A visit to Israel and a treatment for psoriasis and dermatitis

My wife and I returned today from a 12 day trip to Israel (which we have done many times before), and were back at work before noon.

This was a dual purpose trip: visit family, friends and new sites; and re-visit the developers of the new EdenSkin line of products designed to treat common skin conditions such as psoriasis, atopic dermatitis and seborrheic dermatitis.

Some of the exciting sites included the impressive IDF air force outdoor museum in the Negev; the Tel Aviv museum which exhibited the unusual and unique photos of David LaChapelle (born in Fairfield, CT); the Palmach museum in Tel Aviv commemorating the importance of this organization in the creation of the state of Israel, and the Druze village of Dalyiat el Carmel on the slopes of Mount Carmel overlooking the breathtaking Izrael Valley.

And on the medical front, we learned a lot more than what we already knew about the Israeli health delivery system, how effective it is, and how much simpler it is than what we have here. More about it in the future.

We also completed our review of the EdenSkin family of products, developed by a small company in Kfar Saba.

We have been watching the development of QoolSkin for several years. I've been using it successfully in the office for a while. It's herbal, and it contains no steroids, parabens, colors or fragrances. Most importantly, its side effect profile is extremely low, and it works where conventional therapy doesn't. We now keep the product at our office.

Other EdenSkin products include TopicSkin, also an herbal preparation, which I have used for the treatment of allergic dermatitis, and SeboSkin, which I intend to use for the treatment of seborrheic dermatitis.

Looking at the whole picture, this was a great trip, which also carries a potential benefit to our patients.

Avoid those extra winter pounds

Winter is approaching, and the natural tendency for many of us was to stay indoors. For many of us, lack of activity and overeating follows, and the result is those frustrating extra winter pounds.

Weight gain is not only a medical issue. Sure, there is an increase chance of diabetes, high blood pressure, accelerated heart disease, joint pain, and many other medical conditions. But also important are the social, financial and psychological aspects of overweight. Thin and fit is still the general desire of most people. Some of us would become depressed over gaining weight and the inability to lose it, and others would feel that they lost a promotion opportunity because of it. Very few of us would enjoy buying a new, larger wardrobe, or the inability to fit into our summer vacation clothing.

So what are you going to do about it?

Losing weight is a full time job; you have to be aware of your goal at all times. Some of us can do it without much help. Decrease food portions, decrease fat intake, increase exercise --- the usual steps --- works. For others, professional help is a must.
Professional weight loss focuses on the entire person and his/her needs, and includes:

Establishing realistic goals. The ultimate goal of weight loss has to be a target weight that can be both achieved and maintained. This target weight may not be immediately identifiable, but becomes apparent as you work with your health care provider.

Portion control. Both the portion size and content of the food you consume need to be controlled and monitored. Accurate record keeping, while tedious, is extremely important. Your ability to keep records is a good indicator of how successful you'll be in controlling your weight.

Increase in exercise. Exercise helps burn excess calories, but don't count on exercise alone to reach your target weight. Cardiovascular exercise is best, but stretching and muscle strengthening are very important. Exercise at least four days a week, don't be a weekend hero. Special testing before taking on a rigorous exercise program is advisable, talk to your doctor.

Use of appetite suppressants when appropriate. The days of fen-phen long gone, but other medications are available. Stay away from over-the-counter preparations and "miracle drugs," they can be harmful, and, at best, you'll waste your money.

Use of meal replacement. Low calorie meal replacements have been available in super markets for several years. Others, of much higher quality, are available through some physician offices, including ours (e.g., HMR products). These products help in portion control and record keeping, and may keep you from binging.

Treatment of depression. Depression is frequently a cause of weight gain, and if it exists, it must be addressed.
What about weight loss spas? Many of them are very good, effective while you're there. But when you're back at home, you may still need to consult your health care professional.

When addressed correctly, overweight is manageable. And when you need professional assistance, go with those who will focus on your overall medical needs, not just weight loss. We're here to help!

Our Medically Supervised Weight Loss Program

The terms overweight and obese often trigger anxiety and frustration. Weight is a part of our personal self image, and an integral part of our well being. When weight is not under control, distress occurs, and poor health may soon follow. Americans have begun placing a great deal of importance on the "ideal weight" and many have gone to extremes to achieve it.

 Our three decades of experience in weight management have shown that there is no single formula that fits everyone's needs. Weight loss programs have to be individualized; they must be designed to meet your individual needs. Genetics and personal habits must be taken into account in order to form a personal program that will help you achieve your desired goal.

We start our weight loss program with a thorough medical evaluation of your needs and your weight gain triggers. It includes a measurement of your daily caloric requirements and body fat analysis with the use of specialized equipment.

 

  Weight control is achieved through several methods, sometimes alone and often in combination, depending on your needs. A suitable program may include:

• Ways to achieve portion control
• Meal replacement options
• Appetite suppression
• Exercise capacity measurement and exercise prescription
• Stress management
• Chinese and herbal medicine methods

 Whether your reason is medical, cosmetic, or both, we can help you lose weight safely and maintain your weight loss over the long run!

  To find your Body Mass Index (BMI), look at the BMI calculator on the left hand column.

Your weight - setting realistic goals

Have you been repeatedly frustrated with your weight management efforts because you were not able to reach or maintain your goal weight? You may have been setting unrealistic goals for yourself, based on an “ideal of slimness” that comes from society.

Popular magazines and commercial diet programs still show you pages upon pages of beautiful, ultrathin models, many of which have been carefully touched up to make the models appear even thinner than real life. You may be comparing yourself not only to a model, but to an unreal model.

And then there is the Barbie doll. Barbie has the features of an anorexic person, but she still is a child’s role model. Her message is “if you get the body, you can get the guy.” Junior high and high school girls have described the ideal girl as 5’7”, 110 pounds, size 5, long blond hair and blue eyes. TV still shows the slim as the ones that are popular, successful and happy.

The ads keep you aware of how far from their ideal you are, and promote the feeling of failure. It is not surprising that we set goals that are not reachable or maintainable. Nor are they desirable.
The flip side of the drive to become slim is the continuing expansion of the fast food and the sweets industry. Advertising associated with this drive are directed at your emotions. They make it hard to resist unhealthy foods, and they confuse people. You feel guilty if you eat the advertised food, and deprived if you don't.

How can you develop realistic goals? Here are practical considerations:

• Slimness is not the only goal. Other health issues are just as important, including the maintenance of normal cholesterol, blood pressure and glucose levels, smoking cessation, stress management, and regular exercise.

• Your personal weight history and physical activity history should be taken into account. If you are a forty-year old woman who weighed 100 pounds when you were running track in high school, then 100 pounds might not be a realistic goal now.

• Metabolism slows with age. If you continue to consume the same amount of food as you become older, there will be a gradual weight gain throughout adult life. Frequently, you can compensate for this decrease in metabolism by increasing your physical activity.

• Metabolism slows with weight loss. When you are thinner, you require fewer calories to maintain your weight. Again, an increase in physical activity may help significantly.

• The ideal body weight, frequently determined from Life Insurance tables, is neither a good measure of your body fat, nor the best measure of the medical risk of obesity. Body mass index (calculable from your height and weight), the waist hip ratio, and body fat measurement by electrolipoanalysis, are much better ways by which to assess your appropriate weight.

When setting weight goals for yourself, remember this: don't compare yourself with someone else. You are an individual and your body likely behaves differently from someone else's body. When losing weight, make sure you exercise regularly. Feeling good and obtaining the benefits of healthy lifestyle changes is the real goal.

How do we handle emergency calls?

I hope you're having a great summer. I am trying to make the best of the warm weather by getting outside and exercising as much as possible. I hope you the same

I would like to make you aware of an important change in the way we now handle off-hour telephone calls.

As of June 21st, we stopped using our antiquated answering service. Instead, you can now leave a detailed voice message which will be retrieved directly by our office staff. This skips the answering service, and decreases the chance of miscommunication.

All emergency calls are forwarded to me directly, and are acted upon by me personally, or by the covering physician.

All non-emergency calls will be handled during the next working session. If you would like a response by email, leave your email address with your voice message.

This change has already shown a major improvement in our ability to accommodate your needs. Regardless, it's always more effective to call during working hours.

Please remember that before renewing any "routine" medications, each chart has to be reviewed. Charts are not always available electronically, so medications can not be renewed during off-hours.

In life-threatening situations, always call 911 first!!!

Continuing medical education and then some…

First the serious stuff: Just back from taking the Continuing Medical Education courses at the Javits Center in Manhattan.

Two and a half days attending lectures on important topics in the management of conditions which concern so many of us, such as diabetes, heart disease, COPD, sleep disorders, high cholesterol, low back pain, and the metabolic syndrome.

It doesn't matter how much you know, there's always something new you bring back with you from these courses.

And the patients benefit from it.

And now to the ridiculous: You must already know some of the restrictions placed on pharmaceutical companies promotional "giveaways" to physicians. They used to give away trips, tickets to Broadway shows, and engage in other promotional activities which are now considered unethical (don't get me wrong, I'm not taking sides or expressing my opinion here).

At the Javits center meetings, some drug manufacturers were allowed to offer minor refreshments such as coffee and nuts. At several stands, the following sign (or a version of it) was posted: Due to State regulations, we can not serve complimentary beverages to health care providers licensed in the state of Minnesota…

Don't the legislators and regulators have something better to do?

Stew Leonard’s in Norwalk to offer on-site physicals for team members

Stew Leonard's made the following announcement about their innovative way of making high caliber preventive health care more accessible to their employees. I'm here to help, and I hope it's a trend setter.

As part of an on-going commitment to preventive healthcare, Stew Leonard’s will launch a pilot program tomorrow offering on-site physicals for Team Members at the Norwalk store. The Stew Leonard’s “Wellness Mobile” will be led by Dr. Igal Staw, a local Norwalk physician who has served the community for more than 30 years.

“Stew Leonard’s surveyed our Team Members and we found that a lack of time and not having a trusted doctor locally kept many from getting their yearly physicals,” said Jill Leonard Tavello, Executive VP of Culture and Communications at Stew Leonard’s. “By bringing Dr. Staw directly to our store here in Norwalk, we hope to keep our Team Members healthy and reinforce the importance of preventive care.”

On June 3, the first eight Team Members will report to the Wellness Mobile, located in a private trailer behind the store, for blood work, an EKG, and preliminary paperwork with a staff member of Dr. Staw’s office. On June 7 and 8, Dr. Staw will perform the physicals as well as take time to meet with each Team Member regarding their healthcare-related questions. If the Wellness Mobile is a success in Norwalk, Stew Leonard’s plans to expand the program to their other stores in Yonkers, N.Y. and Danbury and Newington, Conn.

“Recent research shows that well over 40% of premature deaths in the United States can be attributed to lifestyle choices,” said Dr. Staw. “My work at Stew’s Wellness Mobile will of course focus on early detection of treatable medical conditions, but the real emphasis will be on assessing each Team Member’s risk for chronic disease and how they can lower that risk through smart, healthy choices in their everyday lives.”

The Wellness Mobile is just the latest example of how Stew Leonard’s has taken an active approach to preventive health care for their more than 2,500 Team Members. On-site cholesterol and blood pressure screenings, mammograms, and flu shots are offered throughout year and discounts on weight loss programs, smoking cessation aids, and fitness center memberships are also provided to both full and part-time Team Members. Additionally, between now and August 31, Stew Leonard’s will give Team Members $500 in Benefit Bucks – or money towards their deductible – to encourage them to visit their doctor for their annual check-up.

About Stew Leonard’s:

Stew Leonard’s, a family-owned and operated fresh food store founded in 1969, has four stores in Norwalk, Danbury, and Newington, Conn. and Yonkers, N.Y. Stew’s earned its nickname, the “Disneyland of dairy stores” because of its country-fair atmosphere, with costumed characters and animated entertainment throughout the store that keep children entertained while parents shop. Stew Leonard’s legion of loyal shoppers is largely due to the stores’ passionate approach to customer service: “Rule #1 -- The Customer is Always Right”; Rule #2 – If the Customer is Ever Wrong, Re-Read Rule #1.” This principle is so essential to the foundation of the company that it is etched in a three-ton granite rock at each store’s entrance. The company’s culture is built around an acronym for S.T.E.W.: Satisfy the customer; Teamwork gets it done; Excellence makes it better; WOW makes it fun. For more information, visit Stew Leonard’s website at http://www.stewleonards.com./

About Dr. Staw:

Dr. Staw’s motto in his practice has been, "We help you live a longer, healthier life..." He was a late comer to medicine; after receiving his doctorate in Biomedical Engineering and doing basic research in the area of pulmonary physiology and certain metabolic processes, he felt that his real calling was patient care. The next five years were spent in accelerated programs through medical school and training in internal medicine and pulmonary medicine. Dr. Staw has been in private practice for over 30 years, and in the last 22 years he has placed great emphasis on prevention. He practices preventive care by first identifying his patient’s health risk factors (the factors which predispose them to disease) and then by developing the best strategy to minimize or eliminate these risks. It is his firm belief that the practice of preventive care, in its broader sense, is one of the most important factors not only in keeping his patients healthier, but also in keeping the environment cleaner, and the economy stronger. For more information, please visit http://www.drstaw.com./