Weight Loss and Health Benefits of Intermittent Fasting
Intermittent fasting is a type of eating plan based around periods of eating and periods of fasting, or avoiding food. Whether you realize it or not, you already go through a period of fasting over the course of a typical day: you fast while you sleep. When following an intermittent fasting plan, you purposefully make these fasting periods longer, by skipping certain meals or by not eating at all on some days. Intermittent fasting isn’t like a traditional diet plan – it doesn’t tell you exactly which foods to eat or how much food to have. Instead, intermittent fasting tells you when to eat.
Why are People Trying Intermittent Fasting?
In the past couple of decades, researchers have realized that one of the reasons calorie restriction may be effective is because it often leads to long periods of fasting. Therefore, many new studies are currently underway to study whether intermittent fasting can also lead to good health and long life.
Weight Loss and Muscle Gain
When it comes to dropping pounds, intermittent fasting is at least as effective as cutting calories. In fact, some clinical trials have found that fasting may lead to even greater amounts of weight loss. Additionally, people with a higher BMI are especially likely to shed pounds when on an intermittent fasting eating plan. Researchers think that the reason fasting helps you lose weight is that it can boost metabolism.
In recent years, intermittent fasting has become very popular among health and fitness enthusiasts, with many personal trainers and fitness communities recommending the diet. Scientific research shows us there is probably good reason for this. Multiple studies have looked at the combination of intermittent fasting with resistance training, which includes strength-building exercises such as weight lifting and bodyweight exercises. The studies found that the combination of fasting with resistance training led people to burn more fat and maintain or possibly even build more lean muscle.
Other Health Benefits
Heart Health
Intermittent fasting can boost heart health in several ways. It can help people lower blood pressure, heart rate, cholesterol, and insulin levels. Fasting also drops levels of fat and sugar in the blood. All of these factors affect a person’s likelihood of developing heart disease or of having a heart attack or stroke. It’s possible that intermittent fasting eating plans could reduce a person’s risk of disease by keeping these factors under control.
Additionally, fasting may help lessen the impact of a poor diet. For example, eating a lot of saturated fat increases a person’s risk of heart disease. When mice are fed a high-fat diet, they develop obesity, high insulin levels, and fatty liver disease. However, mice that are fed a high-fat diet but are only allowed to eat for limited periods of time each day don’t have these heart disease risk factors.
Interestingly, a few studies have looked at the effects of fasting in religious populations. Studies of Muslims and Latter Day Saints found that people were less likely to have heart disease or heart failure while going through a religious fast.
Diabetes
Some studies have also shown that intermittent fasting plans can improve insulin sensitivity and blood sugar levels, meaning that their bodies can better digest and use sugar. When the body becomes more efficient at metabolizing sugar, a person is less likely to develop diabetes. However, these studies have only looked at short-term health effects, and some other studies have shown mixed results. It’s not entirely clear yet whether intermittent fasting can directly lower a person’s diabetes risk in the long run.
Brain Disorders
Intermittent fasting may help the brain age in a healthy manner by encouraging brain cells to grow and form new connections. Animals who fast are better protected against injury and have lower rates of Alzheimer’s disease and Parkinson’s disease.
Cancer
Initial laboratory studies have found that fasting can starve tumor cells and activate genes that protect cells from cancer. In animals, intermittent fasting leads to fewer tumors, less cancer growth, and increased sensitivity of tumors to treatments like chemotherapy. In human studies, very early results have shown that fasting diets may shield cells from damage and lead people to have fewer symptoms after undergoing chemotherapy. These early studies haven’t yet been able to tell us whether intermittent fasting can be an effective cancer treatment in humans. However, many clinical trials studying this question are in progress.
Other Effects
Early evidence also shows that intermittent fasting may reduce symptoms of other diseases such as asthma, arthritis, and multiple sclerosis, and may help heal wounds more quickly.
Intermittent fasting may also have several other health benefits, such as:
- Cells are more protected from damage
- Cells can more easily repair themselves
- The body increases levels of antioxidants
- Cells can more efficiently produce energy
- Old or damaged cells are removed from the body and recycled
- Lower levels of inflammation
These benefits can lead to better physical and mental health. For example, animal studies show that intermittent fasting leads to much better physical endurance, as well as boosted balance and coordination. Additionally, restricting calories may lead to better brain function and an improved memory.
How Does Intermittent Fasting Work in Your Cells?
- Cell Damage: As your cells process food and extract nutrients, they create toxic molecules called free radicals. It’s possible that giving your body fasting periods helps cells produce fewer free radicals. Fasting also allows your body to heal and repair damage.
- Circadian Rhythms: Your circadian rhythms are part of your body’s internal clock. Your body clock links eating/fasting cycles with the outside day/night cycles. This helps your body maximize its energy during the day, when you’re awake. When our body clocks become mismatched with the outside day/night cycles, problems can result. Studies of intermittent fasting have found that when people eat for a shorter period in the middle of the day, they have health benefits related to better metabolism and heart health, but these benefits aren’t seen when the feeding period is later in the evening when it’s dark.
- Ketosis: Intermittent fasting can lead to a change in metabolism. After eating, your body uses carbohydrates such as sugars for fuel, and stores the fat. During fasting, sugars are no longer available in the blood supply, so your body starts using up the fat it stored. During this period, the body also produces molecules called ketones that it can also use as fuel. Ketones also help cells work properly by controlling many proteins within the cell, such as growth factors, DNA repair enzymes, and sirtuins, proteins that control many aspects of health and aging.
How Do I Go About Intermittent Fasting?
- Alternate-day fasting consists of skipping food for a full 24 hours. This may be done once or multiple times per week. For example, one common fasting plan is the 5:2 diet, where someone fasts for two non-consecutive days in a week and then eats normally for the other five days. Or, someone may rotate every other day between fasting and eating. Some alternate-day plans tell people not to eat anything for the entire day, while others say that eating a couple hundred calories is okay.
- Time-restricted fasting is when someone fasts for certain hours each day. They may eat for only eight hours and then fast for 16 hours, or eat during a four-hour window and fast for the remaining 20 hours of the day. In this case, fasting means that you completely go without food. However, it’s important to still drink water during this time, so that you don’t get dehydrated. Other zero-calorie drinks such as coffee are also okay to have during fasting periods.
Most intermittent fasting plans don’t tell you exactly which foods to eat during feeding times. However, it’s still important to eat healthful foods while doing fasting plans. Eating more plant-based meals supplemented with healthy proteins such as chicken or fish will amplify the health benefits that come with intermittent fasting. If you are eating a lot of saturated fats, sugar, and salt during your eating periods, you may still be at increased risk for developing several different diseases.
Is Intermittent Fasting Safe?
By way of example, fasting may be risky for people with diabetes, especially for those who are on medications such as insulin that may cause hypoglycemia. Fasting could lead a person’s blood sugar to drop too quickly.
When women try intermittent fasting, some may find that they stop having their period. If this happens to you, try going back to a normal eating pattern and consult your doctor. Additionally, if you’re pregnant, trying to become pregnant, or breastfeeding, it’s probably not healthy for you to try intermittent fasting.
Minor Side Effects
When fasting, it’s common to feel very hungry. In clinical trials, people have also reported other minor side effects, such as:
- Feeling cold
- Headaches
- Feeling light-headed
- Difficulty concentrating
- Experiencing mood swings
- Less energy
- Bad breath
- Constipation
- Not being able to stop thinking about food
While these symptoms may be difficult to deal with, they do seem to go away over time. After a month or so, people tend to not feel as hungry or experience these symptoms.
Bigger Risk Factors
Sometimes, people who try IF eating plans are at risk for malnutrition. Taking vitamin or mineral supplements may help you ensure your body is continuing to get the nutrition it needs. Additionally, make sure to eat sufficient protein during meals, as protein malnutrition is a possible concern.
People trying IF should also be aware of signs of more serious health problems. Talk to your healthcare provider if you become dizzy, nauseous, or weak, or if you have trouble sleeping or faint.
Is it Possible to Do Intermittent Fasting Long-Term?
So far, we don’t know of any safety concerns for healthy people who try intermittent fasting over the long haul. However, it might be tough to stick with this eating plan, as it can be very inconvenient or be difficult to incorporate into your daily routine.
It may help to gradually ease into a fasting eating plan. For example, if you’re doing alternate-day fasting, you could try to eat 1000 calories on fasting days for the first month, 750 calories the second month, and 500 for the third. Or, to gradually take on time-restricted fasting, you could try to gradually extend your fasting time each day. Try fasting for 12 hours every day the first month, 14 hours the second month, and so on until you hit your goal. If you immediately jump into a very restrictive plan, you may have more trouble sticking with the diet.
For best results, work with a registered dietician or nutritionist to come up with an eating plan that works for you. A professional nutritionist can help you make sure you’re getting all of the nutrients you need to stay healthy and see maximum health benefits!
Benefits, Risks and Alternatives of Hormonal Replacement Therapy for Women
Hormone replacement therapy is a common way to treat symptoms of menopause. Hormones are complicated and come with great benefit as well as risk if not dosed appropriately. Follow-up with regard to clinical symptoms and lab testing is imperative for all patients who decide to initiate and take hormone therapy, so it is important for patients to discuss options with someone who is very experienced in this realm of hormone supplementation therapy. Women should talk to their doctors about which menopause treatment plans may be best based on their own personal symptoms.
Benefits, Risks and Alternatives of Hormonal Replacement Therapy for Women
Hormones are chemicals made by the body. They act as signals, allowing one part of the body to communicate with another part. Hormones are important for many functions in the body, such as growth, metabolism, mood, and sexual reproduction.
Estrogen and Progesterone
Different hormones are responsible for the development and health of male and female reproductive organs. In women, the reproductive hormones are estrogen and progesterone. They are made in the ovaries, and then released throughout the body, where they play important roles in:
- Creating female characteristics during puberty, such as breasts and pubic hair
- Regulating the menstrual cycle, fertility, and pregnancy
- Helping keep the heart working properly
- Supporting brain health and function
- Helping form bone and supporting bone strength
Menopause
As women get older, their bodies gradually stop producing hormones. Their menstrual cycles become more irregular, and eventually stop altogether. Once periods stop, women can no longer get pregnant. This process is known as menopause.
When people go through menopause, they often experience many symptoms that frequently last for seven years or more. One of the most common symptoms is a “hot flash,” in which someone suddenly feels hot, starts sweating, and develops redness or flushing on the chest, neck, or arms. (Most often this is at the level of the neck and above.) Other frequent symptoms include:
- Shorter or longer periods that occur more or less often
- Night sweats
- Sleeping problems
- Vaginal dryness
- Incontinence (leaking urine when sneezing, coughing, or running)
- Lower or higher sex drive
- Mood swings or anxiety
- Thinning hair
- Development of facial hair or sporadic hair on the chin
Women generally start transitioning into menopause in their mid- to late 40s. This transition generally lasts around four years. The period before menopause is termed “peri-menopause” and often starts to occur in a woman’s 30s and can last for more than a decade until menopause occurs. Women is said to have reached menopause when they haven’t had a period for 12 months in a row. Menopause occurs on average, at the age of 52, although it may happen several years earlier or later in many women.
Some women go through menopause at an earlier-than-normal age. It’s not always clear why women go through early menopause, although some possible reasons include smoking, genetics, chemotherapy or radiation treatments, autoimmune diseases, and surgical removal of the ovaries. Typically, women who go through early menopause have the same sorts of symptoms, but the symptoms are more likely to be severe.
HRT Benefits
Menopause symptoms will usually go away eventually on their own, without treatment. However, taking extra hormones as the body stops producing them can help reduce symptoms. Using medications that contain hormones is known as hormone replacement therapy, or HRT.
Women are often at higher risk of having other health problems after they go through menopause, and HRT can also help prevent some of these conditions. For example, a drop in estrogen levels typically leads to bone loss. Women often develop osteoporosis and have a higher risk of breaking bones once they go through menopause. HRT can help women maintain bone strength as they age and stop producing estrogen. HRT can also help post-menopausal women maintain healthy muscle function and improve skin health. Additionally, women younger than 60 who utilize HRT tend to live a little longer.
Using HRT can also help with cognition, or the dreaded “memory fog,” a common symptom experienced by women going through menopause.
People may also go through HRT when they transition away from the biological sex they are assigned at birth. Transgender women may take estrogen and/or progesterone along with testosterone blockers (aka: androgen blockers) as a way to develop more feminine features. HRT can have physical and psychological benefits and lead to greater quality of life for people who are transgender.
Types of HRT
- Estrogen-only medication, which may be called estradiol or conjugated estrogen. Estradiol is the strongest type of estrogen used. Brand names include Premarin, Estrace, and Estraderm, although the molecular structure of Premarin (equine estrogens from horse urine) is different from the female body, so it is not used as much anymore. Other estrogens used include estriol and combinations of the estrogens as well.
- Progestin-only medication, which may be taken along with estrogen-only drugs. One Brand name is Provera, which is medroxyprogesterone. There is a significant difference between progestin and progesterone as progestin is not bio-identical and has a different molecular structure than the female progesterone. To put it simply, medroxyprogesterone and any progestins are molecularly “cousins” of the naturally occurring progesterone found in the female body. In my opinion and in my practice, patients should use bio-identical HRT – this is the only type of hormone supplementation or replacement I recommend.
- Combination estrogen and progesterone medication, including Prempro, Climara Pro, and Activella.
- Combination estrogen and hormone medication, which consists of the drug Duavee. Duavee contains both estrogen and bazedoxifene, a medication that amplifies the effect of estrogen.
- Progesterone-only medication includes brand names such as Prometrium which are bio-identical, of the same molecular structure as the body’s own progesterone.
Ways of Taking HRT
- A pill or tablet taken by mouth, usually once per day.
- A patch worn on the skin, which is taken off and replaced every couple of days.
- Topical treatment, including creams, gels, sprays, or foams, which are often applied to the skin once per day in a specific location (such as the arm or leg)
- Injectable HRT.
- Hormone Pellets that are implanted underneath the skin every 3-6 months, depending on gender and serum (blood) levels.
Another form of HRT raises hormone levels only in the vagina. These products usually give off a lower dose of estrogen, and are effective at treating vaginal symptoms like dryness. However, they won’t work on symptoms that affect other parts of the body, such as hot flashes. Vaginal HRT medications may come in the form of a cream, ring, or vaginal tablet.
Each form has different pros and cons, and specific side effects may be more or less likely with each type of HRT. Please talk to your doctor about which form might work best for you and your specific needs and lifestyle.
Risks
Side Effects
Different HRT medications have different side effects. Some common side effects include headaches, stomach cramps, nausea or vomiting, tender breasts, hair loss, muscle spasms, dizziness, and throat or neck pain. If you are experiencing severe side effects from HRT, talk to your doctor about trying a different medication or stopping your use of the medication.
Health Risks
Taking hormones can lead to certain more serious side effects. Depending on a person’s health and family history, HRT may increase the chance of developing:
- Blood clots
- Heart attacks
- Stroke
- Dementia
For this reason, HRT is often not recommended for people with a history of bleeding problems, heart attacks, stroke, or liver disease. However, not every person is at high risk of developing these conditions. Talk to your doctor to determine whether these disorders are a concern for you.
Taking estrogen can also lead to an increased risk of getting cancer of the uterus. If a woman still has her uterus and has not gotten a hysterectomy, taking progesterone in addition to estrogen can reduce this risk. Additionally, taking progesterone helps protect the uterus and also reduces the risk for abnormal endometrial cell growth or proliferation which can cause the lining of the uterus to become thickened and cause vaginal bleeding.
Does HRT Lead to Cancer?
In the early 2000’s, two large clinical trials that included tens of thousands of women analyzed the long-term effects of HRT. These trials were the first to find that there may be a link between HRT and breast cancer. After following the women in the trial for more than a decade, researchers found that women who took a combination of estrogen and progestin (not progesterone) were more likely to develop breast cancer but I note that these studies were done on subjects that were not taking bio-identical hormones, which are the only type I recommend in my practice. However, women who took estrogen alone had a decreased cancer risk. Since these trials, many more studies have been published, and they have often come to conflicting conclusions, Cancer risk needs to be assessed on an individual basis with any patient who is considering taking HRT and this may be especially important for women with a personal or family history of the disease. Work with your healthcare provider to determine whether the benefits of HRT outweigh the risks.
How to Take Hormones Safely
In order to decrease health risks, some experts recommend taking hormones for the shortest amount of time needed, using the lowest dose that works. HRT carries less risk for younger women and for women who went into menopause within the last few years. However, now we have ample data to support taking HRT for many years and that doing so can help protect the brain, breast, and bones.
If you do decide to take hormones, there are things you can do to take them more safely. I always recommend that patients take an HRT that is the bio-identical form. Make sure to have regular doctor’s appointments where you can discuss both your menopause symptoms as well as any possible side effects from HRT. In particular, tell your healthcare provider if you experience any new bleeding problems. You can also ask your doctor about whether you need to be screened for certain health conditions, as people who take hormones may need to get mammograms or bone density tests more often than others. Finally, do not smoke while taking hormones, as this can lead to potentially dangerous blood clots.
Alternatives to HRT
Relaxation Techniques
Research has found that practices that lead to less stress and anxiety can help improve menopause symptoms. For example, mindfulness meditation can help women have fewer, less severe hot flashes, and help with symptoms related to sleep, mood, and muscle and joint pain. A clinical trial also found that hypnosis could make hot flashes occur 74% less often and be 80% less severe, although scientists don’t know exactly how this works.
Additionally, researchers have studied whether certain types of relaxing physical activities can help with menopause. Tai Chi is a mind-body exercise that involves meditation and relaxation. Studies have found that Tai Chi can help menopausal women have fewer hot flashes, stronger bones, and higher levels of antioxidants in their bodies. Additionally, yoga may help reduce hot flashes. Exercises that engage both the body and the mind might be a way to help treat menopause symptoms.
Herbal Supplements
Many herbal or natural supplements are often taken for menopause symptoms. However, many herbs don’t seem to actually work when they’re studied in clinical trials, or they have not been studied at all.
For example, women undergoing menopause commonly use evening primrose oil. One study found that this supplement could make hot flash symptoms slightly better, while another found that it had no effect. The use of red clover in menopause has also led to mixed results. However, there is some evidence that black cohosh can help treat menopause, especially when combined with St. John’s wort. More clinical trials need to be conducted in order to better determine which herbs are most helpful for treating menopause.
If you do decide to use herbal supplements, make sure your doctor knows. Just because a treatment is natural and comes from a plant doesn’t mean it’s completely safe. Evening primrose oil can lead to bleeding problems when combined with ginseng, and black cohosh may cause liver damage. Some herbal supplements can also have interactions with other drugs, leading to increased side effects.
Change Your Diet
Try tracking your hot flashes and keeping a food diary to see if you notice that certain food or drink makes your hot flashes worse. Caffeine, alcohol, and spicy foods may all act as triggers for hot flashes. Avoiding food and drinks in these categories may help your symptoms improve. Eating lots of fruits and vegetables and having meals at regular times throughout the day can also help you manage your symptoms. Additionally, some women find that eating soy products such as tofu or edamame may help treat menopause.
Manage Hot Flashes
Even if you can’t make your hot flashes disappear, you can make them more manageable. Wear light, breathable clothing, and dress in layers so that you can take off a jacket or sweater if you feel a hot flash coming on. Keep cold water and a fan close by at all times, in order to help cool yourself off if you start sweating. It may also be helpful to sleep with a fan by your bed. Finally, taking slow, deep breaths as a hot flash starts can help them go away more quickly.
Addressing Sexual Symptoms
Using a vaginal moisturizer can help relieve dryness. Additionally, you may want to try a water-based lubricant in order to make sex more comfortable. Kegel exercises may also help work out muscles in the vagina and lead to less urine leakage.
Keep Your Bones Healthy
Because bone density decreases after menopause, and bone breaks become more common, it’s important for women to think about bone health. Exercise and physical activity can keep bones strong as you age. Taking extra calcium or vitamin D can help, too. Calcium comes from foods containing dairy, such as milk and cheese, as well as from leafy green vegetables, salmon, and tofu. Vitamin D comes from getting sunlight. Both calcium and vitamin D can also be taken as supplements. Talk with your physician about making sure that your vitamin D levels are optimal.
Getting Better Sleep
Many women going through menopause have sleeping problems. Try getting better sleep through:
- Getting more physical activity during the day
- Avoiding eating or drinking alcohol before bed
- Drinking warm milk or tea before you sleep
- Turning off your phone and TV when it gets close to bedtime
- Avoiding naps during the day
- Talking to your healthcare provider about treating insomnia
Conclusion
Hormone replacement therapy may be right for some but unnecessary or risky for others. Your physician can help you figure out whether the benefits outweigh the risks based on your health and family medical history and can help guide you in the right direction regarding the benefits of hormone replacement therapy. Contact Dr. Brynna Connor to learn more.
Safe medical care during the pandemic
Are you avoiding the Doctor Due to the Pandemic?
The Serious Implications and How You Can Safely Get Medical Care
Many people are trying to be responsible during the COVID-19 pandemic by limiting their interactions with other people and by not going out in public spaces as often. However, one result of these precautions is that some people have been avoiding going to their physician or getting medical care. This can lead to serious consequences for those who are experiencing other health problems. Thankfully, there are several alternatives to in-person healthcare visits when appropriate, and there are also several ways to reduce your risk of infection for those times when you need to go to the hospital or your doctor’s office.
Have People Been Avoiding the Doctor?
Many people report that someone in their household has put off medical care due to the pandemic. People are starting to feel more comfortable going to their doctor’s office but are still seeking less health care than they did a year ago, according to many surveys nationwide.
Why is this?
It’s possible that people may need slightly less medical attention than they did in past years. With more people working from home and fewer people going out socially during COVID-19, the number of traffic accidents has decreased across the nation, thankfully. Some people may be eating out less and perhaps (hopefully?) cooking healthier meals at home as well so might need less medical care related to that these days. Also, in this year with the COVID-19 pandemic, surgeons had to cancel procedures, physicians had to temporarily close medical offices, and many also had to adjust their schedule in order to see fewer patients for proper cleaning to take place. Some patients may have wanted to see a doctor but couldn’t visit their usual providers for many different reasons.
Additionally, many people lost their jobs, were laid off, or took pay cuts during the pandemic. These factors have caused some Americans to lose their health insurance or to have a hard time continuing to pay for medical care. Many patients have put off getting tests or receiving treatment for chronic illness. However, research has shown that people are also actively avoiding getting medical attention when they need it – and sometimes when they need it most. By now, we all know that social distancing and isolating from other people are important public health measures that can reduce the spread of the coronavirus. Many people may be especially worried about coming into contact with other potentially contagious people in a doctor’s office or hospital. But … wait, there can be serious health consequences of avoiding going to your doctor!
When people avoid getting medical care, there may be long-term consequences. According to a recent article in JAMA (Journal of The American Medical Association, a peer reviewed medical journal), between March and July of this year, nearly 250,000 more people died than expected in the United States. According to this article, two-thirds of these deaths were due to COVID-19, but the other one-third was due to causes like heart attack. This means that many more people were dying from other health conditions than “normal” years’ numbers would indicate.
Many people who experienced symptoms of serious health problems did not seek emergency care due to fear of getting infected with the coronavirus. Within the first ten weeks of the pandemic, emergency department visits decreased for heart attack, stroke, and diabetes. Clearly, not receiving help during a medical emergency can be dangerous. People who have a heart attack are more likely to survive and have less heart damage if they get medical attention ASAP… and this is true for someone who is having a stroke as well. Strokes can cause brain damage, and the faster a person gets help, the better he or she will do in recovery. While most people might realize this, a prevailing feeling of fear toward the coronavirus has reduced the number of patients who seek care when they need it most.
Getting regular checkups is also important for preventing more serious disease. Screenings for cancer have decreased this year for many reasons already mentioned.
Many of us in health care are concerned about these trends. Even the American Heart Association created their “Don’t Die of Doubt” Campaign to encourage people to continue to get medical care when needed—and especially for more urgent health concerns.
So … what do you do?
Weigh Your Risk
The risks and benefits of getting medical care should be thoughtfully considered.
Certain people are at high risk for having severe symptoms if they contract COVID-19 or even the flu. These folks need to take extra precautions to avoid coming into contact with sick people. We know this, of course, but these people need medical care too! Obtaining proper medical treatment can reduce the risk to these people of serious health complications
Certain types of check-ups or treatments can more easily be delayed than others. There are also ways people can still receive medical treatment while reducing their risk.
Work with your physician to decide which options are best for your health.
Alternatives to In-Person Medical Care
Delaying Treatment
Some routine or preventative healthcare visits may be able to be delayed, but check-ups may not be able to be delayed- and specific medical screenings need to happen … so please talk to your physician about the risks and benefits of delaying healthcare visits based on your particular needs. In-person visits are also very important for certain age groups—such as for newborns, infants, and toddlers. Keeping up to date on vaccines is essential, so have the conversation with your physician.
Telemedicine
Thankfully, you don’t always need to see someone in-person to receive healthcare. People who continue to need medical care during this time can take advantage of telemedicine options, (again – when appropriate) as this works great for many medical conditions. Telemedicine makes use of phone calls, online video calls, smartphone apps, or text messages. Virtual visits can be used for a wide variety of health services, such as:
- Acute urgent care for conditions that are not life-threatening
- Monitoring chronic health conditions
- Mental health services
- Health coaching and counseling
- Physical or occupational therapy
- Follow-up appointments after hospitalization, surgery, or changes in medication
Technology in this area has been rapidly improving, making it easier for providers and patients to connect and increasing numbers of health insurance companies are expanding their coverage for “virtual” or remote care. Prescriptions can often be handled entirely over the phone. Physicians may be able to prescribe new medicines virtually and also follow up with patients in this manner to see how new drugs or dosages are working out. There are even online pharmacies that can help you avoid having to pick up medications in person…and many of our local awesome Austin pharmacies are offering delivery services as well!
How to Access In-Person Care Safely During the COVID-19 Pandemic
How Risky is In-Person Care?
In general, your risk of getting COVID-19 increases when the people around you aren’t following basic precautions. Medical clinics and hospitals have adopted new precautions to help keep patients safe. For example, many healthcare offices screen patients before they enter the building by taking their temperature or by asking them questions about whether they have recently experienced COVID-19 symptoms or had sick contacts. Many doctor’s office and clinics have a separate waiting room for people who are visiting due to possible viral infections or may see possible COVID cases at specific times throughout the day. In my practice, I test people who might be sick from the coronavirus or the flu from the ‘comfort’ of their vehicle, and many other physicians are doing the same. Your risk of getting COVID-19 from a healthcare setting is likely much less than it is in most other public spaces. Also, in my practice, I often see people by telemedicine to triage what testing or evaluation might be needed before they come to my office. This lessens risk to them, to me and my staff, and to others who might be using our building.
Prepare Ahead of Time
In a non-emergency situation, you can take precautions ahead of time to help ensure your doctor’s visit is safe and goes smoothly. You may want to read up on any possible new policies that your physician has recently put into effect. For example, some doctor’s offices may have previously allowed other people to accompany you during visits, but now limit the number of other visitors. If you’re concerned about being exposed to COVID-19, ask your physician’s office a few questions before you arrive for your appointment, such as:
- Is there any paperwork that needs to be filled out that I can complete ahead of time?
- Can I check in via phone or text and wait in my car rather than in the waiting room?
- What are the requirements regarding mask wearing and social distancing during my appointment?
- How often do you clean exam rooms and common areas?
- Are other people, such as caregivers or children, allowed during my visit?
- Does this visit need to be in person, or can it be handled virtually through telemedicine?
Staying Safe During Your Visit
#Mask up! Put on your mask before you enter the building where your medical visit is going to occur. Make sure your mask covers both your mouth and your nose. If you don’t have a mask, ask whether your healthcare provider can give you one.
Social distancing is usually possible in doctor’s offices, and many facilities have signs or stickers on the floor to help you visualize how far apart to stand when checking in. Additionally, while in waiting rooms, you can sit a few chairs away from others.
You can also stay safe by reducing how often you touch any surfaces. For example, you may be able to hit elevator buttons with your elbow. When checking out after your appointment, ask if touchless or online payments are an option. Additionally, avoid touching your face or mask while you’re in the building. Once your visit is over, wash your hands before taking your mask off.
Getting Help In An Emergency
In case of a serious health issue, please don’t delay getting care. Every minute can count when it comes to problems such as heart attack, stroke, or a diabetic emergency. These conditions have a higher chance of leading to serious complications or death compared to COVID-19, so the hospital should not be avoided if you need the care. If you’re not sure whether your situation constitutes an emergency, try to call your physician, a nurse hotline, or 911, and ask for additional advice. And, remember, getting urgent medical care is still urgent.
*Brynna Connor, MD is a board-certified physician who practices in the Austin, Texas area with creative, family-oriented medicine. She has special interest in wellness, preventative medicine, and anti-aging and regenerative medicine. Dr. Connor may be reached at 512.382.9500, or schedule a consultation online.
Follow me on Twitter at @doctorbconnor
What’s the deal with masks and COVID?
Masks and COVID
I am a huge fan of the outdoors on a normal year, but given that the year of 2020 has thrown us a major curveball with the pandemic, many of us are re-thinking what used to be such simple, long-standing activities.
And while you may find this counterintuitive, I suggest moving out of your comfort zone and get outdoors as much as possible– especially from a health perspective. Not only will this allow for proper social distancing and other precautions (it’s a lot easier to be six feet away from someone when you don’t have to worry about bumping into walls), but you also will be able to enjoy the beautiful outdoors as well!
With this in mind, outdoor activities are still a great way to have fun and stay safe. Try these:
- Go for a hike!
- Hit the road for a road trip, or go for a “Sunday drive”
- Get out there to watch the leaves change
- Visit an open pumpkin patch, or even a not-so-local apple orchard
- Visit the many bluebonnet fields in the Texas Hill Country!
There are so many options. And by nature of just getting outside you can get some important exercise while doing any of these activities. And be sure to bring a mask just in case.
In cases where social distancing is difficult, experts say that nearly everyone should wear masks. Masks are especially useful when you’re spending time indoors. While masks don’t completely prevent viral spread, they greatly lower the chance of the virus –or any virus—passing between two people. And yes, there are some people who should not wear masks:
- Kids under the age of 2
- People who have breathing problems
- Anyone who is unconscious
- People who would not be able to remove their mask on their own
People who can’t wear masks should take other measures to help protect their families and communities. For example, people who are working out or swimming may not be able to wear a mask. In these cases, exercising outside and keeping a large distance between yourself and other people helps minimize risk.
Everyone should also try to embrace additional protective measures, such as:
- Washing your hands regularly, for at least 20 seconds
- Using hand sanitizer if you can’t wash your hands
- Avoiding touching your face, especially your eyes, nose, and mouth
- Covering your mouth and nose when you cough or sneeze and immediately cleaning your hands disinfecting surfaces that you regularly touch, such as counters, doorknobs, handles, phones, and light switches.
Do Masks Work?
What does the research show? Masks have been worn during surgery for nearly 100 years to prevent surgeons from spreading germs to patients. Healthcare providers also wear them to protect themselves from their patients. We have long trusted masks to protect us in medical settings. As COVID-19 has grown into a global health crisis, researchers are scrambling to get more data about the effectiveness of masks.
In one large study, researchers at the largest healthcare system in Massachusetts studied how quickly COVID-19 spread before and after implementing a mask policy. In the early days of the epidemic, the number of cases among healthcare workers rose by 1.16% per day. After a policy went into place requiring that all employees and patients wear masks, the number of cases decreased by 0.49% per day.
One interesting case is the story of two hair stylists working in Springfield, Mo. The stylists had COVID-19 symptoms while working with clients, and eventually tested positive. However, both the stylists and their clients wore masks during appointments, and none of the 139 patients tested positive or developed symptoms. This doesn’t mean that masks are 100% effective –if you feel sick, stay home. However, it does show that masks can play an important role in protecting people.
Which Mask Types Work Best?
Several past studies have found that surgical masks and N95 respirators, often worn by healthcare workers, can help prevent the spread of seasonal viruses such as the flu. When it comes to COVID-19, mask research is in the early stages, but we are slowly gathering new information.
Mask Types: What We’re Learning:
A few recent studies have provided information regarding which fabric types may be effective at preventing the spread of viruses or respiratory droplets:
- Research using artificial particles that act like respiratory droplets found that a single-layer bandanna wasn’t very protective, but a folded handkerchief worked slightly better. Cloth masks that contained two pieces of cotton fabric blocked the vast majority of the particles, although a small percentage could escape from the top of the mask because of gaps between the nose and the mask.
- Another study showed that many cloth masks worked about as well as surgical masks for blocking respiratory droplets. These included masks made from cotton, polypropylene, cotton polypropylene blends, and polyester. Interestingly, this study found that bandannas essentially offered no protection, and a gaiter or neck warmer made from fleece may actually lead to more respiratory droplets than not wearing anything at all. The authors hypothesized that fleece may break up larger droplets into many smaller ones, which were more likely to hang around in the air. More research needs to be done to find out whether this is in fact the case.
- Hybrid fabrics may block particles the best, according to an additional study. These fabrics include cotton-silk, cotton-chiffon, and cotton-flannel. The study authors also found that fabric with a higher thread count probably was more effective.
- Masks made from one layer of cloth and paper towels may be able to block the majority of virus particles.
- Masks made from 2-3 layers of T-shirt fabric might be a good balance between effectively blocking virus and being breathable.
- When researchers analyzed the ability of nontraditional materials to filter out viral particles, they found that vacuum cleaner bags were fairly effective. People may be able to use these bags as a filter in a mask.
You may notice that there is no clear answer here, and that the results of some experiments may actually be slightly conflicting. This is because many of these studies were very small, and some researchers studied artificial particles rather than actual viruses. Much more research is needed to get clearer data. However, takeaways from these studies show that effective masks most likely:
- Have multiple layers of fabric
- Are made from cotton or cotton blend fabric (although synthetic poly blends may be effective too
- Fit the face snugly, with minimal gaps
The World Health Organization recommends wearing a three-layer mask, in which the outer two layers are cotton and the middle is a filter made from polypropylene fabric. Duke professor Warren S. Warren, who worked on the second study listed above, gave an additional tip: “If you can see through [a mask] when you put it up to a light and you can blow through it easily, it probably is not protecting anybody.”
Buying a Mask
A huge variety of masks are currently available for purchase. Many clothing and streetwear brands are producing different types and styles of fabric masks. Face masks are available from both large retailers such as Amazon and Target, and small businesses, who may sell their products through social media or through ecommerce sites like Etsy.
More expensive designer brands have even been offering masks. No matter what colors, patterns, or styles you prefer, there is a mask out there for you! Masks come in many different sizes. The fit of a mask is also influenced by whether it ties behind the head or uses loops that go around the ear. People have different preferences when it comes to which style of mask feels the most comfortable, so you may have to try a couple of different types before you get one that works for you.
Whichever style you get, you should make sure that the mask is able to completely cover your mouth and nose and fits snugly without any large gaps.
Making a Mask
There are a huge number of tutorials available for making masks of different styles. Try Googling or searching on YouTube to learn more about how to sew yourself a mask! The CDC also offers basic instructions for sewing a simple rectangular mask with elastic ear loops. The CDC’s website also includes a no-sew tutorial for folding a bandanna or piece of square fabric into a face mask.
Putting on a Mask
You should wash your hands anytime you put on your mask. Make sure the mask completely covers both your mouth and your nose. As you’re wearing the mask, don’t push it down around your neck or push it up onto your forehead. You should also avoid touching the mask if possible. If you do need to touch or adjust your mask, wash your hands before and after.
Removing a Mask
Leave your mask on until you get home. Once you’re back inside, take your mask off by touching only the ties or ear loops. Immediately put your mask into the washing machine and wash your hands.
Washing a Mask
Wash your mask after every single use. Follow any care instructions, if they came with your mask. Wash with detergent and warm water in the washing machine, along with your clothes. You can also hand wash using a disinfecting bleach product and rinsing thoroughly.
Conclusions
Masks are an extremely important tool for slowing and preventing the spread of COVID-1 9. For the highest amount of protection, use a mask that contains multiple layers and fits snugly to your face. Following recommended protocols related to wearing and washing your mask will also play a big role in reducing your disease risk. Contact us to learn more.
Keeping your skin safe in the Texas sun
Sun, Skin and Regret in Texas
Keeping your skin safe in Texas is critical. Growing up largely in Texas, or rather, growing up in large Texas, I got a lot of sun! Every weekend we spent waterskiing on the lake, and we didn’t stop until we watched the sun fall below the horizon. I was too busy jumping back in the water to ski again to worry about re-applying my sunscreen.
Miss a turn? No way!
I remember “laying out” on the bow of the boat, counting down the minutes until I got my turn again … and I shudder as I admit that I recall applying baby oil, albeit liberally, in order to maximize my “tan.”
Let’s face it, we live in Texas. Many of us get A lot of sun exposure. We are beckoned to hang out underneath our big sky … we go tubing in our many lakes and rivers, and trips to the beach are great childhood memories. As for sun? It just feels good.
It looks pretty, right?
The glow … the look of our sun-kissed cheeks … pretty, aren’t they? Then, suddenly, we hit our thirties, and the deleterious effects of our sun-worshipping start to show. Here are some pointers to keep your skin safer:
- Avoid extended sun exposure between 10 am and 4 pm. This is when the sun’s rays are strongest.
- Cover up. Loose clothing with a tight-weave helps … and don’t forget that wide-brimmed hat!
- Use sunscreen frequently. Apply this liberally. Apply sunscreen 30 minutes before going outdoors; Reapply about every two hours. According to the American College of Dermatology, sunscreen with an SPF of 30 is ideal (greater than that is not necessarily better); Sunscreen that helps to protect against both UVA and UVB is important. Oh, and leave the baby oil at home.
If you are affected by sunburn:
- Keep it cool. Apply cold compresses — such as a towel dampened with cool water — to the affected skin. Or take a cool bath.
- Keep it moist. Apply aloe or moisturizing cream to the affected skin. Do not use products that contain alcohol, as they can dry out the skin.
- Leave blisters intact. If blisters form, don’t break them. You’ll only slow the healing process and increase the risk of infection. If needed, lightly cover blisters with gauze.
- Take an over-the-counter pain reliever. If needed, take anti-inflammatory medication — such as aspirin or ibuprofen according to the label instructions until redness and soreness subside. Don’t give children aspirin as it may cause Reye’s syndrome, a rare but serious disease.
- Treat peeling skin gently. Within a few days, the affected area may begin to peel. This is simply your body’s way of getting rid of the top layer of damaged skin. While your skin is peeling, continue to use moisturizing cream.
- And, finally … call your physician for treatment if you have severe sunburn that covers a large portion of your body with blistering, you have a high fever or severe pain after sunburn, or if your sunburn does not improve within a few days.
Need more information? Contact us. We are here for you!
$50 STUDENT VISIT
Are you a sick college student away from your family doctor? Show your college ID and contact us to schedule a $50 acute care visit.
