Author: Erin Pearson

Fall is a time of shorter days, crisp air and leaves bursting with color. It can be melancholic, with winter approaching and summer over. But it also can be seen as an exciting time: the start of a new school year, a new sports season, a new television season and a countdown to the holidays!

Autumn is also time to focus on your health and visit your health provider for an annual checkup. Together, you’ll discuss overall health and preventive care and review your current symptoms. Your provider will update your family history and check on your cancer screenings and vaccinations. You’ll review your blood pressure, weight and heart rate and examine all the major body systems.

I liken these annual preventive exams to oil changes for your car: with regular preventive maintenance, we can spot trouble early and optimize longevity and quality of life.

Preventing illness

Flu season typically begins in the fall. The flu vaccine is the best way to prevent influenza, that malady of achiness, fever and a sore throat. Influenza and pneumonia combined are the eighth leading cause of death.

Those at high risk for complications or death from influenza are individuals with chronic diseases, the elderly, children, pregnant women and anyone with a compromised immune system.

The Centers for Disease Control and Prevention (CDC) recommends everyone age 6 months and older be vaccinated for the flu, but despite that, the overall U.S. vaccination rate hovers at around 50 percent.

As the weather chills and we head indoors, illnesses such as common cold viruses spread more readily. Being in close quarters increases the transmission of infectious organisms from person to person.

Good hand-washing is the key to preventing viruses and bacteria from spreading. It’s important to use soap and water and to scrub for at least 20 seconds before rinsing and drying your hands. You know you have scrubbed long enough if you can hum “Happy Birthday” while you wash your hands!

If you are on the go, alcohol-based hand sanitizers with at least 60-percent alcohol content are very effective but may not eliminate as many germs as soap and water.

Healthful foods

One of the most exciting things about autumn is the plethora of healthful foods that are in season. You might think of blueberries as a summer food, but many varieties remain available through the fall. Blueberries are chock full of antibiotics and vitamin C.

Apples are probably the most recognizable autumn fruit. Head to a local orchard and pick them yourself for best freshness and family fun! You get 4 grams of fiber per apple and 14 percent of your daily vitamin C. Apples are 85-percent water, so you also are hydrating yourself at the same time. And all of this for only 95 calories!

Brussels sprouts are ubiquitous in the fall. Just one-half cup provides more than your daily recommended intake of vitamin K. They’re enormously good sources of iron and folate — important for healthy blood cells.

Roasting Brussels sprouts with some olive oil and salt until they’re crisp on the outside but tender on the inside brings out great flavor and texture. Your kids will say they taste like French fries!

And how about all those autumn root vegetables and squash varieties? From sweet potatoes to parsnips, and pumpkins to butternut, the choices are endless. All of these contain high levels of vitamins A and C; phytonutrients, which have anti-cancer properties; and omega-3 fatty acids, which are heart-healthy.

Exercise

The long, hot days of summer that inspired your exercise routines might be gone, but don’t skimp on physical activity just because the days are cooler and shorter! Without the sweltering heat of summer, fall can actually be more conducive for outdoor exercise.

For most adults, the CDC recommends moderate intensity aerobic exercise for 30 minutes a day, five days a week. Intensity refers to the percentage of your maximum heart rate achieved. A good rule of thumb for moderate intensity is that you can carry on a light conversation while performing the exercise. Raking leaves, that common autumn chore, burns 315 calories per hour.

Finally, let’s not forget that National Family History Day is observed on Thanksgiving Day. It’s more than turkey and stuffing you’re sharing; it’s behaviors, lifestyles and genetics, too! Getting to know your family medical history and sharing it with your doctor is important to ensuring you are being screened appropriately for inherited conditions. French philosopher Albert Camus said, “Autumn is a second spring when every leaf is a flower.” Here’s to the fall season! Let’s enjoy this special time and take advantage of the opportunities autumn presents for optimizing our health.

While many associate Seattle with coffee, rain or seafood, many Seattleites see the relationship between the city and cycling to be stronger.

With the start of summer behind us and a refreshing shift in typical summer weather patterns, the increase of cyclists on the road is evident. As more hit the road either for leisure, work or competitive purposes, it’s important to practice safe cycling methods to prevent injury.

The common injuries associated with cycling are usually due to overuse and improper bike fit. Common injuries can include knee pain, hand pain and numbness, neck or back strain and foot numbness or tingling. If pain starts to occur in one of these areas, resting, icing the area and checking the bike fit would be a good start. However, if the condition persists, consult your physician.

The right equipment

Having your bike properly fitted and fully maintained (e.g., gears shift smoothly, tires are inflated adequately and the chain is oiled versus rusted) is essential.

Poor posture on the bike can strain and cause pain in multiple areas, including the back, neck, shoulders and arms. A good bike fit helps with a cyclist’s ergonomics and can help minimize injuries related to poor posture/positioning. It can also help maximize your power while simultaneously minimizing fatigue.

If you’re uncertain how to ensure you’re doing everything correctly, ask for help at a local bike shop — they’re always willing to help out a fellow cyclist.

Always wear a helmet! Wearing a helmet can help prevent and minimize head injuries. A helmet should fit snugly and cover the top of your forehead. If it is tilting back like a bonnet, your brain is not protected and you need to try something else.

The straps should fit comfortably close to your face and chin, not dangling loosely as that will not help should an accident occur. A helmet is critical to your safety and health; spend time ensuring a good fit.

Train accordingly

During the summer, it is easy to turn a simple bike ride into an all-day adventure. It is encouraged to gradually build up to a race or long-distance stamina to avoid injury.

Start with a short ride and then add a few miles each time, building up to the full distance. This is especially important for those training for a ride like the Seattle to Portland Bicycle Classic. A sudden increase in training, high-intensity exercise or excessive knee bending can put excess pressure on the joints and lead to knee pain and tendonitis. Training beforehand makes certain you will enjoy the event more and feel better afterward.

Choose variety

Biking every day can overexert certain muscles. Varying your exercises can help strengthen other muscles that you don’t use while biking. Cross-training with exercises like yoga, weight lifting, running, etc., are great alternative methods. This will help prevent injury in the long run.

With any exercise comes risk of injury. But by using proper preventative care, the chances are less likely and the joy experienced is greater. Following these precautions will help make sure you and your bike are ready for a safe, fun summer. Now get out and enjoy the roads.

Springtime brings sunshine, green grass, chirping birds, blooming bulbs and if you’re unfortunate enough to be a member of the sniffling, sneezing and itching community, then it’s time to carry your tissues. It’s the time of year when flowers, trees and ground molds release their pollen and spores into the air — better known as spring allergy season.

For some, the regional allergy season can begin as early as mid-January and last well into August. What causes this violent reaction in your body, how long will it last and what can you do to find relief?

It all starts with your immune system, which protects your body against microscopic organisms like bacteria and viruses. With seasonal allergies, your immune system overreacts to harmless pollens, dusts and molds.

These grains of pollen, dust or pet dander enter your nasal passages or mouth cavity and your immune system releases its histamine stores and other biochemicals, from mast cells, into your body.

These chemicals trigger a cascade response that results in helping to expel the offending agent by dilating blood vessels and increasing mucus production. This overreaction means you will suffer from sneezing attacks, coughing fits, watery or puffy eyes, itchy or flushed skin and even a sore throat, fatigue and headaches.

The timing for suffering from seasonal allergies is due to the cyclical nature of when trees, grasses and flowers in the Northwest begin to bloom and release their pollen. Typically, the peak tree-pollen season is from February to May, and grass and weeds allergy season is from April through July. Some years the season can span all the way through September.

In addition, our region offers a breadth of weather patterns that make predicting the start and stop of allergy season frustrating. Coupled with continual exposures of other allergens, such as pet dander and dust mites, seasonal allergies can last all year long.

Prevention is the best medicine and trying a few of these minor lifestyle changes can go a long way toward keeping your symptoms under control:

• Limit your early-morning outdoor time (5-10 a.m.) as this is when most plants and trees disperse their pollen.
• Avoid using fans that blow outdoor air into your home, as this can pull in pollen from outside.
• When driving, use your air conditioner to help to filter larger sized allergens.
• Use a dehumidifier to decrease mold growth in your home.
• Shower frequently to remove pollen from your skin and hair.
• Bathe your indoor pets regularly to remove pollen from their fur, and discourage them from sleeping in your bed or on other furniture.
• Use a face mask if you plan on doing extended gardening or mowing the yard.

For fast relief of mild symptoms, I recommend twice-a-day normal saline nasal rinses or using devices, such as a Neti pot, that will help to irrigate your nasal passages and rinse your sinuses. Over-the-counter antihistamines, such as Claritin and Benadryl, are great options and usually safe for most people and readily available at most drugstores.

Additionally, several types of antihistamine eye drops and mast cell stabilizers or corticosteroid nasal sprays are becoming more common over the counter. While eye drops can provide relief for itchy eyes, nasal sprays can help reduce swelling and irritation in your nose. These may help to augment other home treatments.

For those seeking more robust medical treatments and longer-term relief, there are two main forms of immunotherapy treatments, including intramuscular injections or sublingual drops. Both depend on a daily to weekly low-dose exposure to allergens to help remodel your immune system and thus decrease allergy symptoms.

These methods should be prescribed and followed closely by your doctor or allergist. Further research is focused on stopping the overall production of specific types of antibodies and the entire out-of-control cascading allergic response.

At the beginning of the year, many of us make New Year’s resolutions. We resolve to lose weight, quit smoking, exercise more and many other goals to improve ourselves. But a month into the New Year most people find that their motivation has started to wane.

As a psychotherapist, I regularly see people in my practice struggling to make and keep their goals. I work with my patients to set realistic goals and explore tools for keeping to them. If you find yourself in their predicament, here are a few ideas to consider:

Carefully select your goals. First, take a look at the past year. What were some of your successes? No matter how small, what was helpful in reaching those goals and what were your strengths? Think about how you would like your life to be different in six months, one year and five years. Make a short list of what you would like to change. If there are items on your list that have been difficult to change, make a few notes as to why those transformations are tough for you.

Be honest and compassionate with yourself. Do you really want the goals you have set and all that goes along with it? It takes time to achieve worthy goals. Ask yourself if you want the changes to be longstanding, since this means changing basic habits over the long run.

Make your goals achievable. Unrealistic goals will set you up for failure. Define smaller goals that are achievable. Instead of “work out every day,” try a smaller goal like exercising three times a week or walking for part of your lunch break at work. It is also important to pick an action, not a result. For instance, make it a goal to exercise three times a week, not lose 10 pounds.

Start small and build to success. Take time to recognize all progress you make toward your goal. I cannot stress enough that our minds and bodies need time to practice for longstanding habits. Writing down your goals and keeping them with you in your pocket, purse, laptop or smartphone can aid you in reaching your goals.

Planning is key to following through. For example, if your goal is a more healthful diet, prepare your shopping list well before you go to the store and avoid buying things that are not on your list. Prepare a week’s worth of food on the weekends and bring that food with you to work. Use trial and error here. When one strategy does not work, consider trying other strategies.

Support can make all the difference! Tell your family, partner or close friends about your resolutions, and ask them to check in with you. If possible, work with a friend who has a similar goal. Then when you are tempted to quit, he or she can encourage you to keep going. Make sure everybody who is important to you understands that you are going to do this.

Make a list of alternative ways to keep your resolution. This especially important when it comes to exercise and food. Our minds and bodies need flexibility in order to keep our goals. If you know you will be traveling or otherwise out of your normal routine, list different options so you can continue working toward your goal but also take into account you may not get in your normal workout or meal.

The goal that makes all the other goals achievable: Be good to yourself. Consider having this as your No. 1 goal for 2015. Everything else in life is easier if you are working on being good to yourself. “I can’t” or “all or nothing” thinking is very counterproductive. What are the healthy rewards that you enjoy? Where do you enjoy spending time? What gives you pleasure? There are going to be long days at work when you can only get in half of your workout, and there are going to be parties where you may not eat as healthily as you would like. The key is to recognize these moments and not let them sabotage you in reaching your end goal. Keep your eye on the big picture: you feeling healthy and happy!

Tips from Keiko Aikawa, MD, on how to avoid cardiovascular disease.

February is Heart Health Awareness Month, so it’s the perfect time to address the prevalence of cardiovascular disease in women and discuss ways to decrease risk for the development of the disease.

Cardiovascular disease is the leading cause of death in women in the United States. It kills more women than cancer, chronic lung disease, Alzheimer’s disease and accidents combined. Women typically develop cardiovascular disease 10 years later in life than men. After menopause, the incidence and severity of heart disease increase significantly. Women under the age of 45 who develop heart disease, however, have a worse prognosis compared to older women.

Between 1997 and 2012, women’s awareness of their own risks for heart disease has risen from 30 percent to 54 percent, due, in part, to a strong campaign by the American Heart Association to raise awareness and educate the public. But the level of awareness is still not where it should be. Trends of heart attacks are decreasing for men, but are increasing for women. Death rates for cardiovascular disease in women ages 35—55 years old are increasing and can partially be explained by the obesity epidemic.

When I see patients, I always ask about risk factors that may put them at increased risk for heart disease such as obesity and a sedentary lifestyle. Diabetes and smoking are greater risk factors for heart disease in women than in men. Menopause, including surgical menopause, increases a woman’s risk of heart disease because estrogen is protective against cardiovascular disease. I also look for evidence of abnormal lipids including high LDL cholesterol, low HDL cholesterol and elevated triglycerides. Autoimmune diseases such as lupus or rheumatoid arthritis are less well-known risk factors.

Additionally, pre-eclampsia, pregnancy-induced hypertension and gestational diabetes are early indicators of a woman’s future cardiovascular risk.

Next, I ask patients about their family history. Having a first-degree relative with premature coronary artery disease — defined as younger than 55 years old in men and younger than 65 years old in women — increases one’s risk.

Once you know your risk factors, you can take steps toward prevention. Here are some of my recommendations for living a heart-healthy life:

• Avoid smoking. Smoking as few as one to four cigarettes a day can double your risk for cardiovascular disease.
• Maintain a healthy weight and exercise. It’s important to keep a healthy weight and aim to have a body mass index of less than 25 kilograms/meters squared and a waist circumference of less than 35 inches. To support these goals, engage in moderate exercise for at least 30 minutes, five days per week with sustained aerobic activity for at least 10 minutes at a time. (Additional benefits occur when one participates in moderate exercise for five hours per week.)
• Eat a heart-healthy diet. This includes limiting sodium intake to less than 1,500 mg per day and sugar intake to five tablespoons or less per week, limiting foods high in saturated fats and cholesterol, and avoiding trans fats.
• Treat other illnesses and diseases that put you at risk. Ensure that you are treating any diagnoses of hypertension, hyperlipidemia and diabetes mellitus with lifestyle modification or medications.
• Test for high cholesterol. I would recommend that women older than 20 have their lipids checked at least once to see if you’re at risk.

The advice I give to those who want to improve or maintain heart health is this: living a heart-healthy life often requires a lifestyle change. There is not a “diet” that one must get through or an exercise program one must try. It requires a mental shift in how you view exercise and diet and how you prioritize your heart health in your life.

I see many patients who work long, hard hours and have busy family lives and find themselves too busy or too tired to exercise, and too busy or tired to cook a healthy meal or go grocery shopping. It’s a very difficult situation where they cannot make their health a priority due to external pressures. I stress to my patients that when they make time for themselves and their health, they will see huge benefits in the long run so that they can continue to live happy and healthy lives into the future.

Dr. Aikawa is a cardiologist at PacMed.