Are You Walking Outdoors Yet?

Our citron is being acclimatized to the outdoors. Are you?

And The Cough Goes On...

Do you have an untreated cough that has lasted for several weeks? If so, you are not alone. Many patients in my practice have been complaining about a cough that does not seem to go away. I have seen more of it this year than in other years, and it started back in November of last year.

Typically, one would have an episode of bronchitis, sinusitis, or the common cold, which may have been treated with a course of antibiotics. The initial symptoms then partially or fully resolve. A few days or a week later, the nagging cough develops, and is commonly referred to as “post infectious cough.”

The cough may be “productive” (producing mucus), or it may be “dry.” It can occur during the day, when you’re lying down at night, or throughout the night. In more severe cases, the cough will come in “volleys” (paroxysms), and will awaken you, or even frighten you. It may be associated with a post nasal drip or gastric acid reflux. Some medications, particularly some of the medication used for the treatment of high blood pressure, can cause a persistent, dry cough.

The underlying reason for the cough is an inflammatory process which affects the linings of the bronchial tree leading to the lungs. It’s similar to the process responsible for bronchial asthma. It is thought by some authorities that, when left untreated, this condition can leave you predisposed to a recurrence, or even trigger the new onset of asthma.

When the cough lingers, you should be examined by a physician. This is especially important if you have a chronic condition such as asthma, chronic bronchitis or heart disease, and even more so if you have an impaired immunity, take immune suppressing medications, or are a smoker.

In treating the persistent cough, the physician must make sure that conditions other than post infectious cough are ruled out, such as pneumonia, asthmatic bronchitis and the whooping cough (pertussis).

Once other causes have been ruled out or treated, the post infectious cough will resolve on its own. But it may take weeks, and I have seen it last for months. Treating it will generally shorten the duration and severity of the post infectious cough, and should make you feel better much faster.

So, when you develop a lingering cough, don’t just tough it out, have it evaluated medically, and treated if necessary.

FREE Blood Pressure Check and Analysis

Come in all Month Long for a FREE Check!

No appointment necessary, just call 203-853-1919

2000 Post Road, Fairfield, CT

If you have a home monitor in need of calibration, bring that in too, we'll make sure it's working correctly, for FREE too!

Heart Month is All Year Round

Did you know that February was National Heart Month? Did you do anything to make sure your heart was in tip-top shape? If you're like most people, you didn't! High blood pressure is a major risk factor for heart attacks, stroke, diabetes, and almost every major life threatening condition. Come in for a FREE Blood Pressure check! During the month of March, come into the office, at no charge, to get a FREE Blood Pressure check. If you've got an issue, we'll make a plan to solve it, and solve it fast. In March, if you have a home blood pressure machine, we'll check it for accuracy, and ensure you're using the machine correctly, also for free. Just give us a call at 203-853-1919, and let us know you're coming in, appointments for this service are not necessary. Please share this important free service with your friends. You never know when you can save a life. See you at the office.

Are You Still Smoking?

Fifty years after the release of the US Surgeon General report on smoking, the percent of adult smokers has gone down from 42% to 18%. With it, the number of people dying of lung cancer has decreased somewhat. But smoking remains the number one direct cause of death in the US!

The cost of tobacco use to the USeconomy is close to $300 billion (yes, with a "b") a year in direct medical cost and productivity loss. For every dollar spent on cigarettes, $5 are spent on related health care. And for every cigarette you smoke, you are likely to lose more than 20 minutes of life.

More than 440,000 people die in the USeach year as a direct result of smoking, of which 10% are innocent, second hand tobacco smoke inhalers. Most frequently, these are the children of smoking parents. Many more suffer from chronic, tobacco related lung and heart disease.

In my book, the main issue remains the “hard core” smoker. He or she has more than a 50% chance of dying of  lung disease and spending years with an oxygen mask. But the more casual smoker is also at risk.

It’s my hope that, if you are a smoker, the horrible statistics I brought to your attention would give you pause. Stop smoking now, before it’s too late. Do it for yourself, for your spouse, for your kids and your friends.

There are several ways to quit, from “cold turkey” to stress management, to hypnosis and medication. In our practice, we have seen many successful quitters, and most of them did it on their own.

Remember that stopping to smoke is one of those times when becoming a quitter is really becoming a winner.

Fitness and Conditioning: Why is VO2 Important?

If you exercise regularly, if you exercise vigorously and want to know if you could do even better, you may want to know your VO2 max.

When you exercise, your oxygen consumption increases. It does so within limits which vary from person to person. Your VO2max (where V stands for Volume and O2 stands for oxygen) is your maximal ability to consume oxygen during exertion, measured in milliliters of oxygen per kg of body weight, per minute.

Oxygen is inhaled from the atmosphere by the lungs, where it diffuses into the blood stream, and then
propelled by the heart throughout the body. Some of the oxygen is then taken up by the cells and is used in aerobic metabolism for energy production and a variety of metabolic processes.

Normally, the limitation to VO2 max is dictated by the ability of the heart to pump the blood. This max can be impaired in cases of heart disease, especially in congestive heart failure, but it can also be limited by a lung disease – asthma, and COPD for example – and can be further limited by genetic factors.

For individuals in good health, VO2 max can be “trained” to its ultimate maximum with a suitable exercise/fitness program. This may take several months, sometimes up to 18 months of regular exercise.

Your VO2 max is usually tested on a treadmill. It’s a graded exercise test, similar to cardiac exercise testing, with the addition of a small mouth piece through which air composition is analyzed, and the VO2 is computer-calculated during the test. Once you reach VO2 max, your oxygen consumption plateaus, as seen in the graph. Most people complete the exercise within 12-16 minutes (the Olympic athletes will take longer…).

Knowing you exercise VO2 and its relationship to your max allows us to assess your level of conditioning, and better prescribe an exercise/fitness routine in order to improve your performance.

At our facility, we have been cardiopulmonary function testing, which includes both a VO2 max test and cardiac exercise for over 20 years. To my knowledge, we are the only ones in the County who are doing this test outside the hospital. Many of our patients, including some high profile athletes, have benefited from it by safely increasing their exercise capacity and performance.

Insurance may cover some or all of the test; and we have an affordable fee schedule for the uninsured and the under-insured.

Does this whet your appetite? Any questions? Call (203) 853-1919.

My Grandpa Wants You to Have a Physical Exam!

I want you to call (203) 853-1919 now...