A small study recently conducted by Georgetown University Medical Center found that patients with fibromyalgia may get a boost to their memories if they exercise several times a week.

Fibromyalgia is a disease that can cause widespread pain, fatigue, sleep and cognitive problems. It typically affects more women than men, and can be a difficult condition to treat.

Exercise has long been believed to be beneficial to those with fibromyalgia, helping to decrease pain. But this study marks the first time the cognitive benefits of exercise were measured.

At the beginning of the study, nine women were given a functional MRI test. They were also given memory tests and asked to describe their overall well-being and pain levels. Then, their fibromyalgia medications were suspended for six weeks.

They were given a second round of functional MRI and memory tests, and it was found that their memories worsened when they were off of the medication. Then, they started a regimen of aerobic exercise, 30 minutes a day, three times a week.

After they started exercising, the patients’ memory function returned to where it was before the testing began (when they were still taking medication).

More research is needed, and not every fibromyalgia patient is capable of exercising. But the bottom line is that there will be benefits from exercising for most people, whether they have fibromyalgia or not.

We’re in that time of year when New Year’s resolutions are made, and sometimes broken.  So often, those resolutions center on losing weight or getting more exercise.

There certainly is plenty of evidence to prove the benefits of exercises. Exercise can help you lose weight. It can boost your immunity so your body can fight off pesky illnesses like the common cold. It can reduce your risk of developing diabetes, cancer, heart disease and obesity.

But something that recently caught my eye was research that demonstrates that exercise can actually boost your brain’s cognitive abilities.

Researchers in Ireland assembled a group of young men, and quickly showed them the photos and names of a group of strangers.  After a break, the men were shown the photos again and asked to recall the names of the people pictured.

Half of the group then rode a stationary bike at increasingly strenuous levels. And the other half sat quietly for 30 minutes. At the end of that time, they took the test again.

The group that exercised performed significantly better on the test the second time than the group that didn’t exercise.

The reason seems to come from a chemical called BDNF. During the experiment, blood samples were taken and they found that the cycling participants had much higher levels of brain-derived neurotrophic factor (BDNF), which is known to promote the health of nerve cells. The men who sat quietly during the experiment didn’t have a comparable change in BDNF levels.

There are other research studies to support this too, like one out of Brazil that found elderly rats who exercised as little as five minutes several times a week had an increase in BDNF and could perform as well as much younger rats on memory tasks.

More research is needed to determine how much exercise, how often and how strenuous it needs to be. But no matter what, virtually any level of exercise will benefit you…body AND mind.

You can’t touch it or see it, but our bodies certainly do feel the effects of stress. The cumulative effect of too much stress is well known to me as a physician, and other health care providers. Perhaps you can recall filling out a form in your physician’s office where you’re asked to check off how much alcohol you drink in a week, if you have stomach pain, headaches or a decreased sex drive.

While stress isn’t the only reason for those symptoms, it certainly can be a major contributor. A little stress is actually good for the body, but problems emerge when stress piles up. Research has shown it can result in a wide variety of symptoms that include:

• Changes in appetite
• Social isolation
• Jaw clenching and headaches
• Difficulty concentrating
• Difficulty making decisions
• Increased anger, frustration or hostility
• Heartburn, stomach pain and nausea

As a physician, I’ve seen these manifestations of stress and many more in my patients. Prolonged stress takes a toll on the body, revving up chemicals so your body always thinks it’s in a state of “fight or flight.”

In your life, you may encounter a myriad of stressors, ranging from difficulties at work or in a relationship, to raising young children, to caring for aging parents, to mourning the loss of a loved one, to fighting traffic in a long commute.

It’s important that to learn to cope with stress, not only to make your life more enjoyable but to prevent more serious effects that can include:

• Headaches
• Bowel disorders
• Poor digestion
• Skin disorders
• Eating disorders
• Emotional disorders
• Asthma attacks
• High blood pressure/strokes
• Backache
• Arthritis/immune disorders
• Heart attacks
• Ulcers
• Sexual dysfunction

Start by carving out time, no matter how small, to do things you find relaxing. Take a walk, soak in a warm bath, re-read a favorite book, talk to a friend, get a massage, take a nap or listen to music.

Give yourself permission to say no to extra demands on your time; you can’t be everything to everyone. Teach yourself deep relaxation techniques using breathing and guided imagery. You’ll boost your immunity and decrease your stress.

And never be afraid to reach out for more help. You can seek the support of a psychologist, physician, group therapy or chaplain.

The potentially deadly effects of smoking have been known to the medical community and the public for decades: emphysema, cancer and heart disease, to name a few. Nicotine creates a powerful addiction that can prove extremely difficult to break.

So there are thousands of people who smoke a pack of cigarettes a day, year after year. New guidelines from the National Comprehensive Cancer Network (NCCN), the first to be published by a national advisory group, strongly recommend the use of low-dose computed tomography (LDCT) screening for select individuals at high risk for the disease. For the target group of heavy smokers 55 to 74 years of age, regular annual LDCT scans are recommended.

It’s a Category 1 recommendation, an extremely unusual designation from the NCCN that’s based on a wide body of clinical evidence. By contrast, the widely-used cancer screening tests colonoscopy and mammography are only Category 2A recommendations.

The recommendation is targeted at people who fall into the high-risk category. That’s defined as adults 55 to 74 years of age with history of smoking a pack a day for 30 years or more, even if they have stopped smoking within the past 15 years.

One of the trials upon which this recommendation was based found that 85 percent of lung cancers were found in Stage I using low-dose CT testing. By comparison, when CT screening wasn’t used, 85 percent of lung cancers were found in Stage III – IV.

Patients do much better in cancer treatment the earlier a cancer is found, and because the lung is a vital organ it’s much more difficult to biopsy than other organs like the breast or prostate.

But there is still debate in the medical community. While it’s proven that low-dose CT screening is a very effective tool for finding lung cancer, most insurers don’t cover it as a screening test, which means patients must pay out of pocket.

Additionally, I agree with my colleagues who recommend that patients not get CT lung cancer screening as a stand-alone test. The screening itself should be part of a process that involves your physician, a plan for smoking cessation, and possibly other specialists such as a medical oncologist or thoracic surgeon.

Talk to your doctor to find out if this valuable screening tool is right for you.

As a physician, it is very easy to recommend that my patients get their annual flu vaccine. The Centers for Disease Control estimate that the flu kills between 3,000 and 49,000 Americans every year, depending on the severity of the virus floating around. Side effects from the vaccine are mild, if any, and at the very least, the vaccine will help to protect you from feeling really miserable for a week (and missing school, work and family).

A few years back, Flu Mist was introduced, and it provides a very good option for people who prefer to avoid needles. Flu Mist contains a weakened, live version of the virus and is sprayed up the nose. The traditional vaccine is a dead virus, injected with a syringe, and is also a very good option.

But this year, some pharmacies and grocery stores (including some in the Tristate) began offering vaccination via jet injector. A jet injector is a device that allows vaccines and other medical liquids to be delivered through the skin with a burst of steam, no needle needed.

The only problem? There isn’t enough data at this point for the FDA to state that getting your flu vaccine via jet injector will provide you with protection from the flu. The FDA ordered pharmacies and physicians to stop administering the dead virus vaccine via jet injector, and to return to using the traditional syringe.

The FDA is not stating that people who received their flu vaccine via jet injector need to be re-vaccinated.

So, where does that leave you? If you haven’t received your flu vaccine yet, do it to protect yourself, your family, your co-workers. It takes about two weeks to build up immunity, and flu season really swings into high gear in our community in January and February.

If you had your vaccine via jet injector, talk to your physician. He or she can help you determine whether you should be re-vaccinated.

http://abcnews.go.com/blogs/health/2011/10/21/fda-warns-pharmacies-to-stop-pushing-needle-free-flu-vaccine/

http://www.fda.gov/BiologicsBloodVaccines/Vaccines/QuestionsaboutVaccines/ucm276773.htm

It seems that this time of year, you can’t turn around without bumping into chocolate. Big, golden boxes of candies are displayed at every department store. Your neighbor’s annual party always features a chocolate fountain. The break room at work is filled with chocolate goodies sent to the company. And the cookies…oh, the cookies!

If you’re a chocolate lover, you might have heard about research this fall from the University of Cambridge that found eating chocolate can reduce your risk of cardiovascular disease and stroke by a third or more.

The study evaluated more than 100,000 people and divided them into two groups: those who ate more than two bars of chocolate per week, and those who ate less. The group that ate more was found to have a reduced risk of heart disease and stroke. The study didn’t differentiate between milk chocolate, white chocolate or dark chocolate.

It’s promising news, but definitely not carte blanche to eat all the chocolate you want. The study didn’t evaluate what it is about chocolate that might protect the heart and brain, and didn’t discover what types of chocolate are more beneficial than others. And chocolate can still be high in fat and sugar, which contributes to obesity and Type 2 Diabetes.

There have been studies done previously that suggest dark chocolate, in particular, with its higher antioxidants, can have some health benefits.

So what’s the bottom line? If you’re a chocolate lover, eat small amounts, don’t binge, and work it off with some exercise.

So much of a successful physician/patient relationship is dependent upon time. I need to be able to spend time with you so I know your family history and your concerns about changes in your health, and so that I can ask questions and examine you. And you need to be able to spend time with me so you can share concerns, questions and receive information.

I’ve been fortunate to be able to create a practice where the physicians are able to spend more time with our patients. Now, we are adding shared medical visits as another benefit here at the office.

Shared medical visits are group appointments for about a dozen patients at a time where we meet to discuss concerns such as menopause or diabetes. The visits last about 90 minutes.

Shared medical visits are used across the country, from Harvard Vanguard in Boston to Cleveland Clinic and Kaiser Permanente.

I’m happy we’ll be offering them at my practice, because the benefits are outstanding. First, patients can spend more time with the physician. Second, there is an opportunity for patients to learn from each other’s questions and to provide support for each other as they face a similar disease or condition.

Shared medical visits are typically covered by insurance (talk to my office manager, Keri Rickenbaugh, if you have questions about your insurance coverage). And to protect your privacy, every patient in a shared medical visit is required to sign a privacy agreement.

I’m very excited to spend more time with you as we work toward your optimal health. Learn more about shared medical visits, including upcoming topics and dates:

http://lisalarkinmd.com/classes-services/shared-medical-appointments/

Have you seen television commercials with actress Jamie Lee Curtis talking about the “good bacteria” found in Activia yogurt? Or maybe you’ve noticed bottles of probiotic pills showing up in your grocer’s pharmacy?

Probiotics are sometimes referred to as good bacteria. They can be found in supplement form and in some fermented foods, like yogurt, sauerkraut and the spicy Korean condiment kim chee.

Our gastrointestinal tracts are filled with billions of good bacteria. They aid in the digestion process and offer protection from harmful bacteria.  Lately, some research has emerged that demonstrates probiotics can help to alleviate mild symptoms of colitis, including diarrhea.

If you’re one of the 1.4 million Americans who have colitis, you’ll know it’s an inflammation of the colon that can cause chronic abdominal pain and diarrhea. Colitis can be a difficult condition to live with, so it’s exciting news that probiotics may help some people who have it.

More research is needed, but there’s also some evidence indicating probiotics may help to reduce the severity and duration of the common cold, and prevent vaginal yeast infections and urinary tract infections.

Probiotics come in different forms. Some supplements require refrigeration while others can be stored at room temperature.  Side effects from taking probiotics are rare, and they can usually be taken safely by most adults.

Have a conversation with your doctor to see if a probiotic supplement might help you, and what the correct dosage is for you.

Several studies show probiotics can help alleviate mild symptoms of colitis, including diarrhea:
http://vitals.msnbc.msn.com/_news/2011/10/31/8565191-probiotics-do-ease-gut-problems-several-studies-show

An estimated 1.4 million Americans have colitis, an inflammation of the colon that can cause chronic abdominal pain and diarrhea.

Recent studies have shown the probiotics can alleviate symptoms for some people. Probiotics are “good” bacteria found in supplement form and in some fermented foods like yogurt, sauerkraut and kim chee.

Further research needs to be done to determine the right dosage. Talk to your doctor.

The American Heart Association has recently published new guidelines regarding optimal triglyceride levels in the journalCirculation. The new guidelines are based on a comprehensive review of more than 500 studies over the past 30 years. The guidelines suggest that an optimal level of non-fasting triglycerides is less than 100 mg/dL, although anything below 150 mg/dL is considered acceptable.

For patients with borderline triglyceride levels (ranging from 150 to 199 mg/dL), experts recommend losing 5% of current body weight and limiting carbohydrates to 50% to 60% of daily caloric intake. Weight loss has a beneficial effect on lipids and lipoproteins: A 5% to 10% weight reduction results in a 20% decrease in triglycerides, an approximate 15% reduction in LDL cholesterol and an 8% to 10% increase in HDL cholesterol. The AHA writing committee recommends limiting added sugars to less than 10% of daily caloric intake. All individuals are encouraged to exercise at moderate intensity for at least 150 minutes per week, as these activities can reduce triglyceride levels a further 20% to 30%.

Dietary recommendations based on triglyceride levels

Make sure you have been vaccinated against meningococcal meningitis!

Booster Dose for Menactra Now Recommended:
It has been recommended that a booster dose of the meningococcal vaccine be given in adolescents and other patients at high risk for meningococcal disease.   Here are the recommendations from the Advisory Committee on Immunization Practices for our patients age 11 through 18 years old:

Give primary dose at age 11 or 12 years.

Give booster dose:

• At age 16 years if primary dose at age 11 or 12
• At age 16 through 18 years if primary dose at age 13 through 15 years
• No booster needed if primary dose on or after age 16 years

Meningococcal disease is a serious bacterial illness. It is a leading cause of bacterial meningitis in children ages 2 through 18 years in the United States. Meningitis is an infection of the fluid surrounding the brain and spinal cord. Meningococcal disease also causes blood infections. About 1,000 – 2,600 people get meningococcal disease each year in the U.S. Even when they are treated with antibiotics, 10-15% of these people die.  But it is most common in infants less than one year of age and people with certain medical conditions, such as lack of a spleen.

Meningococcal infections can be treated with drugs such as penicillin. Still, about 1 out of every ten people who get the disease dies from it, and many others are affected for life. This is why preventing the disease through use of meningococcal vaccine is important for people at highest risk.

College freshmen that live in dormitories, and teenagers 15-19 have an increased risk of getting meningococcal disease.   Other people at risk include:

• Military recruits
• Patients with a damaged spleen or whose spleen has been removed
• Patients with terminal complement deficiency
• Microbiologists who are routinely exposed to Neisseria meningitidis (the causal bacteria)
• Travelers to countries in which the disease is common.

Menactra is the approved form of the vaccine for ages 11 – 55.  Menomune, the first meningococcal vaccine to be developed, is approved for those over age 55.

See these FAQ from the CDC:

Does my pre-teen or adolescent need it?
Yes. Adolescents age 16 through 21 years have the highest rates of meningococcal disease. Even though the disease is not very common, we want to prevent as many adolescents as possible from getting it. Meningococcal bacteria can cause severe disease, including meningitis and sepsis, resulting in permanent disabilities and even death.

At what age does my pre-teen or adolescents need it?
All 11-12 years olds should be vaccinated with meningococcal conjugate vaccine (MCV4). Now, a booster dose should be given at age 16 years. For adolescents who receive the first dose at age 13 through 15 years, a one-time booster dose should be administered, preferably at age 16 through 18 years, before the peak in increased risk. Adolescents who receive their first dose of MCV4 at or after age 16 years do not need a booster dose.

Why is a booster shot being recommended now?
When MCV4 (Menactra) was first recommended for adolescents in 2005, the expectation was that protection would last for 10 years; however, currently available data suggest it wanes in most adolescents within 5 years. Based on that information, a single dose at the recommended age of 11 or 12 years may not offer protection through the adolescent years at which risk for meningococcal infection is highest (16 though 21 years of age). If we didn’t recommend a booster dose, adolescents at highest risk would not be well protected.

What if my child is about to start college and got their first dose more than 5 years ago?
For the best protection, we recommend that your child receives a booster dose. Meningococcal vaccination is required to attend many colleges. The Advisory Committee on Immunization Practices (ACIP) suggests that your child receive the vaccine less than 5 years before starting school.

How soon after the first dose of vaccine can the booster dose be given?
Adolescents age 16 through 18 years can get the booster dose at any time. The minimum interval between doses is 8 weeks.