Recommended article in The New Yorker about end-of-life care
Atul Gawande is a surgeon and author at Harvard -this is an article he wrote in The New Yorker a couple of weeks ago. I thought this was a very thoughtful piece about hospice care and the difference that good palliative care can make at the end of life.
http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande?
It’s hot out there! Keep well hydrated–here’s how…
With all of the hot, humid weather we have been having lately I thought it would be helpful to discuss ways to stay hydrated. Here is some information courtesy of familydoctor.org:
Hydration: Why It’s So Important
Why is it so important to stay hydrated?
Your body depends on water for survival. Did you know that water makes up
more than half of your body weight? Every cell, tissue and organ in your
body needs water to function correctly. For example, your body uses water to
maintain its temperature, remove waste and lubricate joints. Water is
essential for good health.
How does my body lose water?
You lose water each day when you go to the bathroom, sweat, and even when
you breathe. You lose water even faster when the weather is really hot, when
you exercise, or if you have a fever. Vomiting and diarrhea can also lead to
rapid fluid loss. If you don’t replace the water you lose, you can become
dehydrated.
How do I know if I’m dehydrated?
Symptoms of dehydration include:
* Little or no urine, or urine that is darker than usual
* Dry mouth
* Sleepiness or fatigue
* Extreme thirst
* Headache
* Confusion
* Feeling dizzy or lightheaded
* No tears when crying
Don’t wait until you notice symptoms of dehydration to act. It can be hard
to recognize when you’re dehydrated, especially as you age. Actively prevent
dehydration by drinking plenty of water.
How much water should I drink each day?
There are different recommendations for water intake each day. Most people
have been told they should be drinking 6 to 8 8-ounce glasses of water each
day, which is a reasonable goal. However, different people need different
amounts of water to stay hydrated. Most healthy people can stay well
hydrated by drinking water and other fluids whenever they feel thirsty. For
some people, fewer than 8 glasses may be enough, and for others it may be
more.
Some people are at higher risk of dehydration, including those who get a lot
of exercise, have certain medical conditions, are sick, or are not able to
get enough fluids during the course of the day. Older adults are also at
higher risk. As you age, your brain may be unable to sense dehydration and
send the signals for thirst.
If you are concerned that you may not be drinking enough water, check your
urine. If your urine is consistently colorless or light yellow, you are most
likely staying well hydrated.
You may need to increase the amount of water you are drinking if you:
* Have certain medical conditions, such as kidney stones or bladder infection
* Are pregnant or breastfeeding
* Are going to be outside during hot weather
* Are going to be exercising
* Have a fever or have been vomiting or have diarrhea
* Are trying to lose weight
Besides water, what else can I consume to stay well hydrated?
Water is the best option for staying hydrated. But there are other drinks
and foods that can help provide the water you need. Drinks like fruit and
vegetable juices, milk and herbal teas can contribute to the amount of water
you should get each day. Even caffeinated drinks, such as coffee, tea and
soda, count toward your daily water intake – up to a point. But it’s best to
limit these since caffeine may cause some people to urinate more frequently
or feel anxious or jittery. A moderate amount of caffeine, 200 to 300
milligrams (about the amount in 2 to 4 8-ounce cups of coffee), is not
harmful for most people.
Water can also be found in fruits and vegetables, such as watermelon,
tomatoes and lettuce, and in soup broths.
What about sports drinks?
For most people, water is all that is needed to maintain good hydration.
However, if you are planning on exercising at a high intensity for longer
than an hour, a sports drink may be helpful as the carbohydrates contained
can prevent low blood sugar. A sports drink can also help replace
electrolytes if you have a fever, have been vomiting or have had diarrhea.
Choose sports drinks wisely, as they are often high in calories from sugar and may contain high levels of sodium. Also check the serving
size – 1 bottle may contain several servings. Some sports drinks contain
caffeine. If you use a sports drink that contains caffeine, be careful not
to get too much caffeine in your diet. Keep your caffeine intake less than
450 mg per day.
Tips for staying hydrated
* Keep a bottle of water with you during the day. Consider carrying a
reusable water bottle and filling it from the tap rather than purchasing
bottled water, which is expensive and creates plastic bottle waste.
* If plain water doesn’t interest you, try adding a slice of lemon or
lime to your drink.
* If you’re going to be exercising, make sure you drink water before,
during and after your workout.
* Start and end your day with a glass of water.
* When you’re feeling hungry, drink water. The sensation of thirst is
often confused with hunger. True hunger will not be satisfied by drinking
water. Drinking water may also contribute to a healthy weight loss plan, as
some research suggests drinking water will help you feel full.
* Drink on a schedule. If you have trouble remembering to drink water,
try to create a schedule. For example, drink water when you wake up; at
breakfast, lunch and dinner; and when you go to bed. Or drink a small glass
of water at the top of each hour.
* Drink water when you go to a restaurant. Not only does it keep you
hydrated, but it’s free!
June 22nd schedule update
Thankfully, after spending my day at the county courthouse today, I have been excused from jury service and so will be available at the office during my regular office hours for the rest of the week. Appointments can be scheduled online as usual.
Wondering about the schedule for the week of June 21st-24th?
Dear patients, I have been called for jury duty (after postponing one too many times) next week. I will definitely be unavailable on Monday June 21st, so please call the office to be connected to the on-call doctor on Monday 6/21/10. I am hoping not to be picked and if not, will open up the schedule as soon as I know what the outcome is on Monday. Feel free to call the office for updates and instructions in the meantime if you have questions, or check the online scheduler as needed. I’m keeping my fingers crossed!
Dandelion Greens
Wild greens are among the most nutrition-packed foods available yet they can be a bit of a mystery to prepare and are not familiar to many home cooks. Check them out in the cooking greens section of Wegmans! They are high in iron and Vitamin E.
Here is a simple recipe for dandelion greens–adapted from O Magazine.
1 bunch dandelion greens, approx 1 pound
1 Tbsp. olive oil
1 medium onion, sliced
2 cloves of garlic, chopped
1 tsp. fresh ginger, chopped
1 Tbsp. tamari soy sauce
juice of 1/2 lemon
Wash the greens and chop off tough stems. Bring a pot of salted water to boil and immerse the greens for 1 minute; then remove and drain in colander. Run cold water over the greens and set aside. Heat olive oil in a large skillet, and saute the onion over medium heat until soft. Add garlic and saute until fragrant, about 30 seconds. Stir in greens, ginger, and tamari and cook for 3 minutes, remove from heat. Sprinkle lemon juice on greens and serve. Makes 4-6 servings.
Schedule alert for Memorial day weekend
The office will be closed for Memorial Day weekend and will remain closed until June 5th. During that time my colleague Dr. Marci Chodroff will be covering for urgent concerns that you may have while I am away, and I will update the website and voicemail with her contact information as that time approaches. If you are able to plan a little bit ahead of time, please check to see if prescriptions will need to be refilled that week and let me know now, so I can take care of these types of routine requests before I leave.
Another reason to get more sleep….
Here’s an interesting article about the association with overeating and lack of sleep. For those of you watching what you eat, trying to lose a few pounds, or just trying to maintain good energy levels, this may be just as an important factor to focus on as what you put on your plate or how much time you spend at the gym. With busy lives and multitasking, many of us are trying to make do with less sleep. Most adults require 7-9 hours of sleep per night to stay healthy.
Scheduling Change for April 2010
I will be attending a medical conference from Wednesday April 21st through Saturday the 24th. During that time my colleague Dr. Marci Chodroff will be covering for urgent concerns that you may have while I am away, and I will update the website and voicemail with her contact information as that time approaches. If you are able to plan a little bit ahead of time, please check to see if prescriptions will need to be refilled that week and let me know now, so I can take care of these types of routine requests before I leave.
Welcome to my new blog!
I will use this forum to focus on issues related to health care and wellness, update you on changes occurring in my office, and to announce other news that may interest you.
Hopefully this will help you to be fully informed about what is happening here at the office and provide a place where you can find health news and advice you can use.
To your health –
Lisa Schwartz MD