Archive for September, 2011

High Blood Pressure Can Lower Your Sex Life

September 29, 2011

Robert is a 53 year old man with high blood pressure. He has a job associated with stress. He is 25 pounds overweight. He rarely exercises and admits to being a little heavy handed with the saltshaker. He takes a diuretic, hydrochlorthiazide, and an anti-hypertensive medication and since beginning these two medications, he has noted that his sexual performance has gone into very low gear.

High blood pressure can get worse over time and cause problems with getting an erection. A major study showed that 26% of men with high blood pressure said they had erectile dysfunction (ED). That was twice the rate of ED in men with normal blood pressure. Some medicines for high blood pressure, such as diuretics, can also cause ED. But if you’re able to keep your blood pressure under control — even with medicines — you can help prevent your ED from getting worse. 

An estimated 15 million to 30 million men in the U.S. have ED. Some changes in sexual function are normal as a man ages. Erections may be less firm, or it may take you longer to get erect. ED is sometimes temporary, too. Stress, relationship issues, illness, and drug side effects may cause it. But if your erection difficulty is ongoing and it keeps you from having the sex life you want, it may be time to seek treatment.

Many men have problems getting or maintaining an erection at some point in their lives. If it happens occasionally, it is probably not a medical problem. But if you repeatedly have trouble — if it happens about a quarter of the time or more — you may want to talk to your doctor about treatment. .

Some drugs for high blood pressure may cause ED. These include diuretics (water pills) and beta-blockers. ACE inhibitors and calcium channel blockers are less likely to cause ED. If you started having erection problems after you began taking medicine, talk to your doctor. You may be able to switch to a drug that can lower your blood pressure without increasing your risk for ED.

Even with high blood pressure and ED, you can still have a good sex life. If your blood pressure is under control you may be able to take an ED pill. Cialis, Levitra, and Viagra are safe to take with most blood-pressure medicines. If ED pills aren’t for you, other proven treatments include implants, pumps, and injectable drugs.
 You also need to check your testosterone level if your sexual performance is not what you would like it to be or if your sex drive has gone into the tank.

Heart disease — a common complication of high blood pressure — and ED are commonly seen together. A blockage in a heart artery is a good indication that the same thing may be happening in arteries that supply blood to the penis, making it difficult to get an erection. Many men with heart disease can’t take ED pills due to an interaction with heart disease drugs called nitrates. But new research suggests some men with stable heart disease may be able to slowly stop taking nitrates if their doctor thinks they would benefit from an ED pill. Stopping nitrates can be dangerous, so talk to your doctor first. If ED pills aren’t for you, there are other ED treatments that are safe for men with heart disease.

Robert spoke to his doctor and got the message about the connection of ED and high blood pressure. He began an exercise program, lost the 25 pounds over a six-month period, and cut out salt in his diet. His blood pressure normalized and he was able to stop using the medication and he had a noticeable improvement in his sexual performance.

Bottom Line: High blood pressure can lower your sexual performance. Treating the high blood pressure and healthy life style changes can also significantly improve ED.

This article was excerpted from an article by Brunilda Nazario, MD appearing in WebMD

The Right Way To Eat Fruit

September 28, 2011

We all think eating fruit means just buying fruit, cutting it up and popping it into our mouths. It’s not that easy. It’s important to know how and when to eat fruit.
Why is fruit important? Eating fruit like that plays a major role in detoxifying your system, supplying you with a great deal of energy for weight loss and other life activities.

So What is the correct way to eat fruit? Begin by not eating fruit after a meal. Fruit is meant to be eaten on an empty stomach. Let’s say you eat two slices of bread, then a slice of fruit. The slice of fruit is ready to go straight through the stomach into the intestines, but it’s prevented from doing so. In the meantime, the whole meal rots and ferments, and turns to acid. The minute the fruit comes into contact with the food in the stomach, and digestive juices, the entire mass of food begins to spoil.
Eat your fruit on an empty stomach, or before your meal! You’ve heard people complain: Every time I eat watermelon I burp, when I eat durian my stomach bloats, when I eat a banana I feel like running to the toilet, etc. This will not happen if you eat the fruit on an empty stomach. Fruit mixes with the putrefying other food and produces gas. Hence, you bloat!
There’s no such thing as some fruits, like orange and lemon are acidic, because ALL fruit becomes alkaline in our body. If you have mastered the correct way of eating fruit, you have the Secret of Beauty, Longevity, Health, Energy, Happiness and normal weight.
When you need to drink fruit juice drink only fresh fruit juice, NOT the concentrated juice from the cans. Don’t drink juice that has been heated. Don’t eat cooked fruit; you don’t get the nutrients at all. You get only the taste. Cooking destroys ALL of the vitamins.
Eating a whole fruit is better than drinking the juice. If you should drink the juice, drink it mouthful by mouthful slowly, because you must let it mix with your saliva before swallowing it. You can go on a 3-day fruit-fast to cleanse your body. Eat fruit and drink fruit juice for just 3 days, and you will be surprised when your friends say how radiant you look!
KIWI: Tiny but mighty, and a good source of potassium, magnesium, vitamin E and fiber. Its vitamin C content is twice that of an orange!
AN APPLE a day keeps the doctor away? Although an apple has a low vitamin C content, it has antioxidants and flavonoids which enhances the activity of vitamin C, thereby helping to lower the risk of colon cancer, heart attack and stroke.
STRAWBERRY: Protective Fruit. Strawberries have the highest total antioxidant power among major fruits and protect the body from cancer-causing, blood vessel-clogging free radicals.
EATING 2 – 4 ORANGES a day may help keep colds away, lower cholesterol, prevent and dissolve kidney stones, and reduce the risk of colon cancer.
WATERMELON: Coolest thirst quencher. Composed of 92% water, it is also packed with a giant dose of glutathione, which helps boost our immune system. Also a key source of lycopene, the cancer-fighting oxidant. Also found in watermelon: Vitamin C and Potassium.
GUAVA & PAPAYA: Top awards for vitamin C. They are the clear winners for their high vitamin C content. Guava is also rich in fiber, which helps prevent constipation. Papaya is rich in carotene, good for your eyes.
Drinking Cold water after a meal = Cancer! Can you believe this? For those who like to drink cold water, this applies to you. It’s nice to have a cold drink after a meal, however, the cold water will solidify the oily stuff that you’ve just consumed, which slows digestion. Once this ‘sludge’ reacts with the acid, it will break down and be absorbed by the intestine faster than the solid food. It will line the intestine. Very soon, this will turn into fats and lead to cancer. It is best to drink hot soup or warm water after a meal.
A serious note about heart attacks. Women should know that not every heart attack symptom is going to be the left arm hurting. Be aware of intense pain in the jaw. You may never have the first chest pain during the course of a heart attack. Nausea and intense sweating are also common symptoms. Sixty percent of people who have a heart attack while they’re asleep do not wake up. Pain in the jaw can wake you from a sound sleep. Be careful, and be aware. The more we know, the better our chance to survive.
Bottom Line: There certainly is a medicinal value in eating fruit. But just as important as eating fruit, you need to know how and when to do so.
This article was inspired by an article written by Dr. Oz,

Don’t Let Anti-Depressants Rain on Your Love Life

September 24, 2011

B.B., a 52-year old lady, had a history of depression, which has been controlled with Prozac. She noted a waning of her libido or sexual desire. She consulted with her doctor who prescribed the Prozac and he changed her medication to Wellbutrin, which allowed her libido to return to normal, and controlled her depression as well.
Sexual dysfunction, which includes loss of libido, decrease in arousal or vaginal dryness for women and decreased libido, and erectile dysfunction in men, is common in both men and women with depression. If that wasn’t bad enough, the treatment for depression with the antidepressant medication can cause sexual dysfunction. It is estimated that 30-70% of men and women who use antidepressant medication, such as Celexa, Prozac, Effexor, Zoloft and Remeron, experience a sexual dysfunction. The lowest rate of sexual side effects occurred in patients taking Wellbutrin.
Many men and women who experience these side effects of the medication may try to resolve the problem by stopping the use of their antidepressant medication. This should be avoided, as restoring sexual intimacy is not a good trade off if the depression returns. Fortunately, there’s a solution to this dilemma for those who suffer from depression or for those who require the use of antidepressant medications.
How do you know if your antidepressant is causing sexual problems? Experts say that the trouble is probably the result of the medication if a person who did not previously have sexual dysfunction experiences problems within two to three months of beginning antidepressant treatment.
What To Do

First and most importantly, do not make any changes in your treatment regimen without first consulting your physician. Here are some suggestions which you might discuss with your physician:

1. If you are experiencing sexual side effects from your antidepressant medication, your doctor may consider switching you to Wellbutrin, which has a low rate of sexual side effects. Wait to see if sexual side effects abate.
2. Consider taking your medication after you have engaged in sexual intimacy.
3. With your doctor’s permission you may consider a drug holiday. A drug holiday involves taking a short break from your antidepressant. By taking periodic two-day breaks from antidepressant treatment can lower the rate of sexual side effects during the drug holiday without increasing the risk of a relapse or recurrence of depressive symptoms.

Bottom Line: Sexual side effects are common in men and women with depression. Most men and women can be restored to a meaningful sexual function by sharing with your doctor your concern and having him\her making changes and adjustments in your medication or changing to another drug as described in my patient B.B.

The Circumcision Decision

September 23, 2011

The first concern most men will have about their genital organs occurs right after birth when he undergoes a circumcision….and, unfortunately, the young boy has no part in the decision whether to lop off that precious piece of real estate!

Removal of the foreskin of the penis is one of the oldest surgical procedures known, dating back well over 5000 years. Hieroglyphs picturing ritual circumcision were found in ancient Egypt, and the religious significance of circumcision is described in the Old Testament.

Perhaps because of its long history, circumcision in the U.S. has been generally considered routine surgery. In the mid-1980s, up to 89 percent of newborn males were circumcised in some parts of the U.S.
There are many valid reasons for choosing circumcision, including cultural, religious and ethnic traditions. But in March 1999, the American Academy of Pediatrics (AAP) issued a policy statement that said they no longer recommend routine neonatal circumcision. It stated that although there are some potential medical benefits of newborn male circumcision, those benefits are so slight that they contribute little or nothing to the decision-making process.

So what does this mean for parents-to-be getting ready to make the circumcision decision? Mainly parents are on their own. The AAP does not make any specific recommendation. Parents need to talk with their physician and then carefully weigh the risks versus the benefits of the procedure.

Medical Risks and Benefits

Parents should be assured that the great majority of circumcisions are trouble-free. But circumcision is surgery, and all surgeries run the risk of complications. The most common complications, which occur in only about 1 percent of circumcisions, are: bleeding, which can easily be controlled with pressure, and minor infection, which can be treated with antibiotics.

The medical benefits of circumcision are small. Uncircumcised boys have a higher risk of developing urinary tract infections (UTIs) than circumcised boys, particularly in the first six months of life However, the overall risk of a UTI is still less than 1 percent. Generally, physicians will recommend circumcision for any boy who has two UTIs in the first year of life. A circumcision performed months or years after birth is done surgically under anesthesia, and seems to be associated with fewer complications and less pain and trauma.

Circumcision also has small but measurable benefit in preventing penile cancer, a very rare disease that strikes only about 1 in 100,000 men. Uncircumcised men are three times more likely to develop penile cancer than circumcised men.

Uncircumcised men are also reported to be at greater risk for developing sexually transmitted diseases such as syphilis and HIV infections than circumcised men, but behavioral factors, such as not practicing safe sex, are far more important risk factors.

Overall, the increased risk of developing UTIs, sexually transmitted diseases, or penile cancer is extremely low, regardless of circumcision status.

A Kinder Cut

For those parents who elect to have a circumcision performed on their newborn infant, it is important that the parents select an experienced surgeon to perform the procedure. The AAP recommends that pain relief with a local anesthetic should be used during the procedure. Safe and effective forms of analgesia for circumcision are easily accomplished using a local or topical anesthetic consisting of a gel or cream applied to the foreskin before the procedure. This method has been found to provide adequate pain relief during the 5-10 minute procedure.

Parents considering circumcision should talk with their doctors, and make sure that they are comfortable with whoever will be performing the procedure. Specify in advance what type of anesthesia will be used, and notify the doctor if there are any bleeding disorders in the family.

Parents who choose not to circumcise need to receive instructions on how to care for an uncircumcised penis. The foreskin should never be forced to retract, nor should objects such as swabs or cotton balls be used to clean underneath it. Although most boys will have retractable foreskins by age 3, in some cases, it may take 7 to 10 years. Parents must be patient and allow the process to happen naturally. All boys who are not circumcised need to be instructed on proper hygiene of the foreskin. Failure to do so can result in inflammation of the penis and a foreskin that is even more difficult to retract and clean. Occasionally, this condition, phimosis, or tight foreskin requires a circumcision as an adult.

So if you are considering the “prime cut” for you or your newborn son and have any questions, I suggest you contact your doctor.

Dr. Neil Baum is a urologist and can be reached at 504 891-8454 or on his web site

My Most Memorable Day In The Office-The Day My Mother Became A Saint

September 18, 2011

It was 1976 and I had just started my solo practice. I employed only a receptionist and a nurse. My nurse was absent because of an illness and I asked my middle-aged mother to come and serve as my chaperone for the afternoon.

The first patient was a young lady and I asked her to give a urine specimen and place it in the turnstile in the restroom. My mother, wearing a lab coat, that gave her a medical look, escorted the lady to the exam room. I walked by the restroom and saw the specimen container on the back of the toilet and as I went to take a phone call, I asked my mother to move the specimen to the lab and I would run it through the centrifuge and prepare the specimen to examine under the microscope. My mother said, “Neil, I changed your diaper and I allowed you to pee on me when you were an infant, but I will not touch someone else’s urine specimen. Remember Neil, you chose this specialty, not me!” Okay, I laughed and moved the specimen container myself.

I then met with the patient, took her history, and was ready to perform the physical exam. I gave the patient a paper gown and I stepped out of the room and told her that I would get the “nurse” and return to the room for the exam. The patient was placed in the stirrups on the exam table as the “nurse” stayed by her side and held her hand. I was at the end of the table between the patient’s leg and I inserted the speculum. The patient gave a small grunt of discomfort as I told her that the hardest part of the exam was nearly over. Just a few seconds later, the patient said, “Is she okay?” I remained between the patients leg with the gown obscuring my peripheral vision and asked, “Who are you talking about?” The patient said, “Your nurse. She’s on the floor!” I peeked around the patient’s leg to find that my mother had fainted and was lying on the floor. I removed the speculum and helped my mother to her feet and escorted her out of the room. My mother was very embarrassed and was adjusting her hair and went to the front desk. I reassured the patient that the “nurse” was okay and didn’t provide any further explanation.

I had a discussion with the patient about her treatment and walked her to the desk where my mother had prepared the bill and was ready to collect her payment!

I thought that I’d never see that patient again but interestingly enough she sent two of her friends who all asked where was the “nurse who fainted”? I know I will never forget that day that my Jewish mother, Sara Baum, became a Jewish Saint!

When Your Sex Drive Crawls To A Halt

September 17, 2011

A decrease in your sex drive or a loss of your libido can result in physical and emotional disorders. If this is your problem, you will want to read the rest of this article and learn how to put fuel back in your sex drive.

Sex drive killers

Erectile dysfunction or ED
Nearly 33 million American men suffer from erectile dysfunction. ED is most common in men over age 40 but most men suffer in silence. This is a result of the myth that ED is a normal part of the aging process and it is primarily a psychological problem. The facts are that it is not part and parcel of the aging process and that older men who are healthy and have a partner can expect to successfully engage in sexual intimacy. ED is eminently curable with the help of drugs and injections or surgical procedures.

In women, physical changes like menopause can affect physical intimacy and sexual drive. Although, menopause itself does not affect your ability to have sex, the reduced hormone levels may cause certain discomforts like vaginal dryness and pain during sex. This condition is also easily treated with hormone replacement therapy or just lubrication in women who cannot or wish not to take estrogens.

One of the major hallmarks of depression is reduced interest in sex. Be aware that both depression and antidepressant pills can affect your libido. If you are having a loss of sex drive as a result of using antidepressant medication, tell your doctor as he\she can alter the dosage or change to another medication that doesn’t cause a drop in your sex drive.

Less sleep
There is a direct connection between sleeplessness and reduced sexual urge. Loss of sleep can result in an increase stress hormone cortisol which plays a major role in reducing the testosterone levels, the hormone in both men and women that is responsible for maintaining your sex drive.

Parenting is a one of life’s greatest stressors and can affect your physical and mental health including your sex life. A solution may be as simple as taking time for each other and making a regular date that doesn’t include the children.

Excessive alcohol
Excessive alcoholic consumption is linked to ED and infertility in both the sexes. It is true that a few sips of your favorite wine lowers your inhibitions and puts you in the mood for intimacy but it can also put your sex drive in the tank. Like everything in life, moderation can help preserve your sex drive.

Relationship problems
Marital or relationship problems like lack of trust and proper communication can act as major hindrance to experiencing enjoyable and satisfying sex. Counseling to sort out any personal indifference between you and your partner is effective in restoring your bedroom activities.

Bottom Line: One of the life’s greatest enjoyments is sexual intimacy with the partner you love and enjoy. However, the libido is very fragile and can easily be diminished. The good news is that most libido problems can be resolved and intimacy be restored.

When Medicines Make You Sick

September 11, 2011

Most middle age and older men and women take more than one medication on a regular basis. Unfortunately these medications can interact with each other and produce undesired effects; sometimes the side effects are worse than the disease or condition that the original medication was intended to treat. It is estimated that 4.5 million Americans will return to the doctor’s office or even have to go to the emergency room because of the side effects of medication. There are an estimated 2 million serious drug reactions each year and drug reactions are the fourth leading cause of hospital deaths exceeding only by heart disease, cancer and stroke.

Side effects can produce symptoms ranging from lethargy, insomnia, muscle aches, depression, dizziness, diarrhea, constipation, and even chest paid.

So what can you do to avoid side effects of medications? First be sure your doctor knows what medications you are currently taking. Ask if the drug he is prescribing has any interactions with the drugs you are currently taking. There are computer programs that are available that will alert the doctor of any possible drug interactions. One of the most popular programs is e-Pocrates where the doctor or nurse can write in the drug being prescribed and the drug(s) the patient is currently taking and will list any potential drug interactions. Most electronic medical record programs that are becoming so prevalent among physicians’ practices will notify the doctor of any potential drug interactions.
Also, you can go to the Internet and use one of the search engines such as Google and type in the name of the medication and the phrase “drug interactions” and you will learn what drugs should not be taken together. There are drug interaction checkers available online. One of the best is

Next, ask the doctor what are the most common side effects and what is the likelihood of having any of the side effects. If the medical problem is not serious and not incapacitating, you may decide to forgo any new medications.

Also, ask your doctor if there are any lifestyle changes you can make as an alternative to taking medications. For example, if you have newly diagnosed high blood pressure, you can undergo a weight loss program and significantly reduce the salt in your diet, and you may avoid taking blood pressure lowering medications, which have side effects.

If you are taking multiple medications, you can ask your pharmacist to review all of your medications and the pharmacist will let you know which drugs are incompatible. Some pharmacists will charge you a few for this review but it is certainly worth it especially if you are older and if you take multiple medications. Also, if you are in a Medicare Advantage program, you may qualify for its medications therapy management services.

If you begin to experience a change or symptoms shortly after starting a new medication, you should contact the doctor’s office and speak to the doctor or nurse to find out if this is an expected side effect, how long it might last, or if the side effect is more serious and the drug should be discontinued.

It is also important to mention to your doctor any supplements, herbal medications, or vitamins that you routinely take as these may interact with your prescribed medications.

Final advice: Even if you are experiencing side effects due to medications, don’t stop taking the medication without calling your doctor first.

Bottom Line: For the most part drugs properly prescribed can be very helpful and will alleviate symptoms and treat your medical condition. However, all medications have side effects and you can minimize these side effects by being knowledgeable and informed about drugs and drug side effects.

The Tiger and the Breadcrumbs

September 11, 2011

Another guest-post from Dr. Neil Neimark, M.D. He again provides a wonderful message.

There is a wonderful story told by the great Sufi poet Nasrudin, of the tiger and the breadcrumbs.

One day, Nasrudin is seen in his suburban home spreading breadcrumbs outside of his house. A neighbor passing by inquires, “Nasrudin, what are you doing?” “Can’t you see?” says Nasrudin, “I’m spreading breadcrumbs outside of my house in order to keep the tigers away.” “But Nasrudin,” replies the neighbor, “there are no tigers in this neighborhood.” “See,” says Nasrudin, “it works!”

On some level, the lifestyles we choose work for us, even the apparently unhealthy ones. On some level, they help us to deal with our unwanted, uncomfortable feelings, thoughts and regrets. On some level, they help us avoid our pain, sorrow, fear and conflict. They help us to “mood-alter”. They keep us numb. They keep us from having to deal with our unresolved issues: our loneliness, our uneasiness, our loss.

If we feel uneasy, we may cover up our uneasiness by becoming a “work-aholic,” using our power in the company to avoid the powerlessness we feel in our personal or family life.

We may choose a fast paced lifestyle in order to avoid deeper, more meaningful relationships. After all, if someone really got to know us, they might “find out” how inadequate, alone or afraid we really feel sometimes.

Now, here is the really distressing thought: we may actually choose illness as a lifestyle. Let me say that again: “we may actually choose illness as a lifestyle.” “How could that happen?” you might ask. If the only time we received love and attention was when we were sick, then on some level, the “payoff” for being ill, is getting the love and attention we don’t know how to get appropriately.

After all, when we’re sick, we get to feel as lousy as we really feel. John Bradshaw, the recovery expert, says, “Needs and feelings can be changed into bodily sickness. When one is sick, one is usually cared for. When one is sick, one can feel as bad as one really feels. Sickness works.”

In order to achieve the level of physical and psychological health you deserve in life, please ask yourself, if you are making lifestyle choices to “mood alter” your anger, sadness, hurt, fear or powerlessness.

Now, think about other healthier ways to deal with the uncomfortable thoughts, unresolved feelings and irrational fears you may be holding on to.

Because our physical health derives most directly from our lifestyle choices, I will devote one more newsletter — next week — to exploring the deeper layers of the Iceberg Model, so that you can begin to break through unconscious, self-defeating choices and begin to experience the freedom that comes with conscious awareness.

Till next time, be well. In body and soul,

Neil F. Neimark, M.D.

Labor Day-Now You Know The Rest of the Story

September 2, 2011

Labor Day, the first Monday in September, is a creation of the labor movement and is dedicated to the social and economic achievements of American workers. It constitutes a yearly national tribute to the contributions workers have made to the strength, prosperity, and well-being of our country.

The facts: Peter J. McGuire, general secretary of the Brotherhood of Carpenters and Joiners and a cofounder of the American Federation of Labor, was first in suggesting a day to honor those “who from rude nature have delved and carved all the grandeur we behold.”
But Peter McGuire’s place in Labor Day history has not gone unchallenged. Many believe that Matthew Maguire, a machinist, not Peter McGuire, founded the holiday. Recent research seems to support the contention that Matthew Maguire, later the secretary of Local 344 of the International Association of Machinists in Paterson, N.J., proposed the holiday in 1882 while serving as secretary of the Central Labor Union in New York.

While the origin of Labor is in dispute, what is indisputable is that the United States has the highest standard of living and the greatest labor force in the world. This includes the millions of doctors, nurses, and allied healthcare professionals that make American medicine, even with its problems, one of the best in world. It is appropriate, therefore, that we take a moment to pay tribute this weekend to the the American worker.

Bottom Line: The United States has an unparalleled workforce. Let’s pay tribute to the ones who make this possible, the American worker.