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What are some tips to avoid disappointments in IVF?
Additional Info
- Segment Number 2
- Audio File ER_101/1526er5b.mp3
- Featured Speaker Angeline Beltsos, MD
- Guest Website aParent IVF
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Guest Bio
Dr. Angeline Beltsos is board certified in Obstetrics and Gynecology and in Reproductive Endocrinology and Infertility (REI), practicing medicine since 1991.
Dr. Beltsos completed her residency in Obstetrics and Gynecology at Loyola University in 1995, followed by a fellowship in REI at Washington University in St. Louis, Missouri, completed in 1997.
Dr. Beltsos is also the FCI Clinical Research Division Director and participates in a number of research projects and scientific publications. She has received numerous awards in teaching and has been honored as 'top doctor' from Castle Connelly for several years.
She is a popular speaker both nationally and internationally, and a frequent media resource on the topic of infertility. She is the executive chairperson for the Midwest Reproductive Symposium, an international conference of fertility experts. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
How does the new migraine drug (CGRP) work?
Additional Info
- Segment Number 1
- Audio File ER_101/1526er5a.mp3
- Featured Speaker Richard Lipton, MD
- Organization Albert Einstein College of Medicine
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Guest Bio
Richard B. Lipton, M.D., is the Edwin S. Lowe Professor and Vice-Chair of Neurology, Professor of Epidemiology and Population Health and Professor of Psychiatry and Behavioral Sciences at Einstein.
He also is Director of the Montefiore Headache Center. After graduating from the University of Chicago Pritzker School of Medicine, he did both a neurology residency and a fellowship in Clinical Neurophysiology and Epilepsy at Einstein.
He did a second fellowship in Neuro-epidemiology at the Columbia University. A UCNS-certified headache clinician, he is also a clinical trialist and epidemiologist. He is Past President of the American Headache Society and currently serves on the AHS Board. He is also Chair of the AHS's Chronic Migraine Education Program (CMEP).
He has written over 600 articles in peer reviewed journals and 10 books, including two editions of Wolff's Headache, as well as Headache in Clinical Practice and Migraine and Other Headaches.
His research interests include the epidemiology and burden of episodic migraine as well as risk factors and prevention of chronic migraine. He has developed several measures widely used in clinical practice and research, including ID-Migraine, ID-Chronic Migraine, the Migraine Disability Assessment Scale (MIDAS), the Migraine Treatment Optimization Questionnaire (mTOQ), as well as the Allodynia Symptom Checklist (ASC).
His work has also examined migraine genetics and biomarkers, migraine's comorbidities as well as health-related quality of life and health economics. He has conducted numerous clinical trials and lead national and international clinical trials. He is on the Editorial Boards of several journals, including Neurology.
Dr. Lipton is a three-time winner of the Wolff Award and recipient of the Enrico Greppi Award, all for excellence in headache research. He was recently identified by Thompson Scientific as the most frequently referenced author of scientific publications on migraine in the world. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
U.S. emergency rooms treated 123,355 high heel related injuries between 2002 and 2012.
Additional Info
- Segment Number 3
- Audio File ER_101/1525er5c.mp3
- Featured Speaker Gerald McGwin, MS, PhD
- Organization UAB
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Guest Bio
Dr. Gerald McGwin is a Professor and Vice Chairman in the Department of Epidemiology in the School of Public Health at the University of Alabama at Birmingham (UAB).
He also holds appointments in the Departments of Surgery and Ophthalmology at the UAB School of Medicine. Dr. McGwin obtained his B.S. degree from the University of Vermont and his M.S. degree from Harvard University.
He is an associate editor for the American Journal of Epidemiology, the preeminent journal in that field. Dr. McGwin has a lengthy and distinguished scientific reputation as a researcher having authored or co-authored over 300 peer-reviewed manuscripts, with an emphasis on injury and ophthalmic epidemiology.
Dr. McGwin currently serves as the Associate Director for the Center of Injury Sciences at UAB and the Associate Director for the Clinical Research Unit in the Department of Ophthalmology. He is also the transportation domain director for the CDC-funded Injury Control Research Center at UAB.
Dr. McGwin is also director of the UAB Center for Clinical and Translations Science (CCTS) doctoral program and co-leader of the CCTS' Biostatistics, Epidemiology and Research Design component. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
Are follow-up appointments always needed?
Additional Info
- Segment Number 2
- Audio File ER_101/1525er5b.mp3
- Featured Speaker Juan Fitz, MD
- Organization American College of Emergency Physicians
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Guest Bio
Dr. Juan Fitz is a staff emergency physician at Covenant Medical Center in Lubbock, Texas. He is also on the clinical faculty at Texas tech Health Sciences Center. Dr. Fitz is a longtime member of the American College of Emergency Physicians and serves as a national spokesperson for ACEP.
- Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
What are some foods that can help heal your liver?
Additional Info
- Segment Number 1
- Audio File ER_101/1525er5a.mp3
- Featured Speaker Michelle Lai, MD, MPH
- Organization Ulyssess Press
- Book Title The Liver Healing Diet
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Guest Bio
Michelle Lai, MD, MPH, is a hepatologist at Beth Israel Deaconess Medical Center, one of the top liver health centers in the country, and an assistant professor in medicine at Harvard Medical School.
She takes care of patients with liver diseases and is working on clinical research in non-alcoholic fatty liver disease. She earned a bachelor of arts degree in biology from Harvard University, and a medical degree and a master's degree in public health from Columbia University. She completed her internal medicine, gastroenterology, and transplant hepatology training at Beth Israel Deaconess Medical Center. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
Is there a difference between an ER and an urgent care clinic?
Additional Info
- Segment Number 5
- Audio File ER_101/1524er5e.mp3
- Featured Speaker Ryan Stanton, MD, FACEP
- Organization American College of Emergency Physicians
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Guest Bio
Dr. Ryan Stanton is an emergency physician at Baptist Health Lexington in Lexington, Kentucky. He is the recipient of ACEP's 2012 National Spokesperson of the Year Award, 2014 911 Network Member of the Year Award and was named 2012 Lexington Young Professionals "Rising Star" Award.
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Transcription
RadioMD Presents: Dr. Leigh Show | Original Air Date: June 12, 2015
Host: Leigh Vinocur, MD
RadioMD. RadioMD.com. Spokesperson for the American College of Emergency Physicians. She's Dr. Leigh, and the Dr. Leigh Vinocur Show.
DR. LEIGH: Hi, welcome back to the show. We have a very esteemed guest I am honored to have on. He's talking about his latest book, which is Disease Proof: The Remarkable Truth About What Makes Us Well. Dr. David Katz is president of the American College of Lifestyle Medicine. He's the founding director of Yale University's Yale Griffin Prevention Research Center.
Welcome, Dr. Katz. Thanks for being on the show.
DR. KATZ: Thank you, Leigh. Great to be with you.
DR. LEIGH: So, this is fascinating because – and maybe go back in history, people were dying of infectious diseases at 30. So, now we're living a little longer. This chronic disease issue-- is it that we are living longer and the body is wearing down? Or is it we are wearing down our bodies? What is the actual percentage that you can contribute to lifestyle that contributes to chronic diseases we see today?
DR. KATZ: At least 80 percent of the chronic disease burden in the world. So, the answer to those questions – and they're great questions – is yes to both. We are living longer and eventually body parts do tend to wear down, but the gap between life expectancy and health expectancy keeps widening because we are living longer. We're pretty good with modern medicine and forestalling death, but modern medicine does not confer vitality. Only healthy living can do that. And we're getting more and more chronic disease at ever younger age, as you well know. We have an explosion of Type 2 diabetes even in children. Those kids live to be 80 or 90 or however old they may live to be; they will have had Type 2 diabetes for 70 years. It's a combination of both factors.
The evidence base indicating that 80 percent of this is preventable with lifestyle is absolutely incontrovertible. I could site many papers, but just quickly, there was a paper in 1993 – 22 years ago – in JAMA, entitled Actual Causes of Death in the United States, and it accounted for all of the premature deaths that occur each year in our country. And fully 80 percent of them were attributable just to three things: what I like to call "bad use of our feet, forks, and our fingers" – lack of physical activity, poor diet, and holding cigarettes in our fingers. In other words, if we don't smoke, are physically active, and eat, more or less optimally, that alone could slash chronic disease risk in a person by nearly 80 percent, and slash chronic disease rates in the world by nearly 80 percent. And if we append just a few more priorities – sleeping enough, managing stress, having strong relationships, good social connections – the figure rises above 80 percent. Study after study after study all around the world shows the same thing.
DR. LEIGH: Yes, it is interesting. Even aside from chronic disease, we're now finding – with smoking aside, because, I guess, obesity is the new cigarette or the new smoking today – but the cancers, even types of cancers...
DR. KATZ: Substantially preventable. And dementia, the new age boogeyman – I mean cancer used the be the scariest word in the medical lexicon, I think it's dementia now as we do expect to live longer – but Alzheimer's, dementia shares risk factors with cardiovascular disease. Cancer is an inflammatory process and shares risk factors with diabetes and cardiovascular disease. So, you do the same things right, and you slash your lifetime risk of all major chronic disease.
To site another study done by CDC scientists in Potsdam, Germany among 23,000 adults, compared those who didn't smoke, ate well, were active, and controlled their weight to those who got all four wrong, and the lifetime differences in all major chronic diseases – heart disease, cancer, stroke, diabetes, dementia – was 80 percent. It was 80 percent less total chronic disease among those who got just those four things right. So really, it's an astounding benefit. [dog barking]
DR. LEIGH: Yes. And I got to laugh a little bit because I have to lock my dog out of the room because if she sees a squirrel, we're done. [laughing]
DR. KATZ: [laughing] They're good for my mental health, having my dogs around, but they're not so great for radio interviews.
In any event, Leigh, the critical thing here, I mean this is all true, but the issue is how do you get there from here? There are a couple of key things. First, we really ought to change the world and make it easier. We live in a hypocritical culture. We wring our hands about epidemics, obesity, and diabetes in our children, but we keep running on Dunkin and marketing multi-colored marshmallows to kids and calling it part of a complete breakfast. Yes, it's the lousy part of a complete breakfast, and we've got to be honest about that.
Then, the other issue is while we're waiting for the world to change, we need to take matters into our own hands. What the book Disease Proof is really about is what I call "skill power." Will power is wanting to get there. But you are a medical expert; you've got a skill set. I'm a preventative medicine specialist; I've got a skill set. We know how to eat well in ways that other people may not. We know how to fit physical activity into a hectic schedule in ways other people may not. Skills can be shared; skills can be acquired. What I decided to do in this book was take the skill set I use every day and spell it all out. Say, "I can do it, you can do it, too." But you can't expect it to just happen. You have to take matters into your own hands.
The skills make getting there from here much easier. If you try to do it just with willpower, it's really hard and eventually your willpower wears out. But if you've got "skill power," it gets much easier. For example, you don't need to give up sweets to address the sweet tooth; with skill power you can identify all the stealth sugar hiding in your diet in foods you never thought were sweet in the first place; get rid of that and there's no heavy lifting and rehabilitate your taste buds in the process.
All of a sudden, you're eating much less sugar, taking in fewer calories, starting to feel better, lose weight, and you never even touched desert. Innumerable examples just like that of how knowledge really is the power to get there from here.
DR. LEIGH: It's so true, and at some point I'll have you back and we can have a show, because there is a disparity in healthcare too with indigent populations, food deserts, and whatever. But it's sad. I've had parents come in and say their kids are overweight. Well, you think yogurt is good for you, but when you look at some of these yogurts –
DR. KATZ: Which yogurts? [laughing]
DR. LEIGH: Right! They're adding all this fructose corn syrup.
DR. KATZ: They aren't healthy. You can have plain yogurt, but if you buy the wrong yogurt it's basically a delivery vehicle for a soda. Absolutely. We can get there from here but we often make assumptions that get in our way. We know what a healthy diet is; we really need to work on practicing it and stop debating it all the time. It's doable; it's a challenge, but it's definitely doable. I'd love to talk further whenever there's a chance. Today my dogs wish everybody and healthy, happy weekend.
DR. LEIGH: [laughing] I know, it is crazy. But I always say, even at McDonald's, you can make some healthy choices: go in, get the chicken plain, maybe don't eat the bread, or if you're getting the salad, don't put on all of the dressing, pour it in the thing and you can use your fork and dip it in for a little taste. So, I totally agree with you, Dr. Katz. It is doable even at these places because no matter how much we say, I don't know that we will ever get rid of the McDonald's or we'll ever get rid of these things.
DR. KATZ: We may not and maybe we don't need to. I think, first of all you're right, we can make little tweaks almost anywhere. Secondly, what masters the food supply is the food demand. When enough of us are making those kinds of adjustments all the time, the retailers like McDonald's will change their offering and change their behavior because they've got one great priority, and that is to succeed in business. And that means keeping the customers satisfied. It's up to us to decide what does keep us satisfied, and if our health and the health of our children is a priority, and we shop accordingly, the food supply can change.
DR. LEIGH: I think some of these chains have done little bits, like adding milk, taking things out but it's a long arduous process. It's very interesting. It's a great book. I like the idea that you can do these little steps because it just seems impossible when you look at it on the whole. So, these little steps. What people don't realize is it's not fun, you may live longer, but it isn't fun when you have a chronic disease and you're really sick with it.
I want to thank my guest, Dr. Katz. The book, again, is called Disease Proof: The Remarkable Truth About What Makes Us Well. Where can you get the book, Dr. Katz? It's on Amazon, I'm sure.
DR. KATZ: It is. All the usual places online and bookstores and you can get more information at my website davidkatzmd.com.
DR. LEIGH: This is the Dr. Leigh Vinocur Show, it's Health from the Outside In, on RadioMD. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
What is the remarkable truth about what makes you well?
Additional Info
- Segment Number 4
- Audio File ER_101/1524er5d.mp3
- Featured Speaker David Katz, MD, MPH, FACPM, FACP
- Organization Huffington Post
- Book Title Disease-Proof: The Remarkable Truth About What Makes Us Well
- Guest Website Dr. Katz
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Guest Bio
David L. Katz MD, MPH, FACPM, FACP, earned his BA degree from Dartmouth College (1984; in three years); his MD from the Albert Einstein College of Medicine (1988); and his MPH from the Yale University School of Public Health (1993).
He completed sequential residency training in Internal Medicine (Norwalk Hospital, CT; 1991), and Preventive Medicine/Public Health (Yale University School of Medicine; 1993). He is a two-time diplomate of the American Board of Internal Medicine, and a board-certified specialist in Preventive Medicine/Public Health. He received an Honorary Doctorate (Humane Letters; L.H.D.) from the University of Bridgeport in 2013; and will receive a second honorary doctorate in 2015. -
Transcription
RadioMD Presents: Dr. Leigh Show | Original Air Date: June 12, 2015
Host: Leigh Vinocur, MD
RadioMD. RadioMD.com. It's time for ER 101, in conjunction with the American College of Emergency Physicians. Here's Dr. Leigh Vinocur.
DR. LEIGH: Hi and welcome back to our ER 101 segment. My next guest, a frequent guest of the show ER 101, Dr. Ryan Stanton, emergency physician at Baptist Health in Lexington, Kentucky, and he's the recipient of ACEP's 2012 National Spokesperson of the Year Award. So, welcome back, Dr. Stanton.
DR. STANTON: Thank you.
DR. LEIGH: The question is – and I see it time and time again (and I have to say I've worked in both ERs, urgent cares) – where do you go? People don't often know. They're popping up everywhere because they are filling a void. There aren't enough primary cares. If you call your primary care with a problem that's bothering you that's kind of urgent, they say, "Okay, come in two weeks from now." [laughing] So, they are popping up everywhere, but sometimes people don't really know what is the difference and when they should go where. There was a recent poll ACEP had, correct? That discussed a little bit of this.
DR. STANTON: Absolutely, released recently a poll that talked to emergency physicians about their experiences with urgent treatment centers, basically on the receiving side. And the most important thing for listeners in terms of the lay public to consider, is that urgent treatment centers are on the continuum. They're a valuable aspect of the health care family, but on the continuum based on what your needs are. Urgent treatment centers are basically that. Urgent treatments for things you can't get in to see your primary care doctor.
Basically what I tell people is if you know what's going on and you know it's an easy fix, even as the lay public, then consider an urgent treatment center. But if it's considered a potentially could be an emergency – anything chest pain, anything abdominal pain, anything significant headache or injury – then you need to go to an ER, because all that happens if you go to an urgent treatment center with something that gets upgraded in terms of severity is you get billed twice because you go to the urgent treatment center and then you get sent to an ER.
And I see that all the time in the emergency room. I kind of feel bad for the patients because they've already put out money for one visit when if they had come to me to start with, we would have knocked out everything we needed to do right away. So, the most important thing for patients is to just be aware that urgent treatment centers are for minor things but if you have a significant emergency, you need to go to an emergency room.
DR. LEIGH: Right, and even though, what people don't realize is okay, you know, your bellyache, it could turn out to be nothing. But at an urgent care where they don't have things like – I mean many urgent cares that I worked in didn't draw any blood. You couldn't tell if a person had an elevated white count indicating an infection from their belly pain. And maybe they have an x-ray, but they don't have a tool to really look at the abdomen like a kid with a bellyache and an ultrasound. So, even though you might end up with the ER or if you go to the ER first and it turns out that your bellyache is nothing, it's still something that needs to be assessed, correct?
DR. STANTON: Yes, and your thought needs to be "Can my problem..." or "Do I think my problem..." or "Am I confident that my problem...can be fixed at an urgent treatment center?" If that answer is "no", with the example of belly pain, it could be appendicitis. It could be cholecystitis. It could be a lot of things. Chest pain could be pneumonia. It could be a heart attack. It could be a blood clot in the lungs. If the urgent treatment center isn't the place that is going to fix the problem, don't go there to start with, because they are limited. They are limited in terms of their lab capabilities, imaging capabilities.
Most importantly, if there needs to be some sort of referral, admission, or intervention, they may not be the best group. Simple lacerations, ankle sprains, cold symptoms, allergies, things like that are wonderful types of visits for an urgent treatment center. Walk in, easy fix, easy evaluation, and then out the door. But more complex – especially chest, abdomen – needs to be head on to the emergency room.
DR. LEIGH: I like the way you say if you think you have a little idea of what it might be. Like, okay you have a cold and, I have to say, even bronchitis in young healthy people now, we do treat them outpatient with pneumonia, and you can get x-rays at most urgent cares. But if it's beyond that and you're not a young healthy person, that's another thing to think about. Right? Because a young healthy person that might end up with pneumonia could maybe be treated as an outpatient. But if you're an older person on multiple medications, other lung problems and you have pneumonia, that's a whole different story.
DR. STANTON: Right. Well, a good example around where I live is – Kentucky is still the number one in the country for smoking. We have the highest number of smokers in the country and so we have a lot of COPD and emphysema. COPD and emphysema increases that risk significantly with pneumonia, complications, resistant infections, even death-- hospitalization and death. That group is much more at risk than the 22 year old-- a person who works out, athletic person-- who has a little bit of a viral pneumonia. So, it's completely different how they are treated. And true, many things that we are going to see when it comes into the emergency room that could potentially be dangerous – abdominal pain, chest pain – aren't necessarily going to be admitted or have to have surgery.
But I would rather have you there at that emergency room where I can get things done if you need to be admitted or a surgery, as opposed to somewhere else and having to have you transferred again and then having the evaluation completed and then get that done. That delay in care may make a difference in terms of your course, any type of complications, the type of surgery. Abdominal pain with the appendix being a big issue. If you're delayed a couple or a few hours, it could mean a ruptured appendix. That's a very different course than a simple appendicitis. So, those are things to consider.
One of those things where I think that patients have a good opportunity to know for sure – I mean everybody's going on Google and getting health advice, the Google doctor, Dr. Google, he's doing a lot of diagnosis – and so if it's an easy thing, yes UTC, but if it's not, if it's more complicated due to high risk factors, get to the ER.
DR. LEIGH: Okay. So, actually, I'm going to give you one or two scenarios and then you can explain to me why and what do you think.
So, I have a one-week-old that has a fever of 100.6. ER or urgent care?
DR. STANTON: ER. That is no question. As soon as you say "one-week-old", that's ER because one-week-old, with fever, no matter what the rest of the story is, is a high risk for significant infection and it's going to be admitted. It's going to be a full septic work up, meaning lumbar puncture, culture, labs. That needs to be an ER, because that's a high-risk population. You kind of delved into it earlier: high-risk populations need an ER because there are special considerations and special things we have to do. Three months later, six months later, different story. But one-week-old goes to the ER.
DR. LEIGH: Okay. How about a 15-year-old was playing football, came up from the bottom of the pile, could sort of barely walk, his ankle and hip are hurting him.
DR. STANTON: That one's one that can probably be okay for urgent treatment center, unless you can see a bone. Now, if you stand up or he gets up and you can see something sticking out that's supposed to be on the inside, then that's somebody that needs to go to the ER because that requires antibiotics and surgery. But if he can walk on it, has some pain in a joint, that's an urgent treatment center. If it's more serious, they can transfer over. But the vast majority of those are strains, sprains and those sorts of things, they can be handled at the UTC.
DR. LEIGH: One last – we just have one minute – 84-year-old on six different medications including beta blockers, calcium channel blockers, woke up and their neck feels a little stiff and their shoulder's hurting them.
DR. STANTON: You want to throw in a little chemotherapy and blood thinners in there too? [laughing]
DR. LEIGH: [laughing]
DR. STANTON: Yeah, that's absolutely an ER patient. That person is high risk. That's one of those people that when we walk in the room, we're nervous. We're assuming something terrible is going to happen, even if it is likely benign. But that's somebody that's a very complex situation, special consideration, high-risk for bad things to happen. So, that needs to go to an ER, absolutely.
DR. LEIGH: Yeah, I agree with that. I think the elderly population should not be allowed to go to an urgent care just because with so many confounding factors and variables and things you need to check, there aren't a lot of urgent cares that can do that extensive work up. I think it's interesting, people think ER doctors don't believe in urgent care, but we do. A lot of ER doctors do work at urgent cares, but people have to know what they're good for. I agree with Dr. Stanton. They have a role in today's health care scheme, so I want to thank him for being on the show.
This is the Dr. Leigh Vinocur Show, it's Health from the Outside In, on RadioMD where feeling good starts with looking good. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
Resting Bitch Face is something that plastic surgeons have seen for years.
Additional Info
- Segment Number 3
- Audio File ER_101/1524er5c.mp3
- Featured Speaker Lyle Back, MD
- Guest Website Lyle Back
-
Guest Bio
Originally from New York City, Dr. Lyle M. Back, M.D., F.A.C.S., graduated with honors from Rutgers Medical School. He completed his surgical training at Ohio State and is an ABMS Board Certified Surgeon in both General Surgery (ABS) and Plastic Surgery (ABPS). Dr. Back is a Fellow of the American Academy of Cosmetic Surgery (AACS) and a longstanding member of the American Society of Plastic Surgeons (ASPS).
Dr. Back has served as a professor of Plastic Surgery at Temple University and St. Christopher's Hospital for Children in Philadelphia and has performed reconstructive surgery with "Operation Smile" in Vietnam.
Dr. Back's numerous articles on Cosmetic Surgery and Plastic Surgery have appeared in leading medical journals and popular magazines. Dr. Back is frequently featured in local newspapers and magazines and often appears on radio and television programs. Over the years, he has hosted several live radio and TV shows on Cosmetic Surgery in the Delaware Valley. He has lectured extensively and received many awards for his teaching and training of young surgeons across the country.
Dr. Back has received numerous local honors such as "Top Doc" Plastic Surgeon. Dr. Back is listed in the Guide to America's Top Surgeons by the Consumer's Research Council of America. He is also listed among "America's Cosmetic Doctors and Dentists" in the Castle-Connolly Directory and in The Consumer Guide to Plastic Surgery. He is a highly respected member of the most prestigious local and national surgical societies.
Dr. Back is a well known Cosmetic Surgeon and has been in the Philadelphia area in private practice for over 20 years. He specializes in the full range of the most modern, state-of-the-art cosmetic surgery procedures and non-surgical cosmetic enhancement techniques available today. -
Transcription
RadioMD Presents: Dr. Leigh Show | Original Air Date: June 12, 2015
Host: Leigh Vinocur, MD
RadioMD. RadioMD.com. Emergency physician, TV personality, speaker, and writer. She's Dr. Leigh. It's time for the Dr. Leigh Vinocur Show.
DR. LEIGH: Hi and welcome to the show. This is Health from the Outside In. It's actually vanity's dirty little secret, where feeling good actually starts with looking good. So, it's very apropos. My next guest, Dr. Lyle Back, is a well-known cosmetic surgeon in the Philadelphia area. He's been in private practice for over 20 years.
Well, thank you, Dr. Back, for being on the show. He's going to talk about something very interesting. It's to help women stop looking – or men – so mean and angry; how to reverse that "Resting Bitch Face."
DR. BACK: Oh, boy. Yes. And thank you so much for having me on the show, even though that's kind of a rough title to the subject matter.
DR. LEIGH: Yes. I'm sure we're going to get all kinds of calls, but, you know, this is a little tongue-in-cheek, too. [laughing]
DR. BACK: Of course.
DR. LEIGH: So, let's talk about it, because aging is not fun. It is better than the alternative; I'll give you that. But a lot of things happen to our face when we age. Describe some of the things that are happening that have been coined kind of the "Bitch Face" or "Resting Bitch Face."
DR. BACK: Well, you know, one of the things I want to tell you is that a lot of people think of plastic surgeons, cosmetic surgeons, as the doctors you go to in order to look younger. But what's very interesting to me is a lot of people find out that what they were really looking for was to look happier, to look rested, to look like they're comfortable, confident, not so stressed. I've also found over the years that even after people have had surgical procedures, they'll often comment at looking at their before pictures that they looked very tired or angry or stressed.
So, this is not something new and I think maybe for a lot of people they'd be surprised to hear that this is one of the most rewarding and satisfying aspects of having cosmetic procedures is that yeah, you know, we want people to look younger and we want them to look healthier from the outside in, but looking happy and looking like you're contented and feeling that way, those two things kind of play off each other.
DR. LEIGH: And, actually, I do believe it can make you feel that way. There was a study a long time ago – and I think Malcolm Gladwell mentioned it in one of his books – that when people were using the muscles in their face and using repeating facial expressions that were frowns and things like that, they actually became depressed from it.
DR. BACK: Yep. You know, there's been a tremendous number of studies done on this in the Botox era. We've discovered that that old song that we used to hear when we were kids – "Put on a happy face" – it'll make you feel better. You know what? It's actually true. They've studied a lot of what happens to the brain when someone has an angry look, when they smile more, even some of these things we're talking about today: getting rid of the frown lines and things that make you look sad, depressed, or tired. It turns out that if you don't look that way, the brain kind of figures out "Hey, you know what? Maybe I'm supposed to be happy instead of sad." It certainly has been proven now in a lot of studies.
It's really fascinating to find out that looking better--looking happier--actually makes you feel happier. Then, of course, we get that wonderful circle where you look better, so you feel better, so you look better. What a great circle to be on.
DR. LEIGH: Yeah, I definitely believe it. There's such a thing as a "Bad Hair Day." And every woman has gone through it. They know it. When your hair is not looking good, you feel terrible.
DR. BACK: Absolutely. Just this week a woman said to me, "Dr. Back, do you know what it means when a woman is having a 'Good Hair Day'? It makes her day." She said, "The stuff that you do helps us have a 'Good Hair Day' every day." And I thought, "Boy, that's the best." Because really what we are trying to do as cosmetic surgeons is to make every day a "Good Hair Day." Now I don't have any hair, so I can't have a "Good Hair Day," but I understand the intention.
DR. LEIGH: [laughing] Alright, so let's talk about what are some of the things that happen with aging that create this.
DR. BACK: One of the things we see a lot are women and men getting kind of a sleepy look or a tired look. They get a lot of lines in the forehead or between the eyebrows. A lot of times they'll be asked by well-meaning friends or family, "Are you okay? Are you sick? Are you stressed?" You might not feel that way, but when you have kind of a closed, tired, lined look to the forehead – a heavy brow – it can make you look everything from tired, stressed to even somewhat shifty or you're bored, you're uninterested, you look very apathetic. It can make people think that you feel that way about what they're saying, or even about them, just having that kind of appearance around the eyes. And that comes with aging. It also does come with stress, unfortunately.
When you have deep folds between your eyes, it can make you actually look angry, grouchy, stern, somewhat scolding, because these are the lines that we actually use to express those emotions. And when they're there even when you're not trying to express those emotions, you can kind of have an angry look that also kind of dovetails in with that tired, stressed, sort of exhausted kind of look.
Everyone, as they age, tends to develop some lines and folds and shadows, coming from the angle of the nose down to the corners of the mouth – we call those the nasal labial folds. Sometimes folds or shadows or lines extending down from the corners of the mouth to the jawline. These tend to make someone look a little unfriendly, a little harsh, sort of a scowling look or a mean look, maybe even a little bit judgmental and unapproachable. These are normal things that can happen with aging, and often happen just from being on our planet for a few years.
If you don't feel that way – and gosh, I hope you really don't feel that way – to have people looking at you and think that's your mood, is pretty awful. And to have your brain monitoring these things and think that that's the mood it's supposed to be in, can tend to make you be in that mood.
Fortunately, we have some really good ways of turning that "Resting Whatever Face" around.
DR. LEIGH: Okay, so let's hear it. Let's start with the eyelids. What do you do for that?
DR. BACK: One of the best uses of Botox that there is, is around the eyes. This is where Botox has really earned its reputation as the number one cosmetic procedure in the world. Through just a couple of injections – maybe taking five minutes or so in the office – we can get someone to have a more open look to their eyes, a more rested look, less lines between the eyes, a smoother look to the forehead, eyebrows arched up. The bottom line is good injections of Botox can make someone look rested, pleasant, confident. Many patients comment that they feel like they look like they've been on vacation for a couple of weeks and sleeping really well. That's a great look to have; that's a satisfying look to have. [laughing]
DR. LEIGH: I will vouch for that. [laughing] Yes, I'm a big proponent of the Botox. But there is a point – and we only have probably another minute. We could do a whole show on plastic surgery and maybe we will.
DR. BACK: That would be my pleasure, believe me.
DR. LEIGH: You know, it's beyond the smaller things. It's maybe good to start those. Just in a minute, if you're beyond starting those when you're a little younger to maintain, what are the surgical procedures?
DR. BACK: I don't even know that we would necessarily jump right to the surgical procedures but we might jump to the slightly more invasive things, like fractionated laser or micro-focused ultrasound. Things like that. So, there are still a few tricks we've got up our sleeves before we have to go to surgery.
DR. LEIGH: Wow. That is pretty fascinating and encouraging. In the old days, you just had to wait till you were 65 or 70 and get the major face-lift. Now it's all about these new, little devices and lasers and things that can really do it. And I'm a big proponent of trying to maintain, and I agree, it's not trying to look younger, it's just trying to maintain.
I want to thank my guest. This is the Dr. Leigh Vinocur Show, it's Health from the Outside In, on RadioMD. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
Why is it so important to stay protected from the sun?
Additional Info
- Segment Number 2
- Audio File ER_101/1524er5b.mp3
- Featured Speaker Dana James, MS, CNS, CDN
- Guest Website Food Coach
-
Guest Bio
Dana James, MS, CNS, CDN is a nutritional therapist, writer and founder of Food Coach NYC. She holds her Masters in Clinical Nutrition and is trained in nutrition biochemistry, functional medicine and cognitive behavioral therapy. Her goal is to help women break their antagonist (and often obsessive) relationship with food and their body.
Dana coaches one-to-one, runs workshops in NYC, and holds retreats that help women lead more beautiful and balanced lives.
Dana is also a speaker, and frequent guest on TV shows. Dana contributes to Elle.com, Well + Good, The Coveteur, Shape Magazine, Women's Health, Fitness, The Cut, Eat this, Not That, Buzzfeed, and more... -
Transcription
RadioMD Presents: Dr. Leigh Show | Original Air Date: June 12, 2015
Host: Leigh Vinocur, MD
RadioMD. RadioMD.com. It's time for the Dr. Leigh Vinocur show. Here's Dr. Leigh.
DR. LEIGH: Hi, welcome to the show. We have a very interesting show today. My next guess, Dana James, is a nutritional therapist. She has a Master's in Clinical Nutrition, and she is going to talk about five foods that actually can enhance your natural sun protection. Welcome, Ms. James. Thank you for being here.
MS. JAMES: Thanks, Dr. Leigh, for asking me on the show.
DR. LEIGH: So, this is interesting. Let's run down the list of these foods and talk a little bit about it. And what is interesting to me when I look at this, it seems like it's all about the color. We talk about the color of fruits and vegetables, and that's because there really are chemicals that create the color that are healthy for us. Right?
MS. JAMES: Absolutely right. So, what we want to think about is the plant-based foods because they provide that natural protection. If you think about plants, they don't glump on sunscreen. So, instead they create these polyphenols and flavonoids and antioxidants, which provide them with that natural protection from the sun. And so, when we ingest those, we also get the added benefit of that.
Now, where the research has been done has really been on foods that contain those red pigments, and in particular the lycopene. There was a study that was done several years ago on tomatoes, and it was done in Britain, and it showed that when you consumed the equivalent of about a cup of tomatoes, then that would enhance your SPF by about 50 percent so that you could actually decrease that UV damage if you consumed those tomatoes on a regular basis.
Now with all types of studies that's just looking at one particular point – and that's the tomatoes – so from my viewpoint, as a nutritionist, it's "Well, let's take that research on the lycopene and also have a look at what other foods contain the lycopene and other types of antioxidants that would protect the skin from UV damage. And then when you consumed those, it's also going to provide you with that enhanced protection."
DR. LEIGH: When you talk about this enhanced protection, it's really the antioxidants in it that are kind of repairing the skin from the UV damage, per se. Is that pretty much how these lycopenes and phytochemicals are working?
MS. JAMES: That would be one of them. The other side is not just the repair but also the protective mechanisms, so that when you are exposed to those UV rays, you've got like a barrier because you have more antioxidants in the body.
DR. LEIGH: Okay. So, what are the five fruits or vegetables – well, actually, when I look at the list, one's not either fruit or vegetable – but what are the five foods?
MS. JAMES: Tomatoes is the first one. And with those tomatoes the way you want to be eating them is with a little bit of olive oil, because olive oil helps the absorption of the lycopene because it's a fat-soluble nutrient. So, that's a great one.
DR. LEIGH: Do they have to be raw tomatoes or can you cook them?
MS. JAMES: You can cook them. When you cook the tomatoes, then you intensify that lycopene. You do get that with the raw tomatoes. When we're going into summer, most of us aren't going to be eating cooked tomatoes; we're going to be eating more raw tomatoes in a salad.
DR. LEIGH: Right, but tomato sauce, I guess if you made your own sauce it would be better than buying say jarred sauce. But by having the sauce actually too, it enhances it. Is that what you're saying? It concentrates it?
MS. JAMES: Well, it would be a very small amount and you'd want to be thinking about the high fructose corn syrup that's in most of the sauces. So, my assumption here would be that you would lose that benefit because of that. Because we know that sugar accelerates the aging process.
DR. LEIGH: Right, right. But if you were making your own tomato sauce, and boiling down the tomatoes, that would be a good way.
MS. JAMES: Perfect. Yes. Absolutely wonderful.
DR. LEIGH: And you mentioned heirloom tomatoes. Those are really better than your run of the mill tomatoes?
MS. JAMES: Yes, they are!
DR. LEIGH: Why is that?
MS. JAMES: They contain more of those antioxidants and body nutrients. So, if you think about a tomato that's been vine ripened and you get them from Florida versus an heirloom tomato or one that you picked from your garden. Very different in taste and the density of those nutrients.
DR. LEIGH: Okay. Next on the list: pomegranate seeds?
MS. JAMES: Pomegranate seeds: these are fantastic. Not only do these polyphenols that protect the skin from UVA and B free radicals, but what they can do is they also inhibit pigmentation. Here, you just want to be snacking on about a cup of those pomegranate seeds. Similar to what we were discussing about tomatoes before, I'm not really advising somebody to go out and drink a whole lot of pomegranate juice with sugar in it.
DR. LEIGH: Right, and it's interesting. First of all, they make it very easy now. I hated opening the pomegranates and everything, but you can buy at a lot of stores – for instance, even Trader Joe's – will have pomegranate seeds already deseeded. You can throw them on anything you want. Makes it really easy for people.
MS. JAMES: Yeah, exactly. I've never opened a pomegranate in my life. I grew up simple.
Another one that's really beautiful with us going into summer is watermelon. All we need is about 3 cups of watermelon for their UV effectiveness to come in. That one there, you can absolutely have that in a juice because most of the watermelon there is water. So, enjoy that one.
DR. LEIGH: I love watermelon.
MS. JAMES: Another one is bell peppers. They contain a different type of antioxidant called capsiate and that decreases the inflammation from the sun exposure. And the same type of thing, just toss some red bell peppers into a salad.
DR. LEIGH: These are not necessarily the hot peppers that have that capsaicin; all peppers have it. Maybe it's a little more concentrated in hot peppers.
MS. JAMES: Correct. That's right.
DR. LEIGH: Okay. So that's great. And the last one you talked about was wild salmon. It has to be wild. You can see the difference in color of the two salmon. Is that part of it?
MS. JAMES: That's part of it, but also the wild salmon has a richer component of those Omega 3s versus the farm salmon. This mechanism here is slightly different from the plant-based reaction that we were discussing. Here, the Omega 3s decrease the inflammation from the UVB rays, but they also inhibit an enzyme that causes the formation of those wrinkles. So, slightly different mechanism there but still advantageous for the skin.
DR. LEIGH: Right, and people think, okay, preventing – and with the caveat of this, you are still recommending that people go out and use sunscreen if they're going to be at the beach, right? It's not just bringing salmon to the beach in your set, correct?
MS. JAMES: [laughing] Right, absolutely. You want to be doing that. If I have time I'll share a story. One time I was at the beach, I was away in Mexico, and I thought I put sunscreen on my face. And I came back and I have been out walking for hours and hours, and I was like, "Why is my face really red and tight?" Then I looked down at the supposed sunscreen and I had put moisturizer on my face as opposed to sunscreen, and I was like "Oh no!" Then the next morning I woke up – completely gone.
DR. LEIGH: Really? You had a lot of salmon that night. [laughing]
MS. JAMES: Well, it's just more that I consistently eat this way. So, it's not just that night, but I consistently eat a plant-based diet or I've got sufficient Omega 3s in my diet.
DR. LEIGH: That's really interesting. So, besides bringing your sunscreen, make sure you eat all your fruits and vegetables while you're on your beach vacation because it's important. I think people should realize, too, that it isn't just the burning that we're worry about. A suntan is a little bit of damaged skin, and that's what leads to dreaded wrinkles. So, in my book a suntan is just as bad as a burn, especially if you're going to end up with wrinkles.
I want to thank my guest. It's been fascinating. This is the Dr. Leigh Vinocur Show, It's Health from the Outside In, on RadioMD. Where feeling good starts with looking good. Stay tuned into your health. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
What are the potential dangers of HFCS?
Additional Info
- Segment Number 1
- Audio File ER_101/1524er5a.mp3
- Featured Speaker Kimber L. Stanhope, BS, MS, PhD
- Organization UC Davis
-
Guest Bio
Dr. Kimber Stanhope is an esteemed researcher at the University of California, Davis. She currently works for the Department of Molecular Biosciences in the School of Veterinary Medicine conducting research on the effects of sugar consumption.
Dr. Stanhope earned her BS, MS and PhD in Nutrition, all from UC Davis. She is also a Registered Dietitian. Dr. Stanhope has worked in all aspects of nutrition: dietetic counseling, public health, and research (current). -
Transcription
RadioMD Presents: Dr. Leigh Show | Original Air Date: June 12, 2015
Host: Leigh Vinocur, MD
RadioMD. RadioMD.com. It's time for the Dr. Leigh Vinocur show. Here's Dr. Leigh.
DR. LEIGH: Hi, welcome to the show. It's Health from the Outside In, where feeling good starts with looking good. So, we have a very exciting show. I want to welcome my first guest, Dr. Kimber Stanhope from University of California Davis. She is a registered dietician, but she's also in the Department of Molecular Biosciences and she's going to talk about a very interesting study related to high fructose corn syrup and heart disease, because it seems like that's the new buzz word. Isn't it, Dr. Stanhope? High fructose corn syrup.
DR. STANHOPE: Well, definitely we studied high fructose corn syrup but if you read my new paper closely, you will see that I am not suggesting our results wouldn't also be seen in subjects consuming sucrose sweetened beverages. We did high fructose corn syrup simply because that was the beverage sugar. Most beverages are sweetened with high fructose corn syrup.
DR. LEIGH: That is a good point, excuse me, because so many people are saying, "Isn't sugar sugar?" I mean, really, there's sugar in milk that's lactose; there's sugar in everything. So, I guess that's the question: is there really a difference in the sugars?
DR. STANHOPE: Now, sugar in milk is a completely different story because the sugar in milk does not contain fructose. But sucrose and high fructose corn syrup both contain the monosaccharide fructose and that is where all the problems start when we consume high sugar diets. So, when I say "sugar," I mean our commonly used added sugars, which are high fructose corn syrup, M sucrose, and both of them contain fructose, and that's the important difference. Milk sugar: a completely different story; it doesn't contain fructose.
DR. LEIGH: So, now tell a little bit about the study and what you did, because you initially did a small study just with high fructose corn syrup and now this study is a little bit broader and it looks at some of the other different added sugars.
DR. STANHOPE: Right. Basically, our plans were to do a very big study where we were going to study almost 200 subjects and look at a lot of the different sugars. In 2011, we already published the results of when we gave subjects 25 percent of their energy requirement in drinks that contained high fructose corn syrup, and we published that whoops, when subjects consumed this drink for two weeks, their risk factors for cardiovascular disease, triglycerides, and cholesterols all went up. However, they didn't go up in the group that was consuming glucose sweetened beverages, same number of calories, and, of course, they did go up in the group that was consuming fructose sweetened beverages. Now, we did that study first because we needed to make sure – we needed to know whether high fructose corn syrup even caused problems in young healthy subjects in as little as two weeks. And they did.
DR. LEIGH: That's what was so fascinating to me when I saw the first study was we are talking about, these were young college kids right?
DR. STANHOPE: Most of them were definitely from UC Davis.
DR. LEIGH: Right. So, these are not people with diabetes, not people that are already ill. And yet, you could see that their cardiac markers that we talk about – like know your numbers, what's your cholesterol, what's your triglyceride – went up. That's what so interesting and a little bit frightening about this.
DR. STANHOPE: The other thing that's very important to point out, that we even see the effects when subjects don't even gain weight.
DR. LEIGH: Wow.
DR. STANHOPE: And that's important. Now, some of the subjects did gain weight and guess what? Not surprisingly, the effects were even higher. Cholesterol went up even more but weight gain does not explain these effects. Sugar has an independent effect that doesn't require weight gain for these effects to occur.
Now, when we saw whoops 25 percent of energy requirements in high fructose corn syrup drinks caused this problem, then we started what we called the dose response study, where we gave subjects beverages that contained 0 or 10 percent or 17 ½ and then more subjects that got the 25 percent of the energy requirement as high fructose corn syrup. And that's the new study that was just published last month.
This study shows a very strong dose response effect, meaning the more high fructose corn syrup in the drink, the more the LDL cholesterol, the more the triglyceride went up. But also what totally surprised us is that we saw increases even in the group that only got 10 percent of their energy requirement in those drinks. That's equivalent to somebody adding a half a can of soda to their daily meal plan at breakfast, lunch, and dinner. So, did you really think that a half a can of soda was enough to increase risk factors in a young healthy person in only two weeks?
DR. LEIGH: Wow.
DR. STANHOPE: We didn't think so but that's what our data shows.
DR. LEIGH: So, as little as one can and a half for the whole day of regular soda, sugared soda, can increase these risk factors. Now, did you notice, even maybe after the first study or this study – because it's important to also point out to people: these are blood values; they're markers that make a difference but even in heart disease, if your other risk factors are low, you can have a little bit of a higher LDL. It needs to be maybe under 90 if you have higher risk factors, but it can be over that. So, with that caveat, it doesn't necessarily mean all these people are going have heart attacks, but it's certainly something to think about.
DR. STANHOPE: It's absolutely important to think about, especially when you put it together with the study that was published just a year ago. This is one of those big population studies with thousands and thousands of people in it, and what they did was look at added sugar consumption – and that was added sugar consumption in both solid and liquid form – and they divided the subjects into five groups from lowest, and the group was only consuming 9 or less of their daily calories in terms of percent as added sugar. The group that was in the highest level was consuming over 20 percent of their calories as added sugar. And they, too, saw with increasing amounts of added sugar as part of the daily diet, there was an increased risk of cardiovascular disease deaths. I'm not just talking having it; I'm talking death by cardiovascular disease.
Dr. LEIGH: Wow.
DR. STANHOPE: When you look at that and then you look at our risk factors that increased in only 2 weeks, there is an important connection here.
DR. LEIGH: Yeah, it is very important. These were sugar drinks, but fructose is also – because we only have about 30 seconds – fructose is also in fruit juices too, correct?
DR. STANHOPE: Right, and right now I'm doing a pilot study to compare the effects of fruit juice to added sugar in terms of beverage consumption at the high dose. We've got to get that question answered.
DR. LEIGH: This was very important. Thank you so much. It gives us a lot to really think about because sugar is the new culprit. We used to think it was all fat, but now we're finding it was sugar. Maybe Atkins wasn't so far off. This is the Dr. Leigh Vinocur Show. It's Health from the Outside In on RadioMD, where feeling good starts with looking good. - Length (mins) 10
- Waiver Received No
- Host Leigh Vinocur, MD
