That Time Of Year Again: Cold and Flu Season

Posted on Posted in Continuing Education, Nutrition, Seminars, Webinars

By Mary O’Brien, M.D.

It’s that time of the year again.  It’s that awful season when nearly every third person you encounter looks and feels miserable.  Headache, fever, cough, congestion, myalgia, and malaise signal flu season is in full force.  Health officials are already proclaiming this (2017-18) the worst flu outbreak in over a decade.  Considering the dreadful natural disasters of 2017 and record-breaking cold temperatures across two-thirds of the nation, we shouldn’t be surprised.  Every year flu outbreaks spike shortly after the holidays, and the travel, stress, sleep deprivation, and crowds associated with the holidays.

A few time-tested, common sense measures may help protect you, your loved ones, colleagues, and patients:

  • Wash your hands. Wash your hands.  Wash your hands — thoroughly and often.  Hot, soapy water is best, but hand sanitizers and disinfectant wipes come in handy at the grocery store or in the car.
  • Avoid touching your face, especially around your eyes, nose, and mouth. These areas can serve as an entrance ramp for viruses.  Try to resist the temptation.
  • Increase your fluid intake. Bitter cold temperatures combined with heat from furnaces and fireplaces increase insensible fluid losses (fluid lost from skin and breathing).  The resulting dry mucus membranes are not only uncomfortable, but they’re more vulnerable to viral penetration.  Water is best here.
  • Get more sleep than you think you need. A single night of inadequate sleep can compromise lymphocyte numbers and function.  Give your immune system the restorative time it needs to protect you.
  • Don’t overextend yourself. Most folks are already tired from the holidays.  Give yourself some downtime before you have no choice in the matter.
  • Avoid crowds like the plague. Contagion is partly a numbers game.  No one has to go to a crowded movie theater or restaurant.  Stay home and clean out a closet.
  • Consider getting a flu shot now. So far this year (2018), the efficacy rating is not good.  But, some protection is better than none.  Remember, antibody production will take about two weeks after the shot.

And — finally — if you do get the flu, please stay home.  There is nothing noble or heroic about spreading influenza to colleagues and patients.

In the meantime, stay warm and well.  I have to go wash my hands now.

Protein Powders

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

By Annell St. Charles, PhD, R.D., L.D.N.

Protein supplements and powders have become all the rage over the last few years, particularly for people trying to build muscle.  However, most Americans already get all the protein they need from their diet, and some may even be getting too much.

Proteins are made up of amino acids, which are the key component of muscles and play many important roles in body maintenance.  Meat, poultry, fish, eggs, nuts, seeds, and legumes (dry beans or peas such as lentils, chickpeas, and kidney beans) are good sources of protein, and most Americans consume 12 to 18 percent of their calories as protein.  Dr. Van S. Hubbard, director of the NIH Division of Nutrition Research Coordination, says that most Americans do not need to worry about getting enough protein. “Unless they have some other medical problem, most people are meeting or exceeding their protein requirements,” he says. “Since protein is such a common component of most foods that you eat, if you’re eating a relatively varied diet, you’re getting enough protein.”  However, some populations, like vegetarians and older people, need to be aware of the protein in their diets.  Vegetarians can get the protein they need from rice, beans, eggs, peanut butter, dairy products, and bread.  Vegans need to be particularly careful, as they do not consume either eggs or dairy products.

A recent National Institutes of Health study of men and women age 70 years and older found that those who ate the least protein lost significantly more muscle than those who ate the most protein.  Older adults who lose muscle in their legs and hips are more likely to fall and have injuries like broken hips.  They may also have trouble doing basic things like getting up from a chair, walking upstairs, or taking a stroll due to loss of muscle strength.  For elderly people who cannot eat enough protein or who have diseases that leave them malnourished, a protein supplement can be one way to help get enough protein.

Nevertheless, the majority of Americans derive little benefit from increasing their protein intake.  Long-term studies found that high-protein diets that result in weight loss usually work as a result of the amount of calories rather than the amount of protein being consumed.

Recent weight loss, muscle fatigue, or a drop in muscle strength may be signs of protein deficiency, but these symptoms could also be due to other health conditions.

The Party’s Over

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

By Dr. Laura Pawlak

Holiday food and spirits may have disappeared, but those extra calories can stubbornly remain as body fat.  With each new year, an array of diets emerges, promising to restore your former shape.

My suggestion?  This year, follow a new plan called Intermittent Fasting, which has captured the interest of both dieters and researchers.  Intermittent Fasting is a structured program without the drudgery of daily calorie deprivation.

Although traditional reduced-calorie diets are certainly science-based, intermittent fasting is a sensible alternative.  Studies suggest a modified fast is just as beneficial for weight loss as other diets.

For this program, the term “fasting” is defined as consuming a total of 500 calories for women and 600 calories for men on fasting days. If calorie counting is not convenient, you can eat about 25 percent of your normal calories on fasting days.  More importantly, you abstain from eating all calorie-containing foods and beverages for 14 hours (women) or 16 hours (men) on fasting days.

The popular 5:2 Intermittent Fasting Diet is appealing because the two fasting days each week can be chosen to fit one’s schedule best.  On the remaining five days, you eat sensibly.  If weight loss is your goal, it is important to avoid overcompensation during non-fasting days.

Alternate-day Fasting is a more aggressive approach to weight loss.  You consume only 500-600 calories every other day following the 14- to 16-hour fast. Recently, scientists compared the Alternate-day Fasting program with a standard weight-loss diet for six months followed by a maintenance diet for an additional six months.  Persons choosing the fasting program had slightly greater weight loss than individuals following the standard low-calorie diet.

To limit calories during fasting days, consider making a homemade soup, then establish portions and freeze individual servings.  A simple vegetable soup with legumes and wild rice or whole wheat quinoa is nutritious, high in fiber, and low in calories.  A variety of salad ingredients with fish or turkey and calorie-free dressing is always an excellent choice.  An egg-white omelet using fresh or leftover vegetables provides quality protein needed to protect muscle mass.

To dampen appetite during fasting days, choose vegetables high in fiber and protein-rich foods low in fat. Try adding herbs and spices to cooked vegetables.  They light up your taste buds with pleasing flavors and aromas.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renowned biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

A Different Tradition

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Has your home returned to a relative state of post-holiday normality?  I’m almost there.  The boxes and bags and bows and ribbons have been put away until next year.  The “thank you” notes are in the mail.  And my kitchen table has been restored to an acceptable state of neatness.

Many people will start to focus on new year’s resolutions now, knowing full well the resolutions are unlikely to last.  I have a different tradition at the end of December.  It goes back quite a few years.  In a reflective state of blissful solitude, I write down my own little “year in review.”  It takes some time, thought, and effort, but it’s an exercise that can generate some profound insights.

  • What were the best or most positive events of 2017 — personally, nationally, and globally?
  • What were the worst or most tragic events of 2017 — personally, nationally, and globally? How did I cope or respond?
  • What event or situation made me feel most grateful?
  • What was the most beautiful, unusual, or remarkable sight I saw in 2017? (Personally, it would be difficult to top the perfect, unobstructed view of the total solar eclipse I had from my own backyard in August 2017.)
  • What was the biggest mistake I made in 2017? This one can be tough and sobering.
  • What was the most important lesson I learned in 2017? It’s often related to the biggest mistake I made.
  • What experience or moment touched me the most deeply?
  • What was the most noble, courageous, or generous thing I did in the past year? Coming up short on this one is not a good sign.
  • And finally, what could I do in 2018 to become a better person — physically, mentally, emotionally, and spiritually?

The little, personal “year in review” may not be as fascinating as a list of the year’s top news stories, viral videos, or celebrities who have passed.  It will, however, become profoundly revealing to you 10 or 20 years from now.

Have a happy new year.

 

Something Feels Different

Posted on Posted in Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Are we there yet? I wonder as I stare at my kitchen table covered with gift bags, wrapping paper, bows, ribbon, tape, and scissors. Every year, I tell myself I’ll cut back a bit next year. It never happens. The pressure starts with Christmas-in-July sales on shopping channels. I confess I find it difficult to resist. I love buying and wrapping presents for people. It truly makes me happy, especially when someone is genuinely surprised and delighted. It’s a constructive way to take the focus off myself.

This year however, something feels different. It’s been a tough year with historic, natural disasters. Devastating hurricanes, floods, tornadoes, earthquakes, wildfires, and blizzards have wreaked havoc on tens of millions of people. Mass shootings, riots, and appalling, vicious acts of violence have left most of us stunned and horrified. My heart breaks for all of those who have lost loved ones and homes. How I wish I could ease their anguish.

I cannot restore lost loved ones, homes, and treasured possessions for people in California, Texas, Florida, and Puerto Rico. I can write a few checks and say a few prayers. Those are good things to do, but they never seem to be enough.

Then it dawned on me. There are lots of people suffering all around us every day. They just don’t appear on the evening news. Here, in Myrtle Beach, South Carolina, there are nearly 2,500 homeless teenagers. That seems ironic in a town that’s largely focused on tourism and fun. I decided to give some money to my almost-adult niece and nephew. I gave them instructions to go buy clothes for homeless teenagers. I have no clue what teenagers would want or need, but my niece and nephew do, and they did well. Unloading their bags full of jackets, hoodies, sweaters, socks, underwear, scarves, and hats, they announced they “had a blast” doing it. Surprise! Thinking of other people can be fun.

My kitchen table is still a mess. But this year, I realize how blessed I am to have a kitchen, messy table and all.

 

Let It Go!

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Did you survive Thanksgiving without major family stress or tension? If the answer is “no,” you’re not alone. Holiday gatherings don’t always bring out the best in everyone. Some folks are already frazzled by travel nightmares. Those hosting the feast are tense and worn down by days of planning, preparation, and cooking. No one ever has quite enough room in her kitchen for all the food, much less the guests who congregate in the middle of the mess. There’s nearly always one culinary mishap and someone is sure to announce she has a life-threatening allergy to gravy.

But wait! We haven’t even begun to address deeply ingrained differences in political perspectives, religious beliefs, and good, old-fashioned feuds and grudges. Was all of this supposed to be fun? Fortunately or not, many of us will have another crack at family festivity soon as we try to celebrate Christmas or Hanukkah. I have a few time-tested thoughts that might help—at least a bit.

  • Psychologists tell us that it takes 21 days to replace a bad habit with a good one. That means we have just enough time to make a difference. Starting now, try not to criticize, condemn, or complain. It’s not easy, especially in this culture. However, it will make the next family gathering much easier to endure, if not actually enjoy.
  • Remember some basic neurophysiology. The human brain cannot hold onto diametrically opposed emotions simultaneously. We can’t feel love and hatred at the same time. We can’t feel empathy and anger in the same moment. And we can’t experience gratitude and resentment all at once. It may sound simplistic, but gratitude is often the best remedy for resentment, anger, anxiety, and sadness. Those of us who have food, water, shelter, clothes, electricity, a little money, and a few loved ones have more than hundreds of millions of people around the world. Smile and say “thank you” — a lot.
  • Forgive yourself and everyone else. I’ve watched relatives feud for decades. They make themselves and everyone else miserable. None of us is perfect. We’ve all said and done things that were misguided or thoughtless. However, refusing to forgive is like drinking poison. It makes no sense. Forgiveness represents the ultimate act of overcoming ego. Let it go. LET IT GO!

Please don’t make me sing that song from “Frozen.” I have relatives who would never forgive me.

 

When Something’s Not Right

Posted on Posted in Brain Science, Psychology, Seminars, Webinars
(AP Photo/Laura Skelding)

By Mary O’Brien, M.D.

“Anyone who believes in God is stupid.”  This statement was among many posted by the monster who murdered 26 innocent people in November 2017 in a Texas church.  The victims ranged in age from 18 months to 77 years old.  Eight members of one family were killed, 20 people were wounded. No one had a chance to hide or escape.

The man who committed this atrocity had been seething with anger and brutality for years.  There were many red flags.  He had received a dishonorable discharge from the Air Force and served time for assaulting his wife and child.  His attack was so brutal, the baby suffered a skull fracture.  He was known to have beaten and starved his dog. Any man capable of beating a woman, a baby, and a dog does not turn into a decent human being after 12 months in prison.  The many pieces of this puzzle are already coming together.

In the realm of religious thought and theology, anger is considered one of the seven deadly sins.  Unjust anger, if allowed to smolder, can lead anyone down a vicious path of destruction.

In the realm of clinical medicine, anger and hostility are considered the two most deadly and dangerous emotions.  Those of us in health care encounter angry, hostile people almost every day.  In fact, all of us encounter angry, hostile people with increasing frequency.  Anger triggers a flood of potent hormones and neurotransmitters that can literally change brain function and even brain structure if the process lasts long enough.

However, pathologic anger, violence, and evil do not exist in a vacuum.  There are always warning signs.  All too often they go unnoticed or unreported.  Most of us have been well-schooled to “mind our own business.” After all, we don’t want to be called judgmental, and we certainly don’t want to be sued.  But considering the horrific happenings in Columbine, Aurora, Sandy Hook, Fort Hood, San Bernardino, Orlando, Las Vegas, and New York, it’s time to rethink a few things.

Folks in law enforcement have been begging us for years: “If you see something, say something.” That advice sounds painfully simple, but simple things often save lives. Most of us know when something’s not right. We need to trust our instincts.

The good people of Sutherland, Texas, trusted their instincts hours after the massacre.  In response to unfathomable evil and anger, they held a candlelight prayer vigil.  That doesn’t sound “stupid” to me.

A Real Hero to Honor

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Gary Michael Rose is a devoted 69-year-old husband, father, and grandfather.  Many people in Huntsville, Alabama, know him from his commitment to multiple volunteer projects.  For decades he has served as a Knight of Columbus, helped at a soup kitchen, and repaired broken appliances for the sick and elderly.  That’s only a partial list.

Only a handful of people knew that Gary Michael Rose was a war hero of the highest caliber because for 40 years he never said one word about it.  Not one word.  On October 23, 2017, Captain Rose received the Congressional Medal of Honor.  Now the whole world has a real hero to emulate and honor.

“Mike,” as people call him, trained as a Special Forces medic during the Vietnam War.  His second assignment involved a top secret mission into Laos to stem the flow of weapons to enemy fighters.  It wasn’t long before all hell broke loose.

The men in Mike’s unit sustained heavy casualties.  Desperate to save them, Mike raced into small-weapons and machine-gun fire, tending to the wounded as he shielded them with his own body.  One by one, Mike used one hand to hoist a wounded soldier over his back and held a gun in his other hand to return enemy fire.

Eventually, Mike sustained multiple wounds himself, but that didn’t deter him. When a chopper finally arrived to evacuate the wounded, it was unable to land and was forced to hover above the ground.  Mike lifted and pushed his wounded buddies into the helicopter in the midst of gunfire.  As the chopper began to lift up, the gunner was struck in the neck by a bullet.  Mike fashioned a pressure dressing with several bandanas to contain the bleeding.  But the helicopter was badly damaged and crash- landed.  In an unbelievable display of courage and fortitude, Mike raced in and out of the smoldering chopper to save the wounded before everything exploded.

After four days and nights of constant combat, no food or sleep, and nonstop efforts to save others despite his own injuries, Mike and his men were evacuated.  The Army believed that Captain Gary Michael Rose saved between 60 to 70 men, including the man who was shot in the neck.

All of this happened in 1970.  Mike never discussed it with anyone because the mission was classified.  His men talked about it though — through channels at the Pentagon.  For 47 years his men campaigned to get Mike the medal he deserved.  Mike finally received his medal, and many of men witnessed the ceremony at the White House.

If someone had written a screenplay detailing the heroism of Gary Michael Rose in combat, it would have been rejected as “unrealistic.”  Fortunately for the world, Captain Rose is very realistic.  After a ceremony at the Pentagon, he’s going home to Alabama with his family.  He still has people to help.

 

Anger, News and The Brain

Posted on Posted in Brain Science, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Have you reached the point where you’re afraid to watch the news?  I have.  The sight of one human being kicking another sickens me and every other sane person. However, anger, hatred, and violence are not new.  They are as old as mankind because they stem from primitive, tribal, and “us versus them” thinking.  And lest we think we’re above it all, primitive, tribal thinking occurs daily in neighborhoods, businesses, offices, universities, and political and religious entities around the globe.  No one starts out that way. As a poignant lyric from the World War II musical “South Pacific” reminds us, “You’ve got to be taught to hate and fear, you’ve got to be carefully taught.”

Perhaps more people in the under-50 crowd can relate to a line spoken by Yoda in the “Star Wars” saga.  Cautioning Luke Skywalker about the true enemy, Yoda warns against fear:  “Fear leads to anger, anger leads to hatred, and hatred leads to the dark side.”

That’s not merely a memorable line from a movie.  That is profound.  Wherever we see evil, darkness, or violence, there is almost always some measure of fear.  People fear the loss of their money, their power, their identities, their rights, their beliefs, and their version of “truth.”  All of this sounds like a philosophical discussion until we consider the underlying physiology.

Appropriate fear, as part of the fight-or-flight response, is a survival mechanism.  It has helped humans and other species to endure for many millennia.  Learned fear originates in the amygdala.  Repeated, fearful stimuli, if unchecked by higher centers in the frontal and pre-frontal cortices, can rapidly lead to anger and aggression.  Simply put, a person can literally develop an angry brain.*  The result is an individual who becomes angry too easily and too often.  These people overreact to angry feelings, become aggressive whenever upset, and have great difficulty calming down.  Allowing oneself to simmer in a sea of angry thoughts, feelings, hormones, and neurotransmitters can rapidly lead to some horrible behavior.  We see it every night on the news.

Human physiology is such that anger and empathy are mutually exclusive.  Empathy, being a far more highly-evolved emotion, tends to inhibit anger and aggression.  And calmness is a pre-requisite for empathy.  Long, long ago, in our very own galaxy, someone even wiser than Yoda said, “Perfect love casts out fear.”  Perhaps someday the human race will catch on.  Until then, don’t go overboard watching the news.

Why Humans Need to Cry

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

“Stop that crying, young lady, or I’ll give you something to cry about!”  Most of us heard something similar growing up.  Certainly, there is a time and a place for tears.  However, what most of our parents, teachers, or coaches did not understand was how complex and profound crying can be.  The neurophysiology of crying is far more intricate than most of us realize.

Crying, to oversimplify greatly, involves the autonomic nervous system, the frontal and prefrontal cortices, the brainstem, hypothalamus, basal ganglia, amygdalae, vagus and trigeminal nerves, heart, lungs, facial muscles, larynx, pharynx, eyes, nose, and throat — as well as a host of neurotransmitters.  Anthropologists believe that, in humans, crying developed long before speech.  As tears begin to flow, we become choked up and speechless.  This may explain why crying reveals emotional states that are nearly impossible to express in words.

Clearly, tears can be shed in response to pain and physical distress, as well as to fear and anger.  All mammals experience fear largely as the result of having a limbic system.  Given certain circumstances, most mammals can express anger.  Grief, mourning, and bereavement can move people to tears at any age and in every culture.  Some animals such as dogs, elephants, and primates can manifest behaviors suggestive of loss or grief, but these animals’ ability to shed tears in response to grief has not been scientifically verified.  Grief and mourning have a cognitive component.

Human beings are social creatures.  Barring neurologic anomalies, humans can cry from the moment of birth onward.  The tears, vocalizations, and facial expressions of crying signal a universal plea for help and empathy.  Tears elicit a change in the mindset and behavior of the person who cries and in those who witness the crying.  It’s not rare for someone to “feel better” after a “good cry.”

The ability of humans to feel empathy and compassion for others has had a profound effect on culture and civilization.  Without these emotions, there would be no such thing as hospitals, orphanages, disaster relief, or volunteers of any sort.  The capacity for compassion is not present to the same extent in everyone.  Some individuals have no empathy or compassion at all.  Others are veritable saints.  The next time you feel moved to tears, don’t fight it.  It may just mean your humanity is still intact.


Trimble, Michael, Why Humans Like to Cry, Tragedy, Evolution, and the Brian.  Oxford, UK, University Press, 2012.