The Facts on Falling Back and Sleep

Man and Woman Sleeping [Credit: Monkey Business Images] / []

Most of us love the extra hour we gain when daylight savings time ends in the fall. However, feeling better rested may not result from simply sleeping in an extra hour. Rather, aligning your waking time more with daylight – a physical cue that makes all the difference – is the more likely explanation.

Your biological internal clock, known as circadian rhythm, responds to light and darkness. When your activity does not correspond with sunlight cues, it throws off your circadian rhythm, causing your sleep to be disturbed. The extra hour helps with resetting your body’s exposure to sunlight.

Getting a good night’s sleep is important. If you are wondering how important, consider the risks associated with poor sleep and the benefits of good-quality sleep.

Risks from Poor Sleep

  • Weight gain
  • Heart attack
  • Stroke
  • High blood pressure
  • Diabetes

Benefits from Good-quality Sleep

  • Feeling better
  • Looking younger
  • Experiencing improved memory and concentration
  • Feeling less moody and grouchy

While seven to nine hours is optimal for most adults, you can achieve big improvements in your sleep quality by practicing consistency, which is going to bed and waking up at the same time every day.

If you are not currently doing this, try testing it. Make a point of going to bed and waking up at the same time for a couple of weeks. I did this several years ago. For two weeks, I went to bed at 11 p.m. every night and woke up every morning at 7 a.m. After five days, I felt like the last time I had slept so well was in middle school.

However, if you think you are getting enough good-quality sleep, but are still very tired, that is a signal for getting evaluated. Start by contacting your primary care provider who may be able to treat your sleep condition or recommend someone who can. The good news is that common sleep disorders can be treated.

Rachel Salas, M.D. is the assistant medical director for the Johns Hopkins Center for Sleep at Howard County General Hospital.

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Summer4827805659_9da7bd0ae7_b is all about having fun in the sun. We’ve all made plans to enjoy the beach, lake, and/or pool. Many of my friends are planning to lay on the beach and even out their tans for that perfect summer-kissed glow (due to all the up-coming weddings they are attending). Seems like no big deal, right? Well, it’s NBD until you have few moles removed from your back and your doctor is telling you that a sunburn you got 10-15 years ago is probably what made those moles a problem today. Listen, skin cancer is the most common type of cancer and accounts for about half of all cancers diagnosed. According to the American Academy of Dermatology nearly 145,000 Americans will be diagnosed with some form of melanoma this year. Moreover, 75% of skin cancer deaths are due to melanoma. It is a big deal.

My fiance just had a mole removed from his back two weeks ago. Today, he goes in to have the stitches removed. The doctor explained to us that on a scale of 1 – 5, where “1 is normal” and “5 is cancer” the previous biopsy of the mole was a “3” and that’s why the mole and the area around it needed to be excised. As a cancer survivor and liver transplant recipient, I understand the importance of protecting my skin because I am “100 times more likely than the general public to develop squamous cell carcinoma.” Despite the cautionary tales I’d shared and the “wear sunscreen” speech I’ve relayed from my doctors, friends, and fellow cancer survivors- it wasn’t until this happened to him that it “clicked.”

I don’t want you to have to end up with a cancer diagnosis to realize and practice the simple steps you can take to avoid getting sunburned. Sunburns today could be skin cancer in a year or 10 years. Trust me. Cancer is expensive and interrupts your life significantly. Below are some questions and answers to help make the case for protecting your skin this summer.

Q: If the sun is so scary, are you expecting me to stay inside all summer?

A: Please don’t hide in your closet all summer. Go outside, be active! It’s essential to your health in countless ways. I’m just asking that you be smart about it. Avoid going outside during the hottest part of the day when the sun is at its highest peak. If you can’t avoid being outside during that time, limit your time in the sun, find shade, wear broad spectrum protective clothing, hats, sunglasses, etc. Think about it this way, one hour of sun at 9 A.M. is nearly equivalent to 15 minutes of sun at 1 P.M. Your goal is to stay safe in the sun. As my fiance says regularly, “Fun ends when safety ends.”

Q: So, how much sunscreen do you really need? 

A: You need to apply at least one oz. of sunscreen every two hours in order for it to really be effective. Truly! If you’ve spent 4-5 hours at the beach and a quarter of your 8 0z. tube of sunscreen isn’t gone, you didn’t use enough. If you went with a group and you still have any sunscreen left- clearly, you all didn’t use enough. Rule of thumb: apply sunscreen 30 minutes prior to being out in the sun and reapply often. Even if your sunscreen is labeled as “water-resistant” or “water-proof” you still need to reapply. Efficacy of these kinds of sunscreens means about 40-80 minutes of SPF coverage when wet.

Q: Fine! I’ll wear sunscreen. What SPF (Sunburn Protection Factor) should I use? 

A: There is some debate over this. Many believe that the higher the SPF number is, the greater it is at protecting you from UVA/UVB rays. Actually, it’s pretty negligible; but for someone who has a history of or susceptibility for skin cancer, the marketing of SPF numbers could mean peace of mind. Truth is, no matter the SPF you put on, it’s ineffective after a couple hours. Which means, it’s not necessarily the SPF number that counts, it’s how often you reapply. Effectively, you should reapply after you do anything that could make the sunscreen slough off. Be sure to purchase a quality sunscreen with “broad spectrum” protection. An everyday SPF of 15 (blocks 93% of harmful rays) for your daily commute through life, in and out of buildings, etc. should be sufficient (reapply religiously). Thankfully, many lotions and make up products include SPF 15 already. However, if you’re playing in a sporting event, or near water (which is reflective) in directly sunlight, etc. you’re probably better off with a thicker, higher SPF of 30+ (blocks 97%+ harmful rays) which is the recommendation found on

Q: Sunscreen is gross. Couldn’t I just use a tanning bed?

A: If you want to jump from the frying pan and into the fire, that’s your decision as an adult. However, there’s a reason why Howard County, Maryland does not allow tanning for minors. If you read the report and its findings, I expect that you’ll see how important your skin is too. Perhaps you’ll decide tanning beds aren’t for you and that wearing sunscreen isn’t such a bad idea after all.

Clearly, I’m not a doctor or medical professional. Please consult with your primary care physician or your dermatologist for your skin health needs. Take these questions and answers as what they are: another way to hear the “wear sunscreen” speech.

Remember: use high quality, broad spectrum sunscreen, and reapply religiously!

JP is the HCLS Editor & Blog Coordinator for Well & Wise. She is also a Children’s Instructor & Research Specialist at the Savage Branch & STEM Education Center. She is a storyteller, wannabe triathlete, myriad hobbyist, cancer survivor, and liver transplant recipient.




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Know When to go to the Emergency Room: An Easy Reference Guide

Howard County General Hospital Emergency DepartmentWith so many medical care options these days, it’s confusing to know when you should go to the Emergency Room (ER) and when you should seek care at your physician’s office or urgent care center. When in doubt, trust your instincts. If you think you’re having a true medical emergency, always call 9-1-1.

This easy reference guide takes some of the guess work out of deciding.

First: Try acetaminophen or ibuprofen to control your fever. If your fever doesn’t go down, call your primary care physician or visit an urgent care facility.
Go to the ER: If you have a fever higher than 102 degrees that does not come down with acetaminophen or ibuprofen.

Flu Symptoms
First: Most physicians suggest you stay home and treat symptoms with over-the-counter medications and fluids. Your physician may prescribe medicine. After hours, your physician may have an answering service. Urgent care facilities are also a good option when your physician’s office is closed or unable to accommodate you for a visit that day.
Go to the ER: If you’re having difficulty breathing, a prolonged high fever, severe dehydration or relapse after getting better.

Broken Bone, Strain or Sprain
First: Typically a strain or sprain can be evaluated in a physician’s office or urgent care center. You may be referred for tests, physical therapy or to a specialist.
Go to the ER: If you think you have broken a bone.

Non-urgent Imaging Tests
First: Imaging studies such as an MRI, CT scan, ultrasound or X-ray, can be performed at many area imaging centers.
Go to the ER: If your physician specifically requests that you go the ER for a certain test.

Head Injury
Always go to the ER: If you hit your head, lose consciousness, experience a seizure and/or are vomiting.

Heart Attack or Stroke Symptoms
It’s especially important to call 9-1-1 if you are experiencing chest and/or arm pain, trouble breathing, excessive sweating and fatigue. These can all be symptoms of a heart attack. Howard County Fire and Rescue Services are specially trained to evaluate and stabilize heart attack patients while our team mobilizes at the hospital to prepare for your arrival. Do not drive yourself to the hospital.

Real Time Advice
Many physician practices now offer after-hours urgent care or an answering service, so check with your physician about these types of services. Also know that your primary care physician knows you and your medical history best and can often guide you to the appropriate treatment facility during office hours. Also, your insurance company may have a nurse hotline that can provide treatment and care setting advice. Again, none of these options should delay you from calling 9-1-1 if you feel you are having a true medical emergency.

Robert Linton II, M.D., is the director of the HCGH Emergency Department.

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Caffeine: why it’s not all perks when you have too much

caffeine side effects

[© Kjetil Kolbjornsrud |]

Do you use caffeine to help wake up in the morning or perk up in the evening? If the answer is yes, you are not alone. Millions of people use caffeine on a daily basis. According to Johns Hopkins Medicine, “caffeine is the most mood-altering drug in the world.”

On average, Americans consume about 280 milligrams of caffeine daily—about 30 milligrams alters mood and behavior and 100 milligrams can result in physical dependence. So how many cups of coffee a day is too much? The Food and Drug Administration (FDA) warns that four to seven cups of coffee is too much, however, everyone can be affected differently.

If you consume too much caffeine on a daily basis, side effects can include insomnia, nervousness, irritability, upset stomach, rapid heartbeat, muscle tremors and restlessness. Those who do not consume caffeine on a regular basis may be more sensitive and experience negative effects faster. Also, factors such as age, gender (females are more prone), medications and body mass can play a role in sensitivity.

The recent buzz
In recent years, caffeine use has been on the rise, and the industry is responding to Americans’ obsession with caffeine. While caffeine was typically consumed through coffee, tea, cola beverages and chocolate, more recently, caffeine can be found in all shapes and sizes—from energy drinks and pills, to powder you can mix into food and caffeinated gum. This addiction has become increasingly easier to form.

The addition of these products to the market has dramatically impacted public health, with thousands of caffeine overdoses, addiction and, in rare instances, death. The FDA has stepped in to warn people about the risks involved with consuming too much caffeine and has also banned various new, dangerous caffeinated products.

It’s not all perks
Caffeine can also be especially dangerous to those with existing health conditions. According to the FDA, “People with heart problems shouldn’t use caffeine because it makes their hearts work too hard.” Additionally, “People with anxiety problems or panic attacks may find that caffeine makes them feel worse.”

If you are one of the many caffeinated people out there, it is important that you monitor how much caffeine is in the food and drinks you consume and listen to your body if you think you could be experiencing a reaction or withdrawal. Speak with your primary care doctor about your caffeine intake to see what is right for you.

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Unraveling who really needs a gluten-free diet

gluten-free diet

Celiac disease is a genetically predisposed autoimmune disorder that affects the small intestine when gluten is consumed. Many people follow a gluten-free diet when they do not have celiac disease. For those with celiac disease, it is absolutely essential to eat a gluten-free diet. For everyone else who is avoiding gluten, you may be limiting your choices unnecessarily. [© Andresr |]

The Gluten-free Phenomenon

In the last few years, the phrase “gluten-free” has become a household term. Whether you are walking down a grocery store aisle or reading a menu at a restaurant, it is no longer uncommon to see these words. For those suffering from celiac disease, these new additions are a welcome sight.

What Is Gluten?
Gluten is the name used for the proteins found in wheat, rye and barley. It acts as glue in foods, helping them maintain their shape, and is found in many foods.

Celiac and Gluten Connection
Celiac disease is an autoimmune disorder that affects the small intestine when gluten is consumed. According to Johns Hopkins Medicine, “When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Tiny fingerlike protrusions, called villi, which line the small intestine and enable the absorption of nutrients from food into the bloodstream, are lost. Without these villi, malnutrition occurs, regardless of how much food a person consumes.”

Celiac disease can be confused with irritable bowel syndrome (IBS) or other bowel issues. Patients are diagnosed most often with a blood test, which is a noninvasive approach. However, the gold standard to diagnose celiac disease is through an endoscopy with biopsies of the small intestine. Before any testing for celiac disease, you should continue to include gluten in your diet to ensure accurate results. Many people follow a gluten-free diet when they do not have celiac disease. For those with celiac disease, it is absolutely essential to eat a gluten-free diet. For everyone else who is avoiding gluten, you may be limiting your choices unnecessarily.

Signs of celiac disease can include bloating, gas, indigestion and diarrhea. However, some patients could have constipation or no GI symptoms at all. If you are having digestion issues, you should see your primary care physician first. If there is no diagnosis and symptoms don’t resolve, then you should visit a gastroenterologist who specializes in conditions of the digestive tract.

Anyone can get celiac disease. In fact, about one percent of the population, or nearly three million people, likely have celiac disease and are unaware of it. Celiac disease is a genetically predisposed disorder. Once a family member is diagnosed, you should be aware that you are at a higher risk of having or developing the disease and may want to be tested. However, you can be a carrier of celiac disease and never show symptoms until later in life, if at all. Being a carrier of the gene means you may not have the disease, but may be prone to it. It does not mean you will definitely develop it. Additionally, people with autoimmune disorders such as rheumatoid arthritis, Type 1 diabetes, osteoporosis, abnormal liver function and/or disease, or anemia are at higher risk for celiac disease. If you have one of these autoimmune conditions, you should consider being tested for celiac disease if you have symptoms and are not improving.

Although there is no cure for the disease, there is a lot of research underway for treatment, including prescription drug studies. Currently, the only treatment that is known to ease the symptoms of celiac disease is to eliminate foods containing gluten from your diet.

So What Should I Eat?
The Celiac Foundation’s website or the National Foundation of Celiac Awareness website have a lot of good information on diet options. The most important consideration when choosing your food is to be mindful of reading labels as many unsuspecting foods, and even some medications, contain gluten.

When Am I Going to Feel Better?
If you have celiac disease and start reducing your gluten intake, you should feel better within a couple of weeks. In some cases it takes up to a month before you notice a difference and start feeling better. Often this occurs because you have unknowingly consumed gluten.

Mahmood Solaiman, M.D., is a gastroenterologist with Gastro Associates in Elkridge. Appointments: 410-590-8920.


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Be Realistic

this year i willIt’s that time of year, again. Most of the holiday celebrations are wrapping up and the New Year is just a couple days away. Many people reflect during this time and make promises to “be better” in the coming year. Here’s one piece of advice for you as you mull over your possible resolutions: be realistic.

If you’re 50 lbs. overweight and want to lose those L-B’s, make a plan that you can execute. If you want to stop eating out so much and cook more at home, make a plan that fits your lifestyle. If you want to work on your relationships, take steps that you can actually accomplish. Basically, don’t make promises to yourself and others that you simply cannot keep.

So, here are some suggestions gathered from myriad books, articles, and personal experiences that could help as you draft your own resolutions for the New Year.

Do your research. Read up on your topic of interest. Visit your local library, take a look at their recommendations or look at the best-sellers. You could check out prominent, credible authors’ works or (dare I say it?) briefly search online. The latter of these is best done with high scrutiny, or best yet, with your favorite library staff. Gathering information is always the best thing you can do when you’re not sure where to start.

Consult Expert(s)
If you’re looking to improve your health in any way, visit your primary care physician. Get a physical. Visit a nutritionist. See an endocrinologist, a dermatologist, or a psychiatrist. Whatever your health needs are, take steps to find the specialist who can help you. Remember, finding an expert is like giving an interview. It can take time to find the right expert for your needs. Advocate for yourself and don’t settle for anything less than what’s best for you.

Write it down!
Literally! Write down your goals. Be as specific as you possibly can. Instead of writing down, “Lose weight.” Consider writing, “I will exercise for 30 minutes, three days a week. I will eat a healthy breakfast every morning. I will check in with my doctor to monitor my progress.” Post them where you can see them daily or keep them in a journal. Be committed to that promise to be better and do better in the coming year. Words are incredibly powerful and when written (and read) can provide the inspiration you need to change. It’s real now. Make it happen!

Get Support
There are few things in life you can do alone. Big goals require big support. Little goals require big support. Make sure someone outside of yourself holds you accountable. Tell your family, listen to your experts, and find others who’re on the same journey. It’s proven that those who have meaningful support as they tackle their goals are significantly more successful than those who hide under the table and go at it alone. Every single one of Mark Hyman’s books goes over this; read his works!

Measure Progress, Adjust to the Real World
How do you know you’ve been successful? Well, when you wrote your specific goals down, you should be able to say whether or not to were able to achieve those goals. If you can’t identify whether or not your were successful, it’s time to rewrite your goals in a way that it is measurable. How you measure your progress can also be another discussion with your expert. Remember, it takes 21-29 days to form a habit. Make sure you’re forming good habits. Evaluate your goals and adjust if necessary.

Finally, be kind to yourself. You’re not going to get everything right all of the time. You’re going to mess up. You will fall short. Accept it and learn from it. When you’re realistic with your resolutions you will find success. Success requires work- hard work and a lot of help, but you can do it.

What are some of your resolutions for the New Year? Do you have any advice for resolution makers?

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