May is National Stroke Awareness Month

May is National Stroke Awareness Month. In order to help the community understand the risk factors and symptoms of stroke, a leading cause of death and serious long-term disability in the United States1, local hospitals are offering Stroke & Aneurysm Vascular Screenings. They include non-invasive screenings for Abdominal Aortic Aneurysm, Peripheral Artery Disease and Carotid Artery Disease. Contact your local hospital for more information.

“Time is crucial in the treatment of stroke, as on average, every 40 seconds someone in the United States has a stroke and roughly every four minutes someone dies from a stroke,” said Satish Rao, M.D.1 “The earlier a stroke is recognized and the patient receives medical attention, the greater chance of recovery.”1 Strokes occur when a blood vessel carrying oxygen and vital nutrients to the brain is either blocked by a clot or ruptures. When this occurs, part of the brain is deprived of blood and oxygen, destroying millions of valuable nerve cells within minutes.

“If you suspect a stroke, remember the word FAST – F-A-S-T,” said Satish Rao, M.D. “F is for face – is your face drooping? A is for arms – can you lift both arms? S is for speech – are you slurring your words and T is for time, call 9-1-1 immediately because with stroke, time is brain.”1

The primary stroke symptoms include:

•Sudden numbness or weakness on one side of the face or facial drooping

•Sudden numbness or weakness in an arm or leg, especially on one side of the body

•Sudden confusion, trouble speaking or understanding speech

•Sudden trouble seeing in one or both eyes

•Sudden trouble walking, dizziness, loss of balance or coordination

•Sudden severe headache with no known cause

About Stroke

Stroke is a leading cause of death and serious, long-term disability in the United States1. According to the American Stroke Association, approximately 795,000 people experience a new or recurrent stroke each year, and 87 percent of these are ischemic strokes1. An acute ischemic stroke occurs when an obstruction, such as a blood clot, blocks blood flow to the brain. The obstruction deprives the brain of blood and oxygen, destroying valuable nerve cells in the affected area within minutes. The resulting damage can lead to significant disability including paralysis, speech problems and emotional difficulties. Treatment may be available if you get to the emergency room immediately upon recognition of stroke symptoms. Leading a healthy lifestyle, including lowering risk factors like high blood pressure and weight, exercising daily, and healthy eating can also help reduce your stroke risk.

For more information about stroke, visit

1 Heart Disease and Stroke Statistics – 2013 update: a report from the American Heart Association.

Circulation 2013; 127:e133-242; Epub Dec 12, 2012. American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231

She eats whatever she wants Part 2 – Lifestyle

Life is a gift; style is an option. Lifestyle affects the way we look and feel as much as the way we look and feel affects our lifestyle; 100%! We “wear fitness” so there is no mistaking someone who eats smart while weight training and rocking some daily cardio. You can spot them in a crowd and no doubt their friends will have similar habits and look as fit and happy as they do. It’s their lifestyle! At the same time; a lack of fitness (especially when overweight) can cultivate a lifestyle of negativity and fear; depriving you the joyous freedoms of self confidence, self worth, and self love. My dad always said “you can’t break something that’s already broken”. Is your lifestyle broken? Then do something about it! If you’re experiencing two or more of these lifestyle negatives then its time to make some changes: No “me time”, constantly feeling tired and weak, overweight, scared of the beach, skipping parties and other social events, hate your clothes, feeling down, seeing the glass half empty more often than full? There’s no law that says you have to accept all that! To change your course and head off into the confident sexy sunset; begin by answering three questions: Are you unhappy? Will looking good and feeling good improve your self image and put a smile back on your face? Sacrifice and courage are required for the journey to the other side…you ready to make permanent changes to get what you want? Yes to all of the above means its time for a major lifestyle change. You have a choice! Oh; I realize it’s scary and tough; I’ve been in your shoes but it’s a non-negotiable fact that to get change you must make change. It’s sad to see someone fail because they were too stubborn or afraid to give up their old lifestyle. Here’s what I learned: The most fearful and challenging events in your life will anoint you with strength, confidence, understanding, and purpose; all things that are needed to achieve happiness, peace, and personal success. Now are you ready for some of that? You’ll always wonder what you could have accomplished unless you “go for it”! Remember; there’s a whole other world out there that you’re missing; don’t feel that you’re stuck in this one. New places, faces, and tastes await you in the new world; just say yes and you’re on your way! This is the perfect day for your new lifestyle to begin; congratulations!

The restaurants they choose will also have healthy eating choices available because they have gravitated to them by striving to stay in shape. In a recent survey done in our PT studio I found that 8 out of 10 women who were successful demanded the following components be a part of their style: Gourmet restaurants, regularly scheduled outdoor activities, wine instead of beer, social time instead of television, walking, fashionable clothing, personal trainer or active gym membership, at least some “Me” time, preferred career, and friends that lead similar lives. Try adding a few items into your lifestyle and who knows; could make a slimming difference.

The GOOD and BAD on Carbs

Sometimes after we eat something, like a cookie, we think ‘that was not very healthy’ other times we eat a ‘health food’ and don’t even realize it was as bad as having a banana split! One thing you can look for that can set food apart, is the quality of the carbohydrates (carbs). Carbs are our energy source for EVERY cell in our body. We need carbs for our cells, and organ systems, but it needs to be the right kind of carb to do their jobs effectively. It all comes down to definitions. So let’s make sure we understand the difference between Simple Carbs (the bad ones) and Complex Carbs (the good ones).

Simple carbohydrate’s have little or no nutritional value because they were stripped of their nutrients during processing. We call these BAD CARBS. Food companies might ‘Enrich’ a simple carbohydrate food with a few nutrients after processing or if it had NO nutritional value to begin with, they ‘FORTIFY’ it. Examples of these simple carbs would be bleached or enriched flour, white rice, white pastas, pastries, sugary sodas, and even juice. These simple carbs are digested quickly and will compromise our immune system, contribute to weight gain, and promote diabetes and heart disease.

The best sources of energy for our bodies come from Complex carbohydrates, the GOOD CARBS. These can be found in WHOLE grains, vegetables, fruits and beans. They are naturally loaded with vitamins, minerals, and FIBER. They take longer to digest, which keeps us fuller longer, provide a more constant flow of energy for our bodies, promote a proper blood-sugar balance and encourage healthy digestion.

To promote a healthier body, along with Juice Plus, keep these 5 simple steps in mind:

  1. Fill your day with whole grains.Aim for at least 3 grams of fiber, 3 grams of protein and LESS than 6 grams of sugar in each serving of your whole grain cereal. If the first ingredient says ‘enriched’ or ‘fortified’ put it back. Look for ‘whole wheat’ or some other ‘whole’ grain.
  2. Stay away from white….instead of white rice try brown rice. Instead of white spaghetti, try whole wheat spaghetti. And, if you’re going to eat a baked potato, try a baked sweet potato. Regardless of the kind of potato, skip the sour cream – eat the skin and load it with other GOOD carbs like broccoli and beans, maybe even a little hummus…yummy!
  3. Choose WHOLE fruit instead of juice. – Craving a little OJ for breakfast? Eat the orange instead, it has 2x as much fiber than 12 ounces of juice, and an apple can absorb 20 times it’s weight in waste
  4. Bring on the Beans. They are slow to digest, an excellent source of fiber and protein and will keep you full for a long time.
  5. Serving size. A serving size isn’t the size of your plate…it’s about the size of a computer mouse.

January – National Blood Donors Month

The New Year is finally upon us. With the New year comes the making of resolutions. One resolution that should be on your list is giving blood. Every year the American Red Cross relies on people like you and me to keep their stock of blood full. Countless lives are saved everyday because of good clean blood. The Red Cross has seen a 10 percent drop in donations this winter. The dip in donations has also caused a decrease in the local blood inventory of key blood types including O-negative, A-negative and B-negative.The Red Cross urges everyone to make donating blood a priority this winter. Your help could mean hope for those in need.  To find out where you can give blood and to schedule your appointment, go to or call 1-800-RED CROSS, for additional information.

Medical Technology

 Dr. Alvin Rajkomar was doing rounds with his team at the University of California, San Francisco Medical Center when he came    upon a puzzling case: a frail, elderly patient with a dangerously low sodium level.

As a third-year resident in internal medicine, Dr. Rajkomar was the senior member of the team, and the others looked to him for guidance. An infusion of saline was the answer, but the tricky part lay in the details. Concentration? Volume? Improper treatment could lead to brain swelling, seizures or even death.       

Dr. Rajkomar had been on call for 24 hours and was exhausted, but the clinical uncertainty was “like a shot of adrenaline,” he said. He reached into a deep pocket of his white coat and produced not a well-thumbed handbook but his iPhone.       

With a tap on an app called MedCalc, he had enough answers within a minute to start the saline at precisely the right rate.       

The history of medicine is defined by advances born of bioscience. But never before has it been driven to this degree by digital technology.       

The proliferation of gadgets, apps and Web-based information has given clinicians — especially young ones like Dr. Rajkomar, who is 28 — a black bag of new tools: new ways to diagnose symptoms and treat patients, to obtain and share information, to think about what it means to be both a doctor and a patient.       

And it has created something of a generational divide. Older doctors admire, even envy, their young colleagues’ ease with new technology. But they worry that the human connections that lie at the core of medical practice are at risk of being lost.       

“Just adding an app won’t necessarily make people better doctors or more caring clinicians,” said Dr. Paul C. Tang, chief innovation and technology officer at Palo Alto Medical Foundation in Palo Alto, Calif. “What we need to learn is how to use technology to be better, more humane professionals.”       

Dr. Paul A. Heineken, 66, a primary care physician, is a revered figure at the San Francisco V.A. Medical Center. He is part of a generation that shared longstanding assumptions about the way medicine is practiced: Physicians are the unambiguous source of medical knowledge; notes and orders are written in paper records while standing at the nurses’ station; and X-rays are film placed on light boxes and viewed over a radiologist’s shoulder.       

One recent morning, while leading trainees through the hospital’s wards, Dr. Heineken faced the delicate task of every teacher of medicine — using the gravely ill to impart knowledge.       

The team arrived at the room of a 90-year-old World War II veteran who was dying — a ghost of a man, his face etched with pain, the veins in his neck protruding from the pressure of his failing heart.       

Dr. Heineken apologized for the intrusion, and the patient forced a smile. The doctor knelt at the bedside to perform the time-honored tradition of percussing the heart. “Do it like this,” he said, placing his left hand over the man’s heart, and tapping its middle finger with the middle finger of his right.       

One by one, each trainee took a turn. An X-ray or echocardiogram would do the job more accurately. But Dr. Heineken wanted the students to experience discovering an enlarged heart in a physical exam.       

Dr. Heineken fills his teaching days with similar lessons, which can mean struggling upstream against a current of technology. Through his career, he has seen the advent of CT scans, ultrasounds, M.R.I.’s and countless new lab tests. He has watched peers turn their backs on patients while struggling with a new computer system, or rush patients through their appointments while forgetting the most fundamental tools — their eyes and ears.       

For these reasons, he makes a point of requiring something old-fashioned of his trainees.       

“I tell them that their first reflex should be to look at the patient, not the computer,” Dr. Heineken said. And he tells the team to return to each patient’s bedside at day’s end. “I say, ‘Don’t go to a computer; go back to the room, sit down and listen to them. And don’t look like you’re in a hurry.’”


Published: October 8, 2012

A version of this article appeared in print on October 9, 2012, on page D1 of the New York edition with the headline: Redefining Medicine With Apps And iPads.

Safe Toys and Gifts Month

December is “Safe Toys and Gifts Month,” so be sure to think twice about who your giving to and what they are to receive.


During this time of year lots of toys will be given and received to kids all over the world. Are we aware of the dangers these toys bring? Lots of toys come with small parts, and I don’t know about you, but my kids somehow seem to fit those parts in their mouth, up their nose, or in their ears. Toys these days have the potential to be hazardous without the proper thought and supervision. Be aware of the warnings listed on toys with small parts, especially if young children are in the home. We hope you have a glorious and safe holiday season.