In Observance of This Memorial Day Our Office will be Closed on May 25th.

     In observance of this Memorial Day our office will be closed on May 25th.  

      Please plan ahead to request any prescription refills prior to this time. Our physicians will be “On Call” to address any of your non-emergency health care issues that cannot wait until the office reopens on May 26th.

      We would like to wish you and your families a   safe and  happy Memorial Day.

      Dr. Edgar Cruz, Dr. Cara Jakob and the entire staff of
Total Family Healthcare.

High Blood Pressure & Hypertension, What is it And Why You Should Care!

                We have all likely heard of high blood pressure, or "hypertension", at some point in our lives. Our grandmother may have been taking blood pressure medicines. We may have checked our own blood pressures out of curiosity at those little machines at our local pharmacy.  Or, perhaps our own doctor has mentioned high blood pressure to us.

                But, what exactly is high blood pressure, and why such a big deal about it?  Let's start with some numbers. High blood pressure, or "hypertension," is defined as repeated blood pressure above 140/90mmHg. Normal blood pressure is blood pressure up to 120/80mmHg.  The blood pressures in between 120/80-140/90mmHg are considered "pre-hypertension."

                How do these numbers affect our health?  According to the Centers for Disease Control, heart disease is the current leading cause of death in the United States.  About one third of all deaths above age 35 is due to heart disease, and hypertension is a major risk factor in the development of heart disease. ypertension also increases risk for stroke, heart failure, and kidney disease.

                Just imagine trying to water your lawn using a garden hose that has a kink in it. You'll be working harder and struggling to push the water past the high pressure in the hose, and those flowers in your garden will suffer from the poor supply of water coming through. That is a simplified version of the way our hearts are working to pump blood through our arteries to feed our body's organs like the brain, eyes, kidneys, etc. With hypertension, our vital organs are suffering the damages of a high pressure system.

 The good news is that healthy lifestyle changes like regular exercise, lower sodium diet, and weight loss can significantly lower blood pressure, thereby decreasing the risk for stroke, heart attack, and heart disease.

                Aerobic exercise regularly can lower blood pressure by 5-15mmHg, and the intensity of the workout is more important than its duration. An easy way to improve our diet to a lower sodium diet is to limit or cut out the processed foods and canned foods. Eating fresh foods, and preparing your own meals can help reduce that excess salt in our diet. As for weight loss, there are many benefits to reaching a healthy weight, and better blood pressure is one major benefit. Every few pounds we lose can improve our blood pressure by as many points. Some people may also need medications to treat their hypertension and its risks.

                Now that we know more about hypertension, let's be on the lookout for it, and take healthy steps to help combat it. Talk with your doctor about your blood pressures and whether you have hypertension. Together, you can develop an individual health plan to keep you at your best.

What Your Body is Telling You About Your Diet

When your body is trying to tell you something — for example, that you’re skimping on critical vitamins — it may go to some strange lengths.  Check out these unusual vitamin-deficiency warning signs. The good news: Most are fixable with dietary tweaks — all the more reason to make nutrition a top priority. When food cures don’t work, be sure to check in with your doctor.
 
 
Cracks at the corners of your mouth.

Deficiency: Iron, zinc, and B vitamins like niacin (B3), riboflavin (B2), and B12.
 
It’s common if you’re a vegetarian to not get enough iron, zinc, and B12; or if you’re skimping on essential immunity-building protein due to dieting.

Solution: Eat more poultry, salmon, tuna, eggs, oysters, clams, sun-dried tomatoes, Swiss chard, tahini, peanuts, and legumes like lentils. Iron absorption is enhanced by vitamin C, which also helps fight infection, so combine these foods with veggies like broccoli, red bell peppers, kale, and cauliflower.
 
Red, scaly rash on your face (and sometimes elsewhere) and hair loss.

Deficiency: Biotin (B7), known as the hair vitamin.
 
While your body stores fat-soluble vitamins (A, D, E, K), it doesn’t store most B vitamins, which are water-soluble. Body builders take note: Eating raw eggs makes you vulnerable, because a protein in raw eggs called avidin inhibits the body’s ability to absorb biotin.

Solution: Reach for more cooked eggs (cooking deactivates avidin), salmon, avocados, mushrooms, cauliflower, soybeans, nuts, raspberries, and bananas.
 
 
Red or white acnelike bumps, typically on the cheeks, arms, thighs and butt.

Deficiency: Essential fatty acids and vitamins A and D.
 
Solution: Skimp on saturated fat and trans fats, which you should be doing anyway, and increase healthy fats. Focus on adding more salmon and sardines, nuts like walnuts and almonds, and seeds like ground flax, hemp, and chia. For vitamin A, pile on leafy greens and colorful veggies like carrots, sweet potatoes, and red bell peppers. This provides beta carotene, a precursor to vitamin A, which your body will use to make vitamin A. For vitamin D, though, we recommend a supplement—5,000 IU a day in one that also contains vitamins A and K, which help with D absorption.
 
 
Tingling, prickling, and numbness in hands, feet or elsewhere.

Deficiency: B vitamins like folate (B9), B6, and B12.
 
It’s a problem directly related to the peripheral nerves and where they end in the skin these symptoms can be combined with anxiety, depression, anemia, fatigue, and hormone imbalances.

Solution: Seek out spinach, asparagus, beets, beans (pinto, black, kidney, lima), eggs, octopus, mussels, clams, oysters, and poultry.
 
 
Muscle cramps in the form of stabbing pains in toes, calves, arches of feet, and backs of legs.

Deficiency: Magnesium, calcium, and potassium. If it’s happening frequently, it’s a tip-off that you’re lacking in these. And if you’re training hard, you can lose more minerals (and water-soluble B vitamins) through heavy sweating.

Solution: Eat more bananas, almonds, hazelnuts, squash, cherries, apples, grapefruit, broccoli, bok choy, and dark leafy greens like kale, spinach, and dandelion.

Get Ready for Cinco de Mayo!

     

  Being from Florida I have always had a lot of Spanish speaking friends. Growing up in a small orange producing town, many were from Mexico and I was able to celebrate the holiday Cinco de Mayo, The 5th Of May, with their families.  This commemorates the victory of the Mexican militia over the French army at The Battle of Puebla in 1862. It is not, as many people think, Mexico's Independence Day, which is actually September 16. There was always a lot of music and dancing, but the best the part was always the food!

       Substituting lower calorie ingredients for high calorie ingredients is one of the best ways I know to live healthy and not feel like you are missing out on life. Here are a few recipes for you to try this Cinco de Mayo to help cut some of the fat and calories a party can put on you.

      

Easy, Taste Good Substitutions

• Replace regular sour cream with reduced fat sour cream or Greek yogurt.
• Replace milk cheese with cheese made from 2% milk.
• Replace fried (hard) taco shell with soft, low-carb tortillas.
• Replace ground beef with meatless, chicken or even better fish tacos! At the very least drain the fat off the ground beef. Who wants a soggy taco anyway?

 

 

How to Stay Healthy on Vacation

 

Traveling can be really stressful on your body and on your relationship with the people you are traveling with. Restless nights in unfamiliar hotels, the “I can eat it, I’m on Vacation” diet your about to adopt and the “We have to see everything” timetable can really take a toll on you. Not to mention being locked up in a car or plane for hours on end with billions of everyone else’s germs.

Surprisingly, hotels can be more detrimental to one’s immune system than the health risks associated with flying. Vacationers tend to go to bed late, wake up early and get less than seven hours of sleep a night. This triples the risk of getting a common cold. Lumpy hotel beds and extra firm pillows will also disrupt sleep.

Families and individuals on vacation also tend to consume foods that they normally would not if cooking at home – pizza, ice cream, candy, junk food – and that means a vacation diet that’s high in sugar and low in vitamins and minerals. Sugar has been shown to weaken the white blood cells that attack pernicious bacteria. Don’t cancel that planned trip to the beach or Europe so fast, here are a few recommendations for how to beat a cold and ward off any sickness when traveling.

You should start taking 2,000 milligrams of Vitamin C each day to strengthen the immune system as well as snacking on foods that are high in probiotics (the “good” bacteria). Probiotics are found in yogurt, Kombucha tea, miso soup, Kefir, fermented cabbage (like sauerkraut and Kimchi) and tempeh. They are also available as an over the counter supplement in capsule form. For little ones who may have difficulty swallowing supplements, foods that are rich in Vitamin C include oranges, red pepper, kale, strawberries, broccoli, kiwi and guava. Don’t forget to get plenty of sleep as well.

It’s still important to continue your Vitamin C routine usage when on vacation. Zinc lozenges are easy to pack and help support the immune system and works best when taken at the first sign of illness. You might even consider bring a mask to wear next to the guy with a fever on the plane. Hand sanitizer is also a must, use it frequently and defiantly before eating or drinking anything. You would be surprised how dirty door handles and money are!

If you’re reading this in bed because you’re home sick, leave your air-conditioned house or apartment right now for at least 30 minutes. Direct sunlight helps the liver produce Vitamin D3, which improves bone health and enables the body to build up its stock of antimicrobial peptides, which fight off a wide range of infections. The sun is one of the best ways to prevent a cold and so important for getting over one.

What is Autism?

Autism is a disorder that is prevalent but still widely misunderstood. To the uninformed, this condition may be seen simply as a problem with behavior and socialization, but it’s actually much more complicated and serious than this.

It’s estimated that about 1 in 68 children are diagnosed with some form of autism today, which is an increase of more than 100% since the condition became well-known in medical literature during the 1940s. Because of this, it’s critically important that people have a solid understanding of how this disorder works and how it can be treated. The following overview will help to acquaint you with the basics of autism—including official terminology for the condition, what causes it, and what symptoms to look for in children.

Since the creation of the diagnosis, researchers have significantly changed the ways that they think and speak about autism. Before the publication of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, psychologists had a number of distinct diagnoses for different disorders that affected social and communicative abilities. However, with the advent of the DSM-5, these disorders are now grouped together under the category of autism spectrum disorder (sometimes shortened to just autism spectrum or ASD). This reclassification acknowledges the fact that autism does not affect every individual in the same way. Instead, this approach conceptualizes different levels or types of autism that are different but still intimately related.

Autism Causes

Autism research is still not able to provide a definitive answer as to what actually causes autism, but the general consensus is that there is no singular reason for its existence. However, scientists have been able to propose several different potential factors that may be responsible. These include everything from genetics to environmental factors during prenatal development. Here is a look at some of the more common and widely supported causes that have been put forward.

•Genetics: There is some evidence to indicate that children with certain genetic disorders may be more prone to developing autism. Two of these potentially related disorders include Rett Syndrome and Fragile X Syndrome—both of which cause the brain to develop abnormally and create physical and intellectual disabilities.

•Environmental Factors: It’s also been hypothesized that autism may be caused by environmental factors that occur either before or after birth. Being exposed to certain viral diseases, especially rubella, in the womb can adversely affect a child’s brain development and puts them at a higher risk for autism and other developmental or psychiatric disorders. It’s also been proposed that fetal exposure to grain alcohol may increase the risk for autism. However, the link between the two has not been established as strongly the link between virus exposure and autism. Similarly, lead poisoning and vitamin D deficiencies have been proposed as possible factors influencing the development of autism after birth, but more research is needed to confirm these hypotheses.

It’s important to note that vaccines (especially the MMR vaccine) have been put forth by some as a possible cause of autism. However, research surrounding this issue has been unable to establish a link between the two and has come under scrutiny for being unduly manipulated. To date, there has been only one published study arguing that vaccination causes autism. This study was authored by Andrew Wakefield and published in The Lancet, a medical research journal. However, the journal later retracted the publication after it was discovered that Wakefield had received funds from an organization looking  for harmful evidence to use against manufacturers of vaccines.

Autism Signs and Symptoms

The symptoms of autism can range from mild to severe, depending on a person’s individual case, but most center around difficulties with social interaction and communication.

From a social standpoint, people with autism often have difficulty developing the ability to sustain healthy, normal relationships. This includes things like an inability to maintain eye contact or read facial expressions and other body language. Additionally, people with autism often have difficulty relating to the interests of their peers, and they may also have difficulty feeling empathy for people experiencing negative emotions like sadness or pain.

Communication is also an issue for people with autism. In fact, it’s estimated that as many as 40% of people with the disorder never speak at all. If a person does speak, he or she often has a preoccupation with certain words or phrases that they may repeat over and over again—a phenomenon known as echolalia. Additionally, autism makes initiating and continuing conversations very difficult, and people are often unable to recognize when others use devices like humor or irony in their communications.

Because many of the symptoms associated with autism revolve around talking and other forms of communication, it can often be difficult to recognize the signs in young children—who normally have communication difficulties. For this reason, autism is normally diagnosed after the age of 3, even though in some cases it may be present from birth. Additionally, if symptoms are mild enough, parents may not even realize that their child has autism for many years, if ever.

Autism Treatments

There is no cure for autism, but there are still treatments available that can help people manage their symptoms. Deciding on specific treatments will depend on a person’s unique case and the severity of his or her symptoms.

Behavioral training is one of the most common tools used to help people with autism develop communication and interpersonal skills. This approach can take many forms, but it generally focuses around using positive reinforcement and observation to help children thrive in social environments. For example, students with only mild forms of autism may be placed in a traditional classroom setting and encouraged to observe their peers as examples to model their own behavior on. If a child’s problems are significant enough, he or she may also work with a specialist one-on-one, sometimes for up to 40 hours a week.

Medication is not used to treat autism directly, but it may be used in order to address other problems associated with the disorder—such as depression, hyperactivity, or obsessive-compulsive disorder. However, this approach is typically viewed as less preferable than addressing a person’s issues with behavioral therapy.

It's Almost Summer Time, That Means Sunscreen!!

OK, the Australian’s beat us at another thing besides “football”, that’s soccer to us Americans. They are incredibly good at the prevention and identification of skin cancer. Did you know that one American dies from melanoma every hour? This is a  tragic rate since this cancer is curable when caught early. By now, you should know that you should use sunscreen every day both to help reduce your risk of skin cancer and to prevent pesky wrinkles, dark spots, and other signs of premature aging (This alone is reason enough to use sunscreen, I might be feeling older, but I don’t have to look it!). The good news is that there are many things you can do to protect against skin cancer. Here are some of the best ways to stay safe.

Don’t wait until you're outside to apply sunscreen
How many people have you seen get to the beach, spread out their blankets, strip down to their swimsuits, and then start slathering away?  You actually want to apply your sunscreen 30 minutes prior to exposure. That way, it has time to get absorbed and start working! Skin cancer can strike anywhere, especially since rays can still penetrate the fabric of a one-piece, particularly if it's an older suit that's wearing thin. So it's best to apply sunscreen when you're buck naked. Otherwise, if you already have a swimsuit or clothing on, you're likely to apply it sparingly so you don't get it on your clothes, which makes you likely to miss a spot or not apply liberally enough. Strip down in front of a full-length mirror,  this helps ensure you entirely cover tricky spots like the mid-back and backs of the legs. Have your partner or a friend do your back, from the tops of shoulders on down. The most commonly missed areas are toes and feet, including the bottoms of your feet; underarms; back of the neck under the hairline; ears, especially the tops and back of your ears; eyelids; and inner upper arms. Put that stuff everywhere!

Don’t forget to protect your lips
Just like the rest of your skin, lips are vulnerable to UV rays, so it's extremely important to use sunscreen on your lips. But don't use the same stuff you use on the rest of your body—it tastes weird and won't last that long on your lips anyway. So try a lip balm with SPF, which is thicker so it stays on longer. Then reapply even more frequently than you do body sunscreen, since talking, eating, and drinking removes the sunscreen on your lips faster.

Reapply, You can sweat or rinse it all off!
The small print on your sunscreen label matters, so make sure you're choosing the right sunscreen for your activity, especially if that activity involves sweat, a pool, or the ocean. Make sure you get a water-resistant formulation for swimming or activities where you'll perspire, because non-water-resistant formulas can slide right off. Plus, they tend to migrate into eyes and sting, whereas water-resistant ones won't. Manufacturers can’t make claims that sunscreens are water-proof or sweat-proof, but they can claim their product is “water-resistant” for up to 80 minutes in still (not moving) water. That’s the highest claim allowed in the United States. However,  Remember those Australian’s we talked about earlier? Their standards are for 240 minutes in whirlpool water. That’s four hours of continual coverage in 105 degree moving water. We rarely endorse a product, but we have been using Blue Lizard Australian® Sunscreen for years and it is awesome. It is hard to find in the stores but you can find it online or on our website. Yes it is more expensive, but it is definitely worth it. We have some free samples in the office if you would like to try it.

Don’t only use it when it's nice out
Danger! It may seem counter intuitive to slather on sunscreen on a gray or drizzly day, but you can get UV exposure without ever seeing the sun in the sky. Eighty percent of UV rays still come through on cloudy days, according to the American Academy of Dermatology, so don't let the weather affect your sunscreen use. Seeking solace under a beach umbrella or an awning near the pool doesn't mean you're getting adequate protection from the sun. Why? Sand and water both reflect damaging rays, and 34% of UV radiation gets through when you're under a beach umbrella, so you still have to apply sunscreen if you're sitting under cover. Even if you don't get a sunburn, you're still getting UV exposure. Also, unless you choose to spend your time in a windowless bunker, you're not protected from UV rays when you're inside. Driving can be a major source of incidental exposure. The windows and windshield block UVB rays so you don't see a sunburn, but UVA seeps right in, and that's the spectrum that causes most skin aging and skin cancer. Your best bet is to apply sunscreen every morning, then feel free to sit by a window or take a drive! At the very least, try a moisturizer with SPF so you're not adding a step to your daily routine.

Use a broad-spectrum formula with a 30 SPF
It used to be that many sunscreens only blocked UVB rays, the high-energy kind responsible for sunburns. But shielding against UVA rays is just as important because they penetrate the skin more deeply, are constant throughout the year, and cause premature aging. To be fully covered, look for sunscreens labeled "broad spectrum," which means they for both types of rays.
Yes, tanning oil with SPF 8 technically is sunscreen, but it's just not enough protection. The Skin Cancer Foundation recommends using broad-spectrum sunscreen with at least SPF 15. That’s great if you want to put it on every 20 minutes. But should you go higher? Some say the often, pricier, high-SPF sunscreens are a waste of money, since they don't provide much more protection—SPF 30 blocks 97% of rays, while SPF 50 blocks just 1% more. The super-high SPFs can provide a false sense of security, like you're protected for longer, but you need to reapply just as often as you would an SPF 30.

Don’t forget to protect your eyes
Sunglasses aren't just a fashion statement—they're critical to keeping your eyes safe from UV rays. Make sure your sunglasses offer UV protection, because some inexpensive styles don't have the protective coating. Without it, the dark lenses actually allow your pupils to dilate, allowing even more UV rays in, which can play a big role in cataract development. Finally, a health reason to buy a pair of nice shades!