| PostIndependent.com

Doctor’s Tip: Low back pain? Eat better

Low-back pain is common, interferes with quality of life and can sometimes be disabling. It has many causes, including degeneration of the discs (pads between vertebrae) and degenerative arthritis of the facet joints that hold vertebrae together.

There are no great cures for chronic low-back pain, and you should be cautious about undergoing surgery (except in the case of a large disc bulge pressing on nerves and causing leg weakness). “Failed low back” is a term that applies to people who have spine surgery, fail to improve, end up with one or more additional operations that only make things worse.

In the last few years, it has been determined that what people eat can contribute to low-back pain. The tenth annual International Plant-Based Nutrition Healthcare Conference was held in Palm Desert, California, earlier this month, and three meals a day were included. At breakfast one day (steel cut oats, ground flaxseeds, cinnamon, walnuts, berries, turmeric, soy milk, green tea), I happened to sit next to an orthopedist from the Mayo Clinic, and I told him I was surprised that an orthopedist would attend a  plant-based nutrition conference.

He told me that he spends a lot of his time trying to convince back-pain patients to improve their diet rather than undergo surgery. He pointed out that doctors at the Mayo Clinic are salaried, so they have no financial incentive to recommend surgery (Most doctors in the U.S. work on a fee-for-service basis). He said there is a strong link between back pain and atherosclerosis (cholesterol plaque) of the aorta — the large blood vessel that brings blood, oxygen and nutrients from the heart to the lower body, including the spine.

Smaller arteries branch off the aorta and nourish the discs and the vertebrae. Imaging studies of low-back-pain patients often show cholesterol plaque partially- or totally-blocking blood flow in these small arteries, causing or at least contributing to disk and spinal joint degeneration. Similar blockages can also occur in the small arteries that nourish the nerves in the spine.

Based on work by Dr. Dean Ornish, Dr. Esselstyn and others, we know that atherosclerosis can be reversed with a plant-based, whole-food diet with no salt, sugar or added oil. This diet stabilizes and can reverse heart disease and conditions such as erectile dysfunction (caused by blockages in the small penile arteries).

There are three additional ways that a healthy diet can prevent and reverse back pain: 

1. If a person is say 50 pounds overweight, it’s like a normal-weight person carrying around a 50 pound backpack all day, which would result in back (and knee) pain in most people. A plant-based, whole food diet is the most effective one for attaining and maintaining ideal body weight.

2. Pain is caused by inflammation, and, while an animal-based diet causes inflammation, a plant-based diet is anti-inflammatory.

3. Core strength stabilizes the spine, and people who are sedentary lose core strength as they age, resulting in a higher incidence of back pain.

In conclusion, low-back pain is one more reason to eat a healthy diet — and to stay physically active.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment, or email gfeinsinger@comcast.net.

Doctor’s Tip: Flu shot time — Influenza can cause lost work and school days, and even death

This week’s column is a break from a series about foods to avoid for optimal health because it’s flu-shot time.

An old Chinese saying says that a superior doctor prevents disease, and vaccinations, including COVID and flu immunizations, are one of the shining success stories of disease prevention. They stimulate the immune system to fight off infectious disease, without the vaccinated person experiencing the disease. They have saved millions of lives worldwide and prevented millions of cases of disability, such as deafness from measles, birth defects from Rubella, paralysis from polio and long-COVID.

Thousands of Americans die every year from influenza and its complications — and most of these deaths would be prevented if everyone received an annual flu shot. Of lesser concern but still important is that influenza accounts for many days of lost work and school absences.

The Center for Disease Control and Prevention recommends a flu shot by the end of October for everyone over the age of 6 months, with rare exceptions (Egg allergy is no longer one of them). Children under the age of 6 months should not receive flu shots, so it’s particularly important that care givers for those children are immunized. During the 2019-20 flu season 166 U.S. children died from influenza — deaths that probably would have been prevented had these kids been immunized. Adults 65 and older need extra strength vaccine.

Influenza is caused by viruses — which do not respond to antibiotics. The most severe forms of flu are influenza A and B, with C being milder. In temperate climates such as ours, flu viruses are usually active during the colder months — late fall, winter and early spring. It takes about 2 weeks for the shots to “kick in.” Flu shots can be obtained in most doctors’ offices, in pharmacies and at public-health offices. They are tweaked every year, due to “genetic drift” in influenza viruses. Go to the CDC website to learn about the several flu vaccine options available this year or discuss with your PCP or whoever is giving you the vaccine.

Side effects, other than mild soreness around the injection site for a day or two, are rare. People sometimes say that the flu shot gave them the flu, but that has never been proven to occur. The average adult gets five, non-flu viral infections a year (such as colds), so, out of the millions of flu shots that are given every year, some people will coincidentally come down with one of these other viral infections and blame it on the flu shot they just had.

Influenza is highly contagious and is transmitted by the respiratory route, meaning nasal drainage and droplets expelled by coughing. The incubation period is 1-4 days. Typical symptoms include fever, chills, malaise (feeling really crummy), generalized aching, chest discomfort, headache, nasal stuffiness, dry cough and sore throat. Elderly patients often present with lassitude and confusion but not the other symptoms. Common flu complications include sinus and ear infections, bronchitis, and pneumonia (viral and bacterial), with pneumonia usually being the cause of flu-related deaths.

Did you know that flu shots can reduce death from heart attacks and strokes? Bacterial and viral infections, such as influenza, can cause inflammation that can trigger rupture of arterial plaque — the cause of heart attacks and strokes. According to Bale and Doneen in their book Beat the Heart Attack Gene, a large study showed that up to 91,000 Americans die annually from heart attacks and strokes triggered by the flu — deaths that are not included in the statistics for flu-related deaths.

Rapid flu tests done in doctors’ offices are helpful for diagnosis, although false positives and negatives can occur. Remember that flu shots only prevent influenza A and B — not colds or stomach or intestinal flu. They are not 100% effective in preventing influenza, but the disease tends to be shorter and milder in immunized people, and complications including death are much less apt to occur.

Based on what happened in Australia where the seasons are flipped, experts predict a severe flu season in the U.S. this year. Be pro-active about your health, and get a flu shot if you haven’t already. Flu shots are particularly important during the current COVID-19 pandemic, and flu and COVID immunizations can be given concurrently.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment, or email gfeinsinger@comcast.net.

Torres column: Be genuine

“Don’t be afraid of losing people. Be afraid of losing yourself by trying to please everyone around you.” 

Around 10 years ago, I decided to be myself and stand up for what I believe is true (compared to what other people want me to believe). I decided that I needed to be genuine to myself since I was never honest to myself. 

Before my change, I tried many times to please other people, even though I did not agree with their beliefs and philosophy. I was their puppet. For some reason, doing that made me weak. We know inside of us when we do and say things that make us weak. I knew that, and I never did something to change it, maybe because I was afraid of people not liking me. 

It was not until I decided to become a better person and version of me that I decided to stand up for my values. Something inside of me changed. I knew many people would get annoyed because of my new “attitude.”    

I got fired because of it; I lost many friends; I was less popular with my peers, and I could not fit into many circles of people. It was very difficult in the beginning, but things started to turn around.

Even though things were not turning out good, I started to feel confident and happy. I knew inside of me that everything would come to be okay. For the first time, I was good with myself.

Another bad behavior I had was that I used to lie consciously and continuously for many reasons. You may empathize with me and understand that it is easier (physiologically) to tell a lie then say the truth. But, in truth, it is easier to tell the truth than lie because of the consequences. 

When I decided to stand up for my beliefs, I also decided to start telling the truth no matter the consequences. The truth is hard for many people, and many times will hurt people and make others angry. Even though there are many who never get over their emotions, others will control their emotions, and they understand that telling the truth is the best thing for everyone. 

This year, I discovered an amazing clinical psychologist who recommends not to say things that make you weak and to always say the truth. His name is Jordan Peterson. He explains how doing so helps you put your life back together, and it helps you to be an asset for society instead of a burden. 

I discovered that he is right and being genuine to yourself is the best thing you can do not only to be an asset to society, but also to be happy. 

Many people struggle in life because they are not true to themselves. They suffer anxiety, depression and other psychological symptoms. They put themselves into stress to try to please others, and they end up miserable because they are unable to truly commit to themselves and fail to be liked by everyone.

It is just simply impossible to be liked by everyone. 

Now being true to yourself is not following your carnal desires. It is to listen to yourself, to go against what you know you are doing wrong. It is to contemplate your life and understand that you may be practicing bad behavior even though it is accepted by society. Being true to yourself is to truly do what is right when others disapprove of your behavior.

There are so many behaviors that can be against your will, but your body wants to practice, such as alcoholism, pornography, impulsing shopping, binge eating and others. 

The key here is not to give up and not to let yourself down. You will see how your self confidence increases because every time to do what you know is true to you, you know you are being honest with you. 

If you have not tried to be true to yourself and tell the truth no matter the consequences, maybe it is time for you to try and see how your life turns around.

Becoming an asset for society I think is a good motive, but what I really think is the real reason to change is to find yourself and with that genuine happiness. 

Sandro Torres is owner of Custom Body Fitness in Basalt, Carbondale and Glenwood Springs and author of the books “Lose Weight Permanently” and “Finding Genuine Happiness.” His column appears on the third Wednesday of the month.

Doctor’s Tip: A potpourri of health tips

Following are some random health tips that don’t warrant a whole column of their own:

COLORECTAL CANCER SCREENING: Over 50,000 Americans die annually from colon cancer, which is a preventable disease — it’s very rare in populations on a life-long plant-based, whole food diet. The earliest stage of colon cancer is clusters of abnormal cells lining the colon. The second stage is polyps — small growths that protrude from the lining. The final stage occurs when small polyps — that are initially benign — gradually become malignant and eventually spread. Screening is now recommended at age 45 and earlier if there is a family history of colon polyps or colon cancer. A repeat is recommended every 10 years up to age 75, more often if polyps are found. The old screening method of checking stool from three different bowel movements for blood annually is no longer recommended because it’s too inaccurate. Colonoscopy has been the gold standard for screening for years and should be used in circumstances such as a family history of colon cancer. However, it’s inconvenient, expensive (much cheaper at an outpatient facility in Grand Junction versus here, where it’s done in Valley View Hospital), and associated with a small risk of perforation. According to a recent issue of the Berkeley Wellness Letter, an annual home stool test called FIT (fecal immunochemical test), done with a kit prescribed by your doctor, is inexpensive ($20) and quite accurate; if positive, a colonoscopy is indicated. Another stool test called Cologuard is expensive ($650) and has not been shown to be more accurate than an annual FIT.

GUT/BRAIN CONNECTION: According to an article in a recent Harvard Health Letter, the gut microbiome can influence our emotions, our cognitive capabilities and our vulnerability to Alzheimer’s and Parkinson’s. Three mechanisms are involved: 1) Substances made by gut bacteria can get into the brain via the bloodstream. 2) Gut bacteria can send signals to the brain through certain nerves connecting the two organs. 3) Gut bacteria can stimulate immune system cells in the gut wall, and these immune cells can send signals via gut-brain nerves. The best way to ensure a health-promoting gut microbiome is to lead a healthy lifestyle including eating lots of fiber (found only in plants).

REDUCING ALZHEIMER’S RISK: The same Health Letter cites evidence that 40% of dementia cases could be prevented or delayed with the following: 1) regular aerobic exercise; 2) learning something new as you age; 3) eating a healthy diet; 4) getting at least seven hours of sleep at night; 5) limiting alcohol consumption; 6) maintaining social connections; 7) managing stress through activities such as yoga, tai chi or mindfulness; 8) avoiding tobacco; 9) maintaining normal blood pressure, weight and cholesterol; 10) treating hearing impairment; 11) avoiding head injuries; 12) avoiding midlife obesity; 13) avoiding/reversing diabetes; and 14) avoiding air pollution.

INACCRATE MEDICAL INFORMATION ON THE INTERNET: Sites such as Harvard Medical and Mayo Clinic are reputable. However, according to the June issue of Nutrition Action, published by Center For Science in the Public Interest — which has no industry ties — many other sites such as Healthline, WebMD, Medical NewsToday.com, Everydayhealth.com, SHAPE and Healthy Eating are influenced by ties to the pharmaceutical, food and supplement industries and contain inaccurate information.

CURRENT ASPIRIN RECOMMENDATIONS: If you’ve had a heart attack or stroke, a baby aspirin (81 mg) a day helps prevent a second event. However, aspirin can have serious side effects: stomach bleeding and hemorrhagic strokes (where a blood vessel in the brain bursts). When it comes to preventing a first heart attack or stroke, aspirin might be considered in someone at high risk for a heart attack or stroke, such as strong family history or presence of plaque in their arteries (seen on imaging tests such as coronary calcium scoring or carotid IMT). However, other people should avoid aspirin to prevent a first heart attack or stroke, because the risk outweighs the benefit. And people at risk for bleeding (age over 70, use of steroids or drugs like ibuprofen, history of stomach ulcers or GI bleeding) should avoid aspirin in all circumstances.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Doctor’s Tip: More about micronutrients in childhood nutrition

Today’s column is another in a series about childhood nutrition, taken from the 2020 book “Nourish, The Definitive Plant-Based Nutrition Guide for Families,” by Stanford-affiliated pediatrician Reshma Shah, M.D., M.P.H. and well-known dietician Brenda Davis. So far, macronutrients (protein, carbs, fats) have been covered as well as vitamin and mineral micronutrients. Dr. Michael Greger’s evidence-based website nutritionfacts.org was also used for today’s column.

Under micronutrients we still need to cover antioxidants, anti-inflammatories and phytochemicals. These aren’t as critical for human survival as vitamins and minerals, but are necessary for optimal human health.

ANTIOXIDANTS prevent oxidative chemical reactions that produce harmful free radicals. Examples of oxidation is rusting of metal when left out in the rain, and the white of an apple turning brown when it’s cut in half. Oxidation in our bodies contributes to aging, cancer, diabetes, heart disease, dementia and several other disorders.

Antioxidant content of thousands of foods has been determined, and antioxidants are found in abundance in whole plant foods, and in small amounts in animal-based foods (meat, dairy, eggs and seafood). On average, plant foods have 64 times more antioxidant content than animal-based food. The antioxidant content of the highest antioxidant plant food is 289,711; the highest antioxidant animal food has a content of 100. Of note is that human breast milk is loaded with antioxidants.

Plants with a strong flavor such as herbs and spices have particularly high anti-oxidant contents. Plant-based medical providers tell their patients to “eat the rainbow.” Vegetable examples are greens, red cabbage, red onions, peppers, tomatoes, carrots and sweet or purple potatoes. Fruit examples are berries, oranges, limes, lemons, kiwi fruit, mangoes and watermelon. Grain examples are brown or, even better, black rice.

The antioxidant vitamins are A, C and E, but taking them in pill form — at least in the case of A and E — causes instead of prevents problems, likely because high doses of single antioxidants become pro-oxidants (cause oxidation).

ANTI-INFLAMMATORY MICRONUTRIENTS: Inflammation plays a large role in many diseases. Animal-based diets cause inflammation due to compounds such as heme iron and interleukin-6. Sugar and refined foods are also inflammatory. Colorful fruits and vegetables, omega-3 (EPA and DHA), nuts, seeds and some spices have anti-inflammatory properties. In general, a plant-based diet is anti-inflammatory and an animal-based diet is pro-inflammatory (causes inflammation). When patients switch from an animal to a plant-based diet, they often remark after two weeks that their aches and pains went away.

PHYTOCHEMICALS: Phyto comes from the Greek word for plant, so phytochemicals are found only in plants. A few examples are: 1) Lycopene, found in tomatoes, watermelon and guava, has antioxidant properties and also cuts prostate cancer risk. 2) Flavonoids, found in oranges, lemons, grapefruit, papayas and peaches, inhibit tumor cell growth and detoxify harmful substances. 3) Indoles and lutein, found in spinach, kale, collards and other greens, builds healthy cells and genetic material. 4) Allyl sulfides, found in garlic, onions, chives and asparagus, destroy cancer cells and support the immune system. 5) Anthocyanins, found in blueberries, purple grapes and plums, destroy free radicals. 6) Resveratrol, found in grapes, berries and plums, may decrease estrogen over-production.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Torres column: Why you might be having trouble losing weight

Are you having difficulties losing that extra fat and toning your body? Getting in shape is not as easy as it may seem. In my experience, I have noticed that losing weight and getting fit takes more than exercise and eating healthily. The problem is more formidable than people think, although, of course, it is highly attainable. Signing up in a weight loss program is a first, easy step, though keeping up with the program is harder.

Stress is one of the factors that can affect one’s intentions to work at a weight loss program. One’s working schedule as well as health problems are forms of stress. Work and health issues sometimes are out of our control and, therefore, can mess with our weight loss program. But a balance always can be found. If we don’t find it, we will never get to our desired body weight.

Another factor that can disrupt a weight loss or fitness program is bad habits. I read that a human being can never erase a bad habit. It needs to be replaced by a positive habit. Sometimes, due to lack of knowledge, people don’t even know that their habits are putting their health at risk. Of course, others simply don’t want to give up bad habits because of their prompt relief. Instant gratification is reinforcing, but we can learn to think more long term and, with steady work, begin to morph our day-to-day practices and diet. Good habits result in slow but lifelong rewards, which a bad habit does not do.

Another factor in determining whether or not people will change their lifestyle can be the existence of past traumas. The other day, on my walk, I ran into a young man I know who confided in me that he was afraid to try a real career because he’d been raised to feel he would be a failure no matter what he tried. He was a bright person but had pretty much stopped trying at all. We chatted for a while, and I tried to make him see that without some failures we can’t learn to succeed. And it’s true. People who are successful needed to make many mistakes to get to where they are. For the many arrows that missed the target, one of them will hit it. Some people who have been traumatized by their past don’t give their best or make the commitment to succeed, whether it’s losing weight or sticking to a workout routine. They say, “Why try? I’m not going to succeed.” So they are already failures before they start. My feeling is that, as scary as it sounds, we need to enjoy our failures as much as our success. Life is a journey.

One more factor that sometimes prevents people from beginning physical training is past injuries to the body. People are afraid of pain and want to avoid reinjuring their bodies. For them, if they feel any pain while they exercise, it’s a warning sign to them, and they stop exercising. That’s where a fitness professional comes in. We can help a person differentiate “good” pain from “bad” pain. There are pains that show us that we are getting in shape: One overloads the muscles a little each time, and this helps us get to our goals. Once we know what pain is “good,” we can train our minds not to panic if we feel a twinge or two during or after a workout. Pain is part of all levels of life, and it is needed to succeed in most aspects. It is important to talk to a professional dedicated to your well-being to understand the difference between pains.

Sometimes we wonder why we can’t lose weight and change our lives. These factors most likely are unconscious. Thus many factors contribute to our weight loss or fitness problems, including psychological, physical and environment dynamics. Nonetheless, we have control over our lives, and we can do whatever we want if we really want it from the bottom of our heart. The power of changing is with you and only you.

Sandro Torres is owner of Custom Body Fitness in Basalt, Carbondale and Glenwood Springs and author of the books “Lose Weight Permanently” and “Finding Genuine Happiness.” His column appears on the third Wednesday of the month.

Valley Health Alliance hosts virtual panel to discuss insurance options Wednesday

The Valley Health Alliance invites small businesses and individuals who buy health insurance to Health Insurance 2022, a virtual panel and Q&A event set for noon to 1 p.m. Wednesday.

The panel discussion is to be broadcast on Facebook Live from the Facebook pages of five area chambers of commerce and the Valley Health Alliance.

The hour-long event includes a panel discussion and Q&A on the new health insurance plans available for small businesses and individuals between Aspen and Parachute.

Panelists include representatives from insurer Rocky Mountain Health Plans, Glenwood Insurance, Carbondale Chamber of Commerce, Mountain Family Health Centers, Aspen Skiing Co. and Roaring Fork Family Practice.

“For the second year in a row, we have two choices of insurers in both the small group and individual health insurance markets, and we understand premiums for many plans are going down,” Valley Health Alliance Executive Director Chris McDowell said in a news release.

“It’s important to get folks thinking about health insurance as the year comes to a close,” he said.

The event will be broadcast through the Facebook pages of the following organizations: Aspen Chamber Resort Association; Glenwood Springs Chamber Resort Association; Carbondale Chamber of Commerce; Basalt Chamber of Commerce; Western Garfield County Chamber of Commerce; and Valley Health Alliance.

Visit any of these pages at noon Wednesday, and click on the video link.

Doctor’s Tip: One doctor’s path to learning about the power of food

There is a wealth of scientific literature about the power of unhealthy food to cause disease and of healthy food to prevent, treat and reverse disease. Unfortunately, doctors aren’t given this information in medical school, postgraduate training or in typical medical conferences (the majority of which are sponsored by the pharmaceutical industry).

I recently met a bright young urologist at Valley View Hospital, Aashish Kabra, M.D., who was raised in a vegetarian household but who became totally plant-based a few years ago after happening upon the aforementioned literature. Kabra told me he works plant-based nutrition into the conversations he has with most patients, because food plays a key role in many urologic disorders. He also told me about his “new favorite book,” called “Fiber Fueled, The Plant-Based Gut Health Program for Losing Weight, Restoring Your Health, and Optimizing Your Microbiome,” by gastroenterologist Will Bulsiewicz, M.D., MSCI (Master of Science in Clinical Investigation — in other words, he’s an expert in analyzing and interpreting clinical studies).

The next few columns will be based on “Fiber Fueled,” but first it’s important to know Dr. Bulsiewicz’s story. He attended Vanderbilt for undergraduate school, then graduated from Georgetown University School of Medicine, was chief medical resident at Northwestern Memorial Hospital in Chicago, and chief gastroenterology fellow at The University of North Carolina Hospitals. He earned the MSCI degree from Northwestern, and did an epidemiology fellowship (where you look at large populations of people, see what they eat, what diseases they get, and what they die from) at University of North Carolina School of Global Public Health. He has written over 20 articles in top American gastroenterology journals.

Dr. Bulsiewicz notes that the average American eats 3 pounds of food a day, 1,000 pounds per year, and about 80,000 pounds of food during an 80-year lifespan. So it’s no wonder that what we eat affects our health. As he puts it: “You could nourish your body with life-giving food and reap the rewards of better health. Or you can punish your body with poisons disguised as food that actually take health away with every bite.”

Dr. Bulsiewicz admits to being a junk food addict growing up. Like most physicians, he received minimal training about nutrition in medical school. During the subsequent 10 years of training to become a board-certified gastroenterologist, nutrition was never mentioned again. Toward the end of his training, although he was able to drag himself to the gym a few times a week, he was 50 pounds overweight and felt tired, overworked and just plain lousy.

Then he met his future wife, who happened to be on a plant-based diet, and he began to realize there was a better, healthier way to eat. He lost weight, no longer had “post-meal hangovers,” and felt more energized and stronger. His mind had “more stamina for work,” his mood became more positive, and he looked better.

He began to wonder why he hadn’t heard about plant-based nutrition during his years of medical training and figured there probably weren’t good studies to support it. Having an advanced degree in clinical investigation, he spent some time in the medical library, and found “a mountain of evidence to support the way I was feeling.” He found “study after study providing a uniform, consistent result. Plants are good for our health.” Plants have the most nutrients per calorie of any type of food. They have “vitamins, minerals, antioxidant compounds called polyphenols, and unique medicinal chemicals found in only plant food, called phytonutrients.” Furthermore, Dr. Bulsiewicz found out why fiber is so important. He learned that only plants have fiber, which he came to believe is “the single most important missing piece in the American diet.” This led to his book, “Fiber Fueled.”

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Doctor’s Tip: Should you sign up for Lifeline Screening?

Recently there have been pink inserts in local newspapers advertising health screening by a company called Lifeline Screening, which has been coming to our area for years. People are asking doctors if they should sign up for this testing, which costs $181 and is not covered by insurance or Medicare.

It is always best to prevent disease, and it’s estimated that 80% of the chronic diseases that Americans suffer and die from would be prevented if everyone simply ate more vegetables, fruit, whole grains, nuts and seeds and moved about more. Next best is catching disease early, when it can be treated and often reversed. Given that heart attacks and strokes, caused by atherosclerotic plaque in arteries, are the No. 1 cause of death in the U.S. (at least in non-COVID-19 years) — and given that almost all these deaths are preventable— it’s particularly important to screen for early disease in arteries. Let’s look at the tests offered by Lifeline Screening, none of which involve radiation:

CAROTID ARTERY (PLAQUE) SCREENING: The carotid arteries bring blood from the heart to the head and brain. They are located just under the skin on each side of the windpipe, so are easily accessible for evaluation by ultrasound. When disease is present in these arteries, it is virtually always present in other arteries as well, including the coronary (heart) arteries. The Lifeline Screening test picks up significant plaque, which if present should be a red flag for primary care physicians to determine and treat causative factors such as obesity, hypertension, high cholesterol, diabetes, inflammation, smoking, sedentary lifestyle, unhealthy diet and sleep apnea. A more sensitive test, which picks up earlier, more subtle disease, is carotid IMT, available at Compass Peak Imaging.

SCREEN FOR ATRIAL FIBRILLATION: This arrhythmia is dangerous, because clots can form in the atria (the small, upper chambers in the heart) and go to the brain, resulting in an embolic (caused by a clot originating somewhere else) stroke. Most people with AFib know they have a heart irregularity, but not all. If the Lifeline Screening test shows AFib, you should see your physician right away; if it is not present, it could be because the arrhythmia occurs off and on.

ABDOMINAL AORTIC ANEURYSM SCREENING: The left ventricle of the heart pumps blood through the aorta, the largest blood vessel in the body. In some people, a weak spot develops in the abdominal portion of the aorta, resulting in a bulge called an abdominal aortic aneurysm (AAA). Most people with this condition don’t realize they have it until it bursts, at which point it’s too late to do anything about it because of massive acute blood loss — and some 30,000 Americans die every year from a ruptured AAA. If the bulge is caught early through a screening ultrasound, the weak spot can be repaired. Medical guidelines for screening vary, but in their book “Beat The Heart Attack Gene,” Bale and Doneen recommend that everyone have a screening ultrasound for AAA at age 50, and at age 40 if they have risk factors such as smoking, hypertension or a family history of AAA.

PERIPHERAL ARTERIAL DISEASE (PAD) SCREENING: PAD is atherosclerotic plaque in the arteries of the legs, which can result in leg pain with walking. Surgery to bypass the blockages, and even amputation, are sometimes necessary. Furthermore, if disease is found in leg arteries, it is bound to be present in other arteries such as those in the heart and brain.

OSTEOPOROSIS RISK ASSESSMENT: Thinning of the bones is common as people age — especially women. However, osteoporosis is not normal, and it increases the risk of fractures, which can interfere with quality of life and shorten lifespan. The Lifeline Screening test is an ultrasound of the shin bone. Although this test may be useful for screening, the gold standard test is a densitometry, which checks bone density in the wrist, hip and lower spine.

To answer the question of whether you should sign up for Lifeline Screening, if you’re younger than 40, any benefit is unlikely. If older than 40, the screening could be helpful, and the price is right compared to doing these tests individually, especially given that it would be unlikely that your insurance would pay.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.

Doctor’s Tip: Shortness of breath is a common complaint

A frequent complaint that brings patients to primary care doctors is shortness of breath. Often the cause is weight gain or poor aerobic conditioning. This column is about more serious causes.

Lung infections: Pneumonia usually occurs as a complication of a viral upper respiratory infection such as influenza. Classic symptoms in addition to shortness of breath are moderate to severe cough, fever, chills and sometimes chest pain with a deep breath. Symptoms may be less severe in “walking pneumonia,” but pneumonia can be serious, and people still die from it. Viral pneumonia does not respond to antibiotics, but bacterial pneumonia does. If you have any symptoms of pneumonia, the sooner you get diagnosed and receive appropriate treatment, the better.

One of the hallmarks of severe COVID-19 disease is low oxygen, which causes shortness of breath. Again, the sooner you’re diagnosed and treated, the better. Even better is prevention, through immunization and, when appropriate, social distancing and masking.

Asthma is an inflammatory condition that causes spasm of the breathing tubes in the lungs, resulting in wheezing and shortness of breath. Asthma can be fatal, so if you think you might have it, seek professional help.

Emphysema is caused by loss of alveoli (small, delicate air sacs in the lungs where oxygen enters the blood). Smoking, second hand smoke and air pollution all play a role in this chronic and progressive disease. Exertion causes oxygen levels to drop, resulting in shortness of breath. You can check your oxygen level by buying a finger oximeter at any pharmacy and wearing it while walking briskly up some stairs (normal oxygen level is greater than 90% at all times).

Coronary artery disease (atherosclerotic plaque in your heart arteries) can cause shortness of breath. Especially in women, shortness of breath with or without exertion can be a symptom of a pending or actual heart attack.

Heart arrythmias: In atrial fibrillation and other heart irregularities, the heart beats irregularly and/or very fast. This results in inefficient delivery of oxygen to organs and tissues, causing shortness of breath with exertion and sometimes at rest.

Congestive heart failure occurs when the heart muscle becomes weakened by conditions such as atherosclerosis or tight or leaky heart valves. Blood and fluid back up into the lungs, causing shortness of breath.

Blood clots in the lung: The medical term for this is pulmonary emboli, which can cause shortness of breath at rest or exertion. Usually they are associated with chest pain, but not always, and they can be fatal.

Anemia refers to a low red blood cell count. The most common cause is iron deficiency, from loss of iron due to conditions such as heavy menstrual periods in premenopausal women; or loss from the GI tract from bleeding ulcers, colon polyps or colon cancer. Red blood cells carry oxygen to organs and tissues, and a low red count causes shortness of breath with exertion.

Mental health factors: A common symptom of anxiety is the feeling that the sufferer can’t get a deep enough breath. In severe anxiety such as panic attacks, people start to breath rapidly, which causes the level of carbon dioxide in the blood to fall, which in turn causes numbness and tingling in extremities. Although nobody dies from panic attacks, the sufferer feels like they’re going to die. Treatment is to breathe into a paper sack, which brings CO2 levels back to normal.

The take-home message is this: Many causes of shortness of breath are serious. If you have this condition, see a medical provider on an urgent basis.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.