Rami Hashish , DPT has written a great article featured on the Huffington Post about the benefits and drawbacks of both running outside and on the treadmill. Most focusing on a handful of studies, Rami discusses how treadmills reduce the impact on joints while outdoor running can be good for those with Achilles strains. According to the studies he cites, treadmills can lead to reduced running speeds without the user realizing it. He also writes about how to simulate the additional energy required for running outdoors when on a treadmill. Here is an excerpt from his article:

It’s a beautiful day. The sun is shining and glistening off the ocean’s waves, causing a beautiful reflection of colors in the cloudless yet slightly misty morning sky. In other words, it’s a perfect day for an outdoor run. But it’s hot, too. And you have pale skin and burn easily. It’s also early in the morning, meaning that there aren’t too many sunbathers to gawk at, or at least check out discretely under your Ray-Bans. OK, so indoor treadmill running it is!

My good friend Forrest Gump would never contemplate the nuances of such a choice. Rather, he would just run. But we’re not Forrest Gump. So here’s the dilemma: Should you run on a treadmill or overground? To answer this, let’s disregard the rhyme and reason behind the choice and focus solely on the science.

Read Rami's article To Run Outside or on a Treadmill? A Dilemma Foreign to Forrest Gump on Huffingtonpost.com.

Getting a good night’s sleep can be tough at any stage in your life. In fact, it has been estimated that 90 million Americans suffer from a sleep disorder at one time or another. Those of us who are free of medical disorders are still susceptible to poor sleep habits. And not getting enough sleep can do more than leave us irritable, it can take it’s toll on us in other ways; poor concentration, emotional dysfunction and diminished physical performance.

If you’re having difficulty capturing a full night of rest, try these simple tips to cultivate better sleep habits so you can be more productive, happier and healthier.

1. Sleep in a dark room.

Melatonin is a natural hormone your body releases to help regulate your 24-hour cycle of wakefulness and sleep. Unlike other familiar hormones like seratonin, which can be produced at any time, melatonin is only produced at night, and the darkness of your room will affect its production. Make sure you’re getting the right amount of melatonin by completely shading any windows, and removing any light-emitting electronic devices like your TV or laptop.

2. Don’t eat a large meal before bed

Although eating a large meal will often leave you feeling lethargic, that doesn’t mean it’s going to lead to proper sleep. After consuming a large meal your digestion kicks into high gear, which can prevent you from reaching the deep stages of sleep needed for a restful night.

3. Skip the alcohol

While drinking a glass of wine may help you fall asleep, a few hours after imbibing your body will be stimulated as the alcohol leaves your bloodstream. If you are going to have a drink at night, finish it at least a few hours before hitting the sheets.

4. Avoid stimulants

Antidepressants, Ritalin, Straterra, and even caffeine are all stimulants that can shorten the REM stage of sleep, which is the deepest sleep level. If you want to sleep through the night, these should be the first thing you cut from your nightly or even afternoon routine.

5. Turn off the television and other electronic devices at least an hour before bedtime.

Falling asleep with the TV on is bad for two reasons; first, the stimulation from it will make it harder to fall asleep, and stay asleep. Second, the light produced from the TV may effect melatonin production. Do yourself a favor and turn off your TV, iPad, and other electronic devices at least one hour before bedtime to ease your brain into a state of restfulness.

6. Incorporate exercise into your daily routine.

Resistance training, cardiovascular exercise, and mind-body workouts like yoga can improve not just your overall health and fitness, but if you’re working out hard enough, will also have you falling asleep soundly shortly after your head hits the pillow. Just be careful not to exercise late in the evening, otherwise it may be harder to fall asleep.

7. Use your vacation time

Fatigue builds over time, so make sure you’re taking at least a couple vacations each year. Happy workers are more productive than stressed and fatigued workers, so don’t be shy about using your allotted paid time off in full, especially if it doesn’t roll over to the next year.

8. Take naps

Napping can actually help you sleep better at night. Just make sure to keep it short; a five to fifteen minute nap should be good enough to boost your energy without making it harder to get a full night’s sleep. Avoid napping too late in the day, otherwise you may not be tired enough to get to sleep on time when you need to.

This article was originally written for and posted on Inspiyr.

In another installation of DaddyMDGuides, where doctors share parenting advice, I talk about how to handle a child’s head injury.

How do you prevent concussion in children, and what are the signs of a concussion?

When we think of sports injuries, we think of sprains, strains, pulls, and breaks — the usual orthopedic suspects. It’s easy to forget that sports can cause brain trauma, too, in the form of concussions. Concussions are the mildest form of brain trauma, and they are so frequently caused by contact sports that they account for about 5 percent of all sports injuries. Thankfully, the symptoms of concussions, which are mostly minor neurological impairments, usually subside within weeks, days, or even hours. That said, children and adolescents are at particularly high risk for concussions. Because their brains are still developing, children might have a greater harmful impact from concussions. Thus, concussions may make their maturing brains more vulnerable to re-injury and other trauma.

If a child is hit on the head by a projectile, a ball, or another player, parents should be on the lookout for changes in behavior, fatigue, and thinking in their child. Most parents know to watch for concussions when their child has taken an impact to the head, or gets “knocked out.” I frequently remind parents that a child does not need to be knocked out or lose consciousness to have had a concussion, and for that matter, children frequently bump their heads without getting concussions. Usually the most indisputable symptoms of concussions are the neurological ones — they cause children’s brains to work differently. Children might think more slowly, have a poor attention span, and have difficulty completing complex (but reasonable) tasks.

But the neurological signs are often more subtle than physical ones, so it’s important to know the other symptoms of a concussion, too. Signs and symptoms of a concussion can include dizziness, headache, vomiting, confusion, acting dazed, forgetting what happened before or after the injury, and of course, being “knocked out.” After head trauma, parents should be especially vigilant about a headache that gets worse, lasts for a long time, or is exceptionally severe. They should also observe for confusion, extreme sleepiness, or trouble waking up. If the child vomits three or more times, has trouble walking or talking, or has a seizure, get medical attention immediately.

Although serious injuries from concussions are rare, it is important to prevent re-injury in children who have had concussions. I like to recommend parents consider using helmets in all contact sports.

Luckily, children have their own kind of resilience — it takes a stronger force, usually two to three times the impact that an adult might endure, to produce clinical symptoms. This does not mean that children should take greater risks and play even rougher, though, even if they are wearing a helmet. As a parent myself, I know that it is best to keep an eye on children for about two weeks after their symptoms subside before having them to return to play after a concussion. Because children literally have their whole lives ahead of them, it is best to err on the side of caution.

To view the original web page, visit DaddyMDGuides.com in the Answers category.

Every day at work you execute thousands of precise, frenetic keystrokes while hunched painfully over a monitor. You text and type and staple and file throughout the day, performing a daily marathon with your forearms and fingers.

And like a marathoner, your tireless performance comes at the cost of physical pain. If left unchecked, your low-impact daily tasks may put you at risk for a repetitive stress injury.

Repetitive stress injuries, or RSIs, are caused by repeated everyday actions. The two most common RSIs are tendinitis, the inflammation of a tendon; and bursitis, the inflammation of a bursa sac. Some well-known examples include carpal tunnel syndrome and tennis elbow.

Though repetitive stress injuries often start as an inconvenient ache, the symptoms can become far more severe if they are ignored. People sometimes assume that their risk of RSI depends on the amount of time spent on a certain action. The time spent is actually less important than the number of repetitions.

For example, if you spent two hours typing only 100 words, your risk is far lower than a friend who typed an epic 2,000 words in only 20 minutes. Furthermore, if your friend repeated her typing binge several times daily over weeks and months, she might start to accumulate orthopedic damage if she didn’t rest prudently.

This repetition of a task over time is what leads to RSI symptoms. The most severe RSIs require physical therapy and medication—even surgery. But the majority of RSIs are easily reversible. Paying attention to posture and switching to more ergonomic products can help to prevent or alleviate painful symptoms.

Computer use is a leading cause of office-related RSIs. To fight this epidemic, many ergonomic products are now available to help improve your posture and take stress off vulnerable joints. One of the most common and effective office aids is the ergonomic keyboard. Its split curved keypad surface elevates typing hands to a less damaging posture. Critics have questioned the effectiveness of ergonomic keyboards since their inception, but it’s hard to argue with results; a 2010 study showed that typists with RSI-related disorders were able to reduce the severity of their symptoms by using ergonomic keyboards.

But what about the computer user on the go? In this modern era, mobility is everything, and laptops are more common than ever. But a laptop is a terrible surface for a portable computer. The hip-height keyboard and screen put strain on your wrists and your neck, and your lap is less steady than a table, which also makes for high-stress typing.

To reduce RSI risk, try elevating the computer to eye level and connecting an external keyboard to your laptop. This will allow you to use the computer as comfortably and ergonomically as you might use a desktop.

If you are at risk for RSIs, it may be best to avoid buying an ultra-compact netbook. Netbooks have keyboards that are smaller than regular laptops, and this can increase the likelihood of typing with incorrect posture.

Phone texting and browsing have become key parts of professional communication, and they have simultaneously become a frequent source of RSIs. Smartphones tend to be heavier than regular cell phones. Android phones and iPhones increase RSI risk for the very reasons they make such enticing gadgets—the touch-screen and added functionality make them more useful, and thus they tend to keep your fingers active when you might otherwise be still.

A recent study suggests that to reduce the likelihood of RSI, you should use both thumbs when texting and take breaks between writing messages. If you find your hands truly in need of rest, try an old-fashioned remedy: use your phone to talk instead of type.

Your home life has just as many possible sources of RSIs. Cooking, gardening, needlecraft, and leisure sports all have their own risks. Game controllers are notorious culprits.

To prevent home and leisure injuries, simply remember that even light exercise puts stress on joints. During leisure time, take it easy. Stretch before playing and take breaks before a slight stiffness becomes a full-blown injury.

This article was featured at SFGate.

Wyatt Myers from DaddyMDGuides, a website that provides advice and experiences from doctors that are also raising kids, asked me recently how to have a dialogue about drugs:

How do you talk with your child about drugs?

I often get asked how to keep children away from drugs. I explain to parents that they must model this behavior by making lifestyle choices that help them minimize the amount of prescription drugs that they have to take. When parents must be on these medications, it’s vital that they explain to their children how the meds work and why they are taken. The medications should also be stored safely. As a health care provider, I have to be extra careful about what medications I take, and thus I don’t take any controlled substances. When my son is ill, I make sure to tell him why he can’t take extra medicine, even though, "it tastes good, Daddy!”

Just yesterday, I explained to a patient who is dependent on Valium why I am going to detox her from this medication, as her son recently relapsed on prescription medications and stole some of hers. Sometimes words are not enough. I also have to help modify behavior, which can be difficult for patients to hear.

Visit DaddyMDGuides.com for more guides and recommended products.

Gaining good posture is one of the most underrated ways to instantly change your appearance.

Standing straight and square makes you look fitter and taller, and it improves your alertness and vitality to boot. But the effects aren’t just skin deep: over time, maintaining good posture will help keep your back strong, reducing back pain and injury. By staying active and being mindful of your form, you can convince your body that it is years younger and your appearance will follow suit.

Here are five tips that will straighten you out:

Stand Up

How’s your posture right now? Are you slouching because you feel tired at the moment? You can perk up by standing up.

Your blood vessels constrict during periods of inactivity, making you look and feel tired. An active, dynamic standing posture will reinvigorate you within minutes. Try lengthening your back while you stand, as if it were being lifted by a balloon tied to the back of your neck.

If you want to maximize the age-defying effects of your new stance, those Louboutins have got to go–heels throw off your center of gravity, cause bunions, and lead to back problems down the road.

Try Out

If standing for a few minutes puts a spring back in your step, imagine how good an hour of activity might make you feel. Trying a new physical activity, especially one that requires attention to posture, will do wonders for your bearing and give you a renewed, youthful vigor as well.

Some sure bets for posture improvement are figure skating, ballroom dancing, rowing, tai chi, martial arts and, of course, yoga. With time and practice, that good posture you learned for the tango will bloom into a body awareness that will keep you looking sharp outside the studio.

Tone Up

Planks, sit-ups and your gym’s weight circuit can do more than just give you a killer six-pack–strengthening your core muscles will help you stay straight all day.

Think of it as posture cross-training. Even fitness novices can get great results from wall push-ups, pelvic tilts, hamstring stretching, and bridging. If your back is too sore to sustain a set of crunches, let a physical therapist be your personal trainer. As part of your treatment, your physical therapist can recommend a regimen of gentle but effective exercises that can be done at home, taking years off of your spine and giving you a bold new bearing.

Roll Out

Professional massages can peel off years of pent-up muscle soreness, and foam rollers are like masseuses in a convenient cylindrical form. Daily foam roller use takes stress off of overused muscles, strengthens complementary muscles and helps dissipate knots and tenderness.

You can promote healthy back elongation by lying on your back with the roller cushioning your spine and your arms to your sides. Flatten your spine against the roller as you exhale. You can also reduce upper spine hunching by lying with the roller across the farthest protruding part of your upper back (between your neck and the bottom of your shoulder blades) so that tension on the neck is relieved.

Sit Up

Given all of the sitting, slouching, and slumping that is endemic to most office jobs, work is a great place to undo all of your posture karma.

Don’t let technology take its toll on you. Be aware of your seated posture. Your spine should be in contact with the backrest from your tailbone right up to your upper back. Make sure the center of your computer monitor is six inches below your gaze. If you frequently read from papers, tablets or smartphones, bring the media up to you rather than craning to it. Not only will this save your back, it’ll make you look about ten pounds lighter!

Correcting your posture is faster, cheaper, and healthier than any beauty treatment and it revitalizes you from the inside out. Best of all, it becomes easier and more natural with practice. Make good posture part of your daily health practice, and you can look years younger for years to come.

This article was originally featured in SFGate.

Doctor visits typically increase as the year comes to an end. How many times have you been to the doctor’s office, been poked and prodded, leaving with a prescription, only to recall all of the  things you didn’t ask? Or maybe there was something the doctor said you didn’t quite understand? Since many people are going to the doctor’s office to improve their overall health, the next time you go, make the most of the visit with a few strategic tips.

1. Take an active role in your medical care and treatment.

• Listen intentionally to what the doctor says during all doctor visits, and be proactive with taking notes.
• Do some research on your own and consider that you may just need to talk to more than one healthcare professional.
• COMMUNICATE! Share important information with your doctor — such as other medications and supplements you take, whether you have claustrophobia, and how you handle your symptoms.
• Learn your treatment options and work with your healthcare professional to customize your treatment plan.

2. Take proper care of your body and mind.

• Incorporate stress reduction techniques such as medication, exercise, and stretching into your day.
• Eat well! Proper nutrition goes a long way toward helping heal the body.
• Get counseling or join a support group.

3. Effectively utilize healthcare resources.

• Make a plan and stick to it, such as walking more or eating less carbohydrates.
• Know what triggers your pain/condition and AVOID those triggers.
• Develop effective responses to deal with flare-ups.
• BE PREPARED with extra medications, equipment for long trips, or other necessary preparations.

4. Know your health plan coverage.

• Does your plan put a cap on the services that your doctor is requesting?
• Does your insurance company cover alternative treatments such as acupuncture or chiropractic care?
• Can you receive reimbursements for treatments that may be considered complementary such as nutrition, biofeedback, yoga, or medical equipment? Check to see if your flexible savings account will cover any of these.

5. Ask, ask, ask, and ask again.

• Don’t be afraid to ask questions or about what a medical term means. You did not go to medical school.
• Ask the doctor to clarify or elaborate on any medical jargon used.
• Ask about medication samples. Your doctor may have drug samples that could work for you.
• Ask if any of the special services you need, such as physical therapy or assistance taking care of basic needs, can be done in your home especially if you have limited mobility.

Do winter blues have you down? Here are some simple, inexpensive ideas to rejuvenate your body and improve your mood throughout the winter season.

1. Treat yourself to some spa time.

Even if going to a spa is out of the budget, get yourself a handheld massager to use in the comfort of your own living room. And when it’s cold out, the next best thing to a massage is a hot bubble bath with some soothing music. You get the added benefit of increased blood flow to muscles, helping you relax. Music itself can be a relaxing way of helping you take your mind off your worries as it is the universal language of emotions. From timeless classics to contemporary jazz, indie, and fusion, the secret is to turn the volume down so low that it is almost imperceptible. This little trick allows you to focus on listening and helps silence racing thoughts.

2. Unwind with a relaxing walk.

Chronic stress can produce too much cortisol, a hormone that can ramp up appetite and lead to overeating. A simple exercise like walking just 30 minutes a day helps facilitate weight management and stress reduction all in one.

3. Treat yourself to a little R&R.

Nap time. Sleep loss causes slowed metabolism and increased appetite, putting us at risk for overeating, unhealthy food choices, and inactivity. Most of us don’t make enough time for rest. Curling up with a good book and some hot cider or tea before lying down can help us fall asleep faster during stressful times.

4. Keep finances in check.

Cutting your expenses is a good idea any time of the year. Studies show that financial stress is one of the main reasons adults worry. This concern can be transmitted to your kids. While most kids don’t bear the financial responsibility of their parents, they can often sense something is wrong. Save money by drinking water instead of coffee and sugary beverages. Don’t plan to make any large purchases on credit until you are out of debt. Lastly, pay yourself first, even if it’s only a dollar a week.

5. Go Zen.

Take up mood-boosting yoga, tai chi or meditation! These mind-body strategies incorporate improving posture, relaxing, and stretching to improve balance and coordination while simultaneously decreasing stress. Take time to breathe deeply and say a prayer, or just sit down in a quiet place and simply meditate with relative peace and quiet.

6. Release inner tension.

Never underestimate the power of a good, healthy sex life and reconnecting with your significant other. Enough said.

7. Take time to laugh.

Comedy is good for the soul, and there are clear health benefits of laughter. Whether you rent movies, download comedy sketches, or even go to improv or karaoke, a good laugh goes a long way. Consider taking your kids or young family members skating, skiing, or snow boarding, where everyone is engaged in lighthearted physical activity. Laughter lowers stress hormones and improves blood flow, which increases your energy levels. The more energy you have, the less likely it is you’ll be overwhelmed by depression that sometimes comes with the winter season.

This article was featured on SutterHealth's "MyLifeStages".

Overwhelming and stressful feelings can sometimes burden us during the busy holidays.  With to-do lists a mile long and the clock quickly winding down to the big day, and when the big guy busts through our chimneys, we often forget to take a few moments for ourselves to unwind. Seasonal depression effects many of us. Here are some simple, inexpensive ideas that can help to rejuvenate your body and your mood over the holidays.

1. Treat your self to a massage

Even if going to a spa is out of the budget, there are chair and hand held massagers available at stores like Walmart and Target that can be used in the comfort of your own living room. If it’s just too cold to go outside, the next best thing to a massage is a hot bubble bath with some soothing music in the background as helps increase the blood flow to muscles and allows you to relax. Music itself can be a relaxing way to help you take your mind off your worries as it is the universal language of life. From holiday classics to jazz, from indie to fusion, the secret is to turn the volume down so low that it is almost imperceptible. This little trick allows you to focus on listening and helps silence racing thoughts.

2. Unwind with a relaxing walk

Chronic stress can produce too much cortisol, a hormone that can ramp up appetite and lead to overeating. A simple exercise like walking just 30 minutes a day is a great way to minimize weight gain and reduce stress simultaneously.

3. Treat yourself to a little R&R

It’s nap time. Too little sleep causes slowed metabolism and increased appetite—risking overeating, unhealthy food choices, and inactivity. Most of us don’t get enough rest and curling up with a good book, having some hot cider or tea before lying down can help us fall asleep faster when one is just too stressed to relax.

4. Keep finances in check

Cutting your expenses is a good idea for any holiday season. Studies show that financial stress is one of the main reasons adults worry. This concern can be transmitted to your kids. While most kids don’t bear the financial responsibility of their parents, they can often sense something is wrong. Make holiday cards and gifts at home this year instead of buying expensive tinsel and trappings. Friends and family will find these cards and gifts more valuable than anything produced in a factory and shipped in from another country.

5. Go Zen

Take up restorative yoga, tai chi, or meditation! These mind-body strategies incorporate improving posture, relaxing and stretching to improve balance and coordination, while simultaneously decreasing stress. Take time to breathe deeply and say a prayer, or just sit down in a quiet place and simply meditate with relative peace and quiet.

6. Release Inner Tension

Never underestimate the power of a good love life and reconnecting with your spouse. Enough said.

7. Take time to laugh

Comedy is good for the soul. Whether it’s rented movies, downloaded comedy sketches or even going to improv or karaoke, a good laugh goes a long way. Consider taking your kids or young family members skating, skiing, or snow boarding and keeping everyone engaged in lighthearted physical activity. Laughter lowers stress hormones and improves blood flow, which increases your energy levels. The more energy you have, the less likely you’ll be overwhelmed by depression that sometimes comes with the holidays.

This article was featured on AlwaysNewYou.com

NaturalChoice.net asked me some questions on cancer and how modern and alternative treatments effect it. We discussed general health and how to improve well-being in order to reduce your odds of getting cancer.

California’s Dr. Moshe Lewis specializes in the treatment of pain and is an expert in complementary treatments. We asked Dr. Lewis if he thought cancer patients should ever forgo modern treatments like chemotherapy, surgery, or radiation in favor of alternative treatments.

“No, I believe patients should combine the best of traditional methods with alternative treatments to compliment the best of both and achieve the best care outcome for the patient. It is important to appreciate that testimonials are just that, another person’s experience. There are times, given that a patient is de-conditioned from the stress of chemo and radiation, when it is time to pursue less toxic approaches. Before the development of modern, evidence-based treatments, 90 percent of cancer patients died within five years. With modern mainstream treatments, only 34 percent of cancer patients die within five years.”

Asked if there are complementary treatments he would suggest to cancer patients in general, he replied, “I always recommend that patients check with their regular medical doctor and keep them informed of alternative treatments, vitamins and supplements they may be taking. Many supplements help to alleviate symptoms of cancer and side effects from mainstream treatments, such as anti-oxidants and natural anti-inflammatory agents. Diet-wise I like a vegan approach.


A healthy dose of humor is always an excellent medication. Scientific proof of the health benefit of humor can be found as early as 1989 when the Journal of the American Medical Association published a study that showed that laughter therapy has an immediate symptom-relieving effect.

“Another thing to consider would be hypnotherapy, a mind over body strategy. Like meditation yoga and Tai Chi, the power of relaxation, deep breathing and channeling energy can’t be overemphasized.



 Others to consider include Applied Kinesiology, an energetic testing technique that allows your body to pick the best treatment from a group, as well as Vitamin C. Linus Pauling, the Nobel Prize-winning scientist, investigated the possibility of using vitamin C for cancer.”

Dr. Lewis also believes that healthy living is the best way to avoid cancer. That means no smoking, avoidance of exposure to second-hand smoke, no alcohol, and decreasing or eliminating red meat, smoked and barbecue products, and increasing fruits and vegetables. “For women, this means regular mammograms. For everyone over 50 this means swallowing your pride and going in for that colonoscopy for early detection of colon cancer. All young men and women should learn the testicle and breast self-exam. For everyone this means a regular physical. Early detection of cancer is critical, as we like to isolate the cancerous cells before they become malignant and infiltrate or spread to other parts of the body.

“The second component to combating cancer, or any disease for that matter, is to keep your body in the best possible condition. The healthier you are going into this, the better chance your body has at fighting off the rigors of cancer and treatment and thereby minimize complications along the way. This means keeping illicit drugs and heavy metals (like mercury) out. Sexual activity has to be with condoms to minimize the risk of transmitting dangerous viruses. Radiation exposure has to be eliminated. And there is concern about our drinking water and the use of pesticides, which is all fueling the organic movement.”

As to what patients should do after being declared ‘cancer free,’ Dr. Lewis suggests you take that as a new lease on life. “Of course don’t forget to follow your physician’s advice religiously, including re-check and screening appointments and keep yourself as healthy as possible. Exercise daily and be wary of any changes in your lymph nodes or lab tests.”

Read the entire article, which includes "The Endless Energy" approach, a cancer survivor's view of CAM, and info provided by The National Institutes of Health.

Many urban legends and wives’ tales claim a variety of foods are natural remedies for arthritis. And some osteoarthritis patients swear they work. But do gin-soaked raisins or cayenne pepper really ease osteoarthritis pain? Here’s a look at some of the most popular natural treatments, their downsides and how they might really succeed…

For centuries, people have been trying natural remedies for arthritis in an effort to ease the pain and stiffness of the joint condition. And while doctors would never suggest you use them to replace a regimen of healthful diet, safe exercise and modern medications, grandma’s home concoctions might have some kick to them.

Despite the lack of scientific evidence, patients – as well as some doctors and nutrition experts who treat women with osteoarthritis – support the power of remedies like gin-soaked raisins or hot peppers to ease osteoarthritis pain.

“Although there’s no ‘quick fix,’ I find dietary changes combined with proper exercise therapy can be quite effective in treating and managing osteoarthritis,” says Moshe Lewis, M.D., a rheumatologist and pain management/rehabilitation specialist in Redwood City, Calif. “Even if there’s not a lot of research behind using foods to ease the pain and symptoms of osteoarthritis.”

Lewis routinely suggests his patients use everyday foods thought to combat stiffness and reduce inflammation that leads to osteoarthritis pain. After all, there’s little harm.

“Foods usually don’t have the risk of side effects like constipation, dry mouth, nausea, etc., that prescription pain relievers do,” says Lewis.

Still, many doctors don’t believe natural remedies for arthritis work.

“There are no specific foods which cure osteoarthritis or prevent onset of the disease,” says Magdalena Cadet, M.D., director of rheumatology and osteoporosis services at New York Hospital Queens/N.Y. Presbyterian Healthcare System and assistant professor of medicine at Weill Cornell Medical College of Cornell University.

Click here to read the six page article “Natural Remedies for Arthritis: Are They Worth Trying?” at LifeScript.com

Alice Francis and her husband Alan had always been a dynamic and evenly-matched couple. They both worked in high-energy careers that they loved; they traveled the world together; they exercised together regularly, and led extremely active lives. When Alan’s first flares of chronic back pain prevented him from keeping up with their fast-paced lifestyle, Alice quickly realized that their relationship was about to undergo some drastic adjustments.

“This transition has been life-changing,” she admitted, “and although I wouldn’t want anyone to have chronic pain, I have learned a lot of lessons regarding pain care and advocating for my spouse in this ‘adventure’ ”.

Alice does not like referring to herself as her husband’s “caregiver”, but it is an apt description of the role she has had to fill in Alan’s health care management. As her husband’s treatment progressed through office visits, complex pain regimens, and four corrective surgeries, Alice has taken on an active role in helping her Alan to manage his chronic pain. In the six years since Alan’s degenerative disc disease was first diagnosed, Alice has learned to be an effective champion of her husband’s medical care while maintaining her own positive outlook on life.

Thousands of spouses and children of pain sufferers find themselves in Alice’s position every year. Becoming involved in the care and treatment of a suffering loved one is a natural and loving gesture, but it can easily take its toll on even the most patient caregiver. Here are some of Alice’s tips for others who are caring for loved ones suffering from chronic pain.

Selecting doctors

• After you or your partner have researched several doctors, set up “appointments/interviews’ with your top 3 choices.
• It’s a good idea for you as the partner/caretaker to attend these appointments so that you have two sets of ears. It’s amazing how things can be interpreted differently between the person who is in pain and the person who is there to support!
• This sounds crazy, but I suggest you and the pain patient dress nicely for the appointment. We have found we are definitely treated with a higher level of credibility and respect.
• Let the doctor know that you are deciding what will be the best match in terms of a relationship with a new doctor and you have some questions as well. Sometimes I asked the questions and sometimes my husband did. It really depended on his pain and anxiety level that day. If a doctor is reluctant to be “interviewed”, that should tell you something.
• Take notes! It is very important in all appointments, quite frankly.
• Here are some good questions to ask at an initial interview:

1. How long has the doctor provided pain management?
2. Does the doctor give injections, and if so, where were they trained and what is their general outlook on patient injection needs? (In our experience, doctors who were trained via Mayo Clinic will give only 3 injections per year. Doctors trained in other programs are sometime more open to assessing the number of injections based on the need of the patient.)
3. What is the doctor’s general philosophy on pain management? If they don’t have one, that’s a red flag.
4. How many doctors are in the practice? Will patients generally see the doctor or the physician’s assistant?
5. How far in advance do you need to make an appointment?
6. Who is the contact when you are unable to reach the doctor?
7. Will you be able to get copies of all medical records and appointment notes? (I always request this on a monthly or quarterly basis. It’s important to see what the doctor’s interpretation of the appointment was, which can be quite different than yours or the patient’s.)
8. Has the doctor ever experienced long-term or chronic pain? Although this isn’t a deal-breaker, the doctor’s firsthand experience is a plus. They will most certainly have a high level of compassion and understanding for what the patient is going through.

Alice stresses that finding the right rapport between a doctor and the patient is extremely important, since this doctor-patient relationship could potentially last for years. She found that helping Alan to be proactive about his own emotional needs made it easier to find doctors who were a good match for Alan. “At the beginning of our pain journey, it was very important for my husband to explain to a doctor who he was before pain. He wanted them to have a glimpse of what his life was like before this happened. He was struggling to deal with all the changes going on, and needed people to know that he hadn’t always been the ‘patient’.

“Some doctors were very attentive during this dialogue. Others were very dismissive and condescending. Their reaction was almost always a sign of the care and compassion to come. I suggest the patient or caretaker come up with some brief summary of activities and interests prior to the pain and see what kind of reaction you elicit.”

Providing care for your loved one

• Carry a list of all medications and amounts the patient is taking. If there is an emergency situation, it will be necessary to provide the EMT’s or other medical help with that information
• If you live with the patient you care for, be observant as to what time of day they take their meds. Make it clear that this isn’t policing, but rather just another set of eyes. When someone is in chronic pain, memory can be affected, and it’s just good to have a general idea of your patient’s pattern of medication use.
• Get to know your pharmacist. I know our pharmacist very well. In fact, I can call the pharmacy and say, “It’s Alice”, and they know who I am! It’s important to build a rapport so that you can ask questions and receive the best customer service possible.
• LISTEN to your loved one! This was VERY difficult for me to learn. When he would complain about the pain or express frustration, I wanted to ‘fix it”. Listening was not part of my plan. Many times, he didn’t want me to fix anything. He just needed me to say, “That must be really hard”, or “ I’m so sorry you are having to go through this”. Understanding and improving our communication has helped both of us a great deal.

Alice offers further perspective on the changing relationship of chronic pain patients and their caregiver companions. “My husband went through not only a huge physical adjustment to dealing with chronic pain, but an equally large psychological adjustment. Without work or exercise or the ability to live an active lifestyle, he just didn’t know who he was anymore. I went through a similar adjustment, I’m sure.

“Acknowledging this transition, and how hard it must be, was very important for both of us. Be patient during this time, because your loved one really needs to feel vital and normal. Strongly suggest to your loved one they go see a therapist or psychologist to work through these issues. It can be a huge help to you both.”

Take care of yourself

“Of all the things I have done in my life,” says Alice, “taking care of or being in a relationship with someone you love who is in chronic pain is by far the most difficult. In the beginning I felt like my good days were completely dependent on his good days. That’s no way to live.

“You do need to provide love, compassion, sometimes some physical and mental support. But you also have to realize that you CANNOT fix or change the situation. You can’t make the person take meds or not take meds. You can’t do physical therapy for them. You can’t take the pain away so you just have to let it go. “I developed a sense of normalcy around all of this. I have a career that I love-- it keeps me very busy. I go shopping and traveling some with girlfriends. I exercise on my own, and do things just for me. This new ‘normal’ life really helps provide Alan with a sense of ‘normal’ as well. I strongly encourage you not to forget about you in this process.”

This article is summary and companion article to Taboo Talk's April 6th (2011) radio show/podcast.