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Three R’s Of Health And Wellness

I’d like to talk about how rodents, relationships, and riding relate to overall health and wellness.

This idea comes from a nicely-written New York Times piece entitled, “Does Loneliness Reduce the Benefits of Exercise?” Here, Gretchen Reynolds reviews a few intriguing studies about how relationships may affect exercise, stress hormone levels, and intelligence. The combo caught my eye.

Anyone who pays attention to wellness knows that exercise produces more flexible arteries, more durable hearts, and leaner body shapes. These benefits are obvious, and honestly, sometimes a bit tiresome to write about.

To me, a far more interesting — and lesser known — benefit of regular exercise is that it might make us smarter. Here’s where the rodents come into the story.

As was summarized in the New York Times piece, when researchers allowed rats and mice access to running wheels they observed (a) that they all ran, and (b) those rats that did run scored better on rodent IQ tests, and actually grew more brain cells. This is a striking finding because nerve cells — unlike blood, GI and skin cells, which turnover rapidly — grow very slowly, if at all.

But that’s not the entire story. The Princeton researchers wanted to know whether the rat’s social relationships could have measurable biologic effects.

It turns out that rodents — like humans — are quite social. So social, in fact, that in these trials the brain-growing effect of exercise was blunted when rodents lived alone. Compared to rats and mice that lived in groups, those that were kept in isolation failed to grow new nerve cells in response to exercise. And importantly, isolated rats produced higher levels of stress hormones than those who lived in groups, even though both groups ran the same distance. Read more »

*This blog post was originally published at Dr John M*

End-Of-Life Planning Makes It Easier To Say Goodbye

This is a guest post by Dr. Barbara Okun and Dr. Joseph Nowinski.

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End-Of-Life Planning Makes It Easier To Say Goodbye

Saying goodbye as the end of life approaches can be difficult, even for those with a gift for words. In a moving account in a recent issue of The New Yorker, writer Joyce Carol Oates describes the last week of her 49-year marriage, as her husband was dying from complications of pneumonia. Like A Year of Magical Thinking, Joan Didion’s poignant memoir of her husband’s sudden death and its aftermath, Oates’ essay highlights the need for each of us to think about death and dying — and discuss them with loved ones — long before they become a likelihood.

In our work with individuals and families facing death, we have seen too many people miss the opportunity to say goodbye because they avoid what feels like a scary or taboo topic: What do I want to happen when I die? Beginning this discussion early, preferably while you are in good health, can help pave the way for a “good death.” In our new book, Saying Goodbye: How Families Can Find Renewal Through Loss, we offer a guide to help individuals facing a terminal illness and their families navigate the realities of death and dying. Planning ahead is essential. Here are some suggestions for doing that:

Choose your team. Identify support people and specialists (legal, medical, financial, religious) you can count on to advocate for you and help you make decisions. Designate these people to act for you by signing advance medical directives. Read more »

*This blog post was originally published at Harvard Health Blog*

Personal Genetic Testing: Psychological And Behavioral Effects

Genome-wide profiling is increasingly being marketed towards consumers to assess their risk of developing certain diseases. However, there has been little research into the psychological effects of these tests.

Researchers from Scripps Translational Science Institute have now looked into these effects in a large group of patients. They followed 2,037 participants who took the Navigenics Health Compass, a test that assesses the risk for about 20 common diseases, for a period of three months.

Taking the test did not increase anxiety symptoms, dietary fat intake, or exercise behavior. There was some test-related distress correlated with the average estimated lifetime risk of getting the diseases tested for, but at the same time 90.3 percent of all subjects had no test-related distress at all. The use of screening tests did not change among the group and notably health effects of the test were not studied.

In conclusion, personal genetic testing does not seem to generate a lot of distress, although the study was clearly limited by a high dropout percentage of 44 percent and the self-selection of participants who opted to do the test.

Article in New England Journal of Medicine: Effect of Direct-to-Consumer Genomewide Profiling to Assess Disease Risk

Flashback: An Interview with Navigenics…

*This blog post was originally published at Medgadget*

Treatment-Resistant Depression: New Insights

Only one-third of people with major depression achieve remission after trying one antidepressant. When the first medication doesn’t adequately relieve symptoms, next step options include taking a new drug along with the first, or switching to another drug. With time and persistence, nearly seven in 10 adults with major depression eventually find a treatment that works.

Of course, that also means that the remaining one-third of people with major depression cannot achieve remission even after trying multiple options. Experts are hunting for ways to understand the cause of persistent symptoms. In recent years, one theory in particular has gained traction: that many people with hard-to-treat major depression actually suffer from bipolar disorder. However, a paper published online this week in the Archives of General Psychiatry suggests otherwise — and the findings provide new insights into the nature of treatment-resistant depression. Read more »

*This blog post was originally published at Harvard Health Blog*

Healthcare Staff: Please Hold The Snark

Every once in awhile I have the distinct “pleasure” of being a patient. This week I was reminded about how awful it is. I didn’t mind the blood draws, poking and prodding, injections, or interaction with my physician, but it was the rudeness of the ancillary and administrative staff that really got under my skin. I had forgotten how unfriendly people can be, and how especially hard it is to deal with when you’re not feeling well. Context is everything when it comes to rolling your eyes and sighing heavily. Let me explain.

Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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