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'wellness' posts

High blood pressure in the doctor’s office

“I don’t get it! Everytime I come to your office my blood pressure is high. It’s never like that anywhere else!”

“White Coat Hypertension” is very common and affects many people, even those who feel at ease with their physician. But whether your blood pressure is low or high at the doctor’s office, if you’ve been told you might have hypertension, you are likely to find yourself at home, or in a grocery or drug store with your arm in a cuff trying to figure out if your blood pressure is reasonable. A key to successful self-measurement is knowing the proper technique.

The big studies of blood pressure in the population upon which we base all our definitions of normal and high values were careful to take their measurements in a standardized way. The patient should avoid coffee, tea, nicotine, and other stimulants for at least 30 minutes prior to the test. She should sit quietly for a full 10 minutes reading or softly conversing before measurement. Even reaching across the table to pull the BP cuff near is to be avoided. (Get the machinery next to you when you first sit down.) Use an upper arm cuff. Forearm and finger devices are not reliable. Feet should be flat on the floor, clothing comfortable, and a bare arm may be needed for some machines. Two or three measurements a few minutes apart may be averaged.

A few caveats to mention: if one arm is higher than the other, you have to go by the higher side. Humans have a natural ‘diurnal’ variation, with most of us having a little higher blood pressure in the morning compared with later in the day. Blood pressure rises with physical and mental exertion and takes some time to come down, so don’t expect a resting value if you’ve not been at rest for 10 minutes or more.

Blood pressure is dynamic and always changing. The majority of values should be in a good range; your physician can help you determine if your numbers are in the range you need for optimal health.

Can stress cause a rash?

“Did my stress cause this rash?!”

A patient recently asked this question half-jokingly, but as we talked further about his life circumstances, he came to the answer of his own question. Issues between him and a loved one came tumbling out, his persistent unhappiness with the present state of affairs made it clear that yes, very much so, his stress is playing a role in his rash.

How can this be possible? And if it is true, that our mental states can give rise to very straightforwardly visible physical maladies, how are we to respond?

The interplay of our minds and bodies runs deep. The more time I spend in the practice of medicine, the more amazed I am at the powerful effects that run back and forth between the two poles of our being, the physical and the mental aspects of our selves. Physical events, such as broken bones, strokes, and degenerative disease strike ...

10 things that doctors admire about their patients

Instead of only focusing on what patients need to do to improve their health, let's look at what they bring to a doctor’s appointment.

Here are 10 things that physicians love about their patients:

10. Their preparedness. One might think that doctors cringe when patients pull out “the list” of their concerns and questions. On the contrary: this adds great efficiency and still helps us to be complete in what we do. The last thing a doctor wants is for a patient to go home and worry about something they forgot to ask us.

9. Their self-discipline. I have seen many patients shed pounds, shake off cigarettes, trim down on alcohol consumption and put on those sneakers day after day. If I’m honest, I’d say that I myself exercise just so I can look these inspiring individuals in the eyes when we talk about fitness.

8. Their knowledge. I don’t always know the “latest and greatest” developments in medicine. My patients are well-informed, and not uncommonly alert me to something I need to research or bone up on. They are “iron sharpening iron.”

7. Their ...

Tips for dealing with dust allergy

Although it’s hard to imagine, we are living and sleeping with thousands of little bugs called dust mites.

For many people, ignorance is bliss, but for those who are allergic, these bugs can cause lots of problems. Dust mite allergy symptoms include eye redness and discharge, itching, sneezing, congestion and trouble breathing. Dust mites are a problem all year long, but can be more obvious in the winter when people spend more time indoors.

Dust mites like to burrow into soft surfaces, like carpets, curtains, pillows, mattresses and stuffed animals. It is impossible to completely kill all dust mites, but here are six ways to minimize exposure:

Immune-boosting foods: what you need to know about antioxidants for your health

I felt compelled to write this post primarily because I am exhausted from witnessing those dramatic cold and flu commercials I see everywhere. We all know how to treat a cold or the flu: rest, fluids, and antioxidant rich foods. Yet many of us (I’m guilty, too) reach for Emergen-C thinking that’s all we need and give little (or no) thought to what ‘antioxidant rich’ foods may do to help. So for your health and mine, I’ve highlighted some of those antioxidant-rich foods that should be featured on our plates this season.

First – what are antioxidants?

Antioxidants are nutrients and enzymes that quench free radicals (unstable harmful molecules that are the result of oxidative damage), therefore protecting your cells from damage. Free radicals can do a number on your immune system, thus blunting your ability to respond to a cold. Major antioxidants include Carotenes (beta-carotene), Vitamin C, Vitamin E, Selenium & Zinc.

Where can I get or find antioxidants?

Flu information

As you hear more about flu impacting our community, you may wonder what you can do. Here are answers to some of the frequently asked questions about the flu from King County Public Health.

Also, during the month of January, Public Health – Seattle & King County is offering free flu vaccinations for people without insurance or who cannot afford to pay. For dates, times, locations and more information, click here.

Flu prevention

  • Flu vaccination is the single best way to protect yourself and your loved ones from flu. Health experts recommend flu vaccine for all people 6 months and older, especially for pregnant women and other high-risk persons.  Make sure everyone who lives with or cares for an infant younger than 6 months and with pregnant women gets vaccinated to protect the infant from getting flu.
  • You can also take these everyday steps to protect yourself against the flu:
    • Wash your hands often with soap and water, or use alcohol-based hand cleaners.
    • Avoid touching your eyes, nose, or mouth. Touching these areas spreads germs.
    • Try to avoid close contact with sick people.
  • Help stop the spread of flu:
    • Cover your nose and mouth with your sleeve or a tissue when you cough or sneeze.
    • Stay home from work and school if you are sick until at least 24 hours after your fever is gone, and avoid close contact with others.

How to get flu vaccine

  • Flu vaccine (shots and nasal spray) is available at many healthcare provider offices and pharmacies. You can use http://flushot.healthmap.org to help locate it near you.
     

  • To find free or low-cost flu vaccine in King County call the Family Health Hotline at 1-800-322-2588 or visit www.parenthelp123.org.

Flu illness and symptoms

  • For the majority ...

Eczema season

"It's eczema season" is an often repeated phrase for me lately.

This time of year, I always find myself seeing more patients with eczema. The common presenting complaint is a persistent rash that itches so much that it disturbs sleep. The dry, itchy patches of skin are commonly seen on the back, sides of the torso, arms and legs, but can happen almost anywhere. People with a history of allergies, asthma, or childhood eczema are even more likely to develop eczema in the fall or winter.

There are a number of contributing factors to the increased incidence of eczema in the winter:

Furnaces run more, drying out the air inside homes and buildings. We wear more clothing, increasing the friction on our skin. Hot water feels better, so we tend to spend more time in the shower or bath.

That last one sounds counter-intuitive, but ...

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