everybody a big favor. Nap on!

Click here for a review of some famous nappers.  (I so wanted a famous rapper to be on this list.)

Zing! Living educates, inspires, and empowers people to lead freer, fuller lives by taking better care of their bodies.  Zing! Living offers personal empowerment coaching, small business employee wellness programs, and educational and inspirational speaking engagements on a wide variety of health related topics.  Melanie Lane, MD CPCC is President of Zing! Living and the author of The Nine Daily Habits of Healthy People.  She is a Board-Certified Family Physician, Certified Professional Co-Active Coach, First Degree Black Belt in Kung Fu and formerly overweight person herself.  She has presented workshops and motivational speaking engagements to physicians, physical therapists, occupational therapists, nurses, and weight loss support groups.  For more information about Zing! Living’s services, free online course, or to purchase a book, visit:

http://www.ZingLiving.com.

You can also visit Dr. Lane at:

Twitter:  https://twitter.com/#!/melanielanemd
Facebook:  https://www.facebook.com/drlanehealthylivingcoach
LinkedIn:  http://www.linkedin.com/in/melanielanemd

Take Charge, Be Proactive to Maximize Health

The number one thing you can do to improve your health is to accept responsibility for it. We Americans live in a society where many if not most of us believe that it’s someone else’s job to make us happy and healthy.  Why else would we sue McDonalds for making us fat or Phillip Morris for giving us lung cancer? True these companies are savvy marketers of addictive substances, but each one of us is still personally responsible for anything we knowingly ingest, whether it’s cigarettes, alcohol, Doritos, or Hostess Twinkies. To believe otherwise is to give away our only power to change. To blame other people for our own lifestyle choices puts us at the whims of others’ decisions – something we cannot control. 

It is not our doctor’s, spouse’s, pharmacist’s, therapist’s, trainer’s or anyone else’s responsibility to make us well. In fact it is physically impossible for someone else to do so.  For example, let’s imagine that you see your doctor for symptoms of infection. She takes a good history, performs a thorough exam, orders appropriate testing, and makes the correct diagnosis including identification of the bacteria causing the problem. Next, she prescribes the exact right antibiotic in the correct dose for the correct amount of time and schedules you a follow up exam. Despite doing everything she possibly can to help you, she still cannot make you well.  Why?  You could be:

• hit by a bus in the parking lot
• elect not to pay for the prescription
• take some other antibiotic stashed in your medicine cabinet, which is inappropriate for the infection at hand
• discontinue the medication due to side effects or inconvenience
• have an unforeseen life threatening reaction to the medication
• take all of the medication exactly as directed and still not get well

Notice that none of these scenarios are under the control of your physician, but many of them can be controlled by you. 

So what does taking responsibility for your health entail? It means getting educated about your medical conditions and your medications. It means getting your prescriptions filled and taking them exactly as directed. It means calling your doctor right away to request a substitute if you cannot afford your medication or are having some problem with it. 

Being proactive includes getting laboratory tests completed and following up with your doctor on time. It also means getting your regular preventive care measures taken care of such as dental exams and vaccinations. Taking charge of your health involves healthy eating, daily physical exercise, drinking plenty of water, getting adequate sleep, and participating in some kind of spiritual practice. Ultimately the state of your health is between you and your creator. Everyone else is merely here to support you.

Some readers have balked at my frankly dropping the state of their health directly in their own laps, especially when they struggle with chronic pain resulting from an accident or a genetic disease over which they had no influence. To these individuals I still strongly urge them to be as proactive as possible in maximizing their treatment plans. Sometimes just doing something to improve our health provides enough of an emotional boost to affect our physical wellbeing. Everyone will benefit from actively participating in his or her own wellness journey. To give that power away invites illness and shortens our lives.

Zing! Living educates, inspires, and empowers people to lead freer, fuller lives by taking better care of their bodies.  Zing! Living offers personal empowerment coaching, small business employee wellness programs, and educational and inspirational speaking engagements on a wide variety of health related topics.  Melanie Lane, MD CPCC is President of Zing! Living and the author of The Nine Daily Habits of Healthy People.  She is a Board-Certified Family Physician, Certified Professional Co-Active Coach, First Degree Black Belt in Kung Fu and formerly overweight person herself.  She has presented workshops and motivational speaking engagements to physicians, physical therapists, occupational therapists, nurses, and weight loss support groups.  For more information about Zing! Living’s services, free online course, or to purchase a book, visit:

http://www.ZingLiving.com.

You can also visit Dr. Lane at:

Twitter:  https://twitter.com/#!/melanielanemd
Facebook:  https://www.facebook.com/drlanehealthylivingcoach
LinkedIn:  http://www.linkedin.com/in/melanielanemd

Miracle Juice Cures Arthritis - Wards off Shark Attacks!

Multiple family members have asked for my opinion on the efficacy of “miracle juices.” Typically these products contain the juice of some kind of berry or fruit known to be high in antioxidant properties such as acai berry, pomegranate, prickly pear fruit, etc… They are often very expensive, about $40-50 per month for a 750 ml bottle (the size of a bottle of wine) and are sold through private distributors kind of like Avon. They are often promoted as tonics to treat inflammation, reduce heart disease, relieve arthritis pain, and reinvigorate your entire life.  Sounds great doesn't it? All that in just one shot of juice a day! What’s challenging for my family and I would guess for most people is figuring out how legitimate the claims of these savvy juice marketers really are. 

There is a difference between scientific evidence for the efficacy of a product and anecdotal evidence. By scientific evidence, I mean the substances present in these beverages have be subjected to rigorous testing in a clinical setting – a double blind, randomized, placebo controlled trial. In this kind of trial, neither the doctor nor the patient knows if he is receiving a placebo (fake juice) or the real thing. Additionally, the placebo group and the test group are matched as closely as possible for age, gender, medical problems, lifestyle, and so on. The hope with this model of testing is to eliminate as many variables as possible, so that you can feel confident that the results you’re seeing are actually due to the substance being tested. As you can imagine, these trials are time consuming and expensive. Most juice producers probably do not have the time, money, or desire to perform this kind of testing, so they rely on sophisticated marketing, which includes the use of anecdotal evidence for the product’s efficacy.

Anecdotal evidence is what you get with testimonials – somebody tried it for their back pain and it cured everything that was ever wrong with them and made them look ten years younger. Did the person really have those results or was he paid to say so? Is it really the acai berry juice that cured her or could it have been something else going on in her life at the same time such as a new workout regime or different meal plan? And can you reasonably expect for your body to respond to the juice in the same manner that hers did?

If it’s a major breakthrough discovery, you will not be hearing about it from a distributor you met through a friend of a friend or a late night infomercial. You’ll hear about it from your doctor or a credible source of news. But be careful: check that what you’re reading doesn’t have “Advertisement” written on it somewhere in fine print. Late night informercials are not a credible source of breakthrough scientific anything.

With all of that being said, these juices, when consumed in small amounts, probably do have some health promoting vitamins and antioxidants in them. If you can afford them and like the way they taste, there’s no reason not to buy them. Just don’t expect miracles to happen – there is no magical ingredient in any one food or beverage or cream or powder that will cure everyone of everything. If you can’t afford one of these products, try investing in a juicer and making your own healthy juice or just eat a wide variety of fresh fruits and vegetables. My favorite recommendation for making a healthy change in your eating habits is to shoot for eating a rainbow of different colored fruits and vegetables every day. For example: Red bell pepper, Orange carrots, Yellow tomato, Green spinach, Blueberries, and Purple onion. (I wouldn’t mix these all together at once.  That would be icky.)

You don’t need to buy expensive, exotic lotions or potions to be healthy. Your best weapon against pain, fatigue, and the other symptoms that often accompany aging is a healthy lifestyle. If you need more direction, check out The Nine Daily Habits of Healthy People, my wellness planner, which is designed to help you live life to its fullest.

Zing! Living educates, inspires, and empowers people to lead freer, fuller lives by taking better care of their bodies.  Zing! Living offers personal empowerment coaching, small business employee wellness programs, and educational and inspirational speaking engagements on a wide variety of health related topics.  Melanie Lane, MD CPCC is President of Zing! Living and the author of The Nine Daily Habits of Healthy People.  She is a Board-Certified Family Physician, Certified Professional Co-Active Coach, First Degree Black Belt in Kung Fu and formerly overweight person herself.  She has presented workshops and motivational speaking engagements to physicians, physical therapists, occupational therapists, nurses, and weight loss support groups.  For more information about Zing! Living’s services, free online course, or to purchase a book, visit:

http://www.ZingLiving.com.

You can also visit Dr. Lane at:

Twitter:  https://twitter.com/#!/melanielanemd
Facebook:  https://www.facebook.com/drlanehealthylivingcoach
LinkedIn:  http://www.linkedin.com/in/melanielanemd

The Low Down on Vitamin D

Vitamin D has been receiving a lot of attention in the medical literature over the last couple of years.  For any of you who haven’t been riveted to Web MD or the Archives of Neurology to catch the latest scoop on cholecalciferol, here’s a little review on what vitamin D is, what it does, effects of deficiency, who’s at risk, where it naturally occurs, and in what dose to supplement if you need to. 

Vitamin D is one of the four fat soluble vitamins, including A, D, E, and K, which means that these vitamins are absorbed along with fat in your small intestine.  These vitamins are stored within your body fat, so they can potentially become toxic when consumed in high doses.  You need not worry about Vitamin D though; you would have to consume about 50 times the recommended daily allowance of this vitamin in order to experience any adverse side effects. 

Vitamin D’s primary function is to preserve bone health by promoting calcium and phosphorus absorption in the small intestine.  It also keeps your bones strong by helping bone remodeling cells, osteoclasts, mature.  Vitamin D has enjoyed the spotlight lately due to studies indicating that it also prevents falls in the elderly, which reduces the risk of hip fractures and other devastating injuries.  This probably occurs because Vitamin D helps promote muscle strength. 

Vitamin D deficiency has been implicated in the development of osteoporosis in post-menopausal women, as well as increasing the risks of dementia, depression, and Parkinson’s disease in people over 65.  There also appears to be an association between Vitamin D deficiency and diabetes, heart disease, cancers of the breast, colon, and prostate.

Those most at risk for Vitamin D deficiency are the over 65 population, institutionalized people, and those with darker pigmentation of their skin.  Other causes of deficiency include living at higher latitude where there is less sunlight, medications, and malabsorption of the vitamin due to celiac sprue, cystic fibrosis, or removal of the small intestine.

Vitamin D3 is found amply in fatty fish such as salmon, sardine, and mackerel, and dairy products, which are usually supplemented with Vitamin D.  If you have fair skin, you can also get Vitamin D from 12-15 minutes of sun exposure on the forearms and legs daily; however, doing this will upset your dermatologist.  Fair skinned individuals make the most Vitamin D from sun exposure, but they also make the most melanomas, so supplementation is likely to be your best source of Vitamin D if you aren’t having canned salmon with a glass of milk for breakfast every day.

The controversy over Vitamin D has been whom to test for deficiency, what doses of Vitamin D to recommend for the general public, and whether or not supplementation is actually that effective at thwarting diseases other than rickets and osteoporosis. 

The Institute of Medicine (IOM) weighed in after reviewing over a hundred studies on the effects of Vitamin D deficiency and possible benefits of supplementation.  They recommend testing Vitamin D levels only in those individuals at significant risk for deficiency and those with evidence of associated diseases such as osteoporosis.  For those needing supplementation, the IOM recommends 600 IU daily for adults under age 70 then 800 IU thereafter.  Many practicing physicians in the community feel that Vitamin D supplementation is safe and should be recommended for everyone.  This decision is best left to you in consultation with your health care provider. 

If you choose to take a vitamin D supplement, read the ingredients on the bottle.  There are 5 forms of Vitamin D, and you want the most biologically active form of the Vitamin, Vitamin D 3 also known as cholecalciferol. 

Zing! Living educates, inspires, and empowers people to lead freer, fuller lives by taking better care of their bodies.  Zing! Living offers personal empowerment coaching, small business employee wellness programs, and educational and inspirational speaking engagements on a wide variety of health related topics.  Melanie Lane, MD CPCC is President of Zing! Living and the author of The Nine Daily Habits of Healthy People.  She is a Board-Certified Family Physician, Certified Professional Co-Active Coach, First Degree Black Belt in Kung Fu and formerly overweight person herself.  She has presented workshops and motivational speaking engagements to physicians, physical therapists, occupational therapists, nurses, and weight loss support groups.  For more information about Zing! Living’s services, free online course, or to purchase a book, visit:

http://www.ZingLiving.com.

You can also visit Dr. Lane at:

Twitter:  https://twitter.com/#!/melanielanemd
Facebook:  https://www.facebook.com/drlanehealthylivingcoach
LinkedIn:  http://www.linkedin.com/in/melanielanemd

Govern Your Destiny/Legacy - Part 2

Life is wonderful but uncertain. No matter what age you are, 25 or 105, you could be pummelled by plummeting space craft. (There's an ICD-9 code for it, so it must have happened to somebody.) As we all know, aliens are not likely to consider your wishes when it comes to your medical care.  However, humans will, if you let them know what kind of treatments you want and do not want before they are necessary.  Do yourself a HUGE favor by putting your legal documents in place in the unlikely event that you're found wandering out in the desert mooing like a cow after an alien abduction yourself.

The best way to ensure your wishes are honored is to spell them out specifically on paper with the assistance of a qualified attorney. You and your family will be well served by having your explicit intentions documented by your lawyer. When the time comes to consult these documents, you will save your family, friends and/or other designated representatives a lot of heartache and confusion. Here are some really, really important things to get archived:

• Durable Power of Attorney
• Durable Healthcare Power of Attorney
• Durable Mental Healthcare Power of Attorney (Arizona)
• Living Will 

In my previous blog, I detailed my rudimentary understanding of the Durable Power of Attorney and Durable Healthcare Power of Attorney. In this blog, we'll look at the importance of the Durable Mental Healthcare Power of Attorney and Living Will.

A Durable Mental Healthcare Power of Attorney is a person to whom you give the power to make decisions about your medical care in the event that you become mentally disabled or incompetent to do so yourself. Not all states require this, but Arizona does. This person will have the authority to accept or refuse medical treatment, therapeutic procedures, selection of your physician, and admission to a treatment facility, group home, dementia care facility, etc. The determination of your mental incompetence must be made by a licensed psychiatrist or psychologist. Choose your Durable Mental Healthcare Power of Attorney carefully; he or she should be some one you trust and whom you believe will act upon the wishes you've expressed when you were of sound mind. This person must be a competent adult age 18 or older. If you have no one designated, your spouse is the most likely person to be consulted regarding your care. If you have no friends or family, the state you live in will assign someone to make these decisions for you. Do you really want your state managing your mental healthcare?

A Living Will specifies to your medical provider what kind of treatment you do or do not want in the event that you are in a terminal condition, persistent vegetative state, or irreversible coma. Do you want Comfort Care Only, which is designed to keep you as comfortable as possible without prolonging your life? Do you want or not want Specific Limitations on Treatments such as artificial feeding through an I.V. or cardiopulmonary resuscitation (CPR)?  Do you want a Direction to Prolong Life, which dictates all lifesaving measures be done to prolong your life to the fullest extent possible? It is extremely valuable for you to have this form completed and a copy delivered to your physician. More than once I had an ER physician call me to ask if I had a living will on file for a patient. This document dramatically improves the probability of you having your wishes honored at the end of your life.  Without it, the physician treating you will be obligated to give you the whole shebang (which is very expensive and usually futile).

I can't underscore enough the value of putting your Life Care Planning documents into action.  They provide your loved ones some peace of mind in difficult situations by relieving them the burden of some of the most profoundly life altering decisions about your care.  They also offer you assurance by allowing you to designate the people you trust most (not some unknown attorney or estranged family member) the powers to act on your behalf. What a huge gift to yourself and your family.

* Oh, and one last little thing to think about: please consider designating yourself as an organ donor.  Unless you've been abducted by aliens.  Then you're disqualified.

Zing! Living educates, inspires, and empowers people to lead freer, fuller lives by taking better care of their bodies.  Zing! Living offers personal empowerment coaching, small business employee wellness programs, and educational and inspirational speaking engagements on a wide variety of health related topics.  Melanie Lane, MD CPCC is President of Zing! Living and the author of The Nine Daily Habits of Healthy People.  She is a Board-Certified Family Physician, Certified Professional Co-Active Coach, First Degree Black Belt in Kung Fu and formerly overweight person herself.  She has presented workshops and motivational speaking engagements to physicians, physical therapists, occupational therapists, nurses, and weight loss support groups.  For more information about Zing! Living’s services, free online course, or to purchase a book, visit:

http://www.ZingLiving.com.

You can also visit Dr. Lane at:

Twitter:  https://twitter.com/#!/melanielanemd
Facebook:  https://www.facebook.com/drlanehealthylivingcoach
LinkedIn:  http://www.linkedin.com/in/melanielanemd