JULY 31, 2010 YOU GOTTA HAVE HEART

"Change and growth take place when a person has risked himself and dares to become involved with experimenting with his own life." Herbert Otto

Here are two words most people do not want to hear: Change and Growth. As a child I grew out of the hand made clothes and toys. Did you grow out of your clothes and toys? That I can accept. But as an adult are you willing to grow out of things? Things like family, friends, jobs, love relationships, and even a home? It was not intentional that I grew out of some friends and family! It sounds absurd, but think about it carefully. Perhaps you moved forward in life- not in wealth, but in an emotional and spiritual way. Some things that meant so much earlier in life became trivial. I do not want to force fit an attitude that I have outgrown. It is a hard concept. We all need time to accept. I needed time to realize the truth.

What do you get out of certain family relationships? They will always be your family, but perhaps you are tired of being the one always calling. Perhaps you are tired of being the door mat, or just being there because you live in New York City! In regards to family this is very difficult, but I have seen it. What I haven't seen is the outgrowing of a parent- a mother or a father. In my opinion you would have to have a severe hurt to outgrow a parent. Difficult, but you must realize it does happen. A child abused psychologically and physically by a parent may outgrow their parent and perhaps never see them again. Can you understand that?

I have to realize I have grown, just in the same respect that my own children have grown. Perhaps they do not need dad as often as they did. They haven't outgrown me--it is just they are at different phases and periods in their life. Perhaps your growth is that you need time to realize the past, and finally say I have feelings also. This is growth occurring because of change. You can put the toys away and make room for new, but feelings are different. I do not put feelings away; I just look at them differently today. I want peace and serenity.

Wow -- I didn't think I was going to write the above, but the words flowed. I find it amazing that two words--growth and change can illicit such emotion. I will always remember the fondness of the old toys, friends, homes, et al. BUT, I have put some of them away to make room for the new things in life...

Back to " You Gotta have Heart"...
The major advances in the last twenty or thirty years in Cardiovascular Diseases (CVD) have been the reduction in the number of heart attacks. This has been the result of the tremendous efforts in public education and awareness, new technology in the field, and the development of new medications. It is also true the "Grass Roots" movement of Integrative Medicine (herbs, supplements, yoga) has allowed people to think there is a different way. It is difficult for me to start discussing CVD. I do not know where to begin. I have so many thoughts that flow through my mind.

I think I should begin to define certain terminology. So, as Maria told those Von Trapp children, "Let's start at the very beginning...A very good place to start.."

What is angina pectoris? It is simply defined as squeezing or pressure int he chest. Some describe it as a burning in the chest. What causes angina? Was it what the Italians call..."ags-i-da" or "az-i-da"? I know the spelling is wrong but that is how it sounds. Angina pectoris is a result of an insufficient or reduced blood supply of oxygen to the heart tissue. This drains it of energy. The heart is starving for oxygen as its blood source, the coronary arteries, have decreased oxygen. In most cases it is due to the fact that plaque formation in these vessels restricts blood flow to the heart. These arteries are now partially blocked causing the heart to be vulnerable. Is it only plaque that causes this? Absolutely not! Other conditions such as intense cold, physical exertion and even (although forgotten) emotional stress may increase the need for oxygen and result in 'ags-i-da" or otherwise known as angina.

As a cardiologist, I can use certain medications to prevent this angina. I can use nitroglycerin, aspirin or even a beta blocker. Both aspirin and beta blockers have been shown in all studies to decrease the risk of stroke and heart attack. Are there other modalities that can do the same thing? Of course there are! Isn't this the reason you are reading this blog? What causes the formation of a plaque? That is the million dollar question. It has been debated for years. It is like what came first--the chicken or the egg. What comes first--the insult by a bacteria/virus/parasite to the inner lining of the vessel that causes plaque to build up or is it the actual cholesterol that sticks to the inner vessel? Is a combination of the two.

So that is the first definition--one per day or maybe two.

I want to leave you with this thought. Is there a vitamin or nutrient that has been shown in research studies to reduce mortality and morbidity? In 2003, the effect of using Coenzyme Q 10 (a supplement) for one year reduced the occurrence of total cardiac events including non fatal heart attacks, and even reduced the extent of damage from heart disease.

So you see--we have lots to discuss... I will try to share a heart song every day as we discuss Cardiovascular Disease.

The lyrics below are from the Broadway show stopper- Damn Yankees. The song of course is

"You Gotta Have Heart"

You gotta have heart
All you really need is heart
When the odds are sayin'
You'll never win
That's when a grin
Should start.
You gotta have hope
Mustn't sit around and mope
Nothin's half as better as it may appear
Wait'll next year
And hope.
When your luck is battin' zero
Get your chin up off the floor.
Mister you can be a hero
You can open any door,
There's nothin' to it,
But to do it
You've gotta have heart
Miles 'n' miles 'n' miles of heart,
Oh, it's fine to be a genius of course,
But keep that old horse before the cart,
First you've gotta have heart.

A great slugger, we haven't got
A great pitcher, we haven't got
A great ball club, we haven't got

What've we got?
We've got heart
All we really need is heart,
You gotta have heart
All you really need is heart
When the odds are sayin'
You'll never win
That's when the grin should start
We've got hope
We don't sit around and mope.
None is solitary sob do we heave,
Mister, cause we've got hope.

So who is Herbert Otto? He is not Herbert Otto Gille, the German General who died in 1966. He is a psychologist known for his predictions on the future of sex, relationships, and marriage. He has many quotes which are worth reading.
Until tomorrow...

JULY 30, 2010 WHEN PAT-RICK MET HARRY

"I love the spiritual community we have created among ourselves. Spiritual community is created when we come together on a regular basis with a common intention: to extend love beyond our immediate families. Through this shared affinity, we encourage, challenge and remind one another that nothing is impossible." -Mary Manin Morrissey

I had to read this quote more than once and slowly. What does it really say? I have a community I come together with any time I choose to do so. I have friends who are now my extended family in my 12 step fellowship. We have a shared affinity--the desire to stop drinking. Although that seems so long ago I must remember it is a day at a time.

I get nervous and uncomfortable when I hear that someone I know has decided to drink again. It is more unsettling when I know the individual up close and personal. I often think why did he/she drink/drug again? What prompted this? Did he/she stop going to meetings? Did he/she have a loss.. of a family member, a relationship et al.? It is not my business who,what, why or where. I must always remember this. I am not going to take their inventory! I can extend the hand of my 12 step program. It may not be welcomed and I must and will accept this. If I have expectations I will only get disappointed. So what do I do? What should you do if in a similar situation? Pray, meditate, share, love and remind yourself within your spiritual community that nothing is impossible.

So Rick and I had a date with Harry Connick, Jr. Enchanting, exciting and exhilarating. When he sang, It Had to Be You from When Harry Met Sally I reminisced about my Poppy (my grandfather) strumming the mandolin. It Had to Be You is also a 1947 romantic comedy film starring Ginger Rogers and Cornel Wilde. I think I have a 78 recording of Betty Hutton singing the song. Many other artists have recorded It Had to Be You. My Poppy loved jazz. Today was his birthday, July 30, 1900. His name was James Calamis. Wow, he would have been 110 yrs old.

My brother and I had the pleasure, privilege and love of live-in grandparents. I am sorry that Rick never met my grandparents (Poppy/Nanny) My Poppy was a quiet man. He was not the oldest brother. His older brother was Charlie. Let's see--there was Charlie, Gus, Angie, Nettie, Anna and Katie. With the exception of Great Aunt Nettie, I knew all of them. I miss those times. My grandfather was a hat maker. He made some of the most famous hats in the world--for some of the most famous comics of that time-Harold, Stan, Lou, Bud, and of course Charlie. A signed photograph from Mr. Chaplin to my Poppy hangs in front of my desk .

Poppy was also a butcher. The best of all he was a great cook. Every Sunday was a feast. I do know that every morning my Poppy took a shot of some whiskey--exactly 2 ounces. Both my brother and I went to work with him during the summer. His shop was on 14th street and 5th Avenue. As I fed the squirrels at Union Square Park, I dreamed one day of living and working in New York City. My dad, brother and I gave him a 90th Birthday Party complete with a Barber Shop Quartet. He died peacefully in his sleep at out home at age 92.

I can tell you that my Poppy died without having any heart disease. He ate everything and anything, never smoked, had one 2 oz drink per day, and had no stress. He took the subway every day to New York City from Yonkers. He walked or took the bus from 23rd Street to Empire Street when my mom didn't pick him up at the station. He grew his own vegetables, made his own pasta and gravy (Rick-this is Italian Red Sauce), and never formally exercised. He had a pacemaker placed at age 88. Why do we have Cardiovascular Disease as the Number #1 killer in the United States now? A heart attack happens every 3-5 seconds. People die! There are many on a transplant list who never get a donor heart.

Ever since refined sugar and Wonder Bread become popular we had an increase in both obesity and diabetes-- both leading to the #1 killer- Cardiovascular Disease (CVD) . CVD includes coronary artery disease (blood supply to the heart), Hypertension (high blood pressure), Valvular Heart Disease, Cardiomyopathy, Atherosclerosis and Arrthymias. We will discuss some risk factors. Major risk factors are those that research has shown significantly increase the risk of heart and blood vessel (cardiovascular) disease. Contributing risk factors are associated with increased risk of cardiovascular disease, but their significance and prevalence haven't yet been precisely determined. The more risk factors you have, the greater your chance of developing coronary heart disease. Also, the greater the level of each risk factor, the more that factor affects your overall risk.

Here is a list of CVD Risk Factors:
1. Age
2. Male
3. Genetics
4. Diabetes
5. Obesity/Overweight
6. Hypertension
7. Smoking History
8. High Cholesterol
9. Stress
10. Alcohol Consumption
11. Lack of physical inactivity

It is not only about cholesterol. Cholesterol is just one risk factor.
Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life, their health behaviors and socioeconomic status. Stress may affect other established risk factors.


Until tomorrow...
PS I will ask Rick to find a photo of my Poppy for you to see.


Mary Manin Morrissey (born 1949) is a New Thought minister from Oregon, U.S.A. She was a founding minister of Living Enrichment Center in the 1970s. By the mid-1990s, the church's congregation was variously estimated as numbering between 2,000 and 5,000, making it the biggest New Thought church in the state of Oregon, as well as one of the biggest in the world. She is the author of Building Your Dreams which chronicles her realization of her dream to create a ministry, and No Less Than Greatness, and The Seven Spiritual Principles that Make Love Possible. I recommend going to the Barnes/Noble Cafe and glance at one of her books.

JULY 29, 2010 Que sera sera

"Live life to the fullest and make the best of what today has to offer without worry and fear of what tomorrow might bring"
Thanks Karen

You see, it is one day at a time. No-- a moment at a time. One of my character defects or personality traits that has plagued me is expectation and projection. I am much better at expectations but when I fall into that mode, I get hurt. I have had, like you, days of disappointment and sadness. Why? Because I have expectations of individuals in my life. I no longer live like that! I give because I want to. I do because I want to. I try not to project what will happen tomorrow, the next week or during the year. That for me has created fear. Fear of ....anything. Fear of success, fear of intimacy, fear of financial insecurity. It is so beneficial not to project. I try to live in the moment. Sometimes easier said than done.

The quote above was aching to be discussed today as I listened to a perfect song to match the quote. The song is Que Sera, Sera (Whatever Will Be, Will Be), first published in 1956. It is a popular song which was written by the Jay Livingston and Ray Evans songwriting team. Do you remember what movie the song was featured in? It was not a musical. The song was introduced in Alfred Hitchcock's 1956 film The Man Who Knew Too Much, with Doris Day and James Stewart in the lead roles. Day's recording of the song for Columbia Records was a hit in both the United States— where it made it to number two on the Billboard charts—and the United Kingdom. I always changed the words to this song as you will see below. About 1 month ago, while with friends we had an honesty session. One question was, "Who would you like to meet that is still alive today?" My answer was Doris Day.

When I was just a little 'boy'
I asked my mother
What will I be?
Will I be handsome?
Will I be smart?
Here's what she said to me:

Que sera, sera.
Whatever will be, will be.
The future's not ours to see.
Que sera, sera.
What will be, will be.

When I grew up and fell in love
I asked my husband
What lies ahead?
Will we have rainbows
Day after day?
Here's what 'he said to me..'

Que sera, sera.
Whatever will be, will be.
The future's not ours to see.
Que sera, sera.
What will be, will be.

Now I have children of my own.
They ask their father,
What will I be?
Will I be handsome?
Will I be rich?
I tell them tenderly:

Que sera, sera.
Whatever will be, will be.
The future's not ours to see.
Que sera, sera.
What will be, will be.
Que sera, sera.

The treatment of heart disease is like Que sera sera. We will discuss the basics, but let's relate it to the song. For example, a 64 year old female has coronary artery disease (blockages of the heart arteries). She has chest pain. She has a past medical history of hypertension (high blood pressure), hyperlipidemia (high cholesterol panel), and is pre diabetic. Her nuclear stress test is abnormal. An angiogram reveals two blockages each with 65% stenosis (tightening) and an open stent in the right side artery. No NEW cardiac intervention is done. The doctor states you will need medical therapy. The patient is already on medical therapy. Does the doctor discuss dietary and exercise lifestyle changes? Does the doctor discuss stress issues at home or family problems? The answer is no. Left undiscussed the natural history of corornary artery disease is that it will get worse. The answer is "Que sera sera "

NOT if this was my patient.

So the next few weeks I want to discuss a specialty that I am keenly familiar with. I once thought that heart disease was not reversible. The problem with cardiovascular disease is that we as doctors do not teach or discuss prevention. The goal in treating any cardiovascular disease is to prevent it from ever occurring. I want to see the children and grandchildren of patients, so I can discuss, prevent and treat early as genetics are involved. If your father had high cholesterol wouldn't you as his son want to know if you have high cholesterol? If you do have high cholesterol, wouldn't you want to know treatments besides the logical, quick easy band aid of statin therapy? I know I would. Hopefully you would also.

This is why I am an integrative cardiologist. I utilize all aspects in cardiology, not only the surgical and pharmaceutical interventions. I use my common sense to discuss dietary changes. I am always leery if the intervention I use or recommend for an elderly patient will create more risks for that patient. I weigh the risks and benefits of all treatments I discuss with patients, especially for the elderly population. I also want the family involved in the decision making process. Many of my peer colleagues have grown reliant upon high technology. Technology is needed but at what expense. The pharmaceutical companies are making it more difficult for us to prescribe the medications we want to use, some of the old ones that are generic. Many of the newer and more effective medications are cost prohibitive. Then there is the insurance issue. I could blog daily about what is wrong with our health care system. Who will listen to me? Would the government listen? Would other physicians listen? Possibly the patient will listen!! What do I bring to the table when having a cardiac consult with a patient? This is what I bring to the table:
1. Conventional methodologies
2. Use of pharmaceutical therapy
3. Integrative therapies such as acupuncture and enhanced external counter pulsation

I want to caution you about taking herbs and supplements without consulting a health care professional. You will read in this blog many facts about herbs and supplements and different treatments. It is in your best interest to consult a health care professional.


Doris Day (born April 3, 1922) is an American actress, singer, and animal rights activist. Day's entertainment career began in her late teens as a big band singer. In 1945 she had her first hit recording, Sentimental Journey, and in 1948, appeared in her first film, Romance on the High Seas. During her entertainment career, she appeared in thirty-nine films, recorded more than six-hundred-fifty songs, received an Academy Award nomination, won a Golden Globe and a Grammy Award, and, in 1989, received the Cecil B. DeMille Award for lifetime achievement in motion pictures. As of 2009, Day was the top-ranking female box office star of all time
She deserves an Academy Award NOW. I have admired her ever since I was nine years old.

JULY 28, 2010 The Roaring Twenties

"The curious paradox is that when I accept myself just as I am, then I can change" -Carl Rogers

It has taken a long time to accept who I am. The good news is that I have. I am a sober gay professional who loves unconditionally. It is difficult to love anyone if you cannot love yourself. While working in the Coronary Care Unit in 1994, I had the pleasure of caring for the late Jeessica (Cronin) Tandy. One day Ms. Audrey Hepburn came to visit Ms. Tandy. As I was introduced to Ms. Audrey Hepburn she asked me, "Why did God give you two hands?" At that particular time in my life in 1994, I could not answer that question. Of course I was in awe of her as well, but my tongue was not tied. I just felt I could not answer that question properly. In answer to her own question, this Academy Award winner for Roman Holiday stated, "One hand is to help yourself, and the other to help other people." Today with all honestly and assurance I can do that with confidence. I could have never done anything in life without first helping myself in any way I can.


The bottom photograph are boy-girl female impersonators. I do not like to call them drag queens. I prefer to call them performers of the highest quality. They are the Cherry Grove Flappers from the Roaring 20's. You couldn't ask for a nicer group of fellas. I can also state they are my friends. Yes, friends I can rely on. These friends are doing a benefit performance for the Doctor's Fund for which I have volunteered my medical service.

Miss Tandy was already on the stage in the 1920's. My grandparents were married in the 1920's, actually October 18, 1925. My grandfather was 21 and my grandmother, only 18. It is hard to imagine but both lived through the roaring 20's , only to end up ending the decade with Black Tuesday in 1929.

For the last two weeks I have been concentrating on the mouth, eyes and ears. Due to the nature of the Roaring 20's photograph I should tell you about heart disease and diabetes briefly. It is important to realize that there was not documented heart disease and diabetes in large numbers if at all in the 1920's. That is difficult to comprehend since my grandparents ate butter, cheese, and meat. The difference is that the goats in the backyard of 2 Elizabeth Street (for my granmdmother) and Myrtle Avenue (Brooklyn for grandfather) that provided the milk were fed grass. There were no hormonal injections. The milk was raw. It had many enzymes. It was not homogenized. The meat they eat was fresh. It was from cows, sheep, lambs etc that were raised nearby. New York City was a different place than today. I would encourage you to read The Untold Story of Milk.

So when did the first documented heart attack occur ? We do know it occurred when Wonder Bread became popular. Ever since refined carbohydrates hit the store shelves we have had an increase in heart disease and diabetes. Look at the numbers today! The numbers are staggering. Cardiovascular disease is the number one killer in the United States. Is this preventable? Of course it is. It takes a diligent dietary and exercise lifestyle change. The next weeks of blogs will be devoted to my specialty- Cardiology

A popular song written in 1920 was Avalon. I have the recording on a Decca 78 rpm by Al Jolson. Avalon is a 1920 popular song written by Al Jolson, Buddy DeSylva and Vincent Rose. It was introduced by Jolson and interpolated in the musicals Sinbad and Bombo, both conducted by Benny Goodman. Jolson's recording rose to number two on the charts in 1921.

Until tomorrow...


Jessie Alice "Jessica" Tandy (7 June 1909 – 11 September 1994) was an English stage and film actress. She first appeared on the London stage in 1926 at the age of 16, playing, among others, Katherine opposite Laurence Olivier's Henry V, and Cordelia opposite John Gielgud's King Lear. She also worked in British films. Following the end of her marriage to Jack Hawkins, she moved to New York, where she met Canadian actor Hume Cronyn. He became her second husband and frequent partner on stage and screen.

She was nominated for a Tony Award for her performance as Blanche Dubois in the original Broadway production of A Streetcar Named Desire in 1948, sharing the prize with Katherine Cornell and Judith Anderson in her portrayal of Medea. Over the following three decades, her career continued sporadically and included a substantial role in Alfred Hitchcock's film, The Birds (1963), and a Tony Award winning performance in The Gin Game (playing in the two-character play opposite her husband, Cronyn) in 1977.

JULY 27, 2010 My Own Merry-Go-Round

"Enjoy the little things in life, for one day you may look back and realize they were really the big things." Robert Brault

You may ask who is Robert Brault? I asked the same question. Robert Brault was born on February 10 1938 in Longueuil, QB. He was a hockey player. Brault started his professional career as a hockey player with the Jonquiere Aces team in 1947. His game position was left wing. I found the above quote to be all over the Internet and it is profound. The little things in life--like your parent's birthdays, your children's baptism, Mother's Day and even just any day. As I get older I have learned that those little things turned out to be more important than I realized. I reflected on my childhood when I heard one of my parents' friends had passed. Out of respect all of my parents' friends became Aunt and Uncle. My brother, Paul and I always called them aunt/uncle and considered them part of our extended family. Their children became surrogate cousins. We all had picnics together, pool parties, and even had a bowling league night. After my mother died, my dad still kept in touch, but when he moved to South New Jersey it became more difficult.

I will always look fondly upon my childhood. Have you ever looked closely at your childhood? Was it all that bad? In recovery, I have listened to horror stories regarding parents and childhoods. Some are horrific filled with brutality, unkindness, incest and abuse. I cannot say that regarding my upbringing. I knew I was different. I do know that years of reflection make me happier to know I was loved. While walking to work this morning I was listening to the little sparrow, Edith Piaf. It was an upbeat song, Mon Manège À Moi Lyrics, translated in English to mean My Own Merry-Go-Round

Tu me fais tourner la tête
Mon manège à moi, c'est toi.
Je suis toujours à la fête
Quand tu me tiens dans tes bras

Je ferais le tour du monde
Ça ne tournerai pas plus que ça.
La terre n'est pas assez ronde
Pour m'étourdir autant que toi

Ah! Ce qu'on est bien tous les deux
Quand on est ensemble nous deux.
Quelle vie on a tous les deux
Quand on s'aime comme nous deux

On pourrait changer de planète
Tant que j'ai mon cœur près du tien.
J'entends les flonflons de la fête
Et la terre n'y est pour rien

Ah oui! Parlons-en de la terre
Pour qui elle se prend la terre?
Ma parole, y a qu'elle sur terre!
Y a qu'elle pour faire tant de mystères!

Mais pour nous y a pas de problèmes
Car c'est pour la vie qu'on s'aime
Et si y avait pas de vie même
Nous on s'aimerait quand même

Je ferais le tour du monde
Ça ne tournerai pas plus que ça.
J'ai beau cherché à la ronde
Mon manège à moi, c'est toi 

ENGLISH TRANSLATION
You (make me) turn my head
My own merry-go-round, that is you.
I am always at the fair
When you hold me in your arms

I would make a tour of the world
That will not turn more than this.
The earth is not round enough
To make me dizzy as much as you do

Ah! The two of us are fine
When we are both together.
What life the two of us have
When we love each other the way we do (lit: like the two of us)

We could change planet
As long as I have my heart close to yours.
I hear the blare from the fair
And the earth is not there for nothing

Ah yes! Let's talk about the earth
Who does the earth think it is?
My word, there is nothing but it on earth!
There is nothing but it that can make so many mysteries!

But for us there are no problems
Because we love each other for life
And if there was not even life
We would love each other even so
Because…

I would make a tour of the world
That will not turn more than this.
I have looked all around for
My own merry-go-round, that is you

Let's talk about a common disease called Glaucoma, which leads to blindness. This occurs when the normal drainage of the eye fluids is blocked. It does lead to increased intraocular pressure which eventually causes damage to the optic nerve.

The usual glaucoma cases are chronic not acute. Acute glaucoma is rare. Those with chronic glaucoma usually present with mild headaches and visual disturbances. Most people with chronic glaucoma have no symptoms until their eyesight is actually starting to have problems and begins to deteriorate.

Treatment ranges from topical medications to surgery. The natural approach is to adopt an exercise program, have regular examinations, avoid smoking, and keep food allergies under control.

Other natural remedies include:
1. Vitamin A 10,000 IU/day
2. Vitamin C up to 3,000 mg/day
3. Chromium 200umg twice a day
4. Zinc 50 mg once a day
5. Fish oils up to 3,000 mg/day
6. Rutin 50mg three times a day

Until tomorrow... more about the eyes.

JULY 26, 2010 "SEE" the Herbs and the Truth

"Our ability to identify a teacher and to learn is directly related to our open mindedness and the attitude with which we approach everyone and everything."
Thanks Karen

I thank Karen for this quote. I love people to be open minded and willing to approach everyone and everything with this concept. I also like gratitude not attitude. Unfortunately there are those who cannot grasp this concept. These people may be selfish, have low esteem, of have some type of addiction. I am a teacher. I am not a leader nor do I inspire to promote myself as a leader. I am an educator. I would hope to be 25% as affective as the greatest teacher, Sir William Osler. I am a healer of the sick and the unsick. I want to promote medical prevention and not only have a band aid approach. I do not want any aspect of medicine to be seen as a band aid approach nor any facility to be considered a band aid station. I work too hard to let that happen to anything I am affiliated with.

I have always cared for the older population. I was thrown into this, not by my own choice. When my uncle and my mother died in 1978 and 1982 respectively, they still had their parents alive--my grandparents--my Nanny and Poppy. I wanted them to obtain the highest medical care by professionals who care. I had to facilitate that. In case you didn't realize it we have an ever growing older population. Medicine and technology have allowed them to live longer, but we need professionals who care. Not only in the field of Geriatrics but in all fields of medicine. I love medicine. I love talking to older individuals. I learn a lot from them. I learn about their past, their previous occupation and their interests and hobbies. What people do not realize is that one day they also will be old and wouldn't they want a caring doctor? The sad aspect is some have sought their own medical attention but forget about it due their own narcissistic behavior, self indulgence and plain ignorance. I can't blame these individuals for they have a disease in their own right. I must just plain and simply pray for them
Those need GRATITUDE NOT ATTITUDE.

There is always a flood of medicial newsletters sent to the older population. Some of these newsletters promote the 'magic' cure or 'silver bullet agent.' The problem is that these products might be self promoting and there is no substantial research to support their use. In herbal medicine I have not found any herb for the prevention and treatment of ophthalmic conditions. I have reviewed the American Botanical Council HerbalClips in the last 3 years (2007-2010) I did not find one article on herbs for the eye. Have you heard that both bilberry and lutein are beneficial for the eyes? Is there research or personal clinical use for these herbs/supplements?
In the literature I have seen three herbs used in ophthalmic conditions. These are eyebright, pasque flower and barberry. I have seen patients use N acetylcarnosine for glaucoma for a reduction in intraocular pressure.

Euphrasia (Eyebright) is a genus of about 450 species of herbaceous flowering plants in the family Orobanchaceae (formerly included in the Scrophulariaceae), with a cosmopolitan distribution. They are semi-parasitic on grasses. The common name refers to the plant's use in treating eye infections. See Bottom Photograph The uses of eyebright for the eye are: pressure in the eyes causing tearing, itching, redness, or swelling of the eyelids; sensitivity to light; and dim vision; There are many other uses for eyebright. It has been studied by the FDA with controversial results.

Pasque flower or pasqueflower (genus Pulsatilla) is one of about 33 species of herbaceous perennials native to meadows and prairies of North America, Europe, and Asia, valued for their finely-dissected leaves, solitary bell-shaped flowers, and plumed seed heads. The pasqueflower is also commonly known as the prairie crocus, wind flower, Easter Flower, and meadow anemone. See Middle photograph. This is a tundra plant and found only in the far north where there are tundras. The Latin term is called "Little Frog". The Pasque flower is useful to treat eye diseases like cataracts (opacity on the lens of the eye), which can cause partial or complete blindness.

Berberis (pronounced /ˈbɜrbərɪs/ Bér-be-ris), the barberries or pepperidge bushes, is a genus of about 450-500 species of deciduous and evergreen shrubs from 1-5 m tall with thorny shoots, native to the temperate and subtropical regions of Europe, Asia, Africa, North America and South America. See Top Photograph There are many internal and external use of barberry (berberine). Barberry ointment was shown to significantly reduce skin eruptions in psoriasis during a German study. Berberine is used in eye ointment to treat conjunctivitis and sensitive eyes. Barberry also contains chemicals that reportedly enlarge blood vessels, thereby reducing blood pressure.

The first photograph is that of My Dancing Frog, a unique self painted needlepoint pillow. Since the Pasque or Easter Flower in Latin means 'Little Frog' I will have to put this pillow on my etsy shop as it did not sell at the Cherry Grove Arts Project "PEEP" Show. It was not a real Peep show, but an Art Show exhibiting the best of Fire Island Artists. I am proud to be one of those. Thanks to Michael and Donald for having me display.

Until tomorrow...

JULY 25, 2010 TOUGH AS NAILS

"Force yourself to look at some of your behaviors--go through the motions despite feeling awkward. Work at learning to love yourself." Patrick Fratellone


To move any concept from the mind into our heart and soul takes time and effort. It does not come easily --take it from me. Just the concept of learning to let go has taken years, and is never exactly perfect. Sorry, correct never perfect. (Remember, Progress not Perfection!) I have always tried to force myself to do things that do not come naturally. For example at any Board Meeting, I have learned to deliver, listen and not answer. I have to constantly tell myself to take care of myself. I have learned through many many years (double digit years) to "act as if." Of course I always want to go to the comfortable place or old ways of doing things. No, No, No. I need to think, behave, act (not react) and feel. Think about it--doesn't the old you get you in trouble sometimes? Try the NEW and IMPROVED YOU! People will start to look at you in a different light.


Yesterday we talked about eye problems. While I was writing last night, I thought about the 'loss'? Loss of what I pondered. The loss of one of the five senses-hearing, sight, taste, sound and touch. I thought about the loss of a limb. As I looked at my hands I said, "That is it--I will talk about fingernails." Not a topic that most will think about. To the astute clinician, the fingernail can tell a lot about specific conditions. It can tell you about your state of health. We do not take care of our nails. Yes, some of you may manicure them, but think about this-they are our tools. We put our hands through so much- harsh chemicals, injuries, overexposure to sun, wear/tear. This can lead to cracked/splintered/soft fingernails.

When our knees are old we get them replaced or repaired. Do we ever get a hand or finger joint replacement, or better yet a nail replacement ? Of course, not. The nail will regenerate itself. The fingernails protect the multiple nerve endings in the fingertips and are composed of a protein called keratin. Usually nails grow about 1/8 inch per month. So by deduction it will take about 3 months to grow a new nail. The new nail should be smooth with a pink bed underneath, indicating a good blood supply to the nail. If they are discolored or brittle you must find out the cause.

The nail growth record can show the history of recent health and physiological imbalances, and has been used as a diagnostic tool since ancient times. Greeks and Egyptians have drawings of different types of nails seen at that time. Deep transverse grooves known as Beau's lines may form across the nails (not along the nail from cuticle to tip) and are usually a natural consequence of aging, though they may result from disease.

Discoloration, thinning, thickening, brittleness, splitting, grooves, Mees' lines, small white spots, and receded lunula (crescent-shaped whitish area of the bed of a fingernail or toenail) can all indicate illness in other areas of the body, nutrient deficiencies, drug reaction or poisoning, or local injury. Nails can also become thickened (onychogryphosis), loosened (onycholysis), infected with fungus (onychomycosis) or degenerate (onychodystrophy)

There are some other conditions we need to discuss.

1. Clubbing - this is a condition whereby the nails are curved around the fingertip almost as if representing the beak of a bird. I wanted to discuss this first as I have clubbed nails. It can be due to many conditions. One is being born with a heart defect. This is called a congenital heart disease. When your fingernails are clubbed it is a sign of lack of oxygen. The group of heart conditions are called cyanotic (blue) congenital heart disease. Yes, I was born cyanotic or blue. You have heard the term " blue baby". There are a multitude of conditions such as atrial or ventricular defects (holes in the heart from one chamber to another). For those of you who are reading this now--I am not blue. I had severely blue fingernails and lips at birth. Through the years it got better, but never pink. Yes, I had a congenital heart defect (Not blocked arteries from working with Dr. Atkins and his diet). I had a surgical open heart correction five years ago at age 45. The other diseases associated with clubbing include lung cancer, uremia (kidney disease), bronchiectasis, emphysema and a form of arthritis.

2. Nail pitting - used seen in those who have psoriasis. It is scaly patches on the nail.

3. Spoon shaped - called medically, koilonychia - associated with iron deficiency.

4. Terry's nails - opaque nails with dark band at the end. This is associated with congestive heart failure, diabetes, liver disease, and malnutrition.

5. Beau's lines - indentations across the nail, associated with diabetes, peripheral artery disease, a high fever caused by an infection and malnutrition.

6. Yellow nails- usually associated with respiratory (lung)conditions.

7. Separation of nail/nail bed- this is a complete detachment of the nail from the nail bed. This has many reasons, including injury, fungal infection, psoriasis, thyroid disease and even drug interactions.

The most common nail condition I see is brittle and soft nails. I usually ask if the patient has cold hands and feet, constipation, fatigue, hair loss and low body temperatures. 7 out of 10 times, the patient will say yes. The answer is the patient has thyroid disease, usually an under active thyroid. This is called Hypothyroidism. Ask your doctor about this. A normal thyroid stimulating hormone blood test can be normal and you still have a sluggish or slow thyroid. See April Blogs-there was a blog on the thyroid.

Things YOU should be concerned with:
1. Split nails
2. Nail biting
3. Vertical nail ridge
4. The use of acrylic nails (both women and men-especially for female impersonators)


Until tomorrow...

JULY 24, 2010 DO NOT "THINK PINK"

"The remarkable thing we have is a choice every day regarding the attitude we will embrace for that day." - Charles Swindoll

I love the idea of having a choice every day. Choice to do anything I want to do. When it regards personality traits, good or bad, or attitude or gratitude, I think about it even more in a positive way. What kind of attitude did you embrace for today? Remember it is only for today ! I embraced a lot of gratitude. It actually started at 11:58 pm last evening. It was when a patient, R. R wrote, "They have a heart for me. Should go down for pre-op prep in 5-10 minutes. Thanks for all your care..." I took a deep sigh and tears ran down my cheeks. From the first line, They have a heart for me.. to the end of the text, my smile widened. I was praying for those words one day. I know that 'R' and his family waited for that call since the first day he was told he needed a cardiac transplant. I responded, "My prayers and love are with you. I am so happy for you and your family."

His daughter reported today at 10:00 am that her father got the heart put in at 6 am. She thanked me,"...for all your help and excellent doctoring." I did nothing. I did what I was trained to do. I am not a transplant doctor. I was there for 'R' and his family. I wanted him to always clear his mind, be selfish at this time in his life and lead a less stressful life. Easier said than done. He did a fine job. Naturally, my mind wandered as I tried to fall asleep. I have many thoughts before I go to sleep every night. Last night was NO exception. However, I concentrated on sending out positive love energy and mantras to "R". I embraced the day with gratitude. When we have a stressful day, think of those less fortunate. Can you imagine what thoughts "R" has been waking up with every day--waiting for the call of his lifetime. He got that call last night. Then he had moments of happiness, joy and fear. FEAR of everything he has anticipated until that call.
Please send out love and energy to 'R'.

You would think I would discuss cardiac transplants today. I am not sure I will. I do not want to deviate from the 'above the neck' disorders and diseases. Although transplant is an interesting topic--it does not affect many individuals. I am sure one day I will discuss it.

Continuing with the eyes, lets discuss blepharitis and conjunctivitis. Blepharitis is a condition of the eyes that causes scaly red eyelids. It is like "dandruff" of the eye. Somtimes bacteria make this condition worse. Those with blepharitis have an increased risk of developing conjunctivitis. You must remember that any medical term ending in 'itis' means inflammation. There are steroid cremes that will help this condition. If you want the natural approach (which I hope you do), here are some simple solutions. I love simple solutions to complex problems.

1. Wash the eyelids twice a day with warm soap and water
2. Try using an antidandruff shampoo
3. Consider a food allergy as a cause

Now to those itchy, gritty pink eyes. This is called conjunctivitis. You may wake up with crusted eyelids and discharge. Remember conjunctivitis is contagious. This is why you are sent home from work or school with those pink eyes. You might need an antibioic from a physician. The best approach in treating pink eye is to keep the eye as clean as possible. You can use a clean washcloth with warm water solution on the eyelids. It will help loosen the crusted eyelid. Let it dry or pat with a towel. DO NOT rub the eye with the wash cloth. If not gone naturally in two days, please consult your health care professional. If you have chronic pink eye, you probably have food sensitivities.

So let's NOT " THINK PINK"

"Think Pink" was a musical number sang by Kay Thompson in Funny Face. Funny Face is an American musical film released in 1957 in VistaVision Technicolor, with assorted songs by George and Ira Gershwin. The film was written by Leonard Gershe and directed by Stanley Donen. It stars Audrey Hepburn, Fred Astaire, and Kay Thompson.


Charles Rozell "Chuck" Swindoll (born October 18, 1934) is an evangelical Christian pastor, author, educator, and radio preacher. He founded Insight for Living, currently headquartered in Plano, Texas, which airs a radio program of the same name on more than 2,000 stations around the world in 15 languages. He is currently the senior pastor of Stonebriar Community Church, in Frisco, Texas.

Until tomorrow...

JULY 23, 2010 LIVING IN THE MOMENT with YOUR DRY EYES

"Rest from your thoughts. Give your attention wholly to the present. Therein will come the solution, and when least expected." Thanks Karen


The present, not the past nor the future. We do not wish to shut the door on the past, just not dwell on it. The past as we have discussed is part of your life. You do not have to dwell on issues from the past. Also, projection about what will be the next day, the next week, or even next year can get you in trouble. I like to look ahead but I always see how that can get me in trouble. For example, tomorrow and Sunday is the Cherry Grove Arts Project Sale. It is the 35th year that this event has been held on Cherry Grove. I have been a participating artist for the last 5 years. Of course, I am projecting that I will sell nothing. Instead of letting it go, for some reason I tend to look at the worst. How many of us look at the worst?

You have seen some of my needle craft work on this blog. I know that because many of you have commented on its beauty and craftmanship. Yet I have doubts. Why? Because of my self esteem. Self esteem is the 5th Lifestyle Change on our 7 change pyramid. Low self esteem made me start this needle craft hobby, which can lead to an addiction to needlepoint, but it also lead to increasing my self esteem.

Live in the moment! This is the answer.

Continuing with the organs and/or conditions of the head/neck, I realized I have never discussed the eyes. Some eye conditions you can deal with yourself. However there are a few which require immediate attention by your primary care doctor or the emergency room.

Here is a list some problems/conditions that I would call a doctor or visit the ER:

1. Pain in connection with your contact lenses
2. Unusual sensitivity to light
3. Injury to the eye that involves a cut, puncture wound, or a injury (blow) that causes pain and affects vision
4. Eye inflammation after a cold or a bout of herpes I or II
5. Sudden loss of vision (even partial loss)
6. Foreign body in the eye that cannot be removed with flushing the eye with water

The above are medical eye emergencies! Please take them seriously.

For today let's start with a simple problem--DRY EYES. These poor dry eyes. These eyes are tired, they burn and sometimes tear. How could a dry eye tear? This is usually a condition of older people, but I see it commonly with younger individuals and their contact lenses, or those sitting on the beach sun bathing most of the day.

Did you know that the quantity of tear production decreases as we get older? It can sometimes be related to reduced oil production.
Other causes:
1. Medication side effects, especially the use of diuretics (water pills) can cause dry eyes
2. Diseases, especially the thyroid, rheumatological (such as lupus), rheumatoid arthritis, and Sjorgen's Syndrome (one of the connective tissue disorders)
3. Over-the Counter medications can exaccerbate your problem. Avoid the OTC that contain vasoconstrictors.
4. Dry air in the winter-- use a humidifier. Remember to clean thoroughly
5. Protect your eyes from sun and sand. Use sunglasses for protection.

Visit Cherry Grove this weekend for the Art Show "Peep Show"

Until tomorrow..

JULY 22, 2010 FRIENDSHIP AND COTTON SWABS

What do friends and cotton swabs have in common? Maybe they are both fluffy. NOT


A friend is one who knows you and loves you just the same.
Elbert Hubbard

A friendship can weather most things and thrive in thin soil; but it needs a little mulch of letters and phone calls and small, silly presents every so often - just to save it from drying out completely.
Pam Brown

A man's growth is seen in the successive choirs of his friends.
Ralph Waldo Emerson

These are some quotes I admire about friends. I love all three, but my favorite is quoted by someone you might not know. His name is Henri Nouwen. His books have always touched my heart. Here is the quote...

"When we honestly ask ourselves which person in our lives means the most to us, we often find that it is those who, instead of giving advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a warm and tender hand."
Henri Nouwen

Through my life (now 50 years) friendships wax and wane. The cycles of friendship usually relate to your school years. How many of the friends from grammar school, middle school, high school, college and post graduate school do you still have contact with? Were they really friends or were they acquaintances? Due to classmates.com, my space, and facebook you may or may not have connected with old friends.

Most of us have tests or challenges with friends. I did not do well prior to recovery. I was a good friend to many, but I was always the person to call, write or give silly little presents as Pam Brown puts it. It was not always reciprocated. And I know now that it doesn't have to be. At that time in my life I had expectations of people in general. Today, I have no expectations. I send or call or give because I want to. Yes, because I WANT TO.

I do not expect anything in return. Friends should be a comfort. If there becomes too much drama with any particular friend, I re-evaluate that friendship and perhaps even distance myself for some length of time. Today I feel my selection of friends reflects where I am in my life today or what issues I might be working on. To and fro, back and forth or otherwise giving and receiving support (not material gifts--remember support is a gift) will help me and my friends grow as individuals.

I have some friendships that will last a lifetime. Some are old friendships, more than 15 years and some are new (within the last 2 years) but I know they will last a lifetime. There is always communication. Some old love relationships which I thought we were friends didn't turn out as I expected. See, there are those expectations again. I always gave in past love relationships and even in family relationships. I was the enabler I let it happen in the past. That was early in recovery.

I do have best friend. My best friend, Rick, happens also to be my life partner. This is a special love friendship that will endure the test of time.

I am sharing the lyrics to FRIENDSHIP - inspired by dinner with dear friends last evening.

Words and music by Cole Porter
from DuBarry Was a Lady

If you're ever in a jam, here I am
If you're ever in a mess, S-O-S
If you ever feel so happy, you land in jail; I'm your bail.
It's friendship, friendship, just a perfect blendship.
When other friendships have been forgot,
Ours will still be hot.
Lah-dle-ah-dle-ah-dle dig, dig, dig.

If you're ever up a tree, phone to me.
If you're ever down a well, ring my bell.
If you ever lose your teeth, and you're out to dine; borrow mine.
It's friendship, friendship, just a perfect blendship.
When other friendships have been forgate,
Ours will still be great.
Lah-dle-ah-dle-ah-dle, chuck, chuck, chuck.

If they ever black your eyes, put me wise.
If they ever cook your goose, turn me loose.
If they ever put a bullet through your brrain [sic]; I'll complain.
It's friendship, friendship, just a perfect blendship.
When other friendships have been forgit,
Ours will still be it.
Lah-dle-ah-dle-ah-dle, hep, hep, hep.



Continuing with the Head, I want to move today from the mouth to the ears. Earwax, or cerumen is considered a nuisance. However the earwax is there to protect your ear canals by trapping dust, bacteria, and even tiny bugs to keep them out of your ears. Yet sometimes it doesn't move out and you get a fullness feeling. And you may even have problems hearing. Ear wax can also cause dizziness or an unsteadiness. More and more older people cannot hear. They get withdrawn and depressed. The simple solution is to have their ears checked and remove the wax.

Remember what the pediatrician told you when you were young:
1. Never put anything smaller than your elbow in your ear.
2. Never use cotton swabs as these will push the wax further in.
Many will use Q tips and look at their wax-stained swab with pride and admiration of a job well done. Eventually, they will go too far and injure or rupture their eardrums. Q-tips are not unlike the plungers used to load cannon. They can pack softer wax deeply in the ear canal against the eardrum. By creating a formidable plug and preventing the eardrum from moving normally, it is quite easy to cause some significant hearing loss.

There is some great history about the Q tip.
In, 1923 upon observing his wife applying wads of cotton to toothpicks, Leo Gerstenzang, the original founder of the Q-tips® Company, conceived the idea of manufacturing a ready-to-use cotton swab. He found the Leo Gerstenzang Infant Novelty Co., a firm which marketed baby care accessories. The product was originally called Baby Gays and in 1926, the labels were changed to read Q-tips® Baby Gays. Can you imagine, they were called BABY GAYS. Later the name Baby Gays was discarded and Q-tips® became the identifying mark for cotton swabs.

The Q in Q-tips® stands for quality and the word tips describes the cotton swab at the end of the stick. In 1948, due to increased consumer demand, Q-tips®, Inc., moved its manufacturing facility from New York City to a new facility in Long Island City, New York.

Hollywood brought Baby Gays - Ooopps ....Q-tips® further into the mainstream when America's top Hollywood makeup artist, Ern Westmore, created the "Lesson in Loveliness with Q-tips®" booklet.

The use of a softening agent from the pharmacy to remove the wax is recommended. I tell patients to use the corner end of a soft washcloth. At the corner place a small amount of mineral oil and hydrogen peroxide. Dip the corner in the mixed solution. With the corner in hand, in a twisted motion , swab the inner ear. Day by day this loosens the wax. I do not like to recommend the bulb syringe as even if you use it gently, the gentle push of the water can cause discomfort and sometimes illicit dizziness.

A gentle note: Always dry the inside of your ears after swimming, showering or bathing.



Henri Jozef Machiel Nouwen (Nouen), (Nijkerk, January 24, 1932 - Hilversum, September 21, 1996) was a Dutch-born Catholic priest and writer who authored 40 books on the spiritual life. Nouwen's books are widely read today by Protestants and Catholics alike. The Wounded Healer, In the Name of Jesus, Clowning in Rome, The Life of the Beloved and The Way of the Heart are just a few of the more widely recognized titles. After nearly two decades of teaching at the Menninger Foundation Clinic in Topeka, Kansas, and at the University of Notre Dame, Yale University and Harvard University, he went to share his life with mentally handicapped people at the L'Arche community of Daybreak in Toronto, Canada. His spirituality was influenced by many, notably by his friendship with Jean Vanier. After a long period of declining energy, which he chronicled in his final book, Sabbatical Journey, he died in September 1996 from a sudden heart attack.



"Today I will seek comfort in a friend. I will let myself experience of the comfort, joy, love and enduring qualities of my friendship."

JULY 21, 2010 Mom's Birthday

JULY 21, 2010



"Do not let the grass grow too high before you speak your mind."
--Vincenza (Vincetta,Vinnie) Calamis Fratellone


Letting go of the past. This has always been a very difficult task for me. It has taken many prayers and a great deal of meditation time to understand how to do this. I do believe that God has a birth date and a death date for each of us. It is not a religious belief. I also believe that some people know when there time is near.

On June 1, 1982 my mother had all of her bank/security boxes changed. On June 3rd and June 4, 1982 she went to the St John's emergency room with a severe headache. Both times she was told it was a migraine and given medication. On the night of June 5, she was to attend an event with my father for the Knights of Columbus. She changed her mind at the last minute and asked me to go in her place. Minutes later she wanted me to stay home and give her a cup of tea.

Simultaneously as my father was heading out the door and I was bringing her the tea, she screamed , grabbed her head and her eyes rolled back. Father and son start CPR. Embarrassment from a son's point of view yet he was a medical student. 911 is called. It seems like hours before they arrive, although I am sure is was sooner. I cannot recall. My mother is in ICU on a ventilator with no brain function. It was not heart related, but a bleed in the brain (subarachnoid hemorrhage). Prognosis grim. My father is asked to consider disconnecting respirator which is done on June 10, 1982. My mother is gone.

It seems that this could not be real. But it was. As some of you read this you might have similar stories. Similar circumstances happened to her brother only four years earlier.

How do I let the events go? For years those events haunted me. Did I do something wrong? Were my compressions not enough? Did my father do the correct breaths? It was a nightmare for years. I felt 'less than'. I drank my sorrows for years.

Today I believe all happens for a reason. My mother participated in the planning of her life- the events, her family, the raising of her children et al. She did all this to work through issues. It was a lesson for me to learn. My past has not been an accident nor a mistake. It has been many life lessons. I embrace my past history (moments of perfection and imperfection) with love, anger, tears, and joy. I can also do the same for past love relationships. I can also do the same for my mistakes and for my tragedies. We all have been through this.

Do you think there is a coincidence that my 'new mom', Rick's mother Nancy was born on the same day as my birth mother? It is not a coincidence. It is God's way of telling me - all is alright.
I have always celebrated my mom's birthday since 1982. It used to be painful, but today I celebrate it with love. I also have Nancy's birthday to celebrate. Although born in different years, their astrological sign is the same, Cancer. Although a crab, both are not crabs. They are loving, compassionate, steadfast, creative individuals.

I know as I pray for mom, she is thanking me for being the man I have become. She smiles down with tears in her eyes. She sees the boy she raised. She is happy and I am happy for having known her for twenty years. Nancy is her physical replacement eyes. Nancy gets to see what mom cannot see physically.

God gave me other replacement moms until he put Nancy in my path. They too, are physically still here: Aunt Mary, Aunt MaryAnne, Aunt Susie and Barbara B. Each have played a vital role in getting me to where I am now.

For today, I will let go of guilt and fear of my past and present circumstances. I can now trust where I have been, where I am going and where I am at this moment.
Happy Birthday MOMS!

This is only the second time in this blog that traditional medicine is not discussed. Today's blog does relate to an aspect of healing, however: spirituality.

Until tomorrow...

JULY 20, 2010 ONE STEP FOR MAN, ONE STEP FOR MANKIND

PEACE ON EARTH

"I believe that this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the Moon." - John F Kennedy, 1961.

President Kennedy paid attention to commitments. He made a commitment to land man on the moon before the decade ended. His vision was achieved although he never saw it personally. I have to believe he did see it spiritually. Many of us fear comitment. I used to fear commitment. I never was like that at a child. Somewhere I lost it. I cannot place where and when it happened. I do know after getting sober it took a while to get to do commitments. I take commitments very seriously.

When deciding to make a commitment give careful consideration...is it right for you? If it is not we need to be honest and direct with those involved. If the voice within truly says no, be comfortable with the voice within. Always try to do the right thing. For example, I made a commitment for the last 5 years as a volunteer physician. I am not paid. I love the commitment as I love the community. I want the community to have the same treatment as if they were coming to my office. I feel I have done my best on that and have fulfilled my commitment.

If there are restraints imposed and I feel it does not live up to my commitment, I need to ask myself questions. Is this right for me? What can I do to make it better? Is there a way to make it better? If there are no solutions in my mind, and I have discussed this with my sponsor, then I can make a rational decision. It might mean that I make changes in the commitment, but it is life on life's terms. I always ask God to guide me in making my commitments. Help me to say yes to the highest good and no to what isn't.

I want to discuss cold sores which is still related to the mouth and also related to the sun. These cold sores, are called FEVER BLISTERS. They are commonly exacerbated by stress, the sun, alcohol, sugar, viral infection or just simply being run down. I am surprised I do not get more of these. Usually they begin as a red blister on the corner of the mouth. You can have just one, or they can be multiple. It is estimated that about 85 -90% of the population harbors the herpes I virus (oral herpes) that causes these cold sores. It is more polite to call them fever blisters or cold sores, than HERPES. You could be exposed to herpes or even have it and never have an outbreak.

Usually fever blisters begin with a tinge of pain or a tingling feeling. This is the sign that an outbreak is near. I am more embarrassed when I get an outbreak (rare) than I am bothered by the pain or discomfort. I can take the pain and discomfort.

Today we have antiviral medication for outbreaks: acyclovir (trade name zovirax). It is by prescription only. There is a cream/salve version to be applied topically and an oral form available in capsules. We even have another stronger deug called valtrex. Both are expensive.

There are natural remedies. Let's build up the good bacteria in the colon. This builds the immune system. Lets always try to have more good bacteria than fungal or viral growth. The plain yogurt is only one form of good bacteria. That is the lactobacillus species only.
For immediate relief: Use lysine cream. Lysine is an amino acid. It can be bought over the counter. Use twice a day. You can even take lysine 500mg capsules. I usually have my patients with a predisposition to herpes take lysine (3,000 to 4,500 mg/day): at least 1,000 mg at every meal at the initial tingling to prevent/lessen outbreak. After symptoms ease, decrease the lysine to only 500mg per day.

Another immediate relief is to let a zinc lozenge melt on the lesion.

For prevention: The herpes virus is fueled by foods rich in the amino acid arginine. These are chocolate, all nuts, seeds and grain cereals.



The Apollo 11 space flight landed the first humans on Earth's Moon on July 20, 1969. I know exactly where I was. It is one of those moments in history. It was a Saturday night. My Poppy's cousins were over. There were the 3 brothers and their wives having the usual Pow-wow Italian discussion over family. My brother, Paul and I were in the living room. I believe the landing occurred after 7 PM. It was a day I will never forget. The mission, carried out by the United States, is considered a major accomplishment in human exploration and represented a victory by the U.S. in the Cold War Space Race with the Soviet Union. Launched from Florida on July 16, the third lunar mission of NASA's Apollo Program (and the first G-type mission) was crewed by Commander Neil Alden Armstrong, Command Module Pilot Michael Collins, and Lunar Module Pilot Edwin Eugene "Buzz" Aldrin, Jr. On July 20, Armstrong and Aldrin landed in the Sea of Tranquility and became the first humans to walk on the Moon. Their landing craft, Eagle, spent 21 hours and 31 minutes on the lunar surface while Collins orbited above in the command ship, Columbia. The three astronauts returned to Earth with 47.5 pounds (21.55 kilograms) of lunar rocks and landed in the Pacific Ocean on July 24.

Peace to all --
Until tomorrow...

JULY 19,2010 SUNBURNS

"Admitted to God, to ourselves and to another human being the exact nature of our wrongs" - Step 5 AA

We all have heard 'honesty is the best policy'. It is so true. I do not know who actually said that but it rings so true being sober in double digits. I find it difficult to deal with people who are not honest. We all encounter that every day. However when someone is obviously lying, and he/she does it anyway to your face, it actually disgusts me. I cannot blame them. They are not at fault. They have a disease. A disease called Addiction. We will be discussing addiction, the third lifestyle change in our pyramid in the following months. It is so important to admit our wrong to others, to ourselves and to God. It is a way to set ourselves free. It is a way to release our pain.

I encounter so many alcoholics as a volunteer physician in Fire Island. The ones I know personally, I pray for each and every day. I might get angry at them, but in reality I am praying for them each and every day. Speaking of anger, it is important that you realize anger comes in layers. It is like an onion. I was told that early in recovery. Everything is in layers. My layers have been peeled away a little at a time, even a day at a time. We all must face our anger. Find the root of the anger. For me I feel hurt and disappointed when someone angers me. I get angry at myself for taking the hurt inside and not letting it out. That anger can ruin my entire day if I let it. This is why I meditate, pray and even start the day over at any time I like to. I ask God every day to help the repressed anger come to the surface. Meditation (my 4th Lifestyle Change) and having a Hobby (tied in with the Self-esteem, my 5th lifestyle Change) both help me. I hope these ideas help you.


July is a month of recollection. It is a month of celebration. It starts with my dad July 8th or 12th. Then it is a continuous flow. My brother, Paul and his wife, Maryanne celebrate their wedding anniversary on the 17th, my late Uncle Sonny is the 19th, my mom is the 21st, and so is Nancy, Maryanne is the 26th and my late Poppy was the 30th. It is a mixture of Cancer and Leo astrological signs. I celebrate those loved ones with a prayer or their birthday and the lighting of a candle if they have left us physically. It doesn't matter where I am to light a candle. The beach is no exception. It is actually serene lighting a candle on the beach. Today for Uncle Sonny (by the way, his real name was Gasper) I get to laugh, tear up and recall all the fun times when I light that candle. I get to recall every Sunday dinner at our house when my Poppy cooked all the great food, the vacations and the times at his house in the pool. I only have memories of those who are gone--but these memories complete my life. Miss you all who are listening to Poppy play the mandolin.


For the last 4 days, blogging has concentrated on the mouth. I want to discuss the largest organ of the body - THE SKIN. I want to discuss it in regard to burns. I am choosing burns, as I see many burns while volunteering on Fire Island. The burns I see are sunburns, an example of a first degree burn. Another example of a first degree burn is from hot water. These type of burns get red, may develop a scab and then flake off.

The second degree burns affect a deeper layer of the skin. They redden deeply, probably blister within hours, and eventually heal. Third degree burns affect all the skin layers. The skin is burned through. It may look charred or maybe even white. It does not hurt at the onset. This is a medical emergency and will require immediate assistance from a physician . It will most likely need to be treated in a hospital setting. In emergency medicine we are taught to measure the extent of the burn by percentages.

For us today I am concentrating on the first and second degree burns that can be treated at home. With the exception of a severe sunburn, most of you should have the common knowledge to treat a burn.

Lets start with the basics.

1. The simplest first aid solution for a burn is cool water. As soon as you get a burn, immerse the area in cool water. NOT ICE COLD WATER. If there was clothing and it is sticking to the burn--DO NOT REMOVE THE CLOTHING. In this case you will need to go to the emergency room. Never peel off the clothing

2. NEVER EVER put those old fashioned remedies on burns. You may recall that your grandmother put butter or grease on a burn. This will hold the heat in, prolong the pain and increase the damage.

3. You may have one of the OTC (over-the-counter) burn gels in the medicine cabinet. Apply one of those.

4. Healing remedies I recommend:

a. Apple Cider vinegar - either splash it on or get a cloth and soak in the apple cider . Apply the cloth loosely for one hour.

b. Tea tree oil can be applied topically. Most think that tea tree oil is only useful for fungal infections. It is used as a topical for first and second degree burns.

c. Aloe vera is my favorite remedy. It can be used directly from the plant (refer to previous blog on the Aloe Plant). It is soothing and does relieve pain.

d. Vitamin E - you may not have either aloe or tea tree oil at home, but check your vitamins for Vitamin E gel capsules. Stick the gel cap with a pin, and squeeze onto the burn. It will soothe.

e. Silvadene - Silver sulfadiazine, a sulfa medicine, is used to prevent and treat bacterial or fungus infections. It works by killing the fungus or bacteria. Silver sulfadiazine cream is applied to the skin and/or burned area(s) to prevent and treat bacterial or fungal infections that may occur in burns. It is usually a 1% white ointment. It is ONLY available by a doctors prescription.

Until tomorrow...

JULY 17, 2010 SMILE, LOVE and SING OSCAR II

"To love someone is to seek his or her best and highest good"

"Love without return is like a question without an answer."

The quote we all know--'Tis better to have loved and lost than never to loved at all."
- Alfred, Lord Tennyson

What is love? I know many of us have different notions about what love is. Perhaps we use the three little words too easily - I Love You. Growing up I had a mother and father who did say I love you a lot. I heard it from my mother more than my father. I heard it from my father in his later years. They both provided for my needs and said I love you, and I felt cared for. I felt safe.

It is only when I went into the world on my own, that I got different forms or states of love. I was mistreated by loved ones, and to this day, I feel the same with certain people. I have now learned to cut those people out of my life.I do not need the negative 'karma' Early in sobriety I didn't know what love was. I wanted it so badly. That was unhealthy love. The problem was that I had to love myself first. Today I love myself, which allows me to love others. When I hear I love you from those significant to me I know it is real.

Oscra Hammertsein II and Richard Rodgers wrote many love songs in their musicals South Pacific, Sound of Music, The King and I et al. A quote by Oscar Hammerstein II sums it up:

A bell is not a bell until you ring it;
A song is not a song until you sing it
Love in your heart is not put there to stay;
Love is not LOVE until you give it away.

Today's blogging should be about heart disease. The organ of love. However continuing with the theme of the mouth, I want to discuss gum disease. Periodontal disease and the incidence of heart disease are directly correleated. The meridians of the mouth are in direct line with the meridians of the heart. So those with poor dental hygiene or gum disease listen up very carefully!!!

If gum disease is not a problem then why do 40 million Americans suffer from it? The plant is rooted in the ground, as your teeth are rooted in the gums. If the ground is contaminated or erodes, the plant will suffer and die. See it comes back to those plants and botany! The same thing can happen if the bone supporting your teeth erodes, the teeth will fall out.

The drug Fosomax used to treat Osteoporosis has been shown to cause Jaw necrosis as a side effect. The jaw gets necrotic and the teeth fall out. It is the same when a dentist wants to put a 'post' in. He should check your bone status by a DEXA scan or at least ask if you have had one. If you have osteopenia or osteoporosis I suggest you do not get a post. The first sign of periodontal disease is gingivitis. This is the inflammation of the gum tissue. The loose gum line allows pockets to form. The gum is tender, swollen and bleeds easily when flossing. These pockets collect food debris allowing bacteria to multiply and attack the tissue. The bones start to erode and this is called periodontal disease. The teeth rot and begin to fall out. Or the dentist must pull the teeth. This can lead to bridges if you are lucky, but can end up with dentures for the individual. This gum inflammation is called gingivitis. You must remove the food within the pockets that form. You must do this by brushing, flossing or I prefer dental water piks.

You cannot remove hard plaque or tartar this way. You will need a proper dental hygienist and a good cleaning. There are signs of periodontal disease. The first one, halitosis was discussed previously. Then there is bleeding gums, receding gums and malpositioned teeth. All are signs of periodontal disease. I am not a dentist but have seen the correlation between bacteria in the mouth and a serum blood marker for inflammation/infection of the heart. This serum blood marker is called the HS-CRP (high sensitive C reactive protein) or the cardiac C reactive protein. If I encounter a high or elevated HS-CRP on a routine blood screening I will ask as usual about their dental hygiene. Today there is much research about this correlation. In Reversing Gum Disease Naturally by Sandra Senzon, these points are well discussed. There is a list to consider to prevent periodontal disease thus helping you NOT develop heart disease.

1. Sleep well - immune system gets restored. I woke up early as usual and sleep my usual 4-5 hours. Not good enough. My immune system needs more rejuvenation.

2. Eat a proper diet. Again it comes back to the Lifestyle Pyramid. Dietary Lifestyle Changes

3. Use vitamin and supplementation for your body. Can't say enough about this topic.

4. Drink soothing liquids - this does not include whiskey, wine or vodka--at least it doesn't in my case.

5. Rinse frequently - I use herbal cleanses for my teeth. I now am making my own tinctures with 7song. Two are brewing in the closet-prepared from the herbs Rick and I grew on the terrace.

6. Massage the gum tissue- use an herbal toothpaste. I use baking soda, Tom's toothpaste and Senzon's new toothpaste.

7. Oxygenate - this does not mean having someone inject hydrogen peroxide in your teeth, nor drinking oxygenated water. It means deeper breathing techniques.

8. Think positively- this comes from practicing your 4-7-8- breathing, meditation and positive mantra . Put a positive mantra in the bathroom on the mirror in your own hand writing, so you will see it first thing each morning.

I used to be On My Own. Not a lot, as I am one-man relationship person since 16 years ago. I have always loved les Miserables and the song On My Own. It ties in the self love you always have on your own and the love of another person. You all know my love...

And now I'm all alone again, no where to go no one to turn to,
without a hope without a friend without a face to say hello to.
And now the night is near,
And I can make believe he's here.

Sometimes I walk alone at night
When everybody else is sleeping
I think of him and then I'm happy
With the company I'm keeping
The city goes to bed
And I can live inside my head.

On my own
Pretending he's beside me
All alone, I walk with him till morning
Without him
I feel his arms around me
And when I lose my way I close my eyes
And he has found me

In the rain the pavement shines like silver
All the lights are misty in the river
In the darkness, the trees are full of starlight
And all I see is him and me for ever and forever

And I know it's only in my mind
That I'm talking to myself and not to him
And although I know that he is blind
Still I say, there's a way for us

I love him
But when the night is over
He is gone, the river's just a river
Without him the world around me changes
The trees are bare and everywhere
The streets are full of strangers

I love him
But every day I'm learning
All my life I've only been pretending
Without me his world will go on turning
A world that's full of happiness
That I have never known!

I love him
I love him
I love him
But only on my own.


Until tomorrow...