Happy Spring & Easter! Halitosis (Bad Breath), Eric's Tips-Mindset, Communication for Couples, Proverbs for Parenting

Happy Spring and Easter to all of you very very special and loved people! We were decorating eggs today, and have enjoyed the recent beautiful weather - hope you all have too (and hope you are exercising your very special bodies really daily)!

I am writing about bad breath because Julia asked me about it last week, and I often have patients with this complaint. Please fax me at my office if you have a topic you would like me to cover in an upcoming blog article (621-1680, fax).

Halitosis = Bad Breath!

Bad breath is any offensive odor on the breath, and is present in 15-30% of people (can be as young as age 2, but usually is a problem more of adults, and increases with age). 80-90% of bad breath originates in the mouth - largely the result of bacterial breakdown releasing gasses from stagnant saliva, food debris, mouth cells coming off in normal cell turnover, blood, and postnasal drip in the oral cavity. The odor can be much worse with oral pathology such as gingivitis, periodontitis, cavities, imperfect dental restorations, and unclean dentures. 5-8% of bad breath is from the nasal passages - due to infections, thick mucous or polyps, oral or nasal cancers, and foreign bodies in children. 3% of bad breath originates from tonsils - due to recurrent infection or tonsillolliths (stones). 1-2% can arise from other sources - such as lung infections, kidney or liver failure, cancers, and biochemical disorders. Bad breath almost never arises from the esophagus, stomach, or intestines, and there is no higher incidence in people with dry mouth.

Approximately 25% of people seeking professional help for bad breath are halitophobics = exaggerated concern of bad breath when they actually have little or none.

Treatment (part from "Bad Breath" by Mel Rosenberg, PhD)

People with an identifiable cause of bad breath need to treat those conditions - such as dental problems, postnasal drip, infections. Many cases of bad breath can be alleviated by

*Proper dental care and oral hygiene (thoroughly brushing and flossing your teeth at least twice a day)

*Gentle cleansing of the posterior tongue with a tongue cleaner or toothbrush (often need to get very far back-can hold tongue out with a washcloth and make sure to be gentle)

*Rinsing and deep gargling with an effective mouthwash after brushing and flossing - this is most effective when done at bedtime, since bacterial activity leading to bad breath is greatest during the nighttime

----the most effective mouthwashes contain chlorhexidine gluconate, like Peridex, at 0.12-0.2 percent (only 0.12percent is readily available in the US)

*Eating fibrous foods

*Chewing sugar free gum briefly if the mouth is dry or after meals, especially with high protein intake

*Sufficient daily water intake - 1/2-1 gallon/day

*Decreasing alcohol and coffee intake

*Gargling with saline and or saline nasal irrigations in people with allergy or mucous problems

Information is available at http://www.smellwell.com/, or http://www.youtube.com/ "Bad breath - a human condition". Consulting a good dentist is advisable for most people with bad breath, but be very careful of some "bad breath experts/dentists" who are involved in pyramid marketing operations selling particular and overpriced products.

Factors which can exacerbate bad breath - accumulation of postnasal drip on the back of the tongue, poor oral hygiene (esp. failure to floss), improper dental care (faulty bridgework, crowns, abscesses), mouth breathing, unclean dentures and those left in mouth unnecessarily at night, alcohol consumption, being overweight, menstrual cycle, proteinaceous foods stuck between the teeth, onions and garlic.

Eric's Fitness Tips

By
Eric Walden

Hard Work or Exercise?
IDEA Fitness Journal- Jan 2010

In one of our Harvard studies, we looked at exercise and the mind. We started by asking chambermaids how much exercise they got in the course of a week. Our subjects were women who were exercising all day long at work, but because exercise is generally thought of a s something we do outside of work, they actually saw themselves as not getting any exercise. Despite their beliefs, since exercise is so good for one’s health, we expected them to be healthy. Actually, at the start of the study, they weren’t.
We divided the women into two groups and explained to one group that their work was exercise. We told them, “You’re getting more exercise than the surgeon general recommends.” They were shown how various tasks they did were equivalent to working on different machines at the gym, when we returned a month later, we asked as many questions as we could think of regarding exercise. Were they exercising outside of work now? Were they working harder? And so on. We asked if they were eating more, or differently. There were no changes, they only difference was that now they saw their work as exercise.
In that month, this group had lost weight and reduced their body mass, waist –to-hip ratios, and blood pressure levels. All of this happened because of the change in mindset.

I loved this article when I read it. It reminded me of so many people that I have talked to over the past few years. Those of you who do more of a manual labor type job can count that as exercise. The key to a weight loss is to possibly change the way you eat or maybe add in a couple of bouts of moderate cardio sessions. Or on the flip side if you want to add some strength your work is more like your cardio so going to a gym and lifting some weights may be needed to achieve your goal.

Changing your mindset is sometime what is needed to get your body going in the right direction. It can also be the hardest thing to accomplish. The mind is a powerful tool, but sometimes it is hard to tap into. Self talk is great way to help get the mind on the right path. Telling yourself what you are going achieve each day is a great way to get your mind going.

Hopefully this helps you to be able to change they way you think about exercise and help motivate you.

Family and Faith

"A fool thinks he needs no advice, but a wise man listens to others."

Proverbs 12:15

Communication (from "Simple Secrets Couples Should Know", by Bob and Emilie Barnes)

Communication is sharing information with another person so he understands what you are saying, and it involves talking, listening, and understanding. Honor your mate by selecting the best times to talk, listen, and understand, and it is best to avoid difficult topics right after coming home and at mealtimes (want pleasant, edifying, uplifting conversation).

Talking Tips

* maintain a calm relational voice

* be mindful of proper timing to bring up certain topics

Listening Tips

* Realize everyone has a basic need to be listened to and heard - TAKE THE TIME TO LISTEN

* Listen intently when your partner is talking with you - turn off the TV or stop other things and look in your partner's eyes - even better to touch or hold hands!

* Listen objectively - don't just think about your answers or politely wait or presume or judge while listening

* Reach out and care about what's being said - active participation with our heart and soul and not just ears (and not passive)

* Move past the surface message and get to the heart of what is being said

* Discipline yourself to listen - it doesn't come naturally or easily to any of us, since most are more comfortable being in control and speaking

* Receive and process and understand the message sent - even though the message may be painful, continue to listen

Understanding Tips

* Lack of understanding can occur when there is a difference between what we mean to say and what we really say, and when there is a difference between what we hear and what we think we hear

* Ask clarifying questions to keep the channels of understanding wide open and flowing - repeat to your mate what you heard and then ask, "Is that what you said?"

* Don't get caught up on minor details (like if something happened at 5 or 6 pm) - major on the majors, not the minors

Be sensitive of your mate's general needs.

Men - generally want #1 Sincerity (to know the topic is important to you) #2 Simplicity (hear the simple facts and get to the point) #3 Sensitivity (open up better at the right time and place) #4 Stability (keep their composure during conversation)

Women - generally want #1 Attention (want their mate's full attention when they speak) #2 Agreement (no arguments to break down the communication with their mates) #3 Appreciation (want their mates to value them and their role) #4 Appointments (want their mates to honor the time and place for communication)

General Tips

* Be willing to grow and change - learn from your mistakes and tomorrow is a new day!

* It's ok to disagree but NOT to disrespect or dishonor - never belittle, slander, or attack your partner even in a heated exchange

* It takes effort to communicate well - deciding to communicate better is a matter of will and work

* Don't second guess your partner - keep your mouth shut and hear out your partner

* When you have a communication breakdown, have an prior agreed upon method to ask to stop for right now and restart at a later time

--you must identify problem areas and plan a program to overcome them (at a good nonheated time), and you may need a trained counselor to help

* Remember that the closer you get to God, the closer you will get to each other (the triangle with God at the top and each partner at the bases that I discussed last blog) - perhaps you are not communicating well as a couple because you have not been communicating well yourself with God - through prayer, Bible reading, Church, Christian friend/groups/Bible studies

Secrets to Romancing Your Marriage (great tips at the end of each of the 22 chapters in this very good book)

* Never vacuum during the 4th quarter of a football game

* Laugh at his jokes

* Listen to her stories of the past

* Allow her to grieve over her losses

* Be accountable to each other

* Choose to love your spouse today

* Don't expect to understand each other completely

"Proverbs for Parenting" by Barbara Decker

This is a very good resource for Proverbs useful in parenting. The book "Shepherding A Child's Heart" suggests reading a Proverb every AM with your children, because it is the book of wisdom and teaching. Bruce and I have worked to put this in our routine most days, and we also have Annika memorize verses. When she had problems last week with obeying, I had her memorize Proverbs 4:3 "Hold onto (and obey) instruction, do not let it go, guard it well for it is your life.", and Proverbs 4:23 "Above all else, guard your heart for it is the wellspring of life."

Proverbs for Obedience - 1:5, 1:8-9, 2:1-9, 3:1-4, 3:21-24, 4:1-5, 4:10, 4:13, 4:20-22, 5:1-2, 6:20-23, 7:1-3, 8:32-36, 9:9, 10:8, 10:17, 12:1, 12:15, 13:1, 13:18, 15:5, 15:32, 19:16, 19:20, 21:11, 22:17-18, 23:19, 23:22, 28:7, 29:18, 30:17

We need to always remember, that before we can teach our children something (especially about values), we must be modeling it ourselves and living it in our lives. To teach our children obedience, we must first be obedient ourselves - with God and each other... We all are on a constant journey to grow and become better more valued, faithful, and trustworthy people!

With my hugs and prayers for God to fill you and your family to overflowing with the fruit of His Spirit - love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, and self control!

Gal 5:22

Dr. Lisa

Pesticides in Foods, Eric's Tips-Exercise Routine for Older Adults, Obeying the 1st Time, Keep Listening and Talking

Welcome springlike weather! My son Brendan is enjoying the sunshine to take a nap by our Cavelier puppies, and Annika thinks it is Summer with her shorts and popsicle (on top of the snow pile)!.. With the change in temperature, allergy symptoms will begin to cause major symptoms for many children and adults. If you or a family member or friend are having problems, you can review my May 26th article on "Allergy Treatments and Medicine" (also can access it under "Resources" tab on our main website), and see us in our office to review your individual symptoms and needs. Remember the Neil Med saline irrigation by nettipot or my favorite squeeze bottle is a great natural treatment for allergies in adults and children (my 9 year old and 21 year old often request and use it!).

To follow along with my current healthy diet theme, I decided to research pesticides in foods because the amount ingested in our and our children's lifetimes can dramatically affect our health and cancer risks. Eric's tips will return with his emphasis over his past several articles to help older adults with their exercise and fitness. I then discuss in my "Family and Faith" section suggestions and God's direction for our children to obey without challenge without excuse and without delay, and relationship tips.

Pesticides/Chemicals in Foods

We all need to focus on foods with the least burden of pesticides, additives, and hormones. Generally we can avoid pesticide exposure by 80% when we avoid the most contaminated vegetables and fruits, and even less exposure when we use a natural cleansing spray. A government study showed that if you have 5 servings (the least amount recommended/day in a healthy diet) from the most contaminated foods, you will consume 10 pesticides/day. If you consume 5 servings from the least contaminated foods, you will consume 2 pesticides/day. Below are the current worst and cleanest foods.

Current Worst Foods (should buy organic if at all possible)
peach
apple
bell peppers
celery
nectarine
strawberries
cherries
kale
lettuce (can have some of the most potent pesticides)
grapes (imported are much worse)
carrots (better if you scrub and peel)
pears
white potatoes (have pesticides and fungicides)

15 Cleanest (currently) - still best to wash well and with veggie spray
onion
avacado
sweet corn
pineapple
mango
asparagus
sweet peas
kiwi
cabbage
eggplant
papaya
watermelon
broccoli
tomatoes (used to be on the worst list)
sweet potatoes

Milk-contains pesticides and hormones, best to buy organic or almond, soy, or rice milk

Meat- buy organic to avoid hormones (not much pesticides)

Coffee (often grown in countries without pesticide regulation) - look for USDA Organic label and a step further with Fair Trade Certified label (supports farmers being paid and treated fairly)

http://www.farmfreshdelivery.com/ is a great source of excellent well priced organic local vegetables and fruits which are delivered to you door

"Shopper's Guide to Pesticides" is an iphone application

Tips to Prevent Bacterial Illness from Food
We and our children can get serious and life-threatening bacterial infections from infected or improperly handled food. The Indianapolis Star in their Healthy Living section last Thursday had a very informative article about this, "Focusing on Food Safety" by Shari Rudavsky. Below are their tips to prevent illness.
1. Make sure cold food stays cold and hot food stays hot - refrigerators should be 40 degrees or below (if not it will be a breeding ground for bacteria and illness), and when your refrigerator is full the temperature goes up!
2. Use different cutting boards and different knives to cut raw meat and produce.
3. Wipe down counter tops thoroughly.
4. In the grocery buy a whole head of lettuce or spinach and remove the outer leaves and wash well - a ready to eat product does carry a slightly higher risk.
5. Wash your hands with soapy water before and after handling food.
6. Avoid unpasteurized milk and food made from it, raw eggs, an draw meat.
7. You can sign up for alerts about food safety recalls at the website of Safe Tables Our Priority - http://www.safetables.org/.

Eric's Tips
By
Eric Walden

Physical Activity Guidelines for Older Adults:

Today I want to go over some actual exercises and put together a routine. I want to focus on some problems that may occur for an older population. Some key problem areas for some older adults are their feet and knees. Hopefully if you do have some problems with either of theses area’s you have had them looked at by your doctor. I am a strong proponent of body symmetry. I see so many people that have imbalances that cause so many problems. I feel that a lot of people can reduce some of the knee problems or even feet problems through exercise.
First I want to deal with the feet. Many problems can be caused by the wrong type of shoes. It even can be caused by a lack of flexibility. Flexibility is so important in any walk of life. Make sure to stretch the calf muscles out before you go for a run or walk. The easiest way to do this is by using a step and standing with the balls of your feet on the on the step and let your heels drop down. This will stretch the calf muscle. It will also stretch the Achilles tendon. Having a very tight Achilles can cause pain the heel of your foot and even in the arch of your foot. Sometimes these symptoms may feel like a bruise. Also chances are if your Achilles and calf muscle are tight then so are your hamstrings. This is a first indication that you need to be stretching more than what you are now. Even using no shoes or a flat sole shoe may help stretch out the arch of your foot as well and relieve some pain.

Using different types of machines will help get around some initial pain. Get off your feet by using a recumbent bike or even a rower. Most lifting can be done sitting, so long periods of standing can be avoided. Most people that I have talked to complain of foot pain during long periods of cardio sessions and not weight lifting. It is okay to take a break during cardio sessions. Evening just walking to the water fountain will help relieve some pain.

Knee pain is a totally different problem. Pain in the knee can be caused by a variety of different ailments and imbalances. Most in the older population complain of knee pain from arthritis or lack of cushioning in the knee joint. Again like foot pain getting off your knees can help. Most exercises can be done without standing. There are a few key exercises that can be done to help strengthen the muscles surrounding the knee. Two key ones that come to mind are leg extension and leg press. The bad thing about these two exercises they also may cause some of the most pain as well. But there are ways around the pain. I have any of my clients that are experiences pain to work above or below the pain. Meaning if they are experiencing pain during a leg press movement, I ask them to tell me where the pain begins. Once we are able to figure that out I instruct them to not go down as far. The same goes with the leg extension machine. Working above or below the pain will still help strengthen the muscles surrounding the knee and can help reduce pain to that joint. Another way to strengthen the quadriceps muscles is by static strengthening. An example of this is lying on your back and flexing your leg muscles. Hold this flexion for 10 seconds then relax. Do this 10 times. This will help strengthen those muscles just above the knee. For some more serious cases this may be the best place to start. Do these exercises 2-3 times a day.

Exercise Routine:
Get a good warm up in. This is key for warming up the knees. Here are a few different exercises to strengthen the upper legs.

Leg Press- if any knee pain- work above or below it.
Leg Extension
Leg Curl
Body weight squat
Chair Stand- sit down and stand up out of a chair without using your hands
Step up- stepping up on to a step or small stool.
Adductor- inner thighs
Abductor- outer thighs
Calf raises

Family and Faith

Parenting Tip
I have been having more trouble lately with my nine year old listening well and obeying - are any of you having this same trouble?.. I remembered the book I read last summer "Shepherding a Child's Heart" by Tripp saying you need to parent your child to obey "without challenge, without excuse, and without delay", and NOT after something like counting to three! Does this sound like a dream? Mr. Tripp encourages that it is not a dream and is something we need to teach and often reteach our children. He gives very good God centered instruction for us to achieve this in our children.

After Thursday night when Annika again did not listen and obey (she ignored her dad Bruce's instruction to go to bed after we got home from our small group, while I was on an important patient call), Bruce and I decided we needed to review Mr. Tripp's teaching from his book. Last summer after reading the book, Bruce and I taken the time to discuss some of the teaching from the book with Annika and even her older teenage siblings, especially the main Biblical concept that she and we need to obey God to be in His circle of blessing and protection, and we need to constantly work on and "Above all else, guard your heart, for it is the wellspring of life", Proverbs 4:23. I also several times had to give her a spanking in the Biblical instructional manner Mr. Tripp outlines. This teaching and instruction grew much fruit in her heart and helped her in obeying God and us. But of course she (and we!) often slip back into our own selfish old patterns, and need refresher instructions.

Since it was late last Thursday night, I told her to get back into God's circle of protection and blessing and work on her heart she would either have a spanking in the AM or memorize 2 Bible passages from Proverbs based on instruction. Memorizing verses really helps our children and us hold God's love and teaching in our hearts and minds (I often memorize verses during my almost daily exercise). Annika chose to learn the Bible verses and even enlisted the aid of her best friend Kristen to help her on the bus ride to and from school (you can see the Holy Spirit working all the time for God's kingdom- helping Kristen too!). When she walked in our front door she perfectly knew both verses - the above Proverbs 4:23, and Proverbs 4:3 "Hold on to (and obey) instruction, do not let it go, guard it well for it is your life"... Thank you God and Holy Spirit!

You can read my chapter by chapter review of Mr. Tripp's book in my July 19th blog or under the "Resources" tab on our main website. I will retype here the review of the chapter "Infancy to Childhood: Training Objectives".

A child must learn that he is an individual under authority. He has been made by and for God and has responsibility to honor and obey God in all things. Ephesians 6:1 "Honor your father and mother that it may go well with you and that you may enjoy long life on earth." Children must be taught that they can stay within God's circle of blessing and safety by honoring and obeying and submitting to their parents, and the function of communication and the rod is to rescue them from their disobedience back into God's blessing. Obedience is willing submission of one person to the authority of another (and often means doing something that we do not want to do). A child must be taught to do what he is told--without challenge, without excuse, and without delay. You can teach them to make an appeal, but only when they--begin to obey immediately (not after an appeal), be prepared to obey either way, appeal in a respectful manner, and accept the result of the appeal with a gracious spirit. Knowing our native resistance to authority (selfishness) and inablility to always do what God has commanded, we are confronted with our need for the grace and power of Jesus Christ. Training our children to do what they ought, regardless of how they fee, prepares them to be a person who lives by principle rather than mood or impulse. Genuine submission to Godly authority bears good fruit.

Marriage Tip

Keep Listening and Talking - taken from the book "Simple Secrets Couples Should Know" by Bob and Emilie Barnes
"Dear brothers, don't ever forget that it is best to listen much, speak little, and not become angry." James 1:19

There are 3 partners in a Christian marriage - husband, wife, and Jesus Christ. For healthy communication to exist, there must be communication between all 3 partners. If there is a breakdown in dialog between any 2 members, the breakdown will automatically affect the third member of the partnership. Dwight Small says, "Lines open to God invariable open to one another, for a person cannot be genuinely open to God and closed to his mate... God fulfills His design for Christian marriage when lines of communication are first open to Him." If you and your mate are having difficulty communicating, the first are to check is your individual devotional life with God.

The Barnes' state that whenever they suffer a breakdown in relating with each other, it is because one of them has failed to talk with God on a regular basis. When both are communicating with God regularly, they generally enjoy excellent communication with each other. They show the diagram of a triangle with God at the top and each mate at the other corners. As the diagram suggests, the closer they both are to God, the closer they are together. The inverse is also true - the farther we move away from God by not communicating with Him, the farther apart we will be from our mates.

My next blog I will outline suggestions on how to communicate better.

Suggestions for Romance
*Take complete charge of the children for an AM or PM and tell your mate to do what they would like.
*Learn to delegate at work more, so you can come home at a good hour to be with your mate and family.
*Both husband and wife try being totally positive, accepting, supportive, and nonjudgmental for one entire week. no complaining, nagging, or preaching.
*Take a risk--be romantic.
*Rent a convertible on a sunny day and cruise around just the two of you.
*Serve your spouse breakfast on Saturday morning.
*While on the road, send your spouse a postcard every day you're away.
*Write your spouse a love letter and mail it to your home.
*Record your favorite love songs from the time you were dating and play them in the car as you travel.

My Bible study class this week - still doing "Experiencing God" by Blackaby
My memory verse for the week (and I usually learn during my exercise time), Hebrews 11:6, "Without faith it is impossible to please God, because anyone who comes to him must believe that He exists and that He rewards those who earnestly seek him.", and next week is Luke 14:33, "Any of you who does not give up everything cannot be my disciple."
Mr. Blackaby writes that adjusting your life to God is the second critical turning point in your knowing and doing the will of God. The first turning point was the crises of belief: you must believe that God is who He says He is and that He will do what He says He will do. Without faith in God, you will make the wrong decision at this first turning point. Adjusting your life to what God wants to do through you is another turning point. If you choose to make the adjustment, you can move on to obedience. If you refuse to make the adjustment, you will miss what God has in store for you. The Spirit's job is to guide you according to the Father's will. Then He enables you to do God's will. Mr. Blackaby notes three statements about adjustments and obedience:
1. I cannot stay where I am and go with God at the same time.
2. Obedience is costly to me and those around me (and I can trust God to care for me and my family).
3. Obedience requires total dependence on God to work through me.
A method is never the key to accomplishing God's work. The key is our relationship with a Person - God wants you to know Him, not a method or formula. If we follow someone else's plan, use a method, or emphasize a program, we tend to forget about our dependence on God. We leave the relationship with God and go after a method or program, which Mr. Blackaby calls spiritual adultery. He notes that only God has the right to tell you what to do. Wait before God until He tells you what His will and plans are for you, and then trust Him to enable you. We need to die harder to self and not try harder, and lean into the Holy Spirit's guidance and power.

With hugs and all my praise to our Lord for his word, sacrifice, and guidance and inspiration!
Dr. Lisa