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Fight Alcoholism? Get Rid Of The Sugar!

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For long term success, an alcoholic must learn not only how to stop drinking, but also how to start eating.

Most alcoholics that are admitted into detoxification centers are massively malnourished, and seriously depleted of thiamin, vitamins A, B-12, and C, folic acid, and the essential minerals calcium, magnesiuum, potassium, and zinc.  These deficiencies are corrected at the outset with supplementation by mouth or by injection.  However once past the initial stages of treatment, recovering alcoholics often go back to poor dietary choices such as processed foods that contain little apart from sugar, fat, and calories. The sugar is particlarly bad because alcoholics already produce too much insulin, which means that during withdrawl they crave sugar. 


By eating refined sugars they only make the situation worse, because the pancreas pours out even more insulin, and the cravings for not only sugar but alcohol increase.  Inhaled tobacco smoke makes matters even worse, as it leaches a variety of nutrients from the body.   Dr. Joseph Beasley, the medical director of Brunswick House, Amityville, New York, studied a group of hardened alcoholics, forty percent of whom were cross-addicted to oher substances, such as cocaine.  Not the sort of group you would think should set any records in rehabilitation. 

With the standard program of detoxification, behavioral and family therapy, exercise, and follow-up with Alcholics anonymous, a twenty to thirty per cent recovery rate after one year is considered the norm. However, these patients were also given multivitamin and mineral supplements, and a balanced diet high in fiber and low in refined sugars.  At the end of a year, an astonishing 65% of the group were still sober.

To get the best results in treating alcoholism,  one must treat any other dietary and lifestyle indiscretions.  In fact, Bill W., one of the founders of Alcholics Anonymous admitted in his later years that one of his biggest mistakes was leaving sugar, nicotine, and caffeine in AA. 

So when you battle the bottle, shuck the sugar, and cut the butts, so you'll really have reason to say cheers.

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WEXTING: Walking while Texting is the Traffic Accident for Pedestrians

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One of the newest forms of preventable injury comes via your cell phone.  Now that these devices are ubiquitous and addictive, we are seeing some very serious medical consequences not only for drivers, but for pedestrians.  

Walking while Texting, otherwise known as "WEXTING" is the latest hazard to clog up emergency wards. Sometimes the results are comical, but serious inuries or even death can be the consequence of your next step. 

In headline news we have seen carnage caused by train and bus drivers who are texting and not paying attention to their driving.  Hundreds of needless deaths are caused by such dereliction of responsibility.  Even thousands more are killed as a consequence of texting drivers of cars and trucks.  Driving while talking on a cell phone is illegal in many jurisdictions, so many people have switched to texting.  The results are not much better than talking; one's focus is taken up by the phone, not the road ahead.  To this point, many police now can charge drivers with "driving while distracted", even if they were not actually holding the phone to their ear .  But the one place people think is safe to text is walking.  After all, what harm could come to a pedestrian who walks and texts at the same time?  Well, as it turns out, a lot.  Maybe walking and chewing gum is as much multi-tasking as most people should handle.

In one US study recently it was estimated that over 60,000 people were injured while walking/texting, and 4,000 of them were killed.  

Distracted walkers have been run over by cars, as they tend to step into an intersection without looking in either direction.  Most take an extra 2 full seconds to cross the road, as they walk 20 percent slower while their fingers dance across the keyboards.  Some have fallen into manholes, fountains, and down staircases.  Others have walked of the ends of piers into the sea, and still others into plate glass windows.  Injuries tend to be fractures to bones in the face, eye injuries, concussions, or fractured feet and legs.  If the victim walks into a moving vehicle, the whole body can be crushed with fatal results.

 In the city of London, experiments have started with padding telephone poles to prevent concussions as pedestrians lead with the top of their heads, while focussing on the little screen in their hands. 

 Whether dialing for new songs on your iphone, talking to a real person via your telephone, or texting, the results can be a catastrophe.


In the car, it has now been shown that talking , even through your car's speakers, can be just as distracting as holding an actual phone to your ear.  Our heads are already swimming in an information overload, so even the mental stimulation of conversation can have disastrous results on your present reflexes. This fact has led to police charging distracted drivers even if their phone conversation allowed both hands to be on the steering wheel.  With pedestrians who text, their entire head is pointed to the ground, leaving them blind to forward obstacles.  Even worse when combined with ear buds, now they are also deaf to the noises of surrounding runners, bikes, and cars. 

View this brief news video for some Wexting visual images.

So the action tip is clear.  Just because you are not driving does not mean that walking is always safe.  Texting, dialing up songs, or watching YouTube while you walk is an invitation to trouble.  Give yourself a break, and try to unplug when you are in motion.  Otherwise your next text could be to call for an ambulance.  From a time management point of view, its worth spending a few seconds to stop moving while using your cell phone, in order to avoid spending hours or years recovering from your injuries.  

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Stress and Sleep Disorders

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Insomnia is very often a simple disorganization of ones time, diet, or habits. But for many, the lack of sleep makes them look terrible, and feel even worse. An image of not getting enough sleep

Naturally, when I see a patient with insomnia I prefer to start the treatment with the least offensive weapons possible, and escalate the attack only as required. This means that for many, simple harmless treatments such as investing in a better mattress, using a natural wool pad on top of the mattress, or buying a more comfortable pillow may be enough. For others, especially those on shift work, ear plugs and an eye mask may be needed to sleep through ambient distractions.

Hypnosis, the relaxation response, yoga, and hot baths may also be the answer. However, these harmless treatments may not work for everyone. People who have a snoring spouse, a noisy neighbor, or a dripping tap may truly be at their wits end due to fatigue. Others with a crying baby may be totally exhausted, yet unable to take any medications for fear of sleeping through a neonatal emergency. Still others may be plagued by medical disorders that make sleep difficult.

In many of these cases, the use of medications may indeed be appropriate for a very short term. Often, once the patient has been given a couple of good night's sleep they can recover their energy levels, and may only be given medication sporadically after that. In more severe cases, medication may be needed every night. However, it is always wise to do everything possible to avoid the latter choice, as the cure may be just as bad as the disease. Once the association has been made between sleep and a pill, there is always the potential for Hypnosis, psychological or chemical addiction.

The most common sleep disorders include:

  • Insomnia: Ongoing, long-term trouble with falling asleep
  • Bruxism: Involuntarily grinding or clenching of the teeth while sleeping.
  • Delayed sleep phase syndrome (DSPS): inability to awaken and fall asleep at socially acceptable times but no problem with sleep maintenance, a disorder of circadian rhythms
  • Hypopnea syndrome: Abnormally shallow breathing or slow respiratory rate while sleeping.
  • Excessive daytime sleepiness (EDS) often culminating in falling asleep spontaneously but unwillingly at inappropriate times.
  • Night terror: abrupt awakening from sleep with behavior consistent with terror or fear.
  • Periodic limb movement disorder (PLMD): Sudden involuntary movement of arms and/or legs during sleep, for example kicking the legs.
  • Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep, sometimes injuring bed partner or self
  • Restless legs syndrome (RLS): An irresistible urge to move legs. RLS sufferers often also have PLMD.
  • Sleep apnea: Obstruction of the airway during sleep, causing lack of sufficient deep sleep, often accompanied by snoring. 
  • Sleep paralysis: is characterized by temporary paralysis of the body shortly before or after sleep.
  • Sleepwalking or somnambulism: Engaging in activities that are normally associated with wakefulness, which may include walking, without the conscious knowledge of the subject.
  • Somniphobia: A cause of sleep deprivation. Somniphobia is a dread/ fear of falling asleep or going to bed.

Managing Stress for Better Sleep

  • Assess what is stressful: The first step in getting a handle on stress is to figure out what is causing it. Take a good look at your physical condition and your daily activities. Do you suffer from pain? Are you overloaded at work? Once you identify your stressors, you can take steps to reduce them.
  • Seek social support: Spending time with family and friends is an important buffer against stress. It can be helpful to share your problems with people who care for you.
  • Practice thought management: What we think, how we think, what we expect, and what we tell ourselves often determine how we feel and how well we manage rising stress levels. You can learn to change thought patterns that produce stress. Thoughts to watch out for include those concerning how things should be and those that over generalize sets of circumstances (for example, "I'm a failure at my whole job because I missed one deadline.") Many commercial audiotapes and books can help you learn thought management exercises.
  • Exercise: Exercise can help you blow off steam thereby reducing stress. In addition, flexible, loose muscles are less likely to become tight and painful in response to stress. If you have a medical condition or are over the age of 50, it’s best to check with your doctor before beginning an exercise regimen.
  • Eat a healthy diet: Junk food and refined sugars low in nutritional value and high in calories can leave us feeling out of energy and sluggish. A healthy diet, low in sugar, caffeine, and alcohol consumption, can promote health and reduce stress.
  • Get adequate sleep: A good night's sleep allows you to tackle the day's stress easier. When you are tired, you are less patient and easily agitated which can increase stress. Most adults need 7-8 hours of sleep per night. Practicing good sleep hygiene along with stress-lowering tactics can help improve your quality of sleep.
  • Delegate responsibility: Often, having too many responsibilities can lead to stress. Free up time and decrease stress by delegating responsibilities.

Here's an action tip:
If you are chronically pooped, and think your problem is the result of poor sleeping habits, please see your doctor. If there are no physical reasons for your condition, then ask your doctor to recommend some alternatives to medication, such as the relaxation response, or hypnosis. If medications prove necessary, try to give yourself as little as possible, and to periodically have drug-free week-ends to help clear your system of the metabolites. Make sure your doctor is aware of all drugs, both prescription and otherwise, that you are taking. Most of all, try to aim for safe sleep.

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The CAGE Test For Alcoholism

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Alcoholism is a disease, and a remarkably common one at that. Between one third and a half of all patients in general hospitals are alcoholic, and the costs of treating drunkenness are truly staggering, pardon the pun.

An image of drinking too much alcoholThose that suffer from alcoholism typically have an uncontrollable compulsion to consume alcoholic beverages which generally results in problems to their health, personal relationships and social standing. 



Studies have shown alarming figures:

  • A third of all trauma admissions (ie, car accidents) are drunk or intoxicated.
  • Thirty per cent of all male coronary care unit patients under the age of sixty suffer from alcoholism, while twelve per cent of their female counterparts are alcoholic.
  • Alcoholism present with stomach ulcers, liver disease, bleeding from the esophagus , pre-senile dementia or psychosis , or, especially in winter, exposure to the cold.

For years, there has been a sense of collective hopelessness about the condition, a sort of feeling that the alcoholic is beyond help and reason, and is bent on self destruction. New evidence shows that the opposite is true, that, like other diseases, early detection of alcoholism is the best protection. The ideal person to do the initial screening is the family doctor, but alas, the test has not been widely enough publicized.

In an attempt to give the examination a broader hearing, I will list the four easy questions we could all be asking of anyone who drinks and that we suspect suffers from alcoholism. First, have you ever felt that you should cut down on your drinking? Have people annoyed you by criticizing your drinking or have you ever felt bad or guilty about drinking? Have you ever taken a drink first thing in the morning as an eye opener to steady your nerves or get rid of a hangover?

The acronym for the test is the CAGE test:

  • Cut down drinking: Do you feel the need to reduce the amount you drink?
  • A for annoyed: Do you feel annoyed by complaints about your drinking?
  • G for guilty: Do you ever feel guilty that you drink?
  • E for eye-opener: Do you ever drink a morning "eye-opener" to relieve the shakes?

If you answer yes to any of these questions, or worse yet, to all of them, you are falling into the alcoholic trap and alcoholism may be beginning to affect your life and your loved ones.

Here's an action tip:
Alcoholism is not a hopeless disease, and it can be treated. This is especially true in its most earliest stages. Take the cage test yourself, and see how you do. It’s a sobering thought.

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Quit Smoking With Nicotine Replacement Therapy But Watch The Coffee

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Have you tried to quit smoking by using nicotine replacement therapy but failed? Well, it may be because you are drinking that morning cup of Joe while chewing nicotine gum or just after putting your nicotine patch on.

An image of quitting smoking by using nicotine gum

Smoking is an addiction of tremendous power. The bonds between a smoker and his or her nicotine are stronger than the addiction ties to cocaine or even heroine. In order to help fight the battle, an endless number of gizmos and gadgets have been tried, some with greater success than others. A few years ago one promising idea was a set of six cigarette holders, with the widest aperture being used the first week, then each week the opening became narrower and narrower. At the end of the sixth week the smoker could now suck a tennis racket out of an opponent's hand, but they were still smoking.

One of the more effective aids, however, has been nicotine taken in patch form or made available via chewing gum. With a patch or gum, nicotine levels in the blood rise slowly and stay high for more than two hours, while a cigarette would “spike” nicotine levels within 20 to 30 minutes and then lead to a quick reduction, which can be responsible for inducing craving and more smoking. The patch is relatively more effective than the gum in stabilizing blood nicotine levels and may make it easier to eventually quit.

These products provide the smoker with their nicotine fix, and yet bypass the lungs, as well as the rituals involved in the habit. Nicotine replacement therapy can be very helpful to some to stop smoking, but many fail on it.

An image of quitting smoking by using nicotine gum

Now it turns out that the reason for failure may well be coffee, according to a National Institute on Drug Abuse study published in the Journal of the American Medical Association. Researcher Jack Henningfield found that coffee makes saliva more acidic for about fifteen minutes, and this acidity blocks the nicotine medicine in the gum or patch from getting into the bloodstream. Not only coffee can neutralize these nicotine replacement products, one should avoid any substance more acidic than tap water, including cola, chocolate milk, beer, fruit juices, soy sauce and mustard.

Here's an action tip:
If you are taking nicotine gum or a using a nicotine patch to quit smoking, make sure you follow the instructions carefully. Also make sure that you do not have any acidic foods or beverages while you chew, or, if you have, make sure you rinse your mouth clear with tap water before starting the gum.  And if you need more motivation to quit, review this: /post/2011/02/06/Trying-to-quit-cigarettes-Dont-let-your-plans-go-up-in-smoke!.aspx

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Common OTC Drugs and Driving: A Possibly Lethal Combination

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We all know about the effects of alcohol on driving skills, but we should also be more aware of the effects of drugs behind the wheel.

For years, it was considered macho to be able to drink and drive, and the habit was lionized in many movies. An image of what can happen when drugs and driving are combined Even up until a few years ago, no one thought twice about saying good night to the life of the party, who - two sheets to the wind - weaved his way out to the parking lot to drive home.

But, thanks to the efforts of groups like MADD, mothers against drunken drivers, the police, insurance companies, health agencies (and even some beer and alcohol companies!) the community's view of the amusing drunk starting up his automobile has changed radically. Now there have been many cases where a host or bartender who over-served the drunk can be sued by the victim of a tragedy caused by the drunken driver. as a result, this whole subject is taken a lot more seriously - as it should be.

More than alcohol can impair a driver, a lot of drugs can too, even the common cold and cough remedies. Dr. Bhushan Kapur, director of clinical laboratories for the Addiction Research Foundation (now part of the Center for Addiction and Mental Health ), was one of the physicians involved in a two year study on this subject. 450 critically injured patients were tested with both blood and urine samples in Toronto's Sunnybrook Medical Centre's regional trauma unit, and an alarming 61% of them had taken one or more drugs before their accident. Almost a third of them had taken two or more drugs, including alcohol, marijuana, cocaine, barbiturates, and other narcotics. Prescription drugs such as tranquillizers, and cold remedies, such as antihistamines, were also discovered in many cases. Alcohol, in combination with even the mildest over-the-counter medicines, can greatly magnify the impairment even more.

Here's an action tip:
We've indeed come a long way in our attitude to the drunk driver, although the problem is far from over. But even if you are not drunk, but have a mild fever and have just taken a cough or cold medication, it would be a good idea to let a companion, or a taxi driver do the driving for you.

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Having Difficulty Giving Up Smoking? Don't Be Depressed!

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Are you smoking more and enjoying it less?  Well, researchers may have found the reason why.

smoking can cause depression, making it that much more difficult to quit

It's been known for years that smokers develop permanent facial lines radiating out around their lips, from years of sucking on rolled up vegetable leaves.  Well, in addition to associating smokers with puckered faces, it seems we can also associate them with long faces. 

There are thousands of chemicals other than nicotine constituents in cigarette smoke, of which one, or several, may affect mood in much the same way as a group of antidepressant medications called monoamine oxidase inhibitors or (MAOIs). These MAOIs effectively increase levels of specific neurotransmitters involved in the regulation of mood. Smoking, therefore, may be a way for depressed individuals to self-medicate depressive symptoms.

Dr. Alexander Glassman, of New York State Psychiatric Institute, discussed his findings in the Journal of the American Medical Association.  He notes that people with a history of depression are more likely to smoke, and 40% less likely to quit for good. It seems that even smokers who aren't now depressed, but have suffered major depression at some time in their past, are just as likely to have trouble as those who are currently depressed. 

It just goes to prove the old adage, that it is not enough for a doctor to discover what kind of an addiction each patient has, but one must find out what kind of a person each addiction has.  In other words, by just using generic treatments for smokers without heeding the rest of their health problems, doctors and patients alike can fail, in spite of the best intentions. One of the common features of these cases is that the ex-smoker becomes very depressed after stopping cigarettes.  Because of this Dr. Glassman is studying whether anti-depressant drugs can help such smokers quit successfully. 

If you are planning to quit smoking, by all means do it now.  But if you have had a history of depression, make sure you see your doctor for advice, and, if indicated, for short term antidepressant medications.

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Trying to quit cigarettes? Don't let your plans go up in smoke!

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One of the most difficult of all addictions is to nicotine.  It is said by addicts and therapists alike to be a more difficult substance to quit than alcohol, morphine, or even heroin.  Although Mark Twain did make the great observation that he found it extremely easy to quit, in fact he had done so hundreds of times!

quit smoking

No longer is smoking considered "social"; in fact it has become highly "anti-social".  Cigarette smokers are forced out of the building, in all kinds of weather, and can no longer light up in most restaurants, bars, or even bowling alleys.  An even more compelling reason to quit is the economy.  As cigarettes rise in price (with taxes as well as ingredient cost increases) people begin to think twice about their bottom line.  Five dollars a pack may not seem like much, even if one thinks of each cigarette costing 25 cents.  But a pack a day can quickly add up to $1500 a year, or $15,000 in a decade.  At a time when people are pouring over the ingredient list in every loaf of bread or drink they buy, it seems inconsistent to be sucking poison gas into your body while googling "healthy snacks". 

The Prescription Drug Cartel has humbly leapt into the breech here, offering an array of nicotine patches, gums, or prescription drugs like champix.  But before getting into the list of side effects with these (although there are even worse side effects to NOT quitting cigarettes!), lets review some simple steps that my patients have found invaluable in taking back control of their own lungs.

1. Fight back against the power of imagery:

 Before Hollywood even starts filming, cigarette companies are lining up to pay big bucks for "product placement".  This was not needed in the old days, as Humphrey Bogart started a generation to think of cigarettes as "sexy" or "romantic". 

Bogie didn't know then that his cigarettes would kill him of esophageal cancer at the young age of 57 (weighing only 80 pounds).  Ever wonder why today's movie heroes all smoke cigarettes, even if the actors usually don't in private?  Product placement. 

Action tip: Fight back against the suits in the cigarette companies with your own imagery.  The next time you see a package of cigarettes, think about LICKING AN ASHTRAY: good idea, or bad idea?  Easier question than seeing a package of cigarettes as your best STRESS BUDDY; take with you to a party, or leave behind?  Tougher to say "no" to that question!  Come up with your own images!

2.  Be the WORST personal assistant:

In golf, a great caddy always has the right tools at hand, either a club, or the umbrella, or the towel to wipe off the mud.  A lousy caddy never has anything you need at the right time. For a great illustration of this, see W.C.Fields in this short clip:

Think of being a lousy "cigarette caddy" for yourself.  Instead of having the ashtray, lighter, cigarettes and coffee all in the same place in the morning, do what the lousy caddy would do.  Ashtray is in the spare bedroom.  Lighter is out in the glove compartment of the car.  Cigarettes are in the same pocket as your sunglasses, and you still can't find them.  And the only cigarettes you can find are a stale pack of a brand you hate.  On your coffee break, take a big bottle of water with you instead of the coffee, and have the coffee at your desk where you know you can't smoke.  This breaks up the enabling associations.  (For some reason, cigarettes go with hot coffee and cold alcoholic beverages, but never with plain water.)

3. Remember the Rule of the Subway Jumper:  If a person is stopped in their attempt to jump in front of a subway train, they NEVER jump in front of the very next train.  Once the moment has passed, it is most unlikely that the suicidal urge will resume that quickly.  So if you can use any trick to foul up your next suicide attempt with a cigarette, that's one less nail in your coffin. 

4. Think:  who is in charge of your body?  You, or the smirking suits in the Cigarette Cartel?

When you are under stress, don't let the cigarette cartel convince you that cigarettes are a smart choice.  Picking up a leaf, rolling it up, sticking it in your face, and then setting fire to it.  Sound like a good stress response to you?  Much better to take control, and do your best to butt out.  Try any technique; cold turkey, or gradual rationing of one less cigarette per day.  Or  If the above steps are not enough, please see your doctor for further advice, which could include drugs for a short term, or medical acupuncture to fight the nicotine withdrawal. 


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