I want to recommend 2 great sites for soon-to-be mothers, mothers of newborns, and mothers of babies in their first year of life (Dr. Greene’s site is for all children, too):

• www.HealthTap.com

• www.DrGreene.com

Ron Gutman is founder and CEO of HealthTap, “your Home for Health”. The site officially just launched last month, April 2011. Before HealthTap, Ron co-founded Wellsphere, another pretty cool source for general healthcare information. Wellshpere was acquired in early 2009.

So, it stands to reason that he might put together a pretty cool healthcare site. He has done successfully it before.

Let’s talk a little about the site, HealthTap.com

Image: HealthTap Logo

HealthTap strives to develop a Home for Health that personalizes health information so that you can understand your health, and make the best evidence-based decisions (of course, that appealed to me immediately).

Other features that appealed to me about HealthTap:

• unbiased expert knowledge
• shared insights and experiences from the community
• ability to “rate” the experts, by voting up their answers to your questions
• it’s FREE
• the people who work there are passionate about making this a valuable resource
• that includes the physicians and other experts who volunteer as resources
• you can use it anonymously – your questions are seen only by your username (anything you like)

How to use the site?

Go to www.healthtap.com and click on “Member Sign up”. You can also watch their video on the home page (easily enough, click on “Watch our video”). They don’t ask for much personal info, and it is safe! It’s pretty easy, and the answers to any of your questions are top-notch. And, like Twitter or Facebook, you can “follow” the experts that you seem to feel a connection with.

Right now, the Beta release of the site, launched in April 2011, is focused on pregnancy and the first year of your baby’s life. The site is so great, so successful, that it will likely grow to cover other areas of your healthcare.

Also, be sure to check out the blog too: HealthTap Blog - http://blog.healthtap.com/

Transparency: I am one of the “Founding Medical Experts” for HealthTap. What does that mean? I simply login when I can, spend a few minutes answering your questions, perhaps write a healthcare tip, and connect with people. It’s sort of a sophisticated Facebook for your medical questions.

This is a volunteer position. I do it because I believe in the potential of social networks to improve our healthcare. And because I have profound respect for the Medical Director for HealthTap – Dr. Alan Greene, Pediatrician and Founder of the DrGreene.com site for natural pediatric healthcare. Be sure to check out his site too!

Image: Dr. Alan Greene's Website

Dr. Alan Greene is a Pediatrician at Lucille Packard Children’s Hospital at Stanford in California. He is author of some great books, including Feeding Baby Green (Earth-Friendly Program for Healthy, Safe Nutrition), and Raising Baby Green (Earth-Friendly Guide to Pregnancy, Childbirth, and Baby Care). Dr. Greene is passionate about keeping your pregnancy and baby safe from toxins, and being kind to our environment – a passion that we share.

More about Ron Gutman: Ron is also an angel investor and advisor to early stage technology companies, an advisor to Harvard Medical School’s SMArt Initiative, a host of health “hackathons,” and serves as the curator of TEDxSilicon Valley.

Speaking of TED Talks, take a look at Ron’s own TED Talk on the Hidden Powers of Smiling. It will make you smile. And like nearly every TED Talk that I have watched, this one is inspiring, and worth the few minutes it takes to watch. (this one is less than 7 1/2 minutes)

In Summary

If you are an expecting mom or dad, or parent already, check out these two sites, you won’t be disappointed.

_______________

Hi, I’m Russell Faust, author of this blog, and I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

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Don’t Become an Oxy-Addict!

Oxymetazoline – Afrin, Neosynephrine, Dristan – oxymetazoline.

If you have chronic nasal congestion, oxymetazoline can provide pure magical relief.

For short periods.

It can reduce nasal swelling to help eliminate an acute sinusitis, or simply to help open your nose during a “cold”.

But if you use it regularly, every day, for a week or more, you are potentially in for some serious trouble.

Your nose can become addicted.

Addiction: in this case, meaning “physical dependence,” whereby your nose has developed a tolerance, and you will experience negative physical symptoms of withdrawal resulting from abrupt discontinuation or reduction in dose.

Simply put, you started using oxymetazoline to reduce nasal congestion, and now your nose needs it in order to remain open. If you stop using it, your nose will slam shut, with congestion worse than before you started using oxymetazoline.

The medical term is Rhinitis medicamentosa

Perhaps you have noticed this? You started using oxy last year when you had that cold, just to open your nose so you could sleep. Now you can’t breathe well enough to sleep without it. Sometimes you use it several times a day just in order to breathe.

First rule of using oxymetazoline: never use it for longer than 5 days in a row.

So … what now?

How to manage Rhinitis medicamentosa?

If your nose is severely dependent on oxymetazoline, you may need some professional help in kicking this addiction.

Things that a professional may consider include:

• Stop using oxymetazoline – either cold-turkey, or gradually (recommended). You can do this yourself, without professional help. I have found that a good trick is to alternate the spray in one nostril for one night, and spray for the other nostril the next night, alternating between the sides of the nose. This gives each side a day spray-free for recovery. Gradually reduce the amount of spray used, and gradually increase nights not using spray.
• Daily hypertonic nasal saline rinses (such as Nasopure) for a week only. The hypertonic nature of these can help reduce swelling of the nasal lining. You can do this yourself. (transparency: I have NO financial or other relationship with Nasopure or Dr. Hana Solomon; it’s simply a great product).
  (You can use regular saline nasal rinses forever, but limit use of hypertonic saline to a week to keep those cilia happy.)
• Consider systemic (oral) nasal decongestants, such as sudaphed. Many of these are available over-the-counter, and may help reduce “rebound” nasal congestion.
• Topical steroids – nasal steroid sprays. These can also help reduce nasal congestion, especially during the “recovery” or “rebound” phase. They are by prescription.
• Systemic (oral) steroids. They are by prescription. These are a more intensive treatment to help keep your nasal congestion down during the recovery phase, usually during the first 5 days or so. Should be considered with caution, since systemic steroid use can have some nasty adverse effects.

To say that Rhinitis medicamentosa is annoying is a huge understatement.

No, the withdrawal symptoms are nothing like those of withdrawal from heroin that are portrayed in television dramas. On the other hand, the severity of nasal congestion that results from oxymetazline withdrawal can make the worst cold of your life seem tame.

The easiest way to avoid this hassle is to limit your use of oxymetazoline to (maximum) 4 or 5 days in a row. If you must use it, give your nose a break for a few days after every 4 days of use.

Better yet, just avoid it completely. Use nasal saline rinses instead for optimal nasal hygiene.

As a general rule, do not use spay nasal decongestants in children.

_______________

Hi, I’m Russell Faust, author of this blog, and I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

I invite you to subscribe (it’s FREE) to this blog for weekly updates – you won’t be swamped by updates, I simply cannot write for the blog everyday.

Click here to receive free weekly updates: (http://eepurl.com/FGnP)

Type in your best email address (the one you actually use).

Your email is safe - will never be shared or sold. Ever.

Click here to read our Privacy Policy: http://wp.me/PR4iB-r

When the confirmation email from boogor doctor arrives, click on the link to give your okay to receive free weekly updates, occasional book reviews or product reviews, occasional discount-coupons for products that I use (not affiliates), all without needing to visit the website.

It’s free, it’s convenient. No ads. No spam. You can un-subscribe at any time. How cool is that?

Stay Informed.

Stay Healthy.

Best of health and success to you and your families.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)

What Causes Reflux?

Let’s start the answer by saying “we don’t know”. The rest is mostly speculation, educated guessing. At the bottom of the esophagus (swallowing tube) there is a tightening of muscle where it enters the stomach (called the “lower esophageal sphincter”). This muscle is affected by many things. As you might imagine, anything that loosens that muscle will allow reflux to worsen. Some things that loosen that muscle include caffeine, alcohol, tobacco, mint teas, tight clothing (pressing on the stomach externally), lying down, and even obesity. Some medications also worsen reflux. Let’s assume that your infant isn’t smoking cigarettes, drinking alcohol or coffee. You can see that most of these factors should not be a problem for babies or children, although obesity is becoming more of a problem in children. The biggest factor for reflux in infants is position – they spend most of their time lying down.

What To Do About It?

General Considerations

1. Manage stress. Stress and emotional turmoil will crank up the stomach acid, and have other negative effects. Too much can contribute to reflux, GERD. As always, to the best of your ability, provide your child with unconditional love, emotional support, and a safe and secure home environment.
2. Consider an Elimination Diet protocol. Some specific foods or food groups may be causing reflux or respiratory symptoms (asthma, rhinitis, etc.). Eliminating your child’s symptoms may be as simple as getting rid of a food from their diet. This topic deserves a LONG post all by itself. Take a look at Dr. Jonega’s site (www.allergynutrition.com), take a look at her books (on my Amazon Store here), and search the web for “elimination diet”.
3. Exercise. For children (adults too), make certain they are active. This will benefit their general health. It will help eliminate reflux. Get them up off the couch, pry them away from the video game and the TV, get them outside!!
4. Supplement with a multi-vitamin that contains zinc. Zinc is necessary for a healthy GI tract.
5. Consider using a probiotic for any child who is being treated for reflux (any treatment – conventional or alternative).

Infants

Simple things can help: after feeding try to keep them upright for awhile. If sleeping, try to place them on a slight incline, or prop up their bedding slightly under the head of the crib. Thickening their feedings can help them keep from refluxing. Rice cereal is a good thickener. For this to help, the formula or milk needs to be as thick as stage 1 baby food or tomato sauce (NOT paste!). Note that breast milk contains an enzyme that breaks down the cereal, so it will be good and thick to start, but thins out a few minutes later. You may want to thicken only an ounce at a time to prevent this from happening. Also note that thickened formula will not come out of a regular bottle nipple. Most bottle manufacturers have cross cut nipples and variable flow nipples. Ask your pharmacist to order some for you. Finally:  Not ALL reflux will be cured by thickening.

What Other Treatments Are Available?

For starters, “conventional” medicine uses something that is over-the-counter for adults (considered relatively safe):

Zantac (generic: Ranitidine)

I have had good results with this in my pediatric patients with  asthma, rhinitis, sinusitis, and otitis. It is a prescription for children. I use this mostly as a diagnostic technique: if I suspect reflux as a key factor in a child’s asthma, rhinitis, sinusitis, or otitis, I will place them on Ranitidine. If they clearly improve, we have our diagnosis. We then try to reduce the reflux without drugs. Keep reading …

Natural Alternatives

Here are some “natural” alternatives to consider (see my previous article, A Few Words on Being Natural (http://wp.me/pR4iB-k5) for my thoughts on whether “natural” is always better):

DGL

In the 1940’s licorice was discovered to be effective in treating peptic ulcers. Unfortunately, side effects included high blood pressure, potassium loss, and fluid retention (just another example of “natural” not always being a universally positive remedy). Over time it was discovered that these side effects were caused by a chemical in licorice – glycyrrhizin. The solution is called “de-glycyrrhizinized licorice”, or DGL, where about 97% of the glycyrrhizin has been removed. Research has shown that DGL is a good anti-inflammatory. It has been effective against the esophagitis and other symptoms caused by GERD. How to use DGL? It usually comes as a chewy tablet, kind of like a gummy-bear. Chewing the tablet helps activate the DGL by mixing with saliva.

NOTE that safety information for DGL in children are not available. Dosing information is not available for children. Therefore, this option is only available for treating adult reflux. If you use DGL, store it out of reach of children – the gummy-bear resemblance to candy can be appealing to children.

Barley Grass

That’s a pic of barley grass above (credit, Matt Lavin). Barley grass consumption by humans dates back at least 7,000 years, and active cultivation of barley dates back to Mesopotamia, to about 2500 BC. Barley has amino acids and chlorophyll, and seems to contain effective anti-inflammatory ingredients. In addition, it has 11 times the calcium of cow’s milk, more than 4 times the iron from spinach, 7 times the Vitamin C of oranges, and is loaded with Vitamin B1. Sounds impressive. There has been very little scholarly research on the effects of Barley Grass in humans. It is used as an anti-inflammatory for reflux, similar to DGL. How to use Barley Grass? Dried barley grass is usually boiled and consumed as a tea, or mixed into water or juice.

Melatonin?

You’ve heard of Melatonin? Helps us sleep. This mostly speculation, but some integrative and holistic docs who are pretty smart speculate that our Melatonin also helps reduce reflux. How? Melatonin increases the muscle tone in the Lower Esophageal Sphincter. This might reduce upward flow of gastric contents. That is, increasing the tone in the LES might reduce reflux. Still speculation, but it makes sense that the natural hormone that helps us sleep would also help reduce reflux while we are lying down.

Histamine?

No – don’t give histamine to treat reflux. Reduce histamine to reduce reflux.

For my own reflux, Dr. Joneja’s histamine-restricted diet has made a huge difference! Check her site under Resources, below. It is a GREAT resource for those with food allergies, intolerance, and reflux. She has many free downloads. She has an amazing site! Check it out!

Quercetin

Quercetin is a bioflavonoid. It inhibits release of both histamine and leukotrienes. As a result, it is a strong anti-inflammatory agent. It occurs naturally in onions, garlic, and many dark-colored fruits and vegetables. Ask your pharmacist or naturopathic doctor (ND) about dosing for children. Even better, simply include natural sources in your child’s diet (in your diet too, while you’re at it). As a general principal, it is always better to get your nutrients directly from the source – your food.

Acupuncture

As good at managing reflux as powerful proton pump inhibitors (PPI’s) for difficult-to-treat reflux. I don’t use PPI’s in my patients. To find a Licensed Acupunturist near you, contact the American Academy of Medical Acupunture (see Resources, below).

Nutritional Supplements

There are studies suggesting that magnesium and other elements play a role in histamine release. Be certain that your little tyke has as well-rounded a diet as possible (see Littlestomaks.com for suggestions). The goal, of course, is for them to obtain all of their nutrients from a well-balanced diet. This is a huge challenge, especially in toddlers. Supplement with a good multi-vitamin to be sure. This simple step will help minimize reflux, and help keep them healthy in general. Be certain that the multi-vitamin includes Zinc. Nearly all of us are deficient in Zinc, and it helps the lining of the GI tract to heal, to repair itself. Ginger can have a “gastro-protective” effect – it protects the stomach. BUT: Caution should be taken when using ginger (Zingiber officinale), as some studies have found increased GI distress with high doses or prolonged use. So: if you have reflux, don’t over-do the ginger. Finally, ask your doctor – naturopath, pediatrician, or pediatric ENT. Check the website of the American Board of Integrative Holistic Medicine to locate an integrative healer near you: http://integrativeholisticdoctors.org/D/locate_physician.html

Surgery

As a LAST resort: For those children with life-threatening complications of reflux – failure to thrive, severe asthma, recurrent pneumonia from aspiration, etc. – and these other approaches just are not working – surgery may be a consideration. The most common and most successful is a procedure that tightens the lower esophageal sphincter, the muscle surrounding the esophagus where it enters the stomach. I do not personally perform this procedure, and can only say that some of my patients have experienced life-changing success from surgery to stop their reflux. Beyond that, ask your doc, search the web. . Reminder: the goal of these articles is to educate and inform. This is not medical advice. All treatment should be undertaken with the advice and guidance of a physician who has knowledge of your full medical history, your physical exam and any laboratory test details. See disclaimer: http://wp.me/PR4iB-r Future posts will examine the studies showing how reflux affects rhinitis and sinusitis, and what we can do about it. . I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.” I invite you to subscribe (it’s FREE) to this blog for weekly updates – you won’t be swamped by updates, I simply cannot write for the blog everyday. Click here to subscribe for free weekly updates: (http://eepurl.com/FGnP) Type in your best email address (the one you actually use).  When the confirmation email from boogor doctor arrives, click on the link to give your okay to receive free weekly updates, occasional book or product reviews, without needing to visit the website. It’s free, it’s convenient. No ads. No spam. You can un-subscribe at any time.

Stay Informed.

Stay Healthy.

Best of health and success to you and your families. Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)

Resources

American Academy of Medical Acupunture.  Tel: 323-938-5514. Website:  www.medicalacupuncture.org

Dr. Janice Joneja, PhD, RD (Registered Dietician): http://www.allergynutrition.com/)

This is an outstanding resource for allergy and nutrition information, including food allergies and reflux.

I owe a great debt of gratitude to Dr. Robert Ivker for helping to eliminate chronic sinusitis and reflux from my life.

Refer to his site for further details on steps that you can take: www.physicianhealer.com He is an outstanding resource for Respiratory Health.

Of note, he is an original founder of the American Board of Integrative Holistic Medicine.

Image Credit: Image by Matt Lavin, Flickr:  http://www.flickr.com/photos/plant_diversity/

From this blog:

Is Reflux Causing Your Child’s Asthma? http://wp.me/pR4iB-uV

Things You Should Know About Asthma: http://wp.me/pR4iB-7k

A Few Words About “Being Natural”: http://wp.me/pR4iB-k5

Reflux and Otitis: Does GERD Cause Ear Infections? http://wp.me/pR4iB-fZ

Homeopathy

A system of therapy based on the belief that “like heals like.”  The belief is that disease can be treated with drugs (in minute doses) that produce the same symptoms in healthy people as the disease itself.  According to homeopathy, symptoms are the body’s way of fighting disease.  Homeopathy teaches that symptoms are to be encouraged.

Homeopathy was developed by the German physician, Samuel Hahnemann in the late 18^th century.  It was further developed and popularized by the American physician James Tyler Kent.  Hahnemann  and his followers approached treatments in a holistic way, meaning that they treated the whole body and spirit, not simply focus on the local disease process.

Naturopathy

A system of therapy based on preventive care, on the use of heat, water, light, air, and massage as primary therapies for disease.  Some Naturopaths use no medications of any kind;  some use herbal remedies only.  A few are licensed to also prescribe medications.

Naturopathy is an American invention, founded at the turn of the 20^th century.  By the early 1900’s more than 20 naturopathic medical schools existed, and naturopathic physicians were licensed in most states.

As practiced today, naturopathic medicine incorporates traditional natural remedies – herbal remedies, nutrition, homeopathy, acupuncture, traditional Asian medicine, hydrotherapy, and others.  Naturopathic practices are increasingly supported by results from clinical trials supported by NIH.  Bastyr University of Naturopathic Medicine was the first naturopathic institution with research to be funded by NIH.

Overall, naturopathy focuses on the use of nontoxic, natural therapies.  The tenets of Naturopathy seem worthy:

• First, do no harm
• Use the healing power of nature
• Treat the cause of the disease, not just the symptoms
• Treat the whole person
• Educate the patient about their health
• Focus on preventing disease

Osteopathy

A system of therapy that emphasizes the role of the musculoskeletal system in health and disease.  Osteopathy began in the United States in 1874; the term “osteopathy” was coined by Andrew Taylor Still.  Still founded the American School of Osteopathy in Missouri in 1892.  The state of Missouri offered to allow his school to grant the MD degree, but Still insisted on retaining the DO (Doctor of Osteopathy) degree.

Osteopaths combine the ability to prescribe medications with manipulative medicine.  The goal is resolution of somatic dysfunction in an attempt to aid the body’s own recuperative ability.  This involves manual treatment, or manipulation, of the musculoskeletal system.  Throughout the 20^th century however, osteopathy in the United States has moved closer to mainstream medicine in its practice.  Recent surveys reveal that the majority of Doctors of Osteopathic medicine (DO’s) practice medicine without manual manipulation.

Osteopathy is practiced around the world, including the entire European Union, Israel, Canada, New Zealand, and Australia.

Chiropractic

Chiropractic is a system of healthcare that focuses on diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, especially the spine.  The underlying tenet is that disorders of the spine affect overall health through the nervous system.  The principal therapy involves manual manipulation of the spine and joints.

Chiropractic was founded in the United States in the late 1890’s by D. Palmer, and was further developed into the 20^th century by his son.  Chiropractors faced heavy opposition by organized, conventional medicine in the US.  Thousands of chiropractors were prosecuted for practicing medicine without a license, some were jailed.  Persecution continued until a landmark legal case against the American Medical Association (Wilk v AMA) that found that the the AMA had engaged in restraint of trade.

Whereas Chiropractic has gradually gained acceptance and legitimacy over the last couple decades, the growth of evidence-based medicine poses a challenge to practices that have little research to back up their methods.  Further, competition has grown from other alternative practitioners.  As a result, many Chiropractors have supplemented their chiropractic practices with additional, alternative medicine methods.

Ayurveda

Or Ayurvedic medicine is a system of traditional medicine native to the Indian subcontinent.   Historically, the development of Ayurveda was influenced by Hinduism and Buddhism.  It is now practiced in the rest of the world as a form of alternative or complementary medicine.  Translation from Sanskrit, Ayurveda means life science or life knowledge.  Ayurvedic medicine includes the use of herbal remedies, massage, dietary routines, and yoga.

As with Naturopathy, Homeopathy, and Chiropractic, the safety and efficacy of many of the postulates of Ayurveda have yet to be proven through clinical trials.  NIH, through its National Center for Complementary and Alternative Medicine, currently funds ongoing research into Ayurvedic practices.

Conventional Medicine

Conventional, or “Western” medicine, was labeled “Allopathy” by Hahnemann in the 18^th century.  As you see above, he coined the term Homeopathy.  He meant the term Allopathy in a pejorative or derogatory way, implying that Homeopathy was superior to Allopathy.  Due to this history, conventional medical doctors (MD’s) rarely use the term allopathic medicine.

We all recognize conventional medicine here in this country as the practice of medicine that is most widely practiced.  We also all recognize that there are many challenges with the modern conventional practice of medicine, from crazy costs, to “cures” that are worse than the disease, and many of us are painfully familiar with the specialist who treats only the disease but fails to treat the patient as a whole person.

As people have become more familiar with the limitations of “conventional medicine,” we have turned to alternatives.  Many of these are listed above.  It has been estimated that upwards of 60% of us now see a practitioner who practices some form of alternative medicine, from Ayurveda to Chiropractic and beyond.

Evolution

It is an unfortunate human trait that the practitioners of these various medical philosophies consider their own superior to the others.  Moreover, many look on the other systems of therapy with disdain, with contempt, and can be dismissive of patients who mention having seen a practitioner of another philosophy.

How many of us have seen our doctor roll their eyes when we mention seeing a Chiropractor, or mention taking an herbal remedy, or some other alternative therapy?

Some of us (physicians) are fortunate enough to evolve.  Me?  I’m still an alternative Neanderthal, but I am slowly evolving, slowly integrating.

Integration

Look around: As the practice of medicine evolves into the 21^st century, the most successful practitioners are those who integrate the best of these philosophies.

These practitioners have been around for years, perhaps decades, but as patients take greater ownership of their health, these practitioners are in greater and greater demand.  As it should be.

It is these practitioners who are my role models.  Whereas I may stumble in my attempts, I aspire to bring to my own medical practice the best of “conventional” and “alternative” medicine, to bring my patients to their very best possible health.

• To prevent disease
• To eliminate disease
• To maintain health
• To control disease when necessary
• To treat the whole person
• To educate the patient, to empower them in their healthcare decisions

So, what pathway to health does YOUR healer follow?  Please share your experiences below.

I know, I haven’t mentioned many other healing philosophies, traditional Chinese Medicine for example.  Perhaps I’ll devote an entire post to that some time …

To download a free PDF file of this article, go to the download page here: http://wp.me/PR4iB-s7

Thanks for visiting, and see you here again.  I appreciate your comments and questions.  Keep ‘em coming.  Please, “be excellent to one another.”

Best of health and success to you and your families.

Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)

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Credit: The image of Chinese medicine bottles from http://www.flickr.com/photos/moriza/49897087/