Sunday, August 02, 2015

Lake Health Blogs

Imagine if you will, a world in which all of our current assumptions about what makes us fat are erased. It's hard to do, because we are all so certain that we get fat from eating too much.  That little tune has been played for us every day of our lives in excruciating repetition.  We are so brainwashed that we've never stopped to consider whether it's true.
Suppose what makes us fat is not what we are eating but something that gets disordered in our fat cells? 
Suppose these cells, because of a hormonal imbalance or disrupted signal, start to suck in too much fat and get out of control?  Imagine now that these voracious cells not only gobble up everything we eat but jealously lock all that energy up, thus making it unavailable to the rest of the body.  Under the rules of normal physiology, our fat cells release fat whenever it's needed for momentary energy needs.  But not anymore.  Not this rogue fat.  This misbehaving fat isn't releasing anything.

Imagine now that you set out to walk from your bedroom to your living room.  You ate a half hour ago, but now everything you ate is locked away in your fat cells where the rest of you can't get to it.   What fuel is going to power you?  Your brain directs you to eat, pronto!   How can you be hungry again you wonder.  How can you have such little will power?  Why can't you just forget about food?  What's wrong with you anyway?

Far fetched?  Not at all.   For years, scientists have made various animals fat by manipulating their hormones or operating on certain areas of their brains.   These manipulations have created a disorder in fat storage such that fat is inappropriately sucked into the fat cells.  Animals will often eat more to compensate for the fact that their other cells are starving, or they may stop moving around to avoid burning calories they don't have.  In the case of certain rats who are genetically manipulated to be obese, starving them still leaves them fat.  Their fat is not available for burning, so instead they burn up their muscles and vital organs until they die, still with fatty tissue intact.  All of this is well documented in the Taubes book I've recently been referencing, Why We Get Fat and What To Do About It.  The example of the genetically doomed rats will undoubtedly leave some wondering whether they too are genetically engineered to be fat no matter what they do.  While there may be a tiny fraction of us with some unavoidable genetic variance, we can be fairly assured that this is rare.  We know this because obesity rates were  low until just recently.  Genetic variations of the required magnitude would not have occurred in the past 20-30 years.
In his book, Taubes discusses concepts developed by Julius Bauer, a German geneticist and endocrinologist, in the late 1920s.

"Bauer considered the fat tissue in obesity akin to malignant tumors.  Both have their own agendas, he explained.  Tumors are driven to grow and spread and will do so with little relation to how much the person who has that tumor might be eating or exercising.  In those who are predisposed to grow obese, fat tissue is driven to grow, to expand with fat, and it will accomplish this goal, just as the tumor does, with little concern about what the rest of the body might be doing."

The abnormal (fat) tissue seizes on foodstuffs, even in the case of under-nutrition, Bauer wrote in 1929. "It maintains its stock, and may increase it independent of the requirements of the organism.  A sort of anarchy exists; the adipose tissue lives for itself and does not fit into the precisely regulated management of the whole organism."

Ever have that anarchy feeling?  There's probably a good reason that this fat thing seems to be so out of control....make so little sense.

While there are many signals and hormonal components that regulate food intake, the primary hormone that puts fat into the fat cells is insulin.  Many overweight people are making way too much insulin, a problem that leads fat cells to avidly store and trap too much fat.  The overproduction of insulin is usually the result a insulin resistance, a situation in which muscle cells become deaf to insulin while fat remains responsive.  This insulin resistance may start once we have eaten too many starches and sugars, or as the result of developing in the womb of a mother who ate many S foods, or simply as a result of aging.  Some people have a tendency toward it and other don't.   Whatever the cause, though, once the cycle gets started, the fatty tissue goes rogue, expands beyond the needs of the body, creating hunger and stealing energy from other bodily cells.
We can respond by starving ourselves, but we may wind up like the rats who burned up their muscles because their fat was entrapped and couldn't be released for body needs.  I often notice that people on low calorie vegetarian diets (which rely on grains, breads, etc..) have an emaciated appearance, as if they are losing muscle mass.  I caution that this is strictly an unscientific observation, but it would make sense if they are losing weight while still eating a diet with significant insulin stimulus.  Again, using nothing but subjective observation, I note that our patients who have lost large amounts of weight on low carb, low insulin diets look very well balanced---often as if they had never been heavy.
If fat is a rogue that gets out of control as a result of disordered insulin signaling, guess what?  Being overweight is not the fault of your weak will or your big appetite.  It's just the other way around.  Your inability to stop eating or tendency to store fat easily is a side effect of the chaos imposed by a run away tissue.
If we know this and work to get rid of excess insulin secretion, relief is in sight.  Fat will again flow freely from fat cells and hunger levels will decline.  If we remain in a low insulin state, it will be very difficult for the body to find a way to store fat again.  We will have tamed the beast. 
But ultimately, will power does factor in.  We still have to have the strength to turn our backs on the starchy-sugary diet that's created all of this.  Can you do it?  You can. 

Dr. Barbara Berkeley on Jan 21, 2011

For most people, the prospect of meeting a favorite movie star or sports hero would set the heart aflutter.  Call me a nutrition geek, but I get palpitations from meeting the researchers and authors whose work on obesity I revere. 

Several years ago, a friend from residency, who is now chief of endocrinology at a major academic center, invited me to meet Gary Taubes; the author of "Good Calories, Bad Calories".  Taubes is a science writer with a long track record of producing sophisticated and meticulously researched articles for Science, the NY Times, and other highly respected publications.  In recent years, he had become especially interested in the science of obesity; writing a number of controversial articles that supported carbohydrate restriction and called into question the conventional wisdom of low-fat eating.  "Good Calories, Bad Calories" was the  a book that collected all the research that supported his contention (and mine) that the idea of controlling weight by eating less than you burn is insanely simplistic and that it is insulin-stimulating foods that cause weight gain and illness.  A dense, lengthy book (the paperback version is 640 pages), GCBC defeated many readers.  For me though, every page was a "eureka" moment packed full of research that supported everything I had learned clinically in more than 20 years of working with overweight patients. It became my bible, my favorite book, my go-to reference, the book that had my back.  The pages of my copy were so underlined, annotated, and studded with stars, arrows, and exclamation points as to be barely readable.

The day that I was to travel to the east coast to meet Gary Taubes dawned to reveal an old-fashioned Cleveland blizzard.  I was booked to fly on a small regional jet and believe me, I'm a nervous flyer.  Normally, I would have taken one look out the window at the wind and snow and cancelled my flight.  Instead, I tucked my trusty GCBC under my arm, packed an overnight bag and headed across icy, unplowed roads to the airport.  I sat on the tarmac as our tiny plane (one of those that bounces and creaks across the runway) was doused with pink and green de-icing fluid.  Moments later, the snow was once again accumulating on the windows and the wings were bouncing in the wind.  Was I nuts?  This was definitely a form of temporary insanity.  But moments later, we ascended shakily into the sky, broke through the clouds and continued on to Philadelphia where a cold sun was shining. 

At the university, I greeted my old friend and he ushered me into a large lecture hall where Taubes had just begun what was to be a long and detailed talk.  The assembled crowd was composed of serious academic researchers in the field of diabetes and obesity.  They listened politely and asked many questions, but seemed skeptical.  Taubes answered each question with a wealth of data and a great deal of patience.  It was clear that he was used to speaking to doctors and other scientists, most of whom had spent the past twenty to thirty years believing that dietary fat was the great villain.  I understood his position well.  My practical experience with obese patients was often ignored by peers who listened politely to what I had to say but went on to advise their patients that they eat "moderately”, follow a "low fat diet" and eat lots of "healthy carbs".

After the lecture, I had the great opportunity of spending an hour or so in discussion with my friend and Gary Taubes.  Naturally, I had him sign my copy of GCBC.  The inscription reads:  "This is the most annotated copy of my book I've ever seen."  Later, we all had dinner with other members of the department.  Gary and I avoided carbs while the others ate the rolls, ordered potatoes and (in some cases) fretted about their inability to lose weight.

In the years since the publication of Good Calories, Bad Calories, I have recommended it to many people but few have been able to wade through it and pretty much no one has enjoyed it with the blind excitement that I have.  Apparently, this was a common scenario and now Taubes has produced a scaled down version of his master work called "Why We Get Fat and What to Do About It" (Knopf).  While it (intentionally) lacks the intensive attention to research that characterizes GCBC, it does an excellent job of giving readers the basics.  I recommend it.  And if you are intrigued by what you read, I would suggest going on to GCBC to fill in the blanks. 

The bottom line? It is the overproduction of the hormone insulin that makes us fat.  This overproduction comes from two sources:  eating too many foods that require insulin for processing (the starches and sugars), and the overproduction of insulin that results from body cells that become "resistant" through aging or eating too many S Foods.  Dietary fat and protein do not stimulate insulin.  Consumed alone they cannot make us fat.  Most importantly, insulin prevents us from using the fat in our fat cells as fuel.  We are thus always running on sugar.  We crave more when we run out and we never get into fat burning mode.  We are built to run on the fat in our fat cells as a major fuel.  Most of us can't use it.

This knowledge is the currency of my world.  It is obvious to those of us who "do" weight loss as a career.  It has even---finally---become obvious to entrenched diet programs like Weight Watchers, who recently revamped its point system to reflect the fact that all calories are not alike.  Some make you fat. Others don't.

For those with limited patience or someone who can only borrow “Why We Get Fat" for a day, I particularly recommend the second section of the book called "Adiposity 101".  These facts are well presented and give you a good introduction to the problems created by insulin.  (A similar discussion can also be found in the third chapter of Refuse to Regain on Metabolic Syndrome).

One of the points that Taubes makes repeatedly is that nutritionists and doctors remain entrenched regarding their thinking about weight loss.  They insist that you can lose weight by eating less and exercising more when this formula has been an ineffective proposition for 95% of those who try.  It simply doesn't hold up long term.  He acknowledges that obesity doctors understand his thesis and support it and that docs who don't treat obesity are unwilling to listen to those who do.  That's true.  But it is also true that those who write about and research obesity, but don't treat it, are not privy to the daily observations of this knowledge in practice.  So let me add some brief critiques of what is otherwise an excellent book.

1. Genetically Consistent vs. High Fat, Low Carb

Taubes touches briefly on the wisdom of eating foods that are like the foods eaten by our ancient ancestors.  Theoretically, these are the foods to which we are best adapted.  Following that, however, he pins the blame for obesity on carbohydrates and exonerates fat and protein.  I agree unequivocally with his blame placing, however I remain very circumspect about the sources of our fat and protein.  Taubes is fond of bacon and steak.  I wouldn't have a problem with this if it were not for the fact that the meat we produce today is very nutritionally distinct from the meat we've always "known" how to eat.  Bacon contains carcinogenic nitrites and other preservatives.  Corn fed beef has a reversed profile of omega 6 to omega 3 fatty acids when compared to the meat of animals that graze.  If we hypothesize that we get sick from eating a diet full of carbs because we are not genetically prepared to eat large amounts of carbs, how can we ignore the fact that eating meat that is very modern in composition may be equally damaging?  The way I see it, logic leads me to believe that we get both fat and sick when we eat fuels that our body is not prepared to process genetically.  Trying to get as close as possible to original food sources makes the most sense.  There is no research on this by the way other than voluminous observation of hunter gatherer tribes that survived into modernity and were absent modern diseases.

2. How to Lose Weight

Many of the sources consulted by Taubes in this book suggest an Atkins-style diet for weight loss.  There are also many obesity clinics that still use something called the "Protein-Sparing Modified Fast".  This is essentially an extreme Atkins diet that has patients eat small amounts of mostly chicken, eggs and certain cheeses.  While these diets do cause weight loss, they also can lead to complications of dehydration, dizziness, and potassium and salt depletion.  We have found them to be completely unnecessary and I can't understand why people persist in using them.  Our diet has many more grams of carbohydrate than Atkins or the PSMF.  Our patients eat one piece of fruit and a lot of vegetables and salad each day.  It works beautifully and we achieve large weight losses.  We have rarely had a patient who is resistant.  In other words, it is very possible to lower insulin levels enough to get brisk weight loss without going to total carb elimination.  You just have to know which carbs to avoid and how much to include.

3. Calorie Lowering for Weight Loss

One of Taubes' interests is establishing a study that would document that fact that people on the Atkins diet could eat enormous numbers of calories yet still lose weight.  This would prove that weight loss isn't about the amount of calories at all, but is about how the body uses the calories it gets.  In other words, does it burn up the calories and get rid of them or does it store them?  In the practical world of the weight loss clinic, however, we have found that to get weight loss, patients need to get calories low.  Having tried the Atkins diet myself many times, I found that my calories were automatically limited by the boring nature of eating only meat and cheese.  I don't know if Taubes is right about his belief, but it seems beside the point.  Eating huge amounts of fat and protein doesn't feel good to many people, and weight loss can easily be gotten on a low insulin diet of about 1200-1400 calories that suppresses appetite as a side benefit. 

4. Exercise

Taubes makes the very interesting point that obese people are sedentary not because they are lazy, but because their energy stores are locked up (insulin traps fat energy and makes it inaccessible).  They simply don't have enough energy to exercise and therefore don't want to.  I agree with this.  Our patients who lose weight become much more interested in moving. You only need to read a few weight loss blogs to see how frequently obese, sedentary people turn into avid exercisers, even marathoners. Taubes discounts exercise as an important factor in weight loss.  So do I.  However, I still stick to my guns when stating that exercise is crucial for weight maintenance.  I don't know the technicalities of why it works, but we can suppose that it keeps the muscles efficient in their use of calories and allows for the whole bodily machine to run better.  Exercise is like the oil or lubricant for our metabolic system.  Keep it going. 

I highly recommend that you take a look at "Why We Get Fat" and see if it doesn't get you thinking.  I hope you will come out believing that restructuring your diet to permanently rid yourself of the bulk of your grains and carbs is the true solution for permanent weight control.   It has worked for me and it has worked for all of those I've been able to convert.    

Dr. Barbara Berkeley on Jan 11, 2011

HandsNational Birth Defects Prevention Month is a time to raise awareness of birth defects and promote healthy pregnancies.

 A birth defect is a problem that happens while a baby is developing in the mother’s body. One out of every 33 babies in the United States is born with a birth defect.

 A birth defect may affect how the body looks, works, or both. Some birth defects like cleft lip or neural tube defects are structural problems that can be easy to see. To find others, like heart defects, doctors use special tests. Birth defects can vary from mild to severe. Some result from exposures to medicines or chemicals. For example, alcohol abuse can cause fetal alcohol syndrome. Infections during pregnancy can also result in birth defects. For most birth defects, the cause is unknown.

 Some birth defects can be fatal. Babies with birth defects may need surgery or other medical treatments. Today, doctors can diagnose many birth defects in the womb. This enables them to treat or even correct some problems before the baby is born.

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Library on Jan 04, 2011

Foot on ScaleIf you are overweight, you are not alone. Sixty-six percent of adults in the U.S. are overweight or obese. Achieving a healthy weight can help you control your cholesterol, blood pressure and blood sugar. It might also help you prevent weight-related diseases, such as heart disease, diabetes, arthritis and some cancers.

Eating too much or not being physically active enough will make you overweight. To maintain your weight, the calories you eat must equal the energy you burn. To lose weight, you must use more calories than you eat. A weight-control strategy might include:



  1. Choosing low-fat, low-calorie foods
  2. Eating smaller portions
  3. Drinking water instead of sugary drinks
  4. Being physically active

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Lake Health is leading the way to help individuals achieve safe weight loss that produces long-term solutions. We are dedicated to helping our patients lose weight and change their lifestyles. Weight loss and maintenance are very complex and options for treatment should be individualized. Our menu of specialized programs includes:

For more information on any of these services, please call the Wellness Institute at 440-375-8153.



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Library on Dec 30, 2010

Let's get serious.  How many people do you know who are---right at this moment---resolving to lose weight after January 1st?  Judging by the utter flood of TV commercials for Jenny Craig, Weight Watchers et al, that began right after Christmas, I'd say that the weight loss industry is thinking it's pretty much everybody.   

The New Year's resolution is a charming little tradition.  For a few days, we spend time reassessing our priorities and vowing to right our wrongs, fix what's broken.  But by January 3rd or 4th, life returns to business as usual and most of us have already forgotten our end of the year introspection.  Weight loss, in particular, doesn't respond well to resolution.  What is does respond well to is…planning.

Losing a goodly amount of weight is complicated business.  Our first mistake is to underestimate it.  On the other hand, if we size up the challenge correctly, there are a number of things we can do to vastly increase our chances of success.  So if you want to lost weight this year or if you know someone else who does, here's a battle plan:

1. Forget the January 1st Date!

You should only start a weight loss plan when you have everything in place.  Setting an arbitrary date like January 1st simply because the year changed from 2010 to 2011 is a bad idea.  Instead, allow for several weeks to get everything set up.  Set a "Quit Date" sometime later in the month.  This is what smokers are encouraged to do when they give up cigarettes and it can work for you too.  Pick a date that has some meaning to you (maybe it's the same number date as your birthday or anniversary, or maybe you just like the combination of digits). 

2. Pick Your Strategy 

Most people who start diets do so with only a vague idea of "cutting back" or "eating less junk".  The most effective diets are easy-to-follow plans that restrict food fairly severely and have simple rules.  Research has shown that most diets work---if they are followed strictly.  Your job is to figure out which type of diet you can follow to the letter.  Can you stick with Atkins the whole way, just fat and protein?  Would you do better with a Weight Watchers approach? Are you someone who is more likely to lose if you commit some money to the process?  Do you know that when you diet on your own you quickly lose focus?  Maybe you need to attend a group or see a dietician for accountability.  Do you have a friend or relative who has lost a lot of weight using a particular approach?  Should you interview them to see if that might work for you?

As a basis for starting this process, I can tell you what works for our patients.  We put them on a high quality meal replacement (either bars or protein shakes) during the day and have them eat a Primarian style meal for dinner.  This meal consists of a moderate serving of skinless poultry, very lean meat, or fish, a large salad with non fat dressing, a large serving of green vegetables (steamed, broiled or roasted) and a piece of fruit.  They generally finish the day with a low fat dairy product, like sugar free pudding or low cal yogurt.  We get excellent, consistent weight loss with this regimen but of course, in addition, our patients are checking in with us weekly.  Without trying to be too self-promoting, I will add that my book, Refuse to Regain, contains an eating plan in the middle.  Many people who have switched to this type of eating have lost between 30 and 50 pounds, so this might be another option.

IMPORTANT NOTE: Many people who have weight issues are on medications, frequently for diabetes, hypertension, and cholesterol.  Often these medicines need adjustment when food intake changes.  If you are on medicines and plan to diet significantly, make sure you check with a doctor or dietician prior to starting.  This is especially true for anyone on medicines to lower blood sugar or on diuretic pills.  These can be dangerous when combined with diets.

Once you have decided on your strategy, get everything set.  Make an appointment to begin on your appointed date or purchase your shakes and bars.  Or get your diet plan printed out or buy the appropriate books.  Put everything in one area and get it ready to go.

3. Set Up Your Exercise

While vigorous exercise is most helpful for weight maintenance, mild to moderate exercise will assist in keeping you honest during weight loss.  If you can do more as you go along, fine.  If not, don't sweat it, as long as you are losing.  Most importantly, don't exercise to the point where hunger knocks you off your 100% commitment to your diet plan.

Prior to your Quit Date, figure out how and when you will exercise.  If you are very out of shape, I recommend starting with short bouts (maybe 15 minutes or so) a few times a week.  Don't push it.  Your body is not used to exercise yet.  If you choose walking, figure out a place to walk in both good and bad weather.  If you choose classes like aerobics or spinning, register yourself so that you've committed the money.  If you choose a gym, see if you can hook up with a trainer for the first month just to keep things interesting.  If you choose exercise videos: find them and rent them.  Get everything in place.

4. Purge Your Environment

Just prior to your Quit Date it is very important that you purge non-diet foods from your home and office environment.  Get a big bag and have a throw-away or give-away party.  During the early phases of your diet, strong hormonal signals will be flowing from your brain that will lead you to late night searches for hidden potato chips.  Make sure that they are not there to be found.  Enlist the help of your family.  Tell them that they will have to eat these foods outside the home (or hide them from you...not to be eaten in front of you) for the duration.  Tell them not to give in to your pleas for these foods even if you resort to bribery, coercion, and other trickery!

5. Declare Your Intentions

I have found that the people who do best on diets are those who tell everyone what they are doing.  Many patients tend to want to hide the fact that they are trying to lose.  "It's nobody's business," they say.  Or, "I don't want people asking me a lot of questions."  Naturally, this is your own decision, but generally it seems to be the case that those who boldly declare that they're out to change the way they eat seem to take the commitment more seriously.  After all, they've made a statement.  It's tougher to renege on a promise you've made publicly.  Yes, friends may watch, ask questions, and judge, but you can deal with it.

6. Buddy Up

Most people don't really believe it, but weight loss is tough.  You'll need someone to help you keep going, to praise you and to cheer you on.  Spouses are great, if you can recruit them to work as a team and if you can resist the temptation to give in when they say, " about we have the popcorn just this once?"  A friend who is truly serious about losing weight might be even better.  Weight Watchers groups have been an inspiring source for many.  Dieticians can be great.  Hey, there are even a few good diet docs out there!  Some people use their personal trainers as cheerleaders.  Recruit your team and have it ready on day one.

7. Keep a Record

This isn't just a diet.  It's a serious journey through a new landscape.  Take verbal pictures (and maybe some real pictures too).  Get yourself a nice leather notebook or one with a beautiful cover.  Get yourself a comfortable pen.  Put everything in one place and have it ready to go.  Write a little bit about your journey each day.  You don't have to write down everything you eat (unless you want to), but write a bit about how you felt, what was tough, what was fun, what got you down. 

I have one patient who took a picture of herself in the same clothes in the same place every single week throughout her 100 pound weight loss.  What a visual story that makes!

OK!  NOW you're ready to go.  Forget January 1st.  Your Quit Date may be later in January or it may not come until April, July or November.  The important thing is that you will have thought it through.  You will be prepared and you've given this tough challenge the attention it needs to achieve a successful result.  After all, what we're searching for is not simply a Happy New Year.  It's more a Happy New Life.

Dr. Barbara Berkeley on Dec 28, 2010

Acupuncture has been utilized for over 5000 years.   Many Americans think that acupuncture originated in China.  Interestingly, Egypt, Persia, India and Japan were known to have used acupuncture first, even before China.  However, China is credited for extensive development and research on acupuncture due to the early writings and documents written during the dynasties.  Acupuncture can be traced back as far as the Stone Age in China and is a major component of Traditional Chinese Medicine (TCM).  Modern acupuncture needles are made of a solid, sterile stainless steel. East China was the first to develop needle-like tools made of stone, called "bian" stones.  Bones, rocks, and bamboo were other materials were also used to make the needles.  Metal needles were finally invented after the invention of bronze casting.  Northern China was responsible for developing Moxibustion.  Moxibustion is the burning of an herb, Artemis Vulgaris, on or near the skin to nourish the Qi (pronounced "chee") and warm the body during the cold season.  In modern times, we can use infrared heat lamps to mimic the warming effects of the herb.   China was the first to document the use of acupuncture points,  and thus all systems of acupuncture began with the original Chinese medical text, The Yellow Emperor's Classic of Internal Medicine by Huang Di Nei Jing, compiled during 475-221 B.C.  In the next centuries, Acupuncture developed quickly by the many Chinese dynasties who improved the system of acupuncture.  Another monumental text, "A Classic of Acupuncture and Moxibustion" was written in 400 AD.  This book described the names and number of points for each channel or Meridian, their exact locations, indications, and methods of manipulation.  These ancient texts are the basis for modern acupuncture which has been practiced in the United States for the last 150 years. 

Acupuncture became more popular and accepted in the United States in 1971, after President Nixon made a trip to China.  During this trip to China, James Reston, a journalist traveling with President Nixon, had an emergency appendectomy in China.  On the plane ride back to the United States, President Nixon was surprised to learn that acupuncture was used for Mr. Reston's post-operative pain relief.  When Mr. Reston returned to New York, he wrote an article in the New York Times regarding his experience in China with Acupuncture.    Mr. Reston was amazed by how a patient could be totally awake and that sticking needles into the body could actually block the pain from surgery. Since that time, acupuncture has grown in popularity in the United States.

The report from a Consensus Development Conference on Acupuncture held at the National Institute of Health (NIH), in 1997, stated that acupuncture is being "widely" practiced by thousands of physicians, dentists, acupuncturist, chiropractors, and other practitioners, for relief or prevention of pain and for various other health conditions.  According to the 2002 National Health Interview Survey-the largest and most comprehensive survey of complementary and alternative medicine (CAM) used by American adults today- an estimated 8.2 million U.S. adults have used acupuncture, and an estimated 2.1 million U.S. adults have used acupuncture in the previous years. It is estimated that now 15 million people each year try acupuncture for the first time and more would try this ancient healing method if they only knew more about how it worked.  Hopefully, as you continue to read these blogs, you will have a better understanding of acupuncture, and perhaps try this method for yourself.

Susan M. Kim DC, CCN, CSCS on Dec 23, 2010

Medical patients can often struggle with feeling insecure about asserting their feelings or needs to health care providers. However, when you assert yourself you feel more in control and ultimately your stress is reduced.

Keep in mind that assertiveness is not aggressiveness. Assertiveness is a balance between the extremes of aggressiveness and submissiveness. People who act in an aggressive style demand and expect others to do exactly what they want. Those who act in a submissive style give up their own beliefs, opinions, and wants to the demands of others. They feel guilty to ask for what they want as if others' needs are more important than their own. As assertive person respects others' views and feelings but also values and respects their own.

Look others directly in the eyes when talking to them and maintain an open posture. This will be easier to do if you reinforce for yourself that what you are saying is important. Don't assume a posture that says you are absolutely right---such as glaring at others when speaking, and ending your statements as if there is no questioning or doubting your words.
Be specific when making requests. Vague requests or comments can often be misinterpreted by others or simply ignored. If your request is very specific and direct, there is little room for confusion. For example, instead of asking for someone's help in general, specifically state what you want help with, when, and for how long.
Asserting your opinions, needs, concerns and questions with your healthcare providers will help you with making important decisions and assist you in your coping. Those who feel they have a voice and it matters will feel more in control and engage in a more healthy decision making.

Dr. Lori Stevic Rust on Dec 22, 2010

Is it hard for you to fall asleep or stay asleep though the night? Do you wake up feeling tired or feel very sleepy during the day, even if you have had enough sleep? You might have a sleep disorder. The most common kinds are:

  • Insomnia - a hard time falling or staying asleep
  • Sleep apnea - breathing interruptions during sleep
  • Restless legs syndrome - a tingling or prickly sensation in the legs
  • Narcolepsy - daytime "sleep attacks"

Nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and grinding your teeth are kinds of sleep problems called parasomnias. There are treatments for most sleep disorders. Sometimes just having regular sleep habits can help.

Did you know that Lake Health has two sleep centers?  The nationally accredited sleep medicine program at Lake Health has over 15 years of experience diagnosing and treating a broad spectrum of sleep disorders. Both sleep centers feature four private rooms in a quiet and comfortable atmosphere where patients are monitored overnight for suspected sleep disorders, such as insomnia, obstructive sleep apnea, narcolepsy, snoring, sleep walking and restless legs syndrome.  Accredited by the American Association of Sleep Medicine, the centers offer the most advanced monitoring and diagnostic technology as well as an expert staff of physicians board certified in sleep medicine, professional registered polysomnography technicians, registered respiratory therapists, pulmonologists, otolaryngologists (ENT) and psychologists.  The Sleep Centers are conveniently located at:

Willoughby                                Willoughby Hills
West Medical Center          Chagrin North Office Park
36000 Euclid Avenue         34900 Chardon Road
Willoughby, OH 44094       Building 1, Suite 105
(440) 602-6306                    Willoughby Hills, OH 44094


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Library on Dec 15, 2010

I get asked all the time, "What can acupuncture treat?"   Well, the list is truly endless.  In very simple terms, acupuncture balances the body to try to maintain and restore homeostasis.   Anytime your body is out of balance or in disharmony, acupuncture may be able restore harmony and improve your body's function, thereby, . In 1997, the National Institute of Health (NIH), endorsed acupuncture for some common conditions. The NIH stated "there is sufficient evidence of acupuncture's value to expand its use into conventional medicine."  The World Health Organization recognizes acupuncture and Traditional Oriental Medicine's ability to treating these following conditions.   

Alcohol addiction

Facial Palsy/Tics




Reproductive problems









Seasonal Affective Disorder(SAD)

Carpal Tunnel Syndrome


Shoulder pain

Chronic Fatigue Syndrome





Sleep disturbances/Insomnia

Common cold


Smoking cessation


Irritable Bowel Syndrome


Dental pain

Low Back Pain

Sore Throat





Menstrual irregularities/ PMS

Tooth ache

Digestive trouble

Migraine headaches

Tooth pain


Morning Sickness

Trigeminal Neuralgia



Urinary Tract Infections

Emotional problems



Eye problems


Wrist pain

      Because of the neural, hormonal and immune effects of acupuncture, the list of what acupuncture can treat is extensive.  In the last fifty years, there are been many scientific studies which have validated and clarified how acupuncture works.  The use of acupuncture has dated back over 5000 years.  Since the 1970's, acupuncture has been utilized by millions in the United States.  Acupuncture is an ancient therapy which has been proven to be successful for so many conditions.

Susan M. Kim DC, CCN, CSCS on Dec 09, 2010

Lake Health is committed to the health and safety of our employees, patients and community residents.  Being a smoke-free campus demonstrates our commitment to a health lifestyle.  Did you join us in supporting the Great American Smokeout on Thursday, November 18, 2010 and give up smoking and chewing tobacco for the day or support others in their efforts to quit tobacco?

 Tobacco use is the most common preventable cause of death. About half of the people who don't quit smoking will die of smoking-related problems. Quitting smoking is important for your health and provides many benefits. Soon after you quit, your circulation begins to improve, and your blood pressure starts to return to normal. Your sense of smell and taste return and breathing starts to become easier. In the long term, giving up tobacco can help you live longer. Your risk of getting cancer decreases with each year you stay smoke-free.

Quitting is not easy. You may have short-term effects such as weight gain, irritability and anxiety. Some people try several times before succeeding. There are many ways to quit smoking. Some people stop "cold turkey." Others benefit from step-by-step manuals, counseling or medicines or products that help reduce nicotine addiction. Your health care provider can help you find the best way for you to quit.  (NIH: National Cancer Institute

Lake Health provides smoking cessation classes “Up in Smoke” to employees and the community.  Why not take the first step to better health and make an effort to QUIT SMOKING IN 2010.  For more information call the Best of Health Line at 440-953-6000 or check out the American Cancer Society website at

Start Here

Guide to Quitting Smoking Cancer Society)

Also available in Spanish

Quitting Smoking: Why To Quit and How To Get Help (National Cancer Institute)

Also available in Spanish (National Cancer Institute, Tobacco Control Research Branch)


Harms of Smoking and Health Benefits of Quitting (National Cancer Institute)

Help for Smokers and Other Tobacco Users for Healthcare Research and Quality)

Prevention and Cessation of Cigarette Smoking (PDQ): Control of Tobacco Use (National Cancer Institute)

Quit Guide Cancer Institute, Tobacco Control Research Branch)

Quit Smoking (Office of Disease Prevention and Health Promotion)

Quitting Tobacco: Challenges, Strategies, and Benefits (National Cancer Institute)


FDA 101: Smoking Cessation Products and Drug Administration)

Nicotine Patch Academy of Family Physicians)

Also available in Spanish

Quit-Smoking Products: Boost Your Chance of Quitting for GoodQuit Foundation for Medical Education and Research)

Varenicline (Marketed as Chantix) Information and Drug Administration)

Where to Get Help When You Decide to Quit SmokingWhere (National Cancer Institute)


Helping a Smoker Quit: Do's and Don'ts Cancer Society)

Quitting Smoking - Help for Cravings and Tough Situations Cancer Society)

Skills to Help You Cope with Stopping Tobacco Use Foundation for Medical Education and Research)


Kick the Smoking Habit Roads Media)

Also available in Spanish

Overcoming Addiction (National Institute on Aging)

Quitting Smoking (National Institute on Aging)

Stop Smoking Before Surgery Society of Anesthesiologists)

Smoking and Sleep Medical School)

Financial Issues

How Much Will You Save? Cancer Institute, Tobacco Control Research Branch)

Smoking Cessation: The Economic Benefits Lung Association)

Health Check Tools

Quiz: Do You Need Help to Quit?: Take the Stop Smoking Quiz Cancer Society)

Withdrawal Quiz Cancer Institute, Tobacco Control Research Branch)


Smoking - The Facts Education Institute)

Also available in Spanish


How Can I Quit Smoking? Foundation)

I Quit: What to Do When You're Sick of Smoking, Chewing, or Dipping for Disease Control and Prevention)

Smoking: Don't Let It Steer You Wrong Academy of Family Physicians)

Also available in Spanish


Pregnant? Don't Smoke! Learn How and Why to Quit for Good for Disease Control and Prevention)

Smoking and How to Quit Women's Health Information Center)

Women and Tobacco Use Lung Association)


Smoking: It's Never Too Late to Stop (National Institute on Aging)

Library on Nov 22, 2010