About stoneagedoc

Pediatric infectious diseases specialist, author and public speaker. After 35 years in clinical practice including 40 years in academic pediatrics I now share that experience in helping others to enjoy a long, healthy life without the burden of chronic disease.

Upcoming presentations

Friday, August 3, 2:30 LIFE program at Mira Costa College, Oceanside. Baby Boomer blindness. Details at  http://www.miracosta.edu/life.

Tuesday, August 28, 1:00 Mission Valley library, A day in the life of a Renaissance physician. Learn how it impacts what your physician is doing today.

In the news

Exercise more, feel better

Physical activity – another term for exercise – has lots of benefits that go beyond helping you to keep from gaining weight. Besides making your heart and lungs perform better, moderately intense physical activity can completely prevent type 2 diabetes (which now affects 12 percent of the adult population!) and lowers the risk of osteoporosis and Alzheimer’s disease.

Research from Finland shows that it also improves psychological well-being.  A group of couch potatoes was instructed in the use of weights and resistance bands and they were observed for nine months. Compared to non-exercisers the gym rats reported improved quality of life and fewer depressive symptoms.

Those of you who exercise regularly probably could have predicted that. Better circulation, especially to the brain, improved appetite, more flexibility, more restful sleep and greater physical endurance are all benefits of regular exercise.

Although even those who (by study design) exercised only once a week showed significant improvement those who exercised three days a week showed the most improvement.

Try it. You’ll like it!



Shingles vaccine update

About side effects – I received the second (and final) dose of the new shingles vaccine, called Shingrix a couple of weeks ago. There was some soreness at the injection site, which is typical for most vaccines and it wasn’t very bothersome. However, I felt crummy for two days. That was it! It didn’t keep me from my usual activities except that I took a holiday from the gym for about five days because of the sore arm.

About a quarter of Americans will have had at least one episode of shingles – known as herpes zoster – and if you’re lucky enough to live past 85 the risk is about 50 percent.

Even an “ordinary” case of shingles will include a painful rash that lasts about three weeks. In some cases the pain lasts forever! The worst side effects of the Shingrix vaccine aren’t nearly as bad as that.

Older age carries an even greater risk, that of depressed immune function resulting from leukemia or chemotherapy, in which case the disease can be really severe.

The bottom line: everyone over the age of 50 should have the vaccine, even those who have had shingles in the past or have had the older vaccine (Zostavax). Are the side effects a problem? Nah!







In the news

Thanks for (Ouch!) saving my life

Perhaps you saw the recent news article about how Senator Joe Manchin saved the life of another senator – Claire McCaskill – by performing the Heimlich maneuver/abdominal thrust. The story didn’t describe the details of what caused the airway obstruction but the big news was that Rescuer Joe cracked one of Ms. McCaskill’s ribs. Bad form but a good outcome.

There’s a teaching point here: if the abdominal thrust – the Washington Post called it the Heimlich maneuver – is performed correctly you shouldn’t crack a rib. The good senator obviously placed his hands too high on Ms. McCaskill’s abdomen. The best place is just above the bellybutton. Not only will that avoid vulnerable ribs, it will also avoid the xiphoid process, the arrowhead-shaped bone that points downward (and right at the liver!).

I’m willing to bet that by now Senator Manchin has received dozens of e-mails and tweets to let him know how to improve his technique.



Dieting Guidelines

Spot reducing sounds like a great idea. Too bad it doesn’t work for thighs, chins or upper arms. Categorically, using a vibrating “fat-reduction” tool on any part of your body or exercising one area (like your thighs) will have little effect on the fat there.

Having said that, all fat is not the same. The stuff around a woman’s hips and thighs is hard to get rid of because nature has programmed it to be one of the last stores to melt away during food scarcity in case the owner of the fat happens to be pregnant. Fat around the middle – which is usually an indicator that there is too much heart-damaging fat around the abdominal organs, intestines, etc. – usually starts coming off first when you lower calorie intake and exercise more. Be aware, however, that doing lots of abdominal exercises won’t make that fat go away any faster, it will just give you stronger abs underneath the fat.

That dangling fat at the back part of the upper arms won’t go away any faster if you do lots of arm exercises but the muscles there will get bigger and more firm. Eventually you’ll lose those “angel’s wings” along with the excess fat everywhere else.








Upcoming presentations

Thursday, July 19, 1:00 p.m. Ramona Library The True Mediterranean Diet, (Hint: It’s not what you get at the local pizza parlor but it’s a proven life-extender.)

Tuesday, July 24, 1:00 p.m. Mission Valley Library, Keeping your wits; ten ways to prevent dementia and Alzheimer’s disease.

In the news

Hearing loss on the horizon

Physicians have known for decades that chronic exposure to loud noise leads to hearing loss. Maybe we should be concerned about noise that may not seem to be loud but that is piped directly into our ears via headphones or ear buds.

A study among Dutch children revealed that 14 percent had high frequency hearing loss. High frequency loss matters because it includes conversational tones. In a study in the U.S., 90 percent of pre-teens and teens used a portable music player. Although these two studies are not entirely consistent with each other they reveal a trend – widespread use of music devices and evidence of hearing loss among persons who are likely to be using them for several more decades.

The genie is out of the bottle; it’s unlikely that either trend will reverse itself. When today’s kids reach Medicare age they might have to start learning sign language.

Two recommendations that we should be passing on to our kids (and using ourselves): if someone else can hear what you’re listening to with ear buds or headphones the volume is too high. Second, make a habit of keeping the volume low enough so that you can hear another conversation.

The most commonly used word in the English language today (according to Siri) is “the.” In the future it might be “Huh?.”


Exercise Tips

Should you push yourself? That depends on what you mean by “push.” Very long (greater than one hour) workouts are unnecessary, counterproductive and invite injury.

For those who run, keep in mind that running is a sport, not an exercise. You can hurt yourself in a sport like running but not in an exercise like walking. (I know that I’ll get some flak on this!) Unless you are a competition runner there is only a marginal benefit toward fitness in running versus walking.

If you lift weights you are probably aware that the greatest benefits come with lifting enough so that the final repetition is barely doable. That’s what makes a muscle grow. If you develop pain during an exercise, stop immediately. It is not possible to “work through” an injury. Shoulder injuries are among the most common and they take very long to heal.

Instead of lifting heavier weights, make each repetition last several seconds but decrease the weight by at least a third. The results will be the same and the risk much less.







In the news

Is it time to test your telomeres?

For a few hundred dollars and a small blood sample you can learn how long your telomeres are. These are DNA structures that form caps on the ends of the chromosomes that carry genetic material, protecting them from deteriorating and keeping them from getting stuck to their neighbors. With each cell division some telomere material disappears. When the shortening reaches a critical stage the cell can no longer divide and eventually dies. The shorter your telomeres, the shorter your remaining lifespan will be. Do you really want to know?

Many age-related diseases appear to be linked to the shortening of telomeres, including coronary artery disease and several types of cancer. There is no clear consensus on the role of telomere shortening in the aging process or disease. That hasn’t kept marketers from latching onto the idea that it is helpful to know how your telomere length compares with that of the average person. Some companies provide you with your age in telomere years for comparison with your chronologic age.

Those who promote testing claim that bad news, like showing that your telomere age is a decade or two older than your chronologic age, is an incentive to change your lifestyle. Studies in humans are sparse but exposure to toxic chemicals, a sedentary lifestyle, a diet that is high in animal products and low in plant foods all appear to shorten telomeres. Stress reduction, exercise and foods high in antioxidants appear to make them longer.

No matter how long or short your telomeres may be, adopting a prudent lifestyle will help you to avoid the common diseases of aging. Instead of purchasing a test kit that might or might not predict how many years you have left it makes sense to follow some simple steps: regular, moderately intense exercise, a diet that is rich in plant foods and low in saturated fat, refined grains, sugar and red meat and avoidance of stress. Resveratrol, an ingredient in red wine, has also been found to increase telomere length. A glass or two will also keep you from worrying about them.


Mosquitoes love beer

       In our mid-April blog we offered some thoughts about the importance of avoiding mosquitoes and eliminating their breeding sites.  Now that summer is officially just a few days away here are some more tips that will make you a less attractive target.

Sorry to bring bad news but mosquitoes are attracted to beer drinkers and it only takes one glass to turn them on. A study from Japan seems to have nailed down that theory, which is supported by a mosquito expert at the University of Kentucky. The reasons aren’t clear but it might be the scent of CO2 that is released when you open that can or bottle. (Soda has the same effect.) You also exhale more CO2 when you are more active.

If you are sweating – and who doesn’t in the summer? – you’re adding another attractant. In fact, mosquito researchers use human sweat to entice the critters into their traps.

Dress defensively. Mosquitoes prefer victims wearing dark clothing.











Upcoming presentations

Wednesday, June 6, 1:00 Supermarket suicide and restaurant roulette. Escondido Senior Center. OASIS – see their website http://www.oasisnet.org.

Friday, June 15, 1:00 Emerging infectious diseases and safe travel guidelines, Temecula Higher Education Learning Center. Osher – see their website http://www.csusm.edu/el/olli.

Wednesday, June 20, 2:00 All about Shingrix, the new shingles vaccine, Escondido Senior Center http://www.oasisnet.org

Tuesday, June 26, 9:30 a.m. How wars changed medicine, Oceanside Senior Center, 455 Country Club Lane. Osher – see their website http://www.csusm.edu/el/olli.

Friday, June 29, 1:00 p.m. Emerging infectious diseases and safe travel guidelines, Carlsbad Library Learning Center. Osher – see their website http://www.csusm.edu/el/olli.

In the news

Trans fats are going away – finally!

Trans fats are vegetable oils that have been treated to keep them from becoming rancid. When they are used in baked goods they prolong their shelf life. That’s good for food manufacturers but bad for the heart. Trans fats raise LDL (bad) cholesterol, lower the levels of HDL (good) cholesterol, make blood more likely to clot in vessels of the heart and brain and increase inflammation, which plays a large role in heart disease, stroke, diabetes, cancer, osteoporosis and other diseases.

By June 18 – only days away – the FDA has ruled that food manufacturers must remove trans fats from processed foods. Health experts predict that this will prevent several thousand heart attacks per year.

If you are a label reader you have probably seen some nutrition facts labels that state that the trans fat content of the item is zero. Government folks aren’t very good at math: “zero trans fat” on a food label means that it can have up to 0.5 grams of trans fat. Maybe that helps to explain why the U.S. is a financial mess – the people that make the rules can’t do simple math!



Dieting Guidelines

Your mother was right! Eating slowly is better for you but not for the reasons I heard when I was a kid: “Don’t eat so fast! You’ll choke on your food.” “It’ll make you sick..” Well, that second part was right but the sickness would take years, even decades to develop.

When we eat fast we eat more. That’s because it takes about 15 or 20 minutes for our hard-wired appetite-control mechanism to let us know that we’ve eaten enough. It was once thought that this was a simple mechanism brought into play by a hormone called cholecystokinin that was released when the stomach was full. We should have known! Nothing is really that simple in matters of biology. Scientists now know that there are several mechanisms, some regulated by hormone-like chemicals, that control appetite.

Some of this came to light after lots of people had a part of the stomach removed to lose weight. They didn’t get as hungry as they should have when portion sizes were limited to something about the size of a golf ball. The part of the stomach that had been removed contained cells that produced one of the hunger-causing hormones.

The bottom line: follow Mom’s advice and eat slowly. You’ll end up eating less, especially if your meals consist largely of fiber-rich vegetables.



In the news

The anti-inflammatory diet – not so new

The anti-inflammatory diet has been popping up in the media lately but is it really something new? It’s based on two diets that are not just old but ancient, the Mediterranean diet and the Asian diet. Both contain foods that lower inflammation and are devoid of those that promote it. Perhaps the term Mediterrasian is more inviting and less intimidating than anti-inflammatory.

Inflammation is the mainstay of the body’s defense mechanism, ranging from the pain, swelling and redness that we experience from a splinter lodged in a fingertip to the cough, fever and miserable feeling of a bout of the flu. These reactions are relatively brief, unlike the years-long gnawing damage that leads to heart attack, stroke and numerous other conditions.

The true Mediterranean diet and the traditional Asian diet are nothing like what is found on the menus of your local pizza parlor or Chinese restaurant. Both diets are plant-based, which means plenty of fiber, antioxidants and omega-3 fats, all of which lower inflammation. They lack processed foods that are heavy on the sugar, starch and saturated fat that contribute to obesity. Fat deposits don’t just take up unsightly space, they produce inflammatory chemicals that contribute heavily to cardiovascular disease and to cancer, type 2 diabetes and osteoporosis. Both food styles include very little red meat; there is no beef industry in greater Asia or the countries that surround the Mediterranean Sea. There’s not much of a dairy industry either; most Asians are unable to digest the sugar (lactose) in milk and the Mediterranean climate doesn’t allow milk or its products to maintain freshness. If you think that cheese is the exception that’s correct but it serves as a garnish, not a primary ingredient.

Instead of saturated fat the Mediterranean diet relies on olive oil for almost all of its fat calories. The Asian diet is naturally low in fat but what there is comes mainly from fish, an excellent source of the anti-inflammatory omega-3 variety.

What this hybrid diet lacks is one of its biggest advantages. There is no refined grain (white rice is the exception), no trans fat and no artificial colors or chemical preservatives.

The benefits of the Mediterrasian lifestyle are not entirely due to food. Until fairly recently labor-saving devices were not available to most people and almost every tool and vehicle required muscle power. That not only made obesity less likely it reduced the risk of osteoporosis.


Exercise Tips

Is it pain or just soreness? When you work a muscle hard, especially if it’s the first time, you know how sore it feels the next day and possibly for several days. That is normal and it is known as Delayed Onset Muscle Soreness (DOMS). You can avoid it if you begin an exercise program – or a new type of exercise – with very low weight. I recommend that you go through a routine with no weight at all in your hands for at least two weeks to open up existing blood vessels and grow new ones. Walkers and runners should start with low speeds and short distances. That won’t completely eliminate DOMS but it sure will help.

Pain is different. It sometimes comes on suddenly during or after an exercise, and it’s usually asymmetric – involving only one side of the body, e.g., one shoulder.

Do not try to “work through” DOMS or pain. In the former it’s just not worth the discomfort and in the latter you are likely to make the injury worse.






Upcoming presentations

Wednesday, May 9, 1:00 San Marcos Library Shingrix, the new shingles vaccine. No fee.

Wednesday, May 16, 1:00 Point Loma Library Supermarket suicide and restaurant roulette. OASIS – see their website http://www.oasisnet.org.

Friday, May 18, 1:00 LIFE program at Mira Costa College, Oceanside. How wars changed medicine. http://www.miracosta.edu/life.

Wednesday, May 30, 3:00 Encinitas Library. How to keep your wits; 10 ways to prevent dementia and Alzheimer’s disease. http://www.oasisnet.org

In the news

Am I preaching to the choir?

It’s likely that the vast majority of persons who are reading this blog have healthy habits but a recent study should give you even more resolve to continue and to get better if you’re falling short in some areas.

A study just published in the journal Circulation listed five lifestyle factors that lead to good health. What is newsworthy is how many more years are added to one’s life by following them consistently.

There are no great surprises here. Maintaining healthy weight, getting at least 30 minutes of moderately intense exercise every day, not smoking, healthy eating (at least five servings of vegetables, four servings of fruit, one serving of nuts, no red meat, no sugary drinks and low sodium) and moderate drinking (no more than two drinks a day for men and one drink per day for women).

Women who maintained all five good habits could expect to live 14 years longer than those with the least healthy lifestyles. Men could expect 12 more years than their least health-aware peers.

When these results were tabulated it turned out that only 8 percent of U.S. adults were “five-for-five”.

We have a long way to go!




You need at least 30 minutes a day of moderately intense exercise in order to maintain muscle tone, hold your weight down and keep your heart and lungs working the way nature intended until old age. But do you need a gym membership or hundreds of dollars’ worth of home exercise equipment? Consider these Minirobics, short spurts of activity that are easy to incorporate into your daily routine.

If you use public transportation, don’t get off at the stop nearest your office. If you drive, park your car a couple of blocks farther away than usual. If these simple measures add just 2 blocks – about 1/8th of a mile – to the distance to your place of business, that’s more than a mile a week. Not much but it’s a beginning and you might find yourself stretching that distance by a couple of blocks more every few weeks as you find that you can spare the extra minutes.

Get in the habit of walking up one flight of stairs and walking down three. That’s not just better for your fitness, it’s probably faster than waiting for an elevator.

Stay on your feet whenever you’re on the phone. You’ll burn a few calories and develop better tone in your legs. Standing up while you’re talking on the phone gives your voice more energy.

Don’t park near the entrance to the supermarket. Carrying a couple of bags of groceries to the farthest corner of the parking lot will burn a few more calories. You can usually park in the same place and you’ll never “lose” your car again. Your doors won’t get dinged as often, either.

Stop using the drive-up window at the bank. Wash your own car and save a few bucks per week. At work, use the rest room that’s farthest away from your desk.

If you take a few moments to review your daily routine you’ll find even more ways to use up calories. Some of these Minirobics burn just 5 or 10 extra calories but that’s enough to affect your long-term health. When you use 10 calories a day more than you take in you’ll lose about one pound per year. That doesn’t sound like much but that’s what the average American gains each year between graduating from high school and cashing that first Social Security check.