Archive | September 2020

QUOTE FOR FRIDAY:

“There are multiple factors that play a role in how we experience pain. This includes genetics, social status, exercise and information processing in the brain. And for women, hormones, puberty, reproductive status and menstrual cycle also affect pain threshold and perception.”.

Richard W. Rosenquist, MD –  Chairman of Cleveland Clinic’s Department of Pain Management.

Pain in men versus women. Is it perceived the same in both genders?

miceimages

The nervous system’s dials for communicating chronic pain to the body work differently in male and female mice, according to a study published today in Nature Neuroscience. If this difference is also found in humans, it could lead to chronic pain treatments that are better tailored to the patient. But the most immediate impact might be in basic research — the earliest stages of work — since right now, the mice being used are almost exclusively male.

Chronic pain affects more than 100 million people in the US, which is more than heart disease, cancer, and diabetes combined. And many pain conditions occur more often in women than in men, according to the FDA. That’s why figuring out how male and female mice deal with pain — and whether they do so differently than humans — is so important. After all, most medical research — including pain research — starts with mice.

In the study, researchers focused on microglia, a type of immune cell that can be found in the brain and the spinal cord. These cells are known to play a role in the “volume knob” for pain, explains Jeffrey Mogil, a pain researcher at McGill University and a co-author of the study. The knob turns way up after an injury. A genetic study done in Mogil’s lab a few years ago had indicated that microglia weren’t as important in the pain circuit of female mice. So, the scientists decided to find out if interfering with the microglia would have the same effect in male and female mice.

Male mice had no pain, whereas female mice did

The researchers used mice that were suffering from a hypersensitivity to pain. The scientists gave them drugs that target the microglial cells in the spinal cord, in the hopes that this would prevent the animals from feeling pain. But only male mice responded to the drugs — the female mice still had an increased sensitivity to pain.

When the researchers repeated these experiments in mice under varying conditions, they saw the same results: male mice had no pain, whereas female mice did. “Whatever the manipulation is, in every case, blocking microglia or some part of the microglial system brings the pain sensitivity back to normal in male mice, and doesn’t do anything in female mice,” Mogil says.

Now looking at the human we see this: There is a growing body of literature that indicates women are more likely than men to be undertreated for their pain.

It appears that gender affects not only pain perception, pain coping, and pain reporting, but also pain-related behaviors, including use of healthcare and the social welfare system. It is also probable that men and women differ systematically in their responses to pain treatments, although further research is needed in this area.

For many common pain conditions, including migraine and tension-type headache, facial pain, and abdominal pain, population-based studies indicate higher prevalence rates in adult women than in adult men.

Despite the difficulties with human laboratory experiments on pain sensitivity, many investigators are willing to draw the inference from these studies that women are, in general, more sensitive to painful stimuli than men, and that this difference is biologically based.

Whatever the pain prevalence differences for men and women, most studies show that women seek healthcare for pain at a higher rate than men:

    • One study indicated that women are more likely to be given sedatives for their pain, while men are more likely to be given pain medication.

    • Faherty and Grier studied the administration of pain medication after abdominal surgery and found (after controlling for weight) that physicians prescribed less pain medication for women than for men ages 55 or older, and that nurses administered less pain medication to women than to men ages 25-54 years.

    • Beyer et al examined pain medication given to children and found that, after surgery, boys received significantly more codeine than girls, and girls were more likely than boys to be given acetaminophen.

    • In a 1994 study of 1,308 outpatients, Cleeland and colleagues found that women with metastatic cancer were significantly more likely than men with the same diagnosis to receive inadequate pain medications.

    • In a study of several hundred AIDS patients, Breitbart and colleagues found that, based on the WHO analgesic ladder guideline, women were significantly more likely than men to receive inadequate analgesic therapy.

    • A study by Weir and colleagues found that women are less likely than men to be referred to a specialty pain clinic, at least upon initial encounters with their physicians.

    • A study reviewing cancer care at seven outpatient clinics in California found that female cancer patients were prescribed half the pain medication as male patients with the same pain intensity scores.

    • Males outnumber females two to one in the burn population. This is related to male household and job roles, which increase the risk for burn injury. Furthermore, males more commonly engage in risk-taking behaviors involving chemicals, flammable materials, or electricity.So what do we see so for at this point:

  • We feel pain more intensely than men, according to a new study of 11,000 men and women who were patients at the Stanford Hospital and Clinics.

  • Researchers analyzed electronic medical records of patients’ reports of pain across a range of different diseases, and found a distinct gender-driven difference in how much discomfort patients say they felt. The study included 47 disorders — from cancer to back conditions and infectious diseases — and more than 161,000 patient-reported pain scores. The patients were all asked by nurses or other health personnel to rate their pain on an 11-point scale, with 0 representing “no pain” and 11 signifying the “worst pain imaginable”.
  • Not surprisingly, most responses clustered around either the two extremes of very little pain or extreme pain or the middle score of 5. But overall, women were more likely to indicate higher pain levels than men, says lead author Dr. Atul Butte, chief of systems medicine in the department of pediatrics at Stanford University School of Medicine. And that was true across almost all of the different diseases. “That was the most surprising finding,” says Butte. “We completely wouldn’t have expected such a difference across almost all disorders, where women were reporting a whole pain point higher on the 0-to-10 scale than men.”
  • Of course, self-reports can’t account for the fact that people may define tolerable and intolerable pain in vastly different ways, says Butte, but the fact that a gender difference emerged from such a large number of patients suggests that the effect is real.
  • What accounts for the gender gap? Hormones may explain some of the difference — studies have shown that estrogen in women can help dampen the activity of pain receptors, helping them to tolerate higher levels of pain. That means, however, that they may become more sensitive to pain during low-estrogen parts of the menstrual cycle.
  • There may also be explanations that have nothing to do with biology. Men, for example, may feel compelled by cultural stereotypes to be tough, and therefore report feeling less pain than they really do —especially when asked by the mostly female nursing staff.

Still, even if non-biological factors are influencing how much pain men and women report, Butte says the difference is worth noting. “The reasons may be biological or they may not be, but we should still be aware of the bias that patients have in reporting pain,” he says. He is hoping to continue the research by following up these results with surveys of patients’ ratings after they were treated for pain. That may help doctors to better address the real pain patients may be feeling.

QUOTE FOR THURSDAY:

“No one is certain how many people are affected by Pulmonary Foundation (PF). One recent study estimated that idiopathic pulmonary fibrosis (or IPF, Idiopathic means unknown cause.  IPF which is just one of more than 200 types of PF) affects 1 out of 200 adults over the age of 60 in the United States—that translates to more than 200,000 people living with PF today. Approximately 50,000 new cases are diagnosed each year and as many as 40,000 Americans die from IPF each year.”.

Pulmonary Fibrosis Foundation

Part II Pulmonary Fibrosis Awareness

Symptoms

Signs and symptoms of pulmonary fibrosis may include:

  • Shortness of breath (dyspnea)
  • A dry cough
  • Fatigue
  • Unexplained weight loss
  • Aching muscles and joints
  • Widening and rounding of the tips of the fingers or toes (clubbing)

The course of pulmonary fibrosis — and the severity of symptoms — can vary considerably from person to person. Some people become ill very quickly with severe disease. Others have moderate symptoms that worsen more slowly, over months or years.

Some people may experience a rapid worsening of their symptoms (acute exacerbation), such as severe shortness of breath, that may last for several days to weeks. People who have acute exacerbations may be placed on a mechanical ventilator. Doctors may also prescribe antibiotics, corticosteroid medications or other medications to treat an acute exacerbation.

Complications

Complications of pulmonary fibrosis may include:

  • High blood pressure in your lungs (pulmonary hypertension). Unlike systemic high blood pressure, this condition affects only the arteries in your lungs. It begins when the smallest arteries and capillaries are compressed by scar tissue, causing increased resistance to blood flow in your lungs.This in turn raises pressure within the pulmonary arteries and the lower right heart chamber (right ventricle). Some forms of pulmonary hypertension are serious illnesses that become progressively worse and are sometimes fatal.
  • Right-sided heart failure (cor pulmonale). This serious condition occurs when your heart’s lower right chamber (ventricle) has to pump harder than usual to move blood through partially blocked pulmonary arteries.
  • Respiratory failure. This is often the last stage of chronic lung disease. It occurs when blood oxygen levels fall dangerously low.
  • Lung cancer. Long-standing pulmonary fibrosis also increases your risk of developing lung cancer.
  • Lung complications. As pulmonary fibrosis progresses, it may lead to complications such as blood clots in the lungs, a collapsed lung or lung infections.

Diagnosis

To diagnose your condition, your doctor may review your medical and family history, discuss your signs and symptoms, review any exposure you’ve had to dusts, gases and chemicals, and conduct a physical exam. During the physical exam, your doctor will use a stethoscope to listen carefully to your lungs while you breathe. He or she may also suggest one or more of the following tests.

Imaging tests

  • Chest X-ray. A chest X-ray shows images of your chest. This may show the scar tissue typical of pulmonary fibrosis, and it may be useful for monitoring the course of the illness and treatment. However, sometimes the chest X-ray may be normal, and further tests may be required to explain your shortness of breath.
  • Computerized tomography (CT) scan. CT scanners use a computer to combine X-ray images taken from many different angles to produce cross-sectional images of internal structures in the body. A high-resolution CT scan can be particularly helpful in determining the extent of lung damage caused by pulmonary fibrosis. Also, some kinds of fibrosis have characteristic patterns.
  • Echocardiogram. An echocardiogram uses sound waves to visualize the heart. It can produce still images of your heart’s structures, as well as videos that show how your heart is functioning. This test can evaluate the amount of pressure occurring in the right side of your heart.

Lung function tests

  • Pulmonary function testing. Several types of pulmonary function tests may be conducted. In a test called spirometry, you exhale quickly and forcefully through a tube connected to a machine. The machine measures how much air your lungs can hold and how quickly you can move air in and out of your lungs. Other tests may be conducted to measure your lung volumes and diffusing capacity.
  • Pulse oximetry. This simple test uses a small device placed on one of your fingers to measure the oxygen saturation in your blood. Oximetry can serve as a way to monitor the course of the disease.
  • Exercise stress test. An exercise test on a treadmill or stationary bike may be used to monitor your lung function when you’re active.
  • Arterial blood gas test. In this test, your doctor tests a sample of your blood, usually taken from an artery in your wrist. The oxygen and carbon dioxide levels in the sample are then measured.

Tissue sample (biopsy)

If other tests haven’t diagnosed the condition, doctors may need to remove a small amount of lung tissue (biopsy). The biopsy is then examined in a laboratory to diagnose pulmonary fibrosis or rule out other conditions. The tissue sample may be obtained in one of these ways:

  • Bronchoscopy. In this procedure, your doctor removes very small tissue samples — generally no larger than the head of a pin — using a small, flexible tube (bronchoscope) that’s passed through your mouth or nose into your lungs. The tissue samples are sometimes too small for an accurate diagnosis. The biopsy may also be used to rule out other conditions.The risks of bronchoscopy are generally minor and might include a temporary sore throat or discomfort in your nose from the passage of the bronchoscope. However, serious complications can include bleeding or a deflated lung.During bronchoscopy, your doctor may conduct an additional procedure called bronchoalveolar lavage. In this procedure, your doctor injects salt water through a bronchoscope into a section of your lung, and then immediately suctions it out. The solution that’s withdrawn contains cells from your air sacs.Although bronchoalveolar lavage samples a larger area of the lung than other procedures do, it may not provide enough information to diagnose pulmonary fibrosis. It might also be used to rule out other conditions.
  • Surgical biopsy. Although a surgical biopsy is more invasive and has potential complications, it may be the only way to obtain a large enough tissue sample to make an accurate diagnosis. This procedure may be done as a minimally invasive surgery, called video-assisted thoracoscopic surgery (VATS), or as an open surgery (thoracotomy).During VATS, your surgeon inserts surgical instruments and a small camera through two or three small incisions between your ribs. The camera allows your surgeon to view your lungs on a video monitor while removing tissue samples from your lungs. This procedure is performed after you’ve been given a general anesthetic, so you’ll be asleep during the procedure.During open surgery (thoracotomy), a surgeon removes a lung sample through an incision in the chest between your ribs. The procedure takes place after you’ve been given a general anesthetic.

Blood tests

Doctors may also order blood tests to evaluate your liver and kidney function, and to test for and rule out other conditions.

Treatments

The lung scarring that occurs in pulmonary fibrosis can’t be reversed, and no current treatment has proved effective in stopping progression of the disease. Some treatments may improve symptoms temporarily or slow the disease’s progression. Others may help improve quality of life. Doctors will evaluate the severity of your condition to determine the most appropriate treatment for your condition.

Medications

Your doctor may recommend newer medications, including pirfenidone (Esbriet) and nintedanib (Ofev). These medications may help slow the progression of idiopathic pulmonary fibrosis. Both medications have been approved by the Food and Drug Administration (FDA). Additional medications and new formulations of these medications are being developed but have not yet been FDA approved.

Nintedanib can cause side effects such as diarrhea and nausea. Side effects of pirfenidone include rash, nausea and diarrhea.

Researchers continue to study medications to treat pulmonary fibrosis.

Doctors may recommend anti-acid medications to treat gastroesophageal reflux disease (GERD), a digestive condition that commonly occurs in people with idiopathic pulmonary fibrosis.

Oxygen therapy

Using oxygen can’t stop lung damage, but it can:

  • Make breathing and exercise easier
  • Prevent or lessen complications from low blood oxygen levels
  • Reduce blood pressure in the right side of your heart
  • Improve your sleep and sense of well-being

You may receive oxygen when you sleep or exercise, although some people may use it all the time. Some people carry a canister of oxygen, making them more mobile.

Pulmonary rehabilitation

Pulmonary rehabilitation can help you manage your symptoms and improve your daily functioning. Pulmonary rehabilitation programs focus on:

  • Physical exercise to improve your endurance
  • Breathing techniques that may improve lung efficiency
  • Nutritional counseling
  • Counseling and support
  • Education about your condition

Lung transplant

Lung transplantation may be an option for people with pulmonary fibrosis. Having a lung transplant can improve your quality of life and allow you to live a longer life. However, a lung transplant can involve complications such as rejection and infection. Your doctor may discuss with you if a lung transplant may be appropriate for your condition.

QUOTE FOR WEDNESDAY:

“Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, you become progressively more short of breath.”

Harvard Publishing

Part I Pulmonary Fibrosis Awareness Month

 

Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, you become progressively more short of breath.

The scarring associated with pulmonary fibrosis can be caused by a multitude of factors. But in most cases, doctors can’t pinpoint what’s causing the problem. When a cause can’t be found, the condition is termed idiopathic pulmonary fibrosis.

The lung damage caused by pulmonary fibrosis can’t be repaired, but medications and therapies can sometimes help ease symptoms and improve quality of life. For some people, a lung transplant might be appropriate.

Risk factors

Factors that make you more susceptible to pulmonary fibrosis include:

  • Age. Although pulmonary fibrosis has been diagnosed in children and infants, the disorder is much more likely to affect middle-aged and older adults.
  • Sex. Idiopathic pulmonary fibrosis is more likely to affect men than women.
  • Smoking. Far more smokers and former smokers develop pulmonary fibrosis than do people who have never smoked. Pulmonary fibrosis can occur in patients with emphysema.
  • Certain occupations. You have an increased risk of developing pulmonary fibrosis if you work in mining, farming or construction or if you’re exposed to pollutants known to damage your lungs.
  • Cancer treatments. Having radiation treatments to your chest or using certain chemotherapy drugs can increase your risk of pulmonary fibrosis.
  • Genetic factors. Some types of pulmonary fibrosis run in families, and genetic factors may be a component.

Causes

Pulmonary fibrosis scars and thickens the tissue around and between the air sacs (alveoli) in your lungs. This makes it more difficult for oxygen to pass into your bloodstream. The damage can be caused by many different factors — including long-term exposure to certain toxins, certain medical conditions, radiation therapy and some medications.

Occupational and environmental factors

Long-term exposure to a number of toxins and pollutants can damage your lungs. These include:

  • Silica dust
  • Asbestos fibers
  • Hard metal dusts
  • Coal dust
  • Grain dust
  • Bird and animal droppings

Radiation treatments

Some people who receive radiation therapy for lung or breast cancer show signs of lung damage months or sometimes years after the initial treatment. The severity of the damage may depend on:

  • How much of the lung was exposed to radiation
  • The total amount of radiation administered
  • Whether chemotherapy also was used
  • The presence of underlying lung disease

Medications

Many drugs can damage your lungs, especially medications such as:

  • Chemotherapy drugs. Drugs designed to kill cancer cells, such as methotrexate (Trexall, Otrexup, others) and cyclophosphamide, can also damage lung tissue.
  • Heart medications. Some drugs used to treat irregular heartbeats, such as amiodarone (Cordarone, Nexterone, Pacerone), may harm lung tissue.
  • Some antibiotics. Antibiotics such as nitrofurantoin (Macrobid, Macrodantin, others) or ethambutol can cause lung damage.
  • Anti-inflammatory drugs. Certain anti-inflammatory drugs such as rituximab (Rituxan) or sulfasalazine (Azulfidine) can cause lung damage.

Medical conditions

Lung damage can also result from a number of conditions, including:

  • Dermatomyositis
  • Polymyositis
  • Mixed connective tissue disease
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Sarcoidosis
  • Scleroderma
  • Pneumonia

Many substances and conditions can lead to pulmonary fibrosis. Even so, in most cases, the cause is never found. Pulmonary fibrosis with no known cause is called idiopathic pulmonary fibrosis.

Researchers have several theories about what might trigger idiopathic pulmonary fibrosis, including viruses and exposure to tobacco smoke. Also, some forms of idiopathic pulmonary fibrosis run in families, and heredity may play a role in idiopathic pulmonary fibrosis.

Many people with idiopathic pulmonary fibrosis may also have gastroesophageal reflux disease (GERD) — a condition that occurs when acid from your stomach flows back into your esophagus. Ongoing research is evaluating if GERD may be a risk factor for idiopathic pulmonary fibrosis, or if GERD may lead to a more rapid progression of the condition. However, more research is needed to determine the association between idiopathic pulmonary fibrosis and GERD.

QUOTE FOR TUESDAY:

“Another name for enlarged heart is cardiomegaly. An enlarged heart may be the result of a short-term stress on the body, such as pregnancy, or a medical condition, such as the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms.”

MAYO CLINIC

QUOTE FOR WEEKEND:

“All humans have to eat food for growth and maintenance of a healthy body, but we humans have different nutrition requirements as infants, children (kids), teenagers, young adults, adults, and seniors.”  –

-www.medicinenet.com

 

The recipe to knowing how to live healthier and longer, but don’t forget to do the cooking.

health 1A  HEALTH 2

 

We live for generations relying more on treatment versus prevention (secondary versus primary care).  Yes we have drastically improved in the health care system leaning more to primary through further research and technology.  Also, we have advanced in practicing prevention to some degree; that would be regarding certain illnesses/disease but the society in our nation is still too high on being the ones relying on treatment rather than prevention.  Adults alone are 65% obese which is a main cause for certain diseases remaining on the rise in this country.  These diseases are still on the rise due to some of our cultural eating habits in our homes.  For American culture that includes the restaurant industry and social acceptance of the do’s and don’ts in our communities.  Out of homes in America we are exposed to fast foods, lack of allowing kids to play in a baseball fields with safe/ responsible adults because they don’t have a permit, no desire to be active due to being in the computer too many hours or even watching TV instead of 30 to 60 minutes of exercise squeezed in our daily schedules somewhere.  Due to this behavior we inflict on ourselves either increasing risks of or the cause of or worsening of diseases or illnesses in American citizens or any citizen in some country who lives the same life style; ending line its due to the diet or the poor health habits practiced in the individual’s life.  If you and others knew in our country the baby steps in becoming healthier NOW not tomorrow it would benefit your health and your life line extending it dramatically, especially if you start in your younger years with no illness/disease or very little.  You’ve heard the line I’ll start next month with next month never happening or this will be my New Year’s resolution on Christmas and it’s already forgotten on Jan. 1st.  Unfortunately a lot end up with the poor health due to their sedentary life style being their diet and poor healthy habits.  Don’t put it off anymore, take the first step, and increase the changes you need to a better mind and body.  Join me with others in learning healthy habits.   Prevent the following diseases that obesity alone can cause, which are: 

  1. High Blood Pressure–High blood pressure is the primary cause of death among Americans older than 25. About 75 million people suffer from high blood pressure or hypertension, which is a major risk factor for heart disease. Blood pressure tends to increase with weight gain and age. It is not known why obesity is a major cause of high blood pressure. However, research has shown that obese patients displayed an increase in blood volume and arterial resistance causing more stress to the heart. For people who are overweight and have high blood pressure, losing as little as 8 pounds can help reduce blood pressure to a safe level.
  2. Diabetes–Obesity is considered one of the most significant factors in the development of insulin resistance, and insulin resistance can lead to type 2 diabetes. According to the World Health Organization, more than 90 percent of diabetes patients worldwide have type 2 diabetes. Being overweight or obese contributes to the development of diabetes by making cells more resistant to the effects of insulin. A weight loss of 15-20 pounds can help you decrease your risk of developing type 2 diabetes 
  3. Heart Disease — According to the American Heart Association, obesity is a major risk factor for developing coronary heart disease, which can lead to a heart attack or stroke. People who are overweight are at a greater risk of suffering a heart attack before the age of 45.  Obese adolescents have a greater chance of having a heart attack before the age of 35 than non-obese adolescents. If you are overweight, losing 10-15 pounds can reduce your risk of developing heart disease. If you exercise regularly, the risk of developing heart disease falls even more.
  4. High Cholesterol levels — High cholesterol is one of the leading causes of heart attacks. Cholesterol is transported through your blood in two ways: the low density lipoprotein (LDL), which transports cholesterol to the cells that need it, and the high density lipoprotein (HDL), which is the healthy cholesterol that reduces your risk for heart attack. Having high LDL levels raises your risk of having heart disease by 20 percent. Losing 11-20 pounds can help you significantly reduce your cholesterol level.
  5. Cancer — A study by the American Heart Association found that being overweight increases your chances for developing cancer by 50 percent. Women have a higher risk of developing cancer if they are more than 20 pounds overweight. Regular exercise and a weight loss of as little as 12 pounds can significantly decrease the risk.
  6. Infertility — Being obese can cause changes in the hormonal levels of women, which can result in ovarian failure. Women who are 15-25 pounds overweight are at a higher risk of suffering from infertility and ovarian cancer. Our bodies need to be at an appropriate weight to produce the right amount of hormones and regulate ovulation and menstruation. Don’t think men are immune to infertility. Overweight men have a greater chance of developing motility and a lower sperm count. Shedding 12-14 pounds can help you lower the risks.
  7. Back Pain — Obesity is one the contributing factors of back and joint pain. Excessive weight can cause injury to the most vulnerable parts of the spine, which carries the body’s weight. When it has to carry excess weight, the odds of suffering from a spinal injury or structural damage increase. Being overweight also raises the risk of developing osteoporosis, lower back pain, arthritis, and osteoarthritis. Losing 10-15 pounds can help you decrease the risk of developing these problems.
  8. Skin Ulcers & leading to infected ulcers — Obese and overweight individuals may have skin that folds over on itself. These creased areas can become irritated from the rubbing and sweating, which can cause alteration in the skin from a rash first forming to an actual ulcer of the skin occuring that can lead to ulcer skin infections (local infections) that can go further into systemic infections (which is an infection throughout the circulatory system).
  9. Gastric Ulcers — According to a study by the National Institutes of Health (NIH), obesity can be a contributing factor to the development of gastric ulcers. Gastric ulcers occur when there is an imbalance between the amount of hydrochloric acid that is secreted and the enzyme pepsin. Overweight men are at a greater risk of developing gastric ulcers than women. A weight loss of as little as 7 pounds can help reduce the risk.
  10. Gallstones — Being severely overweight increases the risk of developing gallstones, especially in women. Gallstones are caused when the liver releases excessive amounts of bile, which is stored in the gallbladder. Gallstones are more common in older women and those with a family history of gallstones. Losing 4-9 pounds reduces the risk of developing gallstones. Moderate exercise also can help lower your risk.

If you suffer from type 2 diabetes or pre-diabetes, cardiac disease including high blood pressure or cholesterol and need to lose weight I can help you manage the disease through nutrition and fitness education including behavior modification.  You will  learn healthy habits that will help you lose weight through Dr. Anderson and many other references in books or on the net .  Take the right step in moving towards a healthier, happier and even longer lifestyle.   I hope you like myself and so many others take the step in reaching a healthier body and spread the news to make America overall a healthier country.  It is recommended anyone with a disease or illness to first check with your doctor for clearance before doing any diet or activity changes you plan to add to your life to prevent injury.

References

American Heart Association, National Institutes of Health, mediweightlossclinics.com and the Centers for Disease Control and Prevention.

 

QUOTE FOR THE WEEKEND:

“The only way to know if an abnormal test is due to cancer is to do a biopsy. A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope to check for cancer. A prostate biopsy can cause pain, blood in the semen or ejaculate, and infection.”
 
Centers for Disease Control and Prevention