Behavioral Change for Weight Loss!

I have reviewed many diets over the years and aspects of all of them can be beneficial and aspects of many of them can be detrimental. It is clear that most diets are not sustainable and therefore not effective for life. The Diet de jour is HCG diet which through multiple studies have shown the diet to be ineffective. The results that people are seeing is from the calorie restriction in the diet. The diet calls for you to eat on 500 cal a day. A typical person should eat 1800-2000 calories a day and many Americans are eating 2500-3000 calories a day. Shocking your body into starvation at 500 calories a day will be effective without HCG, the only problem is, how long can you do that for?

Ultimately, we, as medical professional need to stop telling people to lose weight and tell them how to lose weight. We have to start educating. If every patient learned about the consequences of over eating and ways to eat better, obesity would become extinct.

Behavior change is the key. Not pills, shots, exhaustive exercise regimes or extreme diet. I have been working with a local counselor Kari Anderson who specializes in cognitive behavior therapy. My Balanced Life Counseling.
Together we have created a comprehensive 12 week program whose goal is behavior change for the future. Participants will lose weight but we will not be focusing on pounds per se.

Please see her website for program details:
My balanced life counseling programs

Bryan Glick, DO
www.thehealthquest.com

Article on cash physicians like myself

A couple weeks ago I was asked to speak at AZCOM, Arizona College of Osteopathic Medicine, my alma mater, about physicians like myself who don't take insurance. It was a good crowd with a lot of questions. I had a fun time. It's really hard to explain in a sentence or less why this type of health care is the future of medicine.

Please read the article below:
http://www.takebackmedicine.com/med-student-blog/2010/2/13/cash-doctors-improving-quality-increasing-access-lowering-co.html

Bryan Glick, DO
www.thehealthquest.com

Do I have strep throat?

Patients come in all the time with a sore throat and think it's strep throat. In Arizona, it's more commonly postnasal drip from allergies or viral causes top the list but if it is strep what would you look for?

One of the more reliable tools that physicians can use to determine pre-test probability is the Centor criteria:
Fever +1 point
Exudate +1
Absence of cough +1
anterior cervical lymphadenopathy +1
Age <15 +1
Age >45 -1

Let me explain.
Fever- A fever is defined as a temperature of 100.4 F or higher. Also, some data has suggested that the patients report of feeling feverish is also significant regardless of an actual value.
Exudate- Exudates are physical exam findings that show white stuff on your throat. Remember, there are many things that can cause white stuff in the throat, but white stuff on your tonsil with the other findings at the same time is more concerning for strep.
Absence of cough-This history is important because typically a cough is viral and less likely strep.
Ant. cervical lymphadenopathy-This is when you can feel lymph nodes in your neck and they are tender and painful to the touch.
Age <15- More likely strep
Age >15- Less likely strep

Why is all this important?
There is a rare complication to strep throat which left untreated could lead to rheumatic heart disease and can cause complications later in life.

Depending on the number of points, physicians can decide whether or not to treat with antibiotics.
If all the points are present the physician will usually treat. If there is 2 or 3 points some physicians will use a rapid strep in office to get results in minutes. If 1-2 points present, watch and wait is a more prudent approach. Some physicians, especially pediatricians will send a throat culture. This is different than the above rapid strep. This culture is collected in the office and sent to the lab and results can take 3 days. Based on the culture results, physicians will then call mom and call in a prescription for antibiotics.

If you have the above symptoms concurrently, you should call your doctor and be seen. Strep or not, there are many remedies to help patients with sore throats.

Read more from this patient information sheet from the AAFP.org:
http://www.aafp.org/afp/2001/0415/p1565.html

Bryan Glick, DO, MBS
www.thehealthquest.com

My Review of Doctor

Originally submitted at Timbuk2

The Doctor is the cure-all for your motion sickness.

Doctor

Doctor bag

By Dr Glick Health Quest Family Medicine from Anthem, AZ on 1/23/2010

 

4out of 5

Pros: Easy to Transport, Lightweight, Durable, Large Capacity, Good Zippers

Cons: Color

Best Uses: Home visits as a doctor

I am a Family physician that sees patients at home when requested. This bag allows me to carry everything I need to care for my patients.

I was pleasantly surprised to see the color was camo green. The web photo looks like beige/brown. I like the green better.

(legalese)

HCG diet!

Here's the latest on the HCG diet from a natural medicine database:

The HCG diet is now becoming a popular diet promoted for quick and easy weight loss. It combines a very low calorie diet of 500-800 calories daily with injections of the prescription drug human chorionic gonadotropin (HCG). HCG is often referred to as the "pregnancy hormone" because it is the hormone measured in home pregnancy tests. Proponents suggest that HCG decreases hunger, enhances weight loss, and shifts body fat from thighs and buttocks to other parts of the body. But clinical research shows that HCG does NOT improve weight loss or redistribute fat. Explain to patients that consuming a very low-calorie diet can cause short-term weight loss, but it is not a sustainable long-term weight solution.

http://www.naturaldatabase.com/

Doesn't sound like a good idea.
The only true way to lose weight is through behavior modification.

Bryan Glick, DO
http://www.thehealthquest.com/

Ginko biloba, Not as good as once thought!

Ran across a new article in JAMA about "Ginko biloba for the preventing cognitive decline in older adults."
This study is the best kind of study we can perform in medicine. It was randomized, double-blinded, placebo-controlled trial of 3069 patients aged 72-96 years old from 2000-2008.
Patients were either given Ginko 120mg twice daily or identical placebo. Multiple rating scales employed to objectively rate cognitive decline and or improvement.

The authors concluded that Ginko 120mg twice daily did not result in less cognitive decline in older adults with normal cognition or with mild cognitive impairment.

The bottom line is, if you are taking Ginko for memory you are likely wasting your money.

Here's the article:
http://jama.ama-assn.org/cgi/content/full/302/24/2663?home
Ginkgo biloba for Preventing Cognitive Decline in Older Adults
A Randomized Trial
Beth E. Snitz, PhD; Ellen S. O’Meara, PhD; Michelle C. Carlson, PhD; Alice M. Arnold, PhD; Diane G. Ives, MPH; Stephen R. Rapp, PhD; Judith Saxton, PhD; Oscar L. Lopez, MD; Leslie O. Dunn, MPH; Kaycee M. Sink, MD; Steven T. DeKosky, MD; for the Ginkgo Evaluation of Memory (GEM) Study Investigators
JAMA. 2009;302(24):2663-2670.

Bryan Glick, DO
http://www.thehealthquest.com/

Hangover Remidies

There have been multiple remedies suggested for New Years Day hangover. Personally, I have had great results with taking ibuprofen 4 tablets by mouth with a snack, right before bed and 16-20 oz of water. I also, wake up and do the same. Alcohol dehydrates you so make sure you are urinating and your urine is clear, not yellow.

This article I found from 2007 aafp.org reports that:
Drinking a glass of milk and eating a slice of toast with honey or syrup may combat that hangover.

check out the article yourself:
http://www.aafp.org/afp/2007/0315/p796.html

Have fun and be safe.
Bryan Glick, DO
http://www.thehealthquest.com/