Go Colts!, Family Update, Hair Loss, Eric's Tips-Exercise Guidelines for Older Adults, Valentine's Day Ideas

Go Colts!!! We are very lucky to have such a great football team and quarterback and to be going to the Superbowl again. It certainly makes these 2 winter weeks more interesting. I and my family were very blessed to be at the AFC championship game, but we will not be going to the Superbowl. We will be warm and dry at home watching the game this time.

Many people have asked how my family is doing. I want to thank God for my so many blessings, especially a wonderful loving husband and great kids who are very hard working. I am so thankful and proud of them. My husband Bruce is a stay at home Dad for now and really letting God direct him in several men’s Bible studies and taking a college class in the Old Testament. My stepson Easton is making a good living in Chicago selling his artwork and will likely go to grad school in the Fall to get his Masters of Fine Art (http://www.eastonawesome.com/). Christina is a junior at IUPUI majoring in Sports Marketing and Spanish, and is vice-president of campus events for their student organization SOAR (many of you saw her interviewed on TV this Fall in their first annual IUPUI Rigatta). Nathan really likes Purdue (his mother’s alma mater!) and is a freshman majoring in Physics and Pre-med. Brendan is a freshman at Zionsville High School, and has done a great job of being a student athlete with straight A’s (plays second string wide receiver and cornerback on the freshman football team and continues to intensively work out at least twice a week in the offseason). Annika is a third grader at Union Elementary playing travel soccer, in the school play this spring, and takes guitar lessons with her Dad Bruce. The picture above is our new addition just this weekend, Penny, for a playmate for our puppy Ally! (We purchased her from another great breeder in Warsaw, Cindy Koehring , 574-269-9454. She still has 3 sibling Cavelliers from Penny’s litter for sale – all 3 are the ruby color and beautiful with great personalities – a hallmark of Caveliers.)

Hair Loss
Hair loss is a very common concern and affects up to 50% of people in their lives. It can occur anywhere on the body, but is the most cosmetic problem on the scalp. Hair loss is divided into the major categories of focal or diffuse hair loss.

Focal Hair Loss
This type of hair loss is due to an underlying problem that may cause scarring or nonscarring patches of hair loss. Scarring alopecia (lack of hair) causes permanent hair loss from destruction of hair follicles from severe immune diseases like lupus.

Nonscarring
Alopecia Areata: This is single to multiple patches of hair loss which an occur equally in men and women at any age (the most common age is young adult) and it can be from genetic predisposition in 20 – 40 percent of cases or from an autoimmune cause(such as lupus, rheumatoid arthritis, diabetes, vitiligo, or thyroid disease). The classic finding is a smooth hairless patch surrounded by small broken hairs. Treatment is usually topical cortisone, and 30-50% of people recover within 1 year.

Tinea Capitus: Children are most likely to be affected by this fungal infection, usually presenting with a round patch of hair loss with some scaling and surrounding redness. Treatment is usually with an oral fungal medicine, though topical lamisil cream can be tried at first.

Traction Alopecia: Hair loss from pulling on hair from tight braids, curlers, bleaching/coloring, and wigs. Treatment involves eliminating the source of stress.

Trichotillomania: This is a psychiatric hair loss from repeated hair plucking.

Diffuse Hair Loss

Female Pattern Hair Loss
About 50% of women will experience this during their lifetime, and it is characterized by hair thinning over the top of the scalp but with preservation of the front hairline. Women should be evaluated for excess testosterone, anemia, or thyroid problems. Topical minoxidil 2% twice daily is the only approved treatment, but some women with a high level of testosterone can be treated with a water pill spironolactone. Treatment of any anemia and thyroid problems can improve this hair loss.

Male Pattern Hair Loss
This affects up to 50% of all white men by age 50, and a little less percentage of African American men. Hair loss starts in the temporal regions and then spreads to thinning in the vertex and frontal regions in a classic M pattern. Treatments include topical minoxidil 2% (the 5% is no better and can cause more side effects, it is applied twice daily to the scalp), oral Propecia once daily (less side effects in men younger than 40 – can cause decreased libido and impotence and erection disorders), and in some men Nizoral shampoo and Head and Shoulders shampoo 2 to 4 times per week can help. Some studes have shown increased efficacy with combined treatments.

Telogen Effluvium
This type of hair loss results when an increased number of hair cells enter the resting phase rather than the growing phase. Usually an average of 100 hairs are lost each day, but in this type of hair loss 30 to 50 percent of body hair can be rapidly lost. This can be precipitated by severe illness, injury, infection, surgery, crash diets, psychological stress, giving birth, thyroid disorders, iron deficiency, anemia, or drugs (especially can be seen with hormones, antithyroid drugs, anticoagulants, seizure medicines, blood pressure medicines - b-blockers and ACE inhibitors like lisinopril, and lithium). No cause is found in about 1/3 of cases. A hair pull test can help diagnose this (positive if greater than 10 percent of 40-60 hairs being pulled come out with steady traction). Treatment involves removing the underlying stressor and correction of any underlying medical problem.

Anagen Effluvium
This is abrupt loss of 80 – 90 percent of body hair. The main cause is chemotherapy.

Alopecia Totalis
Total hair loss on the scalp and or body presumed from autoimmune disorders or family history.

Natural Treatment:

Generally a balanced life and diet with adequate sleep, manageable stress, healthy diet, plenty of water intake (1/2-1 gallon per day), regular exercise, and general supplements (fish oil, vitamin D, multivitamin, calcium for women) will help avoid excessive hair loss. Biotin supplement has been shown to help some people with hair loss, and in some can help grow longer and thicker hair. Biotin is vitamin B7 and is water soluable, so your body will eliminate any unneeded amount. Adults require 30mg/day in their diet (found in grain, peas, nuts, vegetables), and supplements range from 1000 – 2000mg/day.

Eric’s Fitness Tips
By
Eric Walden

To start of this New Year and I want to a series for older Adults. I want to start out by going over some basic guidelines. In this mini-series I hope to help our older population to get started working out and hopefully stay healthier.

Guidelines for older Adults

American College of Sports Medicine and the American Heart Association published the following Activity Guidelines from adults over the age of 65 (adults 50-64 with chronic conditions, such as arthritis):

- Do moderately intense aerobic exercise for 30 minutes a day, 5 days a week
- Do vigorously intense exercise 20 minutes a day, 2 days a week
- Do 8-10 strength training exercises, performing 10-15 repetitions of exercises 2-3 times a week.
- If you are at risk for falls, perform balance exercises
- Have a physical activity plan

Key Points in the Guidelines for Older Adults

Although the guidelines for older adults and adults with chronic conditions are similar to those for younger adults, there are a few key differences and points to consider.
- It’s important to get started-and seek help if necessary. The general recommendation is that older adults should meet or exceed 30 minutes of moderate physical activity on most days of the week; however, it is also recognized that goals below this threshold may be necessary for older adults with physical impairments or functional limits.
- Functional health is an important benefit of physical activity for older adults. Physical activity contributes to the ease of doing everyday activities, such as gardening, walking or cleaning the house.
- Strength training is extremely important for all adults, but especially so for older adults as it prevents loss of muscle mass and bone and is beneficial for functional health
- If older adults can exceed the minimum recommendations, they should do it!
- Flexibility is also important. Each day older adults perform aerobic or strength training activities, they should take an extra 10 minutes to stretch the major muscle and tendon groups, spending 10-30 seconds on each stretch and repeating stretches 3-4 times.

Family and Faith

Valentine’s Day – is coming soon, and think about planning some special things!

Valentine’s Day is a special time for expressing love and affection to those special to us – spouses, children, family, friends. The following are some suggestions.

Scripture – Song of Solomon (has great scripture to include in a Valentine to your very special love!), Deut. 6:5, Psalm 18:1, Psalm 116:1, Psalm 145:20, Proverbs 8:17, Romans, 8:28, and my memory verse for this week in my woman’s Bible study, Matthew 22:37-37 “Jesus replied, “Love the Lord God with all your heart, with all your soul, and with all your mind.” This is the first and greatest Commandment.”

Decorate for Valentine’s Day – get out any saved decorations, red candles, a heart wreath of paper or fabric

Lend a helping hand – make red hearts with the words in the middle “I did it because I love you” and place it next to something you did to show your love for that person – a bed that has been made, dishes washed and put away, clothes washed and folded, carpet vacuumed, meal or snack made for a family member, bills paid, coffee or dinner made, etc!

How Mom and Dad met, dated, proposed, wedding photos – at a family dinner or time together discuss and bring out photos

Love Messages – write notes to each member of your family to tell them why you love/respect them and appreciate them (be specific) – tuck them in lunchboxes, briefcases, purses, backpacks, or on pillows, and write with red lipstick or soap on your spouse’s bathroom mirror – “I love you!”

Dinner by Candlelight – make a special family and then maybe different dinner for your spouse by candlelight with heart name cards or valentines, special dinnerware you may have or silverware, and maybe even send a special invitation a few days before (even on their pillows), then at dinner discuss how much you love/respect and appreciate each family member

Valentine treasure hunt – buy a package of children’s valentines and make a treasure hunt for your spouse and or your children, with a small love gift with the last valentine

Make a heart shaped cake or cookies

Chinese fortune cookies – take out the fortunes inside with tweezers and replace with your own love/respect or appreciation notes

Pink pancakes – on Valentine’s Day add red food coloring to pancake mix and surprise your family!

Heart sandwiches and chocolate kisses

Homemade Valentines – be creative and make for your spouse, children, and others – decorate with hearts, lace, ribbons, pictures – create a poem or use a Bible verse and write specific reasons as to why your love, respect, and appreciate them

Faith
My spring woman’s Bible study is “Experiencing God” by Blackaby. This week I was struck by the teaching about our love relationship with God. He continually pursues us, and EVERYTHING in our life depends upon the quality of our love relationship with God. Also, we need to not tell God what we are going to do for Him, but ask Him what he wants us to do for Him, and watch, listen, seek and join Him in what He is doing.

My church, Trader’s Point Christian Church just finished a sermon series on Matthew 23, entitled “The Pretenders”in us. Our minister Aaron’s messages delved deeply into the quality of our relationship and heart with God - are we truly following God to reflect His glory in our lives through guidance and learning from the Holy Spirit, or are we hypocrites and “woe to us” if we are more concerned with men’s applause, rules, and pretenses. What are my motivations, and am I more concerned about my image or my character and who I am becoming in my daily decisions and time?

My prayers and blessings for you and your families – and may we continue to see any pretending in ourselves, and help us to be what we already are in You – give us the courage to let You in!
Hugs, Dr. Lisa

Elimination&Gluten-free Diets, Eric's Four D's, Family Traditions&Memories

Happy New Year and new decade!!! I am so happy and blessed to be back to the work I love and writing to you after a very nice family vacation visiting my parents and Aunt Rita in Florida and Disneyworld for two days. We had very treasured family times together, and my favorite was playing the game “Apples to Apples” all together on New Year’s Eve (ages 9 to 83 all had terrific times and many laughs). We will all remember that forever. I hope you all, too, enjoyed many treasured times. It is great to awaken each day with thanks and gratefulness, and as Tony Dungy (and I!) would say, hug your spouse and your kids (and each other) every chance you get!

Elimination Diet & Gluten Free Diet

Spurred on by my thirty-something patient Keelan and listening to my patients, I decided to research elimination and gluten free diets. Keelan suffered from weight gain and mild irritable bowel starting in her twenties despite efforts at healthier eating and exercise. She did an elimination diet and found she had sensitivity to gluten (protein found in wheat, barley, and rye). After eating a gluten free diet this past year she feels so much better and has lost 30 pounds (and now at a good weight for her size/build). If she eats even a little guten (or pasta), she says she can just feel the quick weight increase.

I feel many people are similar to Keelan. Some estimates say about 95% of our population have at least some sensitivity to gluten. I recommend any of you not feeling well or at your best weight to try an elimination diet and then see what you find out to continue a better healthier diet for you. Along with a good diet, it is essential to drink plenty of water (at least ½ - 1 gallon/day – I drink at least a 13oz bottle of water at 3 meals and on my way home from work), and take a few appropriate daily supplements for your best health (for most people extra vitamin D, fish oil, multivitamin, probiotic, and calcium for women – see us for your yearly physicals to go over the best for you), along with exercise and proper rest/sleep. I have found many people are unsuspectingly vitamin deficient (like vitamin D/zinc/iodine/and more, causing fatigue, hair loss/skin problems, decreased libido, and much more), so please see us for your yearly physical to check what you need and consider some vitamin tests (several at no charge in our office and some blood).

BASIC ELIMINATION PLAN
Elimination or allergy diets are used to isolate food allergies or sensitivities. There are a number of medical symptoms that can be related to food, including recurrent yeast infections, rashes and eczema, irritable bowel syndrome, diverticulitis, asthma, migraines, lactose intolerance (deficiency in the enzyme needed to digest milk or milk products) and more.

You can eat: preferably organic meats-chicken-turkey-fish (Moody Meats or even Target are good places), vegetables & fruits (best organic or well washed, good to get at Fresh Market or http://www.farmfreshdelivery.com/), beans, and rice for at least 14-21 days, then gradually add groups as instructed below every 4-7 days and monitor how you feel/symptoms.

Water - most everyone is dehydrated and this can cause many chronic symptoms such as fatigue, headaches, problems sleeping, joint aches - you need to drink at least 1/2 your body weight in ounces/day (#150 lb person needs at least 75 ounces) - filtered or distilled water (no other fluids count and really only other healthy fluids are herbal or green teas)

Eliminate the following foods from the diet for a period of 14-21days to a month:
--Dairy products, including cheese (instead use soy milk and soy cheese; rice milk, rice-based ice cream)
--Egg and egg-containing products
--Food containing gluten, such as wheat and wheat-based products (including pasta), and barley, oat, or rye grains (alternative grains could be brown rice, buckwheat, spelt, millet, potatoes or sweet potatoes)
--Citrus fruits
--Corn and corn-containing products
--All processed foods including caffeine

Note that suddenly stopping some foods (such as caffeine) can result in withdrawal symptoms (typically headaches) – however this usually lasts only a few days.

Next, reintroduce one food group to your diet about every 5 days.

The reintroduction period allows enough time to determine any intolerances.

Celiac Disease (or also called celiac sprue) is allergic reactions to the protein gluten found in wheat, rye, and barley, and can be very mild or severe leading to malnutrition. Gluten sensitivity is often misdiagnosed because the symptoms can be related to other causes. Some of the many possible symptoms are weight gain, abdominal pain and bloating, fatigue or weakness, cold sores, lactose intolerance, headaches or migraines, gas, diarrhea or constipation, irregular stools, depression, respiratory problems, more frequent infections, swelling and rashes, hair loss, acne, infertility, miscarriage, lupus, autoimmune disease, acid reflux, vitamin D deficiency, joint pain, muscle cramping, and allergies. With gluten allergy one’s immune system attacks its own intestinal lining cells which damages them and allows toxins to enter the blood stream, malnutrition, and inflammation.

Below are recommendations from the Celiac Sprue Association. Their website has a tremendous amount of information at www.csaceliacs.org.

Gluten-free Diet: Basics

Generally allowed foods – meats, poultry, most dairy products (except if lactose intolerant which is common in people with celiac disease), fruits, vegetables, rice, and potatoes.

Alcholic Beverages – gluten-free beer, wine and brandy without preservatives and additives, potatoe vodka, rum, tequila

Breads – commercial gluten-free breads and mixes made from ingredients such as white or brown rice flours and starches such as arrowroot, potatoe, or tapioca.

Cereals – gluten-free cereal grains and sources without malt, hot cereals made from corn meal, cream of rice, hominy, and rice

Cheeses – all aged hard cheeses as cheddar, Swiss, Edam, and Parmesan, and check ingredients on cottage cheese, cream cheese, and pasteurized processed cheese (avoid cheeses with vegetable gum, food starch and preservatives not defined by a gluten-free source)

Crackers and Snack Foods – rice wafers, potatoes or cornstarch based, pure cornmeal chips and tortillas, popcorn, vegetable and gluten-free nut based chips

Desserts – gelatin desserts, certain pudding mixes and ice cream and sherbet or yogurt (without suspect additives, wheat flour, or gluten stabilizers), custard, junket, homemade or commercial desserts from gluten-free ingredients

Drinks and Juices – fresh brewed coffee, tea, chocolate made with cocoa, fruit juices, carbonated drinks and some nut and rice drinks, and a few root beers (and instant or processed drinks without malt, additives, stabilizers, or emulsifiers)

Fats and Oils – olive oils, soy, safflower, grape seed, sunflower, corn oils, canola, margarines, butter, lard, cream, cottonseed, pure mayonnaise, peanut butters, and hydrogenated soy oils (and evaluate low fat combinations)

Flours – use gluten-free flours and starches from food already common in one’s diet (many commercial blends are available)

Fruits – fresh, frozen, dried, or canned fruit (evaluate thickeners, additives, or preservatives)

Grains and Grain Substitutes – any gluten-free grains such as rice, brown rice, corn and popcorn, tapioca, sorghum, flax and wild rice, yams, potatoes, sweet potatoes, soy

Meats or Meat Substitutes and Eggs – meats, meat substitutes, fish, minimally processed poultry and eggs prepared with the allowed grains (evaluate all marinades and coatings, hot dogs and sausages)

Miscellaneous – herbs, spices, nuts, coconut, chocolate, pure cocoa

Potatoes-Pasta-Starches – potatoes and sweet potatoes, yams, hominy, rice and wild rice and gluten-free pastas (in the U.S. the word “starch” is made from cornstarch)

Soups-Soy Sauce-Teriyaki Sauces – read all the label of ingredients

Sweets – sugar, honey, maple syrup, molasses, most jellies and jams, plain hard candy, marshmallows, gumdrops, and homemade or commercial candies made with allowed ingredients

Vegetables – fresh, frozen, dried, or canned unless they contain thickening agents to evaluate (canned vegetables may contain emulsifiers, preservatives, stabilizers, and food starch not defined by source)

Vinegars – balsalmic, apple cider and wine vinegars

Eric’s Fitness Tips
By Eric Walden

I used the four D’s during my training for my first bodybuilding competition. This helped me day in and day out to remember why I was torturing my body. Use this as template for your success. Each person has to find what makes them tick and put stepping stones in place to help them succeed. Everyone is different and will take their own path to success, but these are the basics that everyone must have to succeed.

Each of these components in of themselves can not lead you to success, but when combined together they will almost guarantee success. A person must have each of these components to be successful. A person must first have the desire to accomplish a task. Then they must have the discipline to put together a plan of attack. Third, they must have the drive to keep going when the going gets tough. Last, a person has to have the dedication to complete the task.

The four D’s don’t have to be applied strictly to fitness. It can be applied to daily life. But putting together a plan and acknowledging that the road to success isn’t going to be easy.

The Four D’s to Success

Desire- to long or hope for: exhibit or feel desire for a: to express a wish for

Discipline- a: training that corrects, molds, or perfects the mental faculties or moral character; b: control gained by enforcing obedience or order c: orderly or prescribed conduct or pattern of behavior

Drive- to impart a forward motion to by physical force; a: to exert inescapable or coercive pressure on b: to compel to undergo or suffer a change (as in situation or emotional state) c: to urge relentlessly to continuous exertion d: to press or force into an activity, course, or direction e: to project, inject, or impress incisively

Dedication- a devoting or setting aside for a particular purpose

Family and Faith

Parenting Tip:
Thinking about our New Years Eve playing “Apples to Apples” reminds me of the importance of special family traditions and memories. I recently read a helpful book on this topic, “Fifteen Minute Family Traditions and Memories”, by Emilie Barnes. Emilie says that a memory-builder does not have to be limited to one season of the year or a certain holiday. It can be any event that later becomes a happy memory – a family ritual, a season, a tradition, or the creation of a memorable event out of an ordinary day. Emilie reminds us that we need to plan our lives to create treasured memories, and that “successful people do what unsuccessful people aren’t willing to do”.

Special family traditions can be making family dinners and prayers a priority with no TV (and maybe one evening a week planning a longer family dinner with special conversation and often asking “What was the best thing that happened to you today?” or have a jar of canned questions to pull out one or several to ask), a special family handshake, making favorite cookies, having pet names, at least once a day telling your children you love them and often tell them how much you enjoy being their parents, having a “You Are Special Today” plate to honor a family member or guest, make a big deal and honor a child on success, designate one night a week as a family night, and special occasion things like a birthday plate or glass, making special secret valentines for family members, coloring East eggs together, reading the Christmas story from the gospel of Luke before Christmas meal just to name a few. Work to identify your special family traditions, keep them up, and plan others that you want!

Marriage Tip (from “Fifteen Minute Family Traditions”) - Prescriptions For Romance
-compliment your mate and repeat every 4 – 6 hours
-say “I love you or respect and appreciate you” at least 3 times today and every day
-the unasked-for gift is most appreciated – the surprise gift most cherished
-run your hands and feet under warm water before coming to bed
-hug at least ten time today – watch out and it can be habit-forming!
-kidnap your mate – blindfold and drive around a little to confuse then take on a surrpise date
-hide 25 little “I love and or respect you because…” cards (on index cards, post-it notes, heart paper…) all over the house (even car, briefcase, freezer, sock drawer, books, etc) – some may stay hidden for months!
Make God and each other your priority!

Faith
In November and December at my church, Trader’s Point Christian Church, or lead minister Aaron Brocket gave a sermon series “Calling Out the Gods”. “You shall have no other Gods before me and you shall not worship idols.” Aaron talked about how we may at first think following the First Commandment is relatively easy, but actually is the one that always trips us up. There is a false God under every sin – idolatry is the tree and sin is the fruit (replacing God with a god substitute). We must daily look at who or what is sitting on the throne of our heart, or is the object of our worship, or what we sacrifice our time and money for? We must daily choose who we serve. God is not interested in being one among many, but being our one Lord.

Aaron discussed that idolatry is the number one threat to our walk with God, and our marriages and families. Our hearts and thoughts are idol factories, and we must discern our idols in the things we want or find happiness or pleasure in, the way we spend our money or our emotions. What are the idols of our hearts and thoughts - ?work, ?money, ?sexual sin, ?busyness, ?sports, ?alcohol/drugs, ?success. Idolatry is killing us and our sanctification (God’s plan for our lives to become more like Him). What we want drives what we do which reveals who we are. As Christians, we must discern our false gods, and dethrone them by daily remembering that who I am and what I do is based upon the glory of God and Him alone. We cannot remove a false god but must replace it with a new affection and pleasure in God and the Gospel. Then we must continue to choose on a daily and even each moment basis who we serve – a false little “g” god or the one true God…

I thank God first for Him and then for all of you – He so loves and knows and cares for each one of us, and the Bible is His book of love for me and you!
Happy New Year for eternity!
Hugs,
Dr. Lisa