Yesterday I had to tell two men that their lives would forever change….

…..one was given a diagnosis of diabetes and the other was told that he likely has cancer of the pancreas.  Neither one of these men thought that when I walked into their respective hospital rooms that the first sentence out of my mouth after my usual greeting would be “I have the results of your tests.” 

The first man was in his mid-forties, married with two children.   During one of our previous conversations he told me that he had been under a lot of stress at work, that he frequently skipped meals and would often grab a candy bar and a soda during one of his quick breaks before heading back to his desk.  He also revealed that he had been feeling more tired lately, not having the energy he used to and that he had neglected exercise for the past several months.  He even admitted that he had grown up on southern cooking and had recently found a restaurant that served sweet tea like his mother used to make. 

Now for those of you who aren’t from the south, sweet tea is made by brewing black tea and then added either a simple syrup (one part sugar and one part water heated together to make a thick, sweet syrup) to the tea while it’s hot or adding cups and cups of sugar to the hot tea to sweeten it before added enough cold water to make a pitcher.  Now I have to admit that my great-grandmother used to make the best sweet tea but now that I’m older….and wiser…I know that sweet tea is basically “diabetes water” because if you drink enough sweet tea, you’ll end up with diabetes like my patient. 

At first my patient tried to refute the diagnosis of diabetes stating that it’s probably the steroids he’s receiving for his facial swelling that caused his blood sugar to be so elevated.  I explained to him that steroids can increase your blood sugar transiently but that I had ordered a special test called a Hemoglobin A1c which measures how well (or not so well) your blood sugar has been controlled over a several month period.  Although his blood sugars had been high during his hospital stay, his Hemoglobin A1c was also elevated, indicating that his blood sugars had been high for months…..not just days.  Once it finally sunk in that I wasn’t going to change the diagnosis of diabetes, he accepted his role in the way he’s mistreated his body and vowed that he would change the way he eats and would start exercising as soon as he left the hospital. 

I congratulated him on his determination to get his health back on track and encouraged him to continue the change because just by losing 10 to 15 pounds his blood sugar and his blood pressure would be better controlled and he might even avoid needing to take diabetic medications!! 

He was so glad that I had taken the initiative to check his blood sugar and Hemoglobin A1c while he was in the hospital for an unrelated matter because he knew the importance of early detection and early control of diabetes to avoid amputation, blindness and kidney disease. 

As I walked to Mr. D’s hospital room I had to mentally prepare myself for the emotional atmosphere that was about to take place as I told him that the mass found on his pancreas was likely cancer and that pancreatic cancer is one of the most aggressive and most deadly cancers you can have. 

When I first met Mr. D, he complained of severe upper abdominal pain with a poor appetite.  He had recently had a significant amount of alcohol over the past several days and had subsequently developed pancreatitis—-an inflammation of the pancreas.  A CT scan of his abdomen revealed a mass arising from his pancreas which was concerning for cancer.  When I told him the results of the scan, his main focus was on when he was getting released from the hospital because he had just accepted a job up state that was starting next week.  I explained to him that we could schedule a biopsy of the mass in a few days after the holiday weekend.  We’d have to wait on the results of the biopsy to determine if the mass was a more treatable form of cancer—a lymphoma or if the mass was the most common form of pancreatic cancer—adenocarcinoma, which may be amenable to surgery but the long term prognosis still remained bleak. 

Mr. D understood the road ahead and took the news of cancer in stride.  He had lived fast and he had lived hard.  He’d taken his chances before and this was no different.  As I turned to leave his room he offered me his hand and thanked me for being honest with him and said that he’d do what was necessary….including quitting alcohol….to live better. 

So, yesterday was a draining day, physically and emotionally…but in the end, two lives have changed and hopefully….for the better.

To your wellness,

The Health and Wellness Queen

P.S.  I’m just about finished my first book entitled “21 Secrets to Amazing Health” so stay tuned for more information on how you can get your hands on this life-changing book for yourself and for your family.

The New England Journal of Medicine, one of the premier medical journals in the United States just published an original article which raised concern about the safety of a very popular prescription medication for diabetes—rosiglitazone—also known as Avandia. 

Avandia is in a class of drugs that helps to lower your blood sugar and helps get and keep your diabetes under control.  This new study which is called a meta-analysis pools together data from various other studies and tries to answer the question..”Is Avandia safe or is Avandia harmful?”  The authors of the study concluded that “rosiglitazone was associated with a significant increase in the risk of myocardial infarction and with an increase in the risk of death from cardiovascular causes” and that “patients and providers should consider the potential for serious adverse cardiovascular effects of treatment with rosiglitazone for type 2 diabetes.” 

The media publicized these results which prompted the makers of Avandia to send their pharmaceutical reps literally door to door to physician offices, to hospitals and even to my office today to give their take and interpretation on this statistical review of previously published data and to help make sense of all the hype. 

People can argue the validity or the accuracy of these statistical reviews (or meta-analyses) until they turn blue in the face but the fact of the matter is this….this paper was reviewed by other physicians before being published in the New England Journal of Medicine and the simple fact that this article was published in a reputable medical journal means that patients and physicians alike…that means you and me, must take these new results seriously.

Now I’m not here to argue for or against the results of the published study.  What I’m here to do is get you….the consumer…to understand that prescription drugs do come with warning labels.  Now I know some of the warning labels are so small that you’d need a magnifying glass to even read them…and sometimes I’ll even put down my glasses for a closer look at the small print.  The main point is this….prescription drugs can save lives BUT some medications are associated with serious adverse effects….even death. 

As consumers, we all have to weigh the relative benefits of a prescription drug against the potential harmful side effects of the drug.  When I frequently counsel my patients about a new medication I believe will help them, I sit down and discuss the possible side effects…like nausea, headache, diarrhea, decreased sexual libido, etc., so that we, as a team, can decide if this new medication is right for them or not.  Sometimes, after talking with a patient, we decide against starting the new medication and try to find other ways to control the problem.  This open line of communication is vital in getting the necessary treatment and care that we all deserve.

This new article really stresses the need for all of us to be active participants in our healthcare and that means knowing the risks and potential side effects of the medications we take.  So if you have a question or concern about the medications you’re taking, I urge you to speak with your doctor.

To your wellness,

The Health and Wellness Queen

The deadline is approaching…

Starting July 1, 2007 all New York City restaurants will have to start preparing foods with oils that contain LESS THAN 1/2 gram per serving of trans fat.  That means those tasty cannolis….warm doughnuts…and even that famous cheesecake you like to order when you’re eating out…will have to be prepared with something other than partially hydrogenated vegetable oil. 

What exactly does this mean?

This means that magarines and shortenings that have been used for decades and even centuries to make the most delicious, calorie-rich and over-the-top decadent desserts and other foods are now getting a make-over thanks to the New York City Board of Health.  The NYC Board of Health is taking a stand against the rising number of heart attacks and deaths associated with high cholesterol and just plain old poor eating habits which have become custom in our American diet. 

So why is trans fat getting singled out as the bad seed in the bunch when it comes to how restaurants prepare foods?

Trans fat gets it name from the actual chemical structure of the fat molecule.  It finds it’s place somewhere between butter—which is a saturated fat and canola oil, olive oil or soy oil which are polyunsaturated or monounsaturated oils.  Trans fat—like shortening—have been shown to raise your bad (or LDL) cholesterol and lower your good (or HDL) cholesterol…which together spells double trouble when it comes to your heart and your risk for having a heart attack or dying from heart disease. 

The Food and Drug Administration got on board with educating the consumer with the content of trans fat in prepared foods by adding Trans Fat to the Nutrition Label in 2006.  Foods that contain less than 1/2 gram of trans fat per serving are labeled as having zero grams of trans fat per serving. 

So where can you find trans fat?

The majority of foods that contain trans fat are your cakes, cookies, pies, breads, biscuits…anything that you can remember your mother or even your grandmother making with a measuring cup of shortening to make your favorite dessert light and fluffy.  Trans fat can also be found in some margarines, french fries, some potato chips, candy and even some cereal.  So check those Nutrition Labels!

This mandate is not going to change the way your mother makes her famous cookies or pies but it will affect the way chefs and bakers around the city prepare their signature dishes.  This new rule is aimed right at our hearts and our waistlines to try and help get the city of New York on a healthier track. 

But regulating trans fat alone won’t change your overall health status if you don’t also work on controlling the amount of calories you eat and the amount of exercise you get. 

The Institute of Medicine recommends that we get 30 minutes of moderately intense exercise on all, if not most days of the week.  That means walking the dog doesn’t count unless you’re taking a real brisk walk and get your pulse rate up.  You could also try incorporating the At-Home Workout or the Backyard Workout into your exercise regimen to meet your weekly exercise goal. 

And don’t think that New York City will be the only place where trans fat will be regulated.  All eyes are on NYC to see how successful this regulation will be in curbing the city’s rising death rates from heart disease and may even cause a ripple effect when it comes to regulating what we eat when dining out.

So….NYC…..we’ll be watching out for you this summer.

To your wellness,

The Health and Wellness Queen

What do these people have in common?

• A young man who has vomiting and diarrhea after eating spoiled food
• A middle aged woman who is taking a water pill, called a diuretic, to control her blood pressure
• An elderly man with poorly functioning kidneys, who has been taking the same blood pressure medications for years and who missed his recent doctor’s appointment

All these people are at risk for potassium imbalance…either too little potassium like the young man who’s been vomiting and the woman taking fluid pills or too much potassium like the elderly man with worsening kidney function.

So why is potassium so important for your body?

Potassium is an essential mineral that your body needs in order to maintain the normal balance of cellular function in your heart, your kidneys and your muscles…

When you have too little potassium in your body—called hypokalemia—you’re prone to develop muscle cramps, fatigue and may even develop life-threatening heart irregularities.  These heart irregularities indicate that your heart rhythm is abnormal and without immediate treatment these irregular rhythms can lead to death.  The only way to know if your potassium level is dangerously low is to get your blood level tested. 

Not everyone who has an episode of vomiting or diarrhea will develop low potassium but if you’ve been vomiting or having persistent diarrhea for days, are unable to keep down any food then you need to seek medical attention immediately to seek if you have any electrolyte imbalances.  Because with persistent vomiting or diarrhea you may develop other salt imbalances that need treatment. 

If you chronically have low potassium blood levels you’re at risk for having higher blood pressure as your body retains sodium and fluid, which both can raise your blood pressure.  So by eating foods rich in potassium you can maintain the normal cellular function of your heart, your kidneys and your muscles and can even lower your blood pressure.  

Foods rich in potassium are oranges and orange juice, bananas, potatoes, spinach, and legumes.  These foods are natural sources of potassium and allow you to optimize the normal functioning of your body.  Potassium supplements may be necessary if you are on medications like water pills that make you lose excessive potassium in your urine.  Talk with your doctor to see if you should start potassium supplements or if a change in your diet with more potassium-rich foods will be the answer to your low potassiuim levels.

On the other side of the spectrum is having too much potassium in your body—-called hyperkalemia.  Hyperkalemia, when mild, typically doesn’t have any symptoms but when your potassium gets very high…you can again experience a fatal heart rhythm and even cardiac arrest.  Usually you can’t eat so much potassium from food alone to cause you to have severe hyperkalemia unless your kidneys don’t function normally.  When your kidneys don’t function normally, your body holds on to the potassium and can cause elevated potassium in your blood. 

If you suspect you’re at risk for elevated potassium levels, see your doctor and get the necessary treatment.

So you see, sodiuim is not the only mineral you need to know about when it comes to your health.  Your potassium is also important. 

To your wellness,

The Health and Wellness Queen

P.S.  Stay tuned for future posts on other essential minerals like calcium and magnesium here at www.thehealthandwellnessqueen.com

As you study teas on the supermarket shelf, you may be surprised to
know that all teas come from the Camellia sinensis plant, a
warm-weather evergreen. How fresh leaves are processed and their
length of contact with oxygen determine the resulting type of tea.

Oxidation gives the leaves their distinctive color. Green tea is
not oxidized. The leaves are steamed, rolled, and dried. Black tea
is oxidized for two to four hours, and Oolong tea falls somewhere
in between.

According to the Tea Association of the USA, herbal teas aren’t
from the Camellia sinensis plant and are not linked with research
on the health benefits of traditional teas.

Tea is one of the most healthful beverages. It’s fat-free and
calorie-free. Tea is rich in flavonoids and powerful antioxidants
that help to prevent chronic diseases such as heart disease and
cancer, as shown in studies at the Antioxidants Research Laboratory
of the Jean Mayer USDA Human Nutrition Research Center on Aging at
Tufts University. Green and black teas have the most antioxidants.

The American Dietetic Association notes that a certain number of
flavonoids in tea are lost during the decaffeination process, so
decaffeinated teas are somewhat less beneficial than regular brews.

How to make tea

From Kevin Hickey of the English Tea Store

Hickey says loose tea brewed in a teapot makes the best-tasting
tea. He recommends one teaspoon of loose tea per person plus one
for the pot.

* Use freshly drawn water. Water loses oxygen when it stands and
that keeps the full flavor of the tea from being released.

* Warm the pot first. It helps to maintain the brewing temperature
long enough to extract more flavor from the tea.

* Use boiling water to make the tea. Water that is “off the boil”
does not allow the tea to brew properly.

* Brew for 3 to 5 minutes. Shorter times will not reveal the full
flavor and quality of the tea. Longer brewing will result in a
bitter-tasting tea as tannin will start to be extracted from the
tea leaves.

* Stir the tea in the pot once or twice while it is brewing.

* For tea bags, the same brewing directions apply.

* In a cup, brew 1 to 2 minutes.

This Sunday will mark my second Mother’s Day and as I was busily running errands today trying to get my last minute Mother’s Day gifts together, I started to think about the millions of people who won’t be celebrating Mother’s Day.  Millions of people whose mothers are deceased, millions who are no longer in contact with their family and for some reason or another won’t be sending their mother a Mother’s Day card or a bouquet of flowers….and millions who don’t even know who their real mothers are. 

Despite the commercialism that surrounds many of our holidays, Mother’s Day has always been a special day for me to reflect upon all the women in my life who have loved me as a mother should…..and who’ve served as my nurturer, my role model, my advisor, my friend and my protector through the years.  From my great-grandmother who served as my cheerleader, always encouraging me to do well in school even at a very young age….or my biological mother who supported my decision to expand my horizon and travel to another district for high school…..or my grandmother Gwen who always came to my school performances, awards banquets, assemblies and graduations….to my mother-in-law who has served as my advisor, my life coach and my role model when it comes to balancing God, family and career.  All these and countless other women have played an integral part in developing my maternal makeup…which in years to come Rufus will appreciate. 

What I’ve learned over the years and continue to see at work day after day is the reflection and manifestation of a mother’s love in the lives of her children—biological or not.  This love is able to transcend blood lines and develop into an impermeable bond between mother and child that lasts throughout the years, through the loss of a spouse, through the loss of physical or emotional health and provides us with the key to understanding the true power of a mother’s love.

Not long ago I was taking care of a 92 year old woman who had been visiting South Florida from upstate New York and was admitted to the hospital after suffering a fall.  She had known osteoporosis and already had significant curvature of her spine limiting her ability to walk long distances.  After her fall, we found that she had a new fracture in her spine but because of her advanced age and the risks involved with surgery, she opted to forego surgery and start with physical therapy.  When I first walked into her hospital room she was sitting alone in her chair and I silently wondered how this 92 year old woman could have traveled all the way to Florida from New York all by herself and then walked in a younger woman in her late fifties.  The friendly banter between the two women quickly led me to conclude that the younger woman was her daughter….but I was wrong.  The younger woman was her daughter-in-law.  I was pleasantly surprised but not shocked at the revelation since I myself have a very strong bond with my mother-in-law.  

I wanted to know more about their plans to return to New York so I sat down on the edge of the bed and listened as the younger woman explained that she had already called the airlines to verify that they’d have direct flights from Florida to New York and available first-class seats.  She had already contacted her own physician to arrange direct airport transfer to an assisted living facility where her mother-in-law would stay, have available nursing care and get the physical therapy and rehabilitation she needed.  The younger woman must have sensed my unspoken question and told me that her mother-in-law had wanted to take one last trip to Florida while she still could and so she arranged to travel with her mother-in-law for her last hoorah in South Florida.  She was able to fulfill one of her mother-in-law’s last requests and she did it out of love….plain and simple. 

So as we look to our mothers….to those who have played the role of mother in our lives….remember this story of a woman and her mother-in-law and you’ll see the incredible power of love in this generation and in generations to come.

Happy Mother’s Day!

To your wellness,

The Health and Wellness Queen

If your answer is yes….then join the club.  You’re not alone in your uneasiness when it comes to certain tests like cardiac catheterizations, colonoscopies, mammograms, MRIs, CAT scans or even certain surgeries like open heart surgery. 

Every day I explain to my patients why I’m ordering specific tests, why I believe they’re necessary and what I hope to find out.  I have the luxury of only seeing patients in the hospital so I can spend the necessary time to answer their questions and even answer the questions of other family members who are present or who may be miles away in another state.  But this is not always the case….

Typically, you’ll be given a piece of paper to sign by a nurse stating that Dr. X will be performing a procedure that day or the next day and the nurse will try to explain the procedure and then have you sign the form giving consent to have the procedure performed. 

But it’s not always that simple. 

You have questions about how Dr. X.  Where did s/he train?  Where did s/he go to medical school?  You want to know how many similar procedures s/he has done in the past and what’s their success rate.  You want to know how long you’ll be out of work and more importantly, will the procedure be painful.  You want to talk with your family—your spouse, your sister, your brother, your cousin or even your parent—before agreeing to have any procedure done.  You want to hear from another doctor confirming that you indeed need to have the test performed.  You want to have the doctor really take the time to explain the procedure…the pros and cons of having the test done now versus waiting.  You want the doctor to understand where you’re coming from. 

So today, as I walked into Mrs. G hospital room, I saw a young middle aged woman sitting on the edge of the bed, expectant and waiting for me to introduce myself.  I explained that I work with Dr. J and would be the doctor in charge of her care today.  I had already read her chart and knew that Mrs. G likely has an advanced stage of breast cancer that had caused severe hardening of her left breast but she has gone almost five months without any treatment.  I suspected that something drastic must have caused Mrs. G to forego treatment for so long. 

So I sat on the edge of the bed beside her and asked her how she first noted something was wrong with her breast.  Mrs. G went on to explain that it first started with a palpable lump on the side of her nipple that slowly got bigger and so she went to her doctor and had a mammogram, which she reports “didn’t show anything.”  She then went to a specialist and had a breast biopsy and was told she had “cancer” and the doctor recommended a bone scan before he would start any treatment like chemotherapy, surgery or radiation.  That’s when things fell apart….a bone scan that Mrs. G didn’t know why she needed and didn’t understand why a doctor who knew she had cancer wouldn’t start treatment immediately and why he was ordering a test that was so difficult to schedule. 

So months passed…with the breast mass growing larger, the skin over her breast turning hard like leather and the pain in her breast increasing with each passing day…..and ultimately, Mrs. G ended up in our emergency room because she couldn’t take the pain anymore. 

Now I don’t know exactly what transpired between Mrs. G and the specialist but what I do know is that Mrs. G case is not unique.  Everyday, people get frustrated with the healthcare system, having to call this doctor to okay a procedure before another doctor will even schedule your appointment OR having serious questions about why you need a particular test and NOT getting the answers or the level of comfort and concern you deserve. 

What I encourage my patients and even my family members to do is appoint one person to be their healthcare advocate, someone…it could be a friend, it could be a family member or it could even by your own doctor….who will be your point person when it comes to making these tough decisions.  You can give this person permission to speak personally with the doctor to ask the questions you’re too afraid to ask or don’t even know to ask.  Someone who has your best interests at heart and can take the time to really explain the details of the test with you and help you make the best possible decision. 

For my family, I’m the “unofficial” healthcare advocate.  For me, my husband’s my healthcare advocate. 

Who’s in your corner?  Who’s your healthcare advocate?  So before you’re wheeled on a gurney to your next procedure….really take the time to understand the procedure and make use of your healthcare advocate…they’ll give you the support and comfort you never knew you needed.

To your wellness,

The Health and Wellness Queen

P.S.  Now is the time for you to be your own best healthcare advocate by getting and staying in shape.  Click here to get your copy of The Backyard Workout now.  You’ll get a customized total body workout along with the amazing fool-proof food plan!  Order your copy today.

Is your workout in need of a complete overhaul?

Are you tired of doing the same old workout or fitness routine week after week without any results?

Do you wish you could have your very own personal trainer by your side during each and every workout?

Do you want to get your hands on a comprehensive workout package that is designed by two of the top professionals in their fields?…..

Well, the wait is over…..

I, The Health and Wellness Queen, along with my husband, The Strength and Conditioning King have teamed up to create for YOU a workout system that will revolutionize how you think about exercise and take your fitness, weight loss and knowledge base to a whole new level.  What we’ve created is a unique package that gives you the tools to customize and individualize your workouts according to your fitness level and experience. 

Whether you’re a soccer mom or an Olympic level athlete, this workout is designed just for you.  We’ve taken the guesswork out of program design and provided you with an easy to understand resource that will remarkably transform your body into the fit, toned and healthy body you’ve been waiting for. 

This workout system is The Backyard Workout. 

This workout will not only give you the key to getting your body back in shape but we will reveal the very same food plan that I used to lose the baby fat after giving birth to Rufus and my husband used to maintain weight when he was competing in Olympic level Judo.  We still follow this Fool-proof food plan to stay in amazing shape.

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To your wellness,

The Health and Wellness Queen

P.S.  Don’t miss this opportunity to get your hands on The Backyard Workout package and discover how you can get your very own personalized workout program.