EAT, DRINK and BE MERRY!!

Eat, Drink and be Merry!

No really, I mean it. No one wants to think about health all the time.

If they do, it becomes a little obsessive and takes the fun out of life and that creates its own problems.

Sometimes as a doctor I feel as if I am the bad guy. People expect me to give them gloomy news and lectures about being healthy which are assumed to be boring. Worse still, they have a look on their faces like they have been called into the principal’s office and expect to be punished.

It’s not my job to be a parent or disciplinarian. In addition to the obvious role of treating medical conditions, I am available to give advice and be a resource when it comes to wellness and preventive medicine but only when someone wants it.

Being healthy should never be a chore, it should be something that we happily embrace and enjoy the benefits of. 

Things that you do to improve your health should be invigorating and put a smile on your face.

It is important to have hobbies and activities that you enjoy and indulge in regularly. I like to travel, it helps me recharge and open my mind to new things.

Everything is good in moderation, so please eat, drink and have a Merry Christmas and a Healthy and Happy New Year.

Dr. Tuakli

Quick notes: How to lose weight over the holidays

I said in a prior blog: the best way to lose weight is not to gain it in the first place. So here are some tips to help you maintain and hopefully lose weight during the holidays.

Chromium: double the amount you take and take it before the two heaviest meals of the day.

Chia seeds: these provide fiber and a feeling of fullness to prevent you from eating too much.

CoQ10: A great anti-oxidant that is very important in aging. It helps generate natural energy so you can keep moving.

Acidophilus probiotics: To keep your gut working well.

Apple Cider Vinegar: some find it curbs their appetite.

Drink 1 to 2 glasses of water before you sit down to that big meal, warm water is better than cold.

Get enough sleep

Figure out what exercise you can comfortably do daily over the holidays, even if it is just a walk around the block. Knock it out early in the day.

Last but not least, 'purge the pantry' after the big dinner and gift-giving there will be a lot of weight generating food and treats in your house (aka 'left-overs'). Get rid of them quickly and efficiently before they become a temptation  and you feel you need to 'finish' them off for days and weeks to come.

Best wishes for the season, have a healthy and happy new year!

Dr. Tuakli

How to avoid traveler's diarrhea

This is the first of a series of blogs about staying healthy while you travel.

The commonest cause of illness in people who travel is diarrhea and except for specific kinds of diarrheal diseases like typhoid and cholera there are no shots to protect you from it. The main reason people get diarrhea when they travel is because they become exposed to bacteria that their system is not used to. It is not because the people in the host country are dirty, when they come here they get diarrhea too.
The good news is that you can pretty much avoid diarrhea altogether if you follow certain precautions.
There are three stages of prevention, first is primary prevention where you avoid exposure to the bacteria altogether. Secondary is what to do if you do get diarrhea and tertiary is antibiotic medication if the diarrhea doesn't stop.

Step one: Take a mega acidophilus capsule once or twice a day, only take it with cold liquids. So you don't kill the live bacteria.
If you are going to a third world county take a tablespoon of peptobismol liquid every evening before dinner. Be aware that peptobismol can turn your tongue black so rinse your mouth after taking it, also know that it will give you black stools which are harmless.
Handling water is very important, only drink bottled water and make sure you don't buy it on the street. If you don't have access to bottled water, drink boiled water. Never put ice in your drinks and avoid salads because the lettuce and tomatoes may have been washed in dirty water. Only eat cooked vegetables and peeled fruits. Also avoid dairy products.
Have a liberal amount of hand sanitizer available at all times.
Sometimes despite your best efforts you still develop diarrhea.

First let's define diarrhea. Diarrhea is either defined by frequency or consistency. If you have six bowel movements a day and that is not your norm you have diarrhea, on the other hand just one bowel movement a day that is running out of you like water is also diarrhea. If you believe you have diarrhea you should move on to step two.

Step two: Take two capsules of Loperamide as soon as you think you have diarrhea and one after each loose stool (this is with the prescription strength). If your diarrhea persists longer than 24 hours immediately move to step three which includes taking a prescription antibiotic. It is very important to avoid dehydration especially in warmer countries so increase your fluid intake. Local sodas (unopened without ice) are good for this.

My goal for my patients when they travel is to make sure they do not need to access medical care for any reason. The level of healthcare services vary greatly in other countries and you certainly don't want a medical mistake to lead to your demise. Be wise and be safe.

Don't forget your sunblock and insect repellant.

Bon voyage

Travelogue: Madeira Portugal

Madeira, Portugal

This travelogue is about a small island off the coast of Portugal, later I will tell you why I recommend it but before I do let's talk about getting there.
As always when you see a deal that is too good to be true, it usually is. We traveled to the Azores, as that area is called, on TAP which is the Portuguese national airline. The price at first glance was unbelievable especially since we were going to be staying at a 5 star hotel.
The airline only flies out of Boston and Newark so we drove to New Jersey. Not a bad 3 hour ride. The price did not include any baggage beyond a handbag! Extra luggage cost $120 round trip and then there was the seat at the back across from the toilet. It cost another $45 per person, each way, to upgrade the seats. All I can say is beware the cheap deals they may end up costing more in the long run. We could have flown out of a closer airport for the same amount of money.
We wondered about racial profiling since we seemed to be the only people searched on the way in and I was again double screened in Lisbon. I'm OK with it if that is what it takes to be safe :)
I must say I did not sense any racism at all while my husband and I were in Madeira. The people were very gracious and welcoming.
Madiera is a beautiful island and like its people it is serene and calm. There were no hoards of tourists since it was late fall (Thanksgiving) but still the weather was very pleasant. The largest number of tourists seemed to be from England and not surprisingly almost everyone spoke English. It apparently does not appeal so much to young people because it doesn't have sandy beaches and major discotheques.

It has a wonderful relaxed atmosphere and no one is in a rush. There were an amazing number of restaurants everywhere, this is testament to the fact that their major industry is tourism. If you like sea food you are in luck, we saw very few cows on the island.
If you really want to enjoy Madeira you should go on a couple of island tours and then rent a car. You can criss cross the island and back in a day, the roads are great and the system of tunnels exciting. Up in the hills it is nice to see the homes and traditions. We bumped into a funeral procession walking from the church to the burial ground in Santana.
Many people go on lavadas which are walks that follow the irrigation system on the hillsides but even if you dont go on a lavada you will still get your steps in. We averaged 12,000 a day just walking downtown for dinner each day. If you are conditioned to avoid desserts Madeira is not for you, between afternoon tea and the dessert shops it is very hard to resist, I gave up trying after 2 days, I was so grateful for those steps!
Shopping: Madeira is famous for its wine, apart from this it is definitely not a shopping capital. It has a huge mall and the usual boutiques but certainly doesn't rival Madrid or Rome. Its a good place to buy lingerie, funny enough, much better quality, selection and price than in the US.
Spoiler alert: Black Friday sales are universal now as a result of globalization. The people have no idea what Thanksgiving is but they do sales on Black Friday, we noticed it in Rome last year too. Works for us!

Dance like no one is watching!

Seasons Greetings!

Dance like no one is watching, make a point of enjoying the Holiday season!

It’s hard to believe yet another year has sailed by in what seems like a blink of an eye. As always we must look forward to the opportunities inherent in a new year. I am proud to say 2018 will be my 29th year in practice.

If you are looking for gifts for the season 'Good Health' never goes out of fashion and we have lots of things and gift certificates  that you can give the ones you love. If you have money left in your HSA or flex spending account use it on something really worthwhile like our special deals or put it towards co-pays for next year.

Our year end specials for 2017 include:

10% off HCG Weight loss program

10% of Fillers and Botox

10% off all face products including Beautox

2 bottles of Stop aging skin therapy for $100 save $20

$200 off VIP program through December 31^st

5% off Anti-Aging program

5% off new HRT (Hormone replacement therapy) consult

All vitamins are 10% off through the end of the year

Also remember it is going to be a bad flu season, if you still haven’t had your flu shot get one now, it is free with your insurance! Stop by and get some Air Defense for the entire family.

I will be out of the office from December 19^th thru 26^th so call now for any appointments or refills. The office will be open from 9 AM to 5 PM except for Xmas and New Year’s day.

Let’s make 2018 the best yet!

Enjoy the season, stay warm and be well.

Dr. Tuakli