From Beijing to Shangai, China is a fascinating country!

Hi there!
I just got back from China and thought I would share a (short) travel log with you.
China is an amazing country and their history dates back centuries. Most of the towns we went to were 2500 years old!
To see the architecture and walls that were put in place so long ago before the times of tractors and bulldozers, that are still standing is amazing. On the modern end of the spectrum the technology in the schools and the children's dedication to learning is also astonishing. America by contrast is not yet 300 years old and has a lot of catching up to do.
I was with a group representing Columbia in a cultural exchange with our sister city of Liyang.
Of note most of the tourism in China is actually internal and there are hoards of people everywhere crowding every tourist attraction. it is nice to see that they are so interested in their country and their history.
Getting a visa is much more expensive and more of an ordeal than most other countries so if you plan to go there give yourself a couple of months to get the visa squared away. Another tip: you will be traveling 24 hours or more each way, this is draining so make sure everything you need is in your hand luggage. Get a travel consult not because you need a lot of shots but you can get advice that can prevent you getting sick on your trip: what to take, prevent blood clots, infections etc
 Pictures are worth a thousand words so here goes!

Liyang middle school

With newlyweds

Black eggs!

BREAST CANCER AWARENESS

Yoghurt!

A new road sign............................South Africa

A different kind of road sign

If you ever have the opportunity to go to South Africa grab it with both hands and don’t think twice.

Cape Town is the most beautiful city in the world, it has to be seen to be believed. The whole of South Africa is phenomenal but especially the Cape area. From the vineyards to the beaches, from the mountains to the wildlife it is all amazing.

For your first trip it is well worth going with a tour company because you will see so much without having to worry about the logistics of getting around and experiencing everything.

I have attached one of my favorite road signs followed by a series of pictures, I took this month (June) with my phone.

Unfortunately, I can’t share enough shots to do the country justice but hopefully it will give you a little flavor of the awesome beauty of the place.

If you want to go and/or have questions I am always available to answer them. Enjoy!

Watch out!

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

Central Europe: Prague Czech Republic, Vienna Austria, Regensburg Germany, Bratislava Slovakia and Budapest Hungary.

This summer we sailed down the Danube from Germany to Hungary. We started our trip in Prague which is the capital of the Czech Republic. There was no sign of the old 'iron curtain' although we did go to the museum of communism, which looked like an old movie set inside. It made the old days of Soviet rule seem very dark and bleak. No sign of all that now! Prague is a very 'in' place right now and there were huge crowds of tourists. Globalization has made everything so familiar and almost everyone speaks English. For me the high points were a trip to the symphony and the amazing hotel we stayed in, the Imperial. It is self described as an 'art deco' hotel but it is so much more. The architecture (and the menu) in the restaurant were its stand out features. I wasn't impressed with the shopping but maybe I didn't go to the right places.
Next up was Passau and Regensburg in Germany. Two very nice towns where you don't have to go anywhere special to find great food and ambience. They both have a relaxed small town feel. Shoe shops everywhere especially Birkenstocks! My husband does not stop talking about the leberkase    he ate in Germany, a meatloaf-like concoction of sausage and cheese that is baked in the oven (see picture below).
From Regensburg we sailed on the Danube to Vienna. Spoiler alert the Danube is not blue! Not even close: greenish brown more like. One of the guides explained to us that if you go high up in the hills, when the sun is full at mid day, on a day when the sky is cloudless (and wear your blue tinted glasses:) looking from above it can appear to be blue. Sort of sounded like the sighting of an eclipse!
Unfortunately this year central Europe suffered an unusual heat wave, temperatures were 25 degrees above normal so Vienna was hot. There were hoards of tourists everywhere and it was hard to appreciate the usual tourist attractions. Believe it or not we didnt even sample the famous viennese chocolate cake. Of course, we took in a symphony which was nice and although we didnt go into any stores except to cool off, there was obviously excellent shopping to be done.

Onward to Bratislava and its huge iconic castle. Bratislava is the capital of Slovakia the other half of the former Czechoslovakia. I always knew the name of that country because I remembered hearing that my mother as a student had ventured behind the iron curtain with my Dad in the 50's and apparently that was a major deal. Its very western now and in the city we didn't need an interpreter. Partly because of the heat and the walking we got a little castle/cathedral/palace weary on the trip because they are all so much larger than life. The logistics of building these structures however has me in awe, how could they move those huge stones without any cranes? How many centuries of back breaking work would it take to create them even today?

Our last stop was BudaPest in Hungary, this is a city made of two cities Buda and Pest (pronounced Pesh). Two things you should know if you want to go here: the cost of everything is soooo reasonable, great place to shop and remember to go to the peoples market down the street from the shopping mall in Buda and get the world's best cheesecake from "Pam's". There is the antique and knick knack market that all the tourists go to downtown. My advice is don't bother with it unless you just want to buy paprika, which is what Hungary is famous for. The people's market is much better, better quality, better prices, more authentic. Last but not least just outside Budapest about 30 minutes ride is a town called Szentendra, it is referred to as an artist's colony but it is so much more. The shops are so quaint and they sell everything. One even had anti-aging face cream with 'stem cell extracts'! The antique stores have real antiques at very reasonable prices. If you are a shopper Hungary is for you!

Travel is inspiring and informing, it would be great if more people would travel and interact with people foreign to themselves and their way of life, maybe then we could begin to stamp out xenophobia.

The Body Holiday in Saint Lucia

If you are into sun, sand, activities too numerous to mention, daily massages and all your food and drink included you should try the Body Holiday in St. Lucia. What a fabulous 5 star resort, the service is unparalleled.
I recently returned from the beautiful island of St. Lucia where the Body Holiday was kind enough to allow me to speak and do a book signing. This was the first reveal of my new book Sex, Sanity and Sleep. To make things more exciting a couple of my patients were there as well.

After my talk I had the opportunity to chat with many women and as usual the theme song was "why doesn't anyone else talk about these issues so women don't have to suffer so much?" Well this was a start, I was able to reach out to women from Boston to Alabama as well as many in the UK and Canada.

I have talked to the resort manager about having more women's health as well as anti-aging seminars in the future. Hopefully they will materialize, if you would be interested in a week of pampering please let me know.

Back from London!

As promised I am starting my travelogue about my most recent trip.  Yesterday my husband and I returned from London, UK where we went for ‘spring break’. 

We  had stayed in Paddington, an area that is very central, in west London. It is not purely by chance that I like to stay in Paddington, it happens to be the area I grew up in until I went to high school. So I have family there including an elderly, mentally ill aunt whose situation I tried to impact while I was there.

One of my cousins had driven down from Southport (4 hours away) to pick us up at the airport and spend the day. We were intrigued by his self driving car. After a stop in north London to see my mother, we dropped the huge suitcase of clothes I had brought for my aunt at her apartment. She stays in a building for the elderly and it was fascinating to see the difference in how the ‘welfare state’ in England works compared to the US.  Unlike here, the term welfare does not have a negative connotation to the man on the street.

We stayed at the Park Grand Paddington Hotel, my goodness, despite its grand title and 4 star rating it was the smallest hotel room I have ever seen (even in Paris, which is notorious for small spaces). We had to literally crawl across the bed to open the curtains in the morning. The best thing about this hotel however (besides being a 10 minute walk to Paddington station) is the free cell phone that comes with the room. You can call anywhere in the world for free and it works throughout England. It was great for getting directions, google-ing and keeping up with my family.

One thing about most neighborhoods in central London, physically, they don’t seem to change except for the new freeways. Many neighborhoods look exactly the same as they did 50+ years ago. I took a picture in front of my childhood home, its hard to imagine that the top flat where we had stayed just sold for 300,000 pounds and the bottom for almost a million. Outside, except for the dark unpainted door that I used to hate, it doesn’t look that different. The pavement appears to be the same original stones that were there when I was a child.

After two days of family issues our ‘vacation’ began, my poor husband was starting to look exhausted as we started our planned day trip to Oxford. We left from Paddington station and the trip took exactly 1 hour and 5 minutes. If you travel outside of rush hour (after 9AM) the prices are very reasonable. The ticket was about $30 round trip. After the obligatory visit to two world famous bookstores (my husband is a professor) we walked around the town and in and out of the college campus. A very pretty and historical town, the weather was great, which in England means it did not rain. I stuffed my face with an English scone with all the toppings, clotted cream, jam and butter. Not very healthy but it had to be done J.

FYI, if you go to Oxford you can skip the trip up the tower, not much to see.  But definitely go to the natural history museum especially if you are with kids: everything is very hands on and they have life-like animals from all over the world along with dinosaur bones and other fascinating articles in an amazing building. We were able to tour the town, take in the atmosphere, buy books and return by 4pm. Great day.

Other highlights of the trip were a luncheon cruise down the river Thames with my cousins and a trip to Covent garden to see the Carole King musical ‘Beautiful’. It’s a cheerful sing-along kind of show, very entertaining. It happened to coincide with St Patrick’s Day fortunately we managed to get out of there before too many revelers got sloshed (drunk).

London is an incredibly vibrant city but it is by no means the only place one should visit in the UK.  The truth be told it would probably take a year or more to really see all the sights.

I was happy to discover that one side benefit of travelling is a refreshing break from ‘breaking news’!

Our trip was short and sweet and the flight in and out was very efficient, landing ahead of time. FYI, if you are going to fly out of Dulles save yourself the hassle and park at the Crowne Plaza hotel their shuttle is free and very efficient.

I started to read 'the happiness project' on the way back. I didn’t get through too much of it but I share some of the insights from it that are particularly good for health in my next blog.

Last but not least, keep moving whether you are here or abroad.

Cheers!

Dr. Tuakli

Saturday Hours for 2017……………..starts this weekend!

Happy New Year! I am going to make a concerted effort to blog more this year, not just about 'health' but about 'life' in general.

Things that I find interesting and want to share. One subject is travel, whenever a patient asks me where I went and I tell them, they always say "did you like it?" or "what is it like?" Last year I went to England (my birth place), Spain, Italy, Portugal and St. Lucia and I have so much to tell you about these exciting places. Where better to talk about it than my blog? If you like to hear about this kind of thing please remember to give it a thumbs up and I will keep it up :)

Anyway, stay tuned, I will talk about that in my next blog.  The purpose of this one is a little more mundane: Don't forget that we are in the Laurel office on the first Saturday morning of the month………..which means I will be there this weekend. Give us a call for an appointment so you don't have to miss work or get stressed while trying to commute.
Warm regards and Best wishes for 2017. Dr. Tuakli