What I Am All About

Wednesday, September 25, 2019

Life Extension and Brain Boosters


Brain Boosters Revised


The following is a cut-and-paste response with my added comments and advice to a real friend of mine who has cognitive issues. No matter what station in life you are at, there are many take home issues here. As always, consult with your physician before blahdy blahdy Hell.


Josh: 

This is mostly cut-and-paste from the Life Extension website. I've put my thoughts in italics. While it addresses cognitive decline with aging, It's great advice for all of us. At the end I'll give my best recommendation for you.


Proactive lifestyle changes, cognitive and nutritional interventions such as phosphatidylserine and glyceryl phosphoryl choline have been shown to decrease the rate of intellectual decay and potentially reverse age-related cognitive decline.


I .Lifestyle changes can help reduce age-related cognitive decline:


A.Switch from a western diet high in simple sugars and saturated fats to a Mediterranean diet high in mono- and polyunsaturated omega-3 fats, fiber, and polyphenol.


An eating pattern based on the traditional Mediterranean diet has been shown to have anti-aging effects on brain, cardiovascular, and metabolic functions, and on overall longevity. Findings from a variety of studies suggest eating a Mediterranean-style diet can slow cognitive decline and may reduce risk of dementia. If you are already eating Indian cuisine, it will be easy to go.


With its emphasis on fruits, vegetables, unrefined whole grains, legumes, and extra virgin olive oil, as well as moderate amounts of seafood, fermented dairy products, and red wine with meals,200 the traditional Mediterranean diet provides ample amounts of critical nutrients such as mono- and polyunsaturated fatty acids, antioxidants, vitamins, minerals, and phytonutrients. It can be used as a template that can be adapted to favor local and seasonal availability of specific foods.

A study including 832 participants examined every two to three years for up to 18 years found that those whose diets most closely reflected a Mediterranean diet experienced significantly less cognitive decline than those whose diets least reflected a Mediterranean diet. A study based on data collected over 16 years from men participating in the Health Professionals’ Follow-up Study found that those whose diets were most Mediterranean-like were 36% less likely to report poor subjective cognitive function than those whose diets were least Mediterranean-like. Examining the brains of cognitively normal older-age subjects has revealed that adherence to a Mediterranean-like dietary pattern is associated with reduced β-amyloid accumulation. The components of the diet most closely linked to this effect were high fruit and vegetable consumption and moderate wine consumption.


A. Olive oil

Use extra virgin olive oil on vegetables, legumes, salads, stir-fries, and sautés;

Flavor food with herbs, spices, garlic, onion, and lemons.


B. Vegetables (mainly deep greeny veggies like kale, asparagus, and the cruceriforms. From Wikipedia:


Have vegetables with both lunch and dinner;


Use vegetables as a main dish often;


Have some raw, dressed with olive oil and vinegar, every day.


C. Fruits


Fruit products often contain added sugar (Low consumption).


Eat raw fruits as dessert most days. Stick to berries, pomegranates, and green bananas (which is a prebiotic).


Include a variety of seasonally appropriate fruits.


D. Unrefined whole grains


Use whole grain bread, pasta, and flour;


Include whole unrefined grains for the fiber, but try to avoid wheat because gluten has its own drawbacks. For more wheat alternatives, check out my friend Dr.Bill David's website, www.wheatbellycom).


E. Legumes


Include a variety of beans, lentils, and peas.


Cook dried beans or choose canned beans without additives.


Because some legumes are high in lectins, l recommend only those I mention in my post of the same name.

http://bit.ly/2l3Q4u7


F. Nuts and olives


Have nuts and olives as snacks. Peanuts are not avoid choice, though.


Eat a handful of raw nuts daily.


Choose a variety of nuts.


G. Moderate seafood intake


Fatty fish (tuna, salmon, sardines) twice or more weekly;


Shellfish (oysters, clams, squid, shrimp) occasionally. No, avoid clams and oysters unless farm-raised.


H. Moderate fermented dairy (yogurt and cheese, kefir).


Use unsweetened yogurt and flavor with fruit.


Have small amounts of fresh or cured cheese occasionally;. Hard cheeses are best. I love cottage cheese though, so I chest on this one.


Avoid ice cream. Well, except Breyers Butter Pecan.!


I.Home cooking


Limited intake of homemade baked goods and processed baked goods (high in sugar, processed fats, and additives). 8n fact Josh, just avoid altogether.


Bake at home;


Use olive oil instead of butter. Naw. Use organic, range-fed butter and ghee liberally. 


Eat baked goods only occasionally or better, not at all 


Little meat and limited poultry.


I disagree with this. Range-fed livestock and chicken, wild salmon and tuna, crab and shrimp, calamari, and lobster are tasty and healthy foods. Avoid clams and oysters since they are filter-feeders which means you are eating fish poop and spawn. Overlooked meats in the US are goat and sheep. Also, Dave Asprey recommends organ meats from range-fed livestock.


Limit meat consumption to a fistful per meal.


J. Beverages


Avoid beer, hard liquor, and sugar-sweetened soft drinks.


Include moderate amounts (up to 1 glass per day for women and 2 glasses per day for men) of wine, preferably red, always with meals. Merlot, Shiraz, and Port. You want a red wine so dry it makes you pucker. 


Drink water instead of soft drinks. Limit fruit juices most of all. If you decide to do Intermittent Fasting, break your fast with a single glass of apple or grape juice. These replenish your liver's glycogen stores but too much decreases sperm count and semen volume.


Read up on Bulletproof Coffee which is coffee with ghee (or range-fed organic butter such as KerryGold) and coconut or MCT oils. www.bulletproofcoffee.com. I think. It's what I drink.



Tuesday, August 27, 2019

A Fool for a Patient

My Quora Answer to:
What was the most incorrect self-diagnosis you've encountered in your practice as a doctor?

My own. Any doctor who treats himself has a fool for a patient.

After my 5 muggings in Nicaragua over the Thanksgiving weekend in 2013, I developed a well-deserved diagnosis of PTSD. Which seemed to be fairly well-controlled until October 1, 2018. A few panic attacks here, occasional night terrors there, but I still maintained the ability to think and act rationally until then. And the next 6 weeks were pure Hell.

Mid November I finally came out of it. Here were my problems: hypersexuality, drinking, spending sprees, racing thoughts, weeks on end of “blacking out,” legal problems, and most distressful, loss of short term memory. I got on a bus 4 times to see my psychiatrist at the time, and 3 times I failed to get off the bus because I forgot where I was going. The 4th time was a disaster anyway because my psych couldn't see past the alcohol issue. I rarely, if ever, drink when I'm not psychotic, but her reply to my plea for help was, “go check into an ER.” That was the last time I saw her.

It wasn't until the first week in February that a more astute and compassionate doc diagnosed me with Bipolar Disorder. It was a bumpy road until then because I still believed (self-diagnosed) that the 6-week episode was PTSD. Once I got the correct diagnosis, everything fell into place. It was as if she shook a container of puzzle pieces and rolled out a finished masterpiece.

All is good now.

http://bit.ly/2Zv53uU

Monday, August 19, 2019

Scary Patients

My Quora Answer to:
As a doctor, have you ever been in danger from your patient?

Yes. Just one.

I was working in the ER at Waupun Hospital when the EMT's brought in a patient from a local prison. Waupun, Wisconsin is home to three prisons and close to a few others. The local economy thrives off of kidnapping and caging people.

Before I entered the bay, my nurse pulled me aside and warned me not to get close to the patient. He explained that the prisoner had permanently disabled a nurse at another hospital by attacking her physically during her intake exam. It was the only time in my career when I saw and treated a patient without doing a physical exam.

NB: I always did physical exams even with my psych patients. In addition, a physician can learn a lot just by observation. In medspeech, we document this with “A, A, Ox3, in NAD” which is shorthand for Awake, Alert, Oriented to person, place, and time, and in No Acute Distress. With ambulatory patients we also observe gait and lower body strength but the prisoner was shackled to a gurney and I was NOT going to unchain him just to observe his gait. That's how scared I was.

https://qr.ae/TWraSN