Puritan Ad

Personal Care - 468X60

Acne: 5 Don'ts of Acne Treatment

90% of Heartburn is Self Inflicted!

I often see patients in the office who are suffering from something that, although is distressing to them and causing them true discomfort, is completely self-inflicted.  These conditions remind me of the story an old doctor told me one time about a patient who came into his office complaining of a headache. 

As the old doctor interviewed the patient, he noticed that the patient kept banging himself in the head with a hammer...  In the coming months I'm going to be touching on several of these topics.  For now, Let's start with Heartburn, AKA: reflux, GERD or esophagitis.  Heartburn is not always self-inflicted, but easily over 90% of all the cases I see are...

Gastroesophageal reflux diseaseYour stomach was made to hold acid 24/7.  There is nothing wrong or abnormal with there being acid in your stomach.  It is actually a good thing; without it, you would not be able to digest much of your food.  Commercials on TV sometimes lead you to believe that acid is the problem, but the problem is when the acid lingers too long somewhere it should not be. 

Your esophagus is made to only endure an occasional splash of acid without much trouble, but cannot handle being in contact with stomach acid for hours at a time. 

The average person probably had some acid splash back up into their esophagus just a few minutes ago, but since their esophagus is not already irritated, they felt no discomfort, and didn't even know it happened.

There is a small pucker-muscle between your stomach and your esophagus that normally prevents much more than the occasional splash of acid back up into the esophagus.  As long as this muscle works properly, Heartburn is a rare thing to have.

So, with this understanding of heartburn, we can make some deductions:
  • stomach acid is a liquid, so it follows the law of gravity
  • anything that keeps open the way between stomach and esophagus increases Heartburn
  • anything that irritates the stomach or esophagus lining can increase Heartburn
  • anything that increases stomach pressure can increase Heartburn
No More Heartburn: Stop the Pain in 30 Days--Naturally! : The Safe, Effective Way to Prevent and Heal Chronic Gastrointestinal Disorders
Further Reading
Now with this understanding, it is pretty easy to create a list of things that will increase your risk of Heartburn, and increase how severe it is if you have it.  By knowing what can cause Heartburn, you can do thinks to prevent it, or make it better without medicine.  A good rule of thumb to remember is that although you might suffer from Heartburn symptoms during waking hours, most of the damage is actually done while you sleep. 

When you lie in bed, any leak in the pucker muscle between your stomach and esophagus allows the acidic stomach liquid to seep up into the esophagus.  Since the esophagus is made to handle an occasional acid attack without much pain, you don't notice this initially.  By the time that the esophagus' acid defenses are broken down, you are sound asleep. 

Therefore, you can lie in bed for hours with stomach acid eating at the lining of your esophagus before you have any pain.  The next day, however, the least splash of acid causes pain in the already irritated esophagus; ugh, Heartburn!

So our first way to prevent or improve Heartburn is to place a brick under each head-post of your bead.  Not enough lift for you to notice, but just enough to keep the acidic liquid down in the stomach where it belongs.  I have had patients who have taken thousands of dollars worth of Nexium or Prevacid or Protonix be able to stop the medicine within two weeks of putting the bricks where they belong.  For those of you with water-beds, no, this won't work.  Also, propping up on pillows will not work as well as the bricks because the act of propping up can actually increase pressure within the stomach.

The Gluten Connection: How Gluten Sensitivity May Be Sabotaging Your Health--And What You Can Do to Take Control Now
Possible Cause
 The next things we can discuss increase the pressure inside the stomach, thus pushing stomach acid up into the esophagus.  These are being overweight, and being pregnant, or propping up on too many pillows.  These things increase the pressure and decrease the room in the stomach and can push acid back up into the esophagus.  So yes, I have had many patients excitedly tell me that since they have lost that weight (or had that baby) the Heartburn is gone!  Eating a big meal right before bedtime can also lead to this same thing.

Another culprit that can lead to Heartburn is anything that relaxes the pucker-muscle between the stomach and the esophagus.  The most common substances that cause this are Nicotine, Caffeine and Alcohol.  This does not mean you have to stop drinking coffee, or the occasional mixed drink; it does, however, mean you need to QUIT SMOKING! (or dipping, or chewing) 

These substances have a time limited effect on this pucker-muscle so stopping them before dinner time will usually keep them from causing much problem, unless your esophagus is already irritated and inflamed by one of the other causes.  A Hiatus (Hiatal) Hernia can also cause this pucker-muscle to fail.  This is a more complicated mechanical process, but it is safe to say that if you have a hiatus hernia, you should avoid any of the other causes of Heartburn. 

Living Gluten-Free For Dummies
Makes it Easier

You must remember that the tissue lining your esophagus is like the skin on your hand; it will take 2-3 weeks for it to completely heal after you stop doing whatever it was that damaged it.  So if your stop doing all the wrong stuff and start doing all the right stuff, it's going to take from 2-3 weeks before you really feel the benefits of your changes.  Be patient, not having Heartburn it is worth the wait.  Years of continued reflux can lead to scarring of the esophagus or even cancer.

Anti-inflammatory medicines, such as Steroids and NSAIDS block a chemical pathway in the body and can lead to stomach irritation, which can lead to Heartburn.  If you must take these types of medicines, do so with your first meal of the day so the food protects the stomach lining, and you will probably be upright for the next few hours after taking it. 

More and more often, I am finding that patients with Heartburn have a mild form of lactose intolerance or gluten intolerance, and when they stop dairy and/or wheat products their Heartburn goes away.  I must confess that when I switched to Almond Milk (really good stuff!) my years-long mild Heartburn disappeared...

Bob's Red Mill Gluten Free Pizza Crust Mix, 16-Ounce Bags (Pack of 4)
Makes Great Pizza!

By following these few guidelines, and their underlying logic, you should not have to take medicines to treat your Heartburn more than occasionally.  These medicines seem relatively safe when taken for brief periods of time (usually no longer than six weeks), but may lead to a whole 'nother set of problems if taken for long periods of time.  Remember, the acid in your stomach is good and is supposed to be there...

  A worst-case patient scenario would be an overweight smoker who turns in after a late-night dinner of rib-eye, baked potato and all the fixin's, washed down with a couple of Whiskey Sours, finished off by a Marlboro Light, and two ibuprofen to prevent a headache in the morning.  Heartburn!  Don't be this guy...

You can email this to a friend any friend who would benefit from this info by clicking the little envelope icon () just below...

What is RelayHealth.com?

Hello again,

I have been asked the title question a few hundred times now in the office, so I thought I'd explain what RelayHealth.com is and how it can help you save time and even money.

Country Doctor's Book of Folk Remedies & Healing Wisdom
Good Info...
RelayHealth.com is a web-based service I have been a member of for a few years now and it allows you, the patient, to make/change/cancel appointments, request lab and xray results and even have a patient/doctor visit with yours-truly, all online from any computer in the world.  To some people this seems a little unusual, to others it is the best thing since see-through windows

Let's say that you have had a "cold" for 4-5 days and instead of it getting better, it seems to be morphing into a painful sinus infection.  Your choices at this point are:
  • suffer at home and hope it gets better
  • drag yourself off the couch, make yourself presentable, trudge to the office and hand over that co-pay
  • go to the E.R. and wait hours and pay thousands (please don't do this!)
  • sign on to Relayhealth.com, enter some simple medical history, initiate a Web-Visit with your doctor, then sit back and relax.  Before the end of the next business day you will have received a reply from me (yes it's really me!), along with an attached prescription, should you need one, that you can forward to the pharmacy of your choice.  A quick trip to pick up your prescription at the pharmacy drive-thru and your are now at a happy, healing place.  Keep in mind, you just had a visit with your personal doctor that probably cost less than your co-pay, and you did it all in your boxer-shorts (I doubt the lady at the pharmacy window noticed!)
RelayHealth.com is great for any non-life-threatening medical condition that is probably going to require a prescription to get better.  You are far too busy to have to sit and wait at my office for such things as a bladder infection, sinus infection, yeast infection, minor bronchitis, stop-smoking medicine, refills on some medicines, etc.

All Creatures Great and Small
A Timeless Book...
Another great use for RelayHealth.com is for busy people who take chronic medication that requires routine labwork.  Lets say you take something for High Blood Pressure, or High Cholesterol and you are on your last refill.  Now I am going to require that you come in for routine blood-work to make sure your liver and kidneys are happy with the medicine we have been using, but what if you are just too busy to make it to the office this month?  Or what if you are in Utah visiting your Aunt Hattie?  Simple, just log onto RelayHealth.com and explain the situation in a Web-Visit and a month's refill will soon be on its way, and we'll see you in the office next month.

Instead of sitting in the office (I promise we do everything we can to decrease your wait!) just to ask me some questions you have about your condition, or the medicine you take or a new therapy you read about on your favorite website, you can ask me all those things and receive a written response from yours-truly before the end of the next business day.  Oh, and did I mention you could do all this while lounging in your boxers?

Ok, ok, you get the point.  Your good health is what we work for and we always love to see you in the office, but if you'd rather, you always have your doctor 24/7 at RelayHealth.com.  You have to have been seen at least once in the office by me or Ms Kristin (our very smart and sweet FNP) in order to use RelayHealth.  Please tell your friends they don't have to sit in the doctor's office for waaaaay too long any more...
They Are Waiting 2...
You can email this to a friend any friend who would benefit from this info by clicking the little envelope icon () just below...

Home Grown has More Vitamins!

 Years ago doctors would tell you that you get all the vitamins you need from the food you eat.  They considered it a silly waste of money to take vitamin supplements.  Today, many health/nutrition authorities are sure the old guys were sorely misguided. 

Now, it seems that both are/were right; it is possible in decades past that crops grown with the old methods had measure-ably more vitamins and minerals in them than today's Corporation-Grown Franken-Fruits.

All New Square Foot Gardening: Grow More in Less Space!
An Easy Start
A new study of organically grown (the your great-great grandparents used to do it) versus modernly grown strawberries shows very reliably that strawberries grown the old-fashioned way (in real dirt, fed with lots of manure, and no chemicals) have more vitamins and antioxidants than strawberries grown the modern way (lots of chemicals, hormones, fertilizers and pesticides).  The home-grown strawberries also looked, felt and tasted better than the chemically tweaked variety. 

 It is easy to infer from this that organic gardening would not only yield better strawberries, but better produce of every kind, produce that is actually packed with vitamins, minerals and antioxidants, just like in the good old days.  So, that old country doctor from our childhood may have been right.

Landscaping With Fruit: Strawberry ground covers, blueberry hedges, grape arbors, and 39 other luscious fruits to make your yard an edible paradise. (A Homeowners Guide)
A Beautiful Way to Start

It is very possible that you could get all the vitamins and minerals you need from the properly grown foods in your diet.  Obviously, any doctor of today who opines this same theory about foods grown by the giant Agri-Companies really needs to brush up on his study of nutrition, and gardening.

So today's take-home message is, either grow your own, or buy it from someone you trust to grow it properly; it has now been proven to make a difference.  I'm sure that many a grand-parent and old country doctor are nodding their head as they read this; and will say "I told you so!"  The way your food is grown actually matters to your health and the health of your family.

Berries of all varieties are packed with energy-giving nutrients and health-protecting antioxidants; you can grow your own with very little cost and minimal effort, your family will love the taste and appreciate the nutrition.  My two favorite books on how to do it yourself can be found here and here.

You can email this to a friend any friend who would benefit from this info by clicking the little envelope icon () just below...

Small Town Medicine

I always dreamed of the big city.  I seems Human Nature will have us dream of things we have never experienced; only to discover that reality is often less thrilling than the dream.  Having received most of my medical training in the big city I'll have to say I was quite ready to return to the small town to practice medicine.
Country Doctors Casebook: Tales from the North Woods (Midwest Reflections)
Good Reading
 Practicing medicine in a big city entails a certain degree of preening and fawning in front of more prominent alpha-Doctors.  For it seems that big impressive words are much more important than leaving a patient with a good understanding of what is actually the matter with their health. 

Often, it seems that a patient of mine will return from a visit to a big-city specialist without a clue as to their diagnosis, prognosis, and more generally, just what the hell the guy meant to say at all.  I found myself having to explain their condition in Plain Words, the implications of it, and what they could actually do about the situation to either make it better, or just make it seem better.

An Incomplete Education: 3,684 Things You Should Have Learned but Probably Didn't
Necessary Reading
 So I figured there might be others out there who had just returned from the specialist - or even worse, their own doctor - wondering just what the hell the guy had been talking about.  Did he actually use the words positive predictive value in their very quick pseudo-conversation?  Had they really been expected to understand what an endarterectomy was?

In this blog you will find my attempts to explain just what doctors mean by the big words they say, and how, by living and eating properly, you can avoid many a doctor visit...

You can email this to a friend any friend who would benefit from this info by clicking the little envelope icon () just below...