Let’s Talk Sex

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For women, sex is very complicated. It takes a variety of emotional and physical stimulation to create excitement and then climax. You have to be in the mood and then have a partner who you want to be with. You can have the best sex in your life tonight – then next week do everything the same – and it is a bust. Why?

Men think about sex and they are to the races. For women it takes longer to get excited. Women need emotional stimulation. It helps if they receive back rubs, hugs, cuddles, and then gradually increase physical contact.

Here are five tips you can do and share with your partner that will help get you in the mood:

•           Have a romantic/personal dinner

•           Take a walk along a moonlit beach

•           Dress up and go dancing

•           Watch a steamy movie

•           Take a bath with your partner

Give it a try and share your experiences with us!

-Dr. Robert Feldman M.D. – Obstetrics and Gynecologist

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“Laugh and the world laughs with you. Snore and you sleep alone.”

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Sleep Apnea and Snoring.

Anthony Burgess, an English writer and composer, summed it up quite clearly in the above quote.  Although, it has long been the subject of jokes as well as an annoyance to many a bed partner, loud snoring can be a signal that something is seriously wrong with your breathing during sleep. Snoring is a sign that the airway is not fully open.  The distinctive sound comes from efforts to force air within the narrowed passageway of either the upper airway (your nose) or your pharynx (the back of the throat).

An estimated 10-30% of adults snore. It can be seen in both men and women of all sizes and shapes. For most of them, snoring has no serious medical consequences.  However, loud habitual snoring can be the first indication of much more serious disorder: obstructive sleep apnea.  People with sleep apnea don’t breathe properly during sleep.  They don’t get enough air and oxygen, and their sleep is poor as the brain keeps arousing him to a lighter stages of sleep, to allow them to start breathing normally again.  This can prevent the deep sleep we need to awakening feeling refreshed.  Sleep apnea can lead to daytime sleepiness and can trigger high blood pressure, heart disease, heart attack, and stroke.  It can put your at higher risk for diabetes and depression as well.

People with sleep apnea may have trouble concentrating and can become unusually forgetful, irritable, anxious or depressed.  They may also complain of insomnia symptoms, morning headaches, as well as sexual dysfunction.  Sleep apnea can even be seen in children who may erroneously be labeled slow or lazy in school.

General measures for the treatment of sleep apnea include:

•           Normalize weight.  Even a weight loss of 10-20% of your body weight may significantly improve the symptoms of obstructive sleep apnea.

•           Avoid alcohol and nicotine.

•           Avoid certain sleeping pills that suppress breathing at night.

•           Consider medications to relieve nasal congestion.

Specific treatments for sleep apnea include:

•           Continuous positive airway pressure (CPAP, pronounced SEE-pap).  CPAP is the most common form of treatment for obstructive sleep apnea.  In this highly effective therapy, a gentle flow of air is delivered through the nostrils to keep the airway open during sleep.

•           Oral appliances address sleep apnea by devices that open the airway by bringing the jaw, tongue, and/or soft palate forward.  They are best obtained and individually fitted by dentist with specialty training and sleep disorders.

•           Surgery may address physical abnormalities that interfere with breathing during sleep, including tonsils or adenoids  (this is common in children) and malformations of the jaw or soft palate.  Surgical intervention is usually pursued only after an initial trial with CPAP.

•           Nasal expiratory resistance valves (a bandaid type adhesive valve replaced nightly over the nostrils) have shown variable efficacy.

•           A new pacemaker device is under investigation which stimulates a nerve in the jaw, helping to keep the airway open.

Fortunately, sleep specialists are now able to detect and diagnose nighttime breathing disorders.  Proper treatment can not only bring your bedpartner back into your bedroom, it canprevent or reverse the potentially life-threatening consequences of sleep apnea.  When treatment is effective, patient sleep more soundly through the night, awaken feeling more refreshed, and experienced less daytime drowsiness.  They are also, subsequently, at less risk for associated medical illnesses.

Dr. Tim Grant M.D. – Neurologist and Sleep Specialist

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The Secret Ingredient: Fenugreek

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There is great comfort in coming home on a chilly dark winter evening to a warm kitchen and a hearty stew bubbling with sweet scented aromas. Fenugreek leaves cooked with root vegetables is a favorite of mine. Its sprouts and leaves have a sharp-sweet taste, which adds texture, taste and healthy nutrients to salads and curries.

Fenugreek a small annual leguminous herb belonging to the family of fabaceae has a long history as a culinary and medicinal herb in the ancient world. Native to sub-Himalayan plains of India, today it is widely grown in Europe, Asia and Africa. Strongly aromatic and flavorful, fenugreek has been used by the Egyptians, Greeks and Romans for medicinal and culinary purposes. It has also been very popular in the Indian Ayurvedic tradition.

Its seeds have been used in these traditional medicines as a laxative, digestive, and as a remedy for cough and bronchitis. It is also believed to help control cholesterol levels and aid in the metabolism of sugars.

Fenugreek seeds are a great source of minerals, vitamins, soluble dietary fiber and phytonutrients. It’s rich in copper, potassium, calcium, iron, selenium, zinc, manganese, magnesium and phosphorous and it is high in protein. It is also rich in many vital vitamins including thiamin, pyridoxine (vitamin B6), folic acid, riboflavin, niacin, vitamin A, and vitamin-C.

Several human trials have found that Fenugreek may help lower total cholesterol. Fenugreek seeds contain compounds known as steroidal saponins that are believed to inhibit both cholesterol absorption in the intestines and cholesterol production in the liver. Dietary fiber may also contribute to fenugreek’s health benefits, increasing the bulk of the food and assisting in smooth digestion and helping to relieve constipation.

The high content of soluble fiber in Fenugreek seeds is also believed to help lower blood sugar by slowing down carbohydrate digestion and absorption. Animal research studies suggests that fenugreek may also contain a substance that stimulates insulin production and improves blood sugar control.

Sweet potatoes are the perfect partner to balance the slight tangy taste and bitterness of the Fenugreek leaves. But don’t worry if you cannot find fresh Fenugreek in your neighborhood, high quality supplements can provide you with the goodness of the freshest sourced Fenugreek.

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-Dr. Jack Miodownik-Aisenberg M.D. PhD – Internist

Ask the Gastroenterologist

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How often should a person poop?

Everyone is different but a normal person poops between 3 times a week and 3 times a day.

I always tell patients it’s not the quantity but the quality. Size, shape, consistency, and satisfaction are what counts. Some people poop daily but are abnormal because they have loose stool and diarrhea. Some go 3 times a day but have straining, hard stool, and constipation

A healthy diet together with liquids and exercise are important for normal bowel function. Try to allocate 5-10 minutes at the same time every day to train your body to be regular.

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-Dr. Howard Schwartz M.D. – Gastroenterologist

5 Tips for a Leaner You

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Ever wonder why some people just seem to be able to eat whatever they want and yet not gain any weight? Can it be more than a special metabolism that they may have? Perhaps, as many people around the world do, including some of the tips that we share here are their inner tricks for leaning out. Doing these daily may just be easier than you think.

1. Do not be afraid of hot sauces or spices! – Hot peppers, red or green, as well as sauces that contain hot peppers and spices have a common ingredient known as capsaicin. Capsaicin is what gives the green and red peppers of all sizes their punch, you know that spark you get when you bite into one of these that makes you sweat and look for something to put out the fire. Point is, including hot spices and hot peppers in your daily diet actually does help burn an extra few calories and burning extra calories can always be a positive when looking to lean out.
2. Enjoy ice cold water – Did you know that one of the jobs of your esophagus is to make sure whatever you swallow, whether it is hot or cold – is to get that food or liquid to body temperature before it reaches the stomach. Think of it, this is how your stomach does not get burned or frozen when you drink hot coffee or eat ice cream. Studies show that this process, especially when you use ice cold liquids, will make the body burn a few extra calories. Over a few days time, if drinking six to eight ice cold drinks (water), this can equate to a benefit aiding in weight and waist line control.
3. Include protein in each meal. Protein, such as fish, chicken, lean steak and other sources are not easy for the body to digest and metabolize when compared to carbohydrates and even fats. In fact, research has taught us that protein based foods not only help you feel fuller throughout the day but also cause extra calories to be burned daily. So including protein in each meal as this can aid in weight control by both helping you feel fuller (so you eat less) and in burning extra calories. A double bang for your buck!
4. Aim to avoid juices and sugary drinks – This may sound like a no-brainer, but often people do not realize that the calories and sugars in fruit juices and store bought, pre-made juices add up quicker than anticipated, and this leads to unexpected weight gain. Avoiding juices and instead drinking ice-cold water and eating whole fruits (versus drinking the juices) is helpful when looking to achieve weight control
5. Add fiber to your life. Fiber helps makes us feel full, maintain normal cholesterol levels and aids in regularity. In addition, fiber (often found in whole fruits, vegetables and whole-grains) also helps us bulk up a meal or snack so that we eat less throughout the day. Including foods with fiber in meals and snacks can aid in weight control.

 

These five tips are all things that you can start now, today, and do daily to help tip the scale in the direction that makes you smile versus feeling frustrated with your efforts. To recap, include hot spices or peppers in your diet, drink ice-cold water, have some protein in every meal, avoid sugary juices and shakes and make sure that your diet has plenty of fiber. Do these five easy steps and your waist and weight control is bound to be easier.

– Douglas S. Kalman PhD RD

To continue to learn more about health and whole body nutrition, please follow us on Twitter @Miami_Nutrition or my Twitter, @dougkalmanphdrd

Is Knee Surgery Really Necessary?

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A study in Finland presented in New England Journal of Medicine this week revealed that knee surgery is no better than conservative therapy. The study was conducted in patients with non-traumatic meniscal injuries and showed that patients that received a sham or fake surgery had the same results as those patients that received real surgery by the end of 12 months post-treatment.

This questions the risk, benefits, and costs of a surgery that is conducted over 500,000 times a year and accounting for $4 billion in annual medical costs in the United States. Every knee injury is different and you should discuss the pros, cons and the need for knee surgery with your physician and discuss the options of conservative therapy.