Why Sex Isn’t Always Just Fun and Games

Couple in bed

When you go to see your doctor, you may be surprised if he or she asks about your sex life (and a little bashful to approach the topic). Chances are, she’s not trying to pry. Rather, she may discover something that directly impacts the treatments she is providing to you. The thing is, older adults often don’t think of themselves as being at risk for sexually transmitted infections, which might partly explain why infections have been rising dramatically in the over-50 age group for the last decade. It’s World AIDS Day today, and I’d like to spend some time talking about why being careful with your sex life can have a big impact on other areas of your health as well. Read more  »

Have Your Healthiest Thanksgiving Yet

Family at the dinner table at the Thanksgiving day.

I always always find myself with mixed feeling around Thanksgiving time. On the one hand, it serves as a great excuse to get the whole family together for a reunion you would rarely otherwise have. On the other hand, it can be one of the most hectic and stressful weekends of the year, especially if you’re traveling. Many of my patients tell me it derails their exercise regimens and diets they’ve been working on for months. Like me, you’ve probably wondered if it’s even possible to have a healthy, low stress Thanksgiving. Well I’ve got news for you. Not only do I think it’s possible, I think it’s within your reach this year. Spend a few minutes with me learning how to make this Thanksgiving a healthy one without significant sacrifices. Read more  »

Kicking the Habit Is Closer than You Think

woman quit smoking

A few weeks ago, I wrote about how much I worry about my patients with diabetes, but there’s another group I often fret about: smokers. As a society, we’ve made huge leaps in helping people quit and in preventing people from starting in the first place. In spite of that, there are still a lot of people out there who smoke. As I’ve mentioned in the past, living a healthy life is impossible if you smoke cigarettes. The damage this habit wreaks on almost every organ of your body contributes to the early death of the equivalent of two 747 planes of Americans every day. But if you’re a smoker, you’ve probably heard all of this before and chances are good you’re ready to quit. The Great American Smokeout is this week, and I want to get into what you can do to get off of cigarettes and the sorts of changes you can hope to see once you kick the habit. Read more  »

A Pressing Health Issue for the Men in Your Life

couple beach sunglasses fun

I’ve noticed more than a few new mustaches around the office recently, reminding me that we’ve once again entered the month of November or, more accurately, Movember. This year’s Movember advocates are emphasizing the importance of mental health for men, a topic I think is one of the most important challenges men face. I’d like to take a few moments this week to talk about men’s mental health, in particular, why men are particularly vulnerable to mental health problems, and how you can get the men in your life on track for better mental health. Read more  »

Turning the Tide Against Diabetes

Diabetes blood sugar reading

I always worry about my patients with diabetes. As I’m a cardiothoracic surgeon, all of my patients are sick by definition, but of all of my patients, it is the diabetics who are the most unpredictable. Diabetes was a disease almost unknown in children and uncommon in adults 20 years ago. Today, it’s one of the most common adult diseases and is on the rise in kids. This potentially devastating disease can affect just about every organ of the body and dramatically shorten your life. Fortunately, we’re turning the tide. Over the years that diabetes has become more common, it’s also become better understood. It’s National Diabetes Month and I want to spend some time talking about diabetes and what you can do to defeat it.

Diabetes Is Just One Piece of the Puzzle

While you probably know that diabetes is a disease that affects your blood sugar, you might not know that it’s part of a larger health problem. Diabetes rose with the growth of obesity and the two diseases are intimately intertwined in ways we don’t fully understand. Both are part of a larger syndrome of associated conditions called the “metabolic syndrome” made up of three to five conditions:

  • Diabetes
  • High blood pressure
  • Obesity
  • High LDL cholesterol (the bad kind)
  • Low HDL cholesterol (the good kind)

The fact that these conditions often appear together indicates that all are symptomatic of a deeper problem with the way your body is dealing with food and energy balance. Healthy bodies can handle cholesterol, fat, and sugar in a way that prevents blood vessel and weight problems. Bodies with metabolic syndrome lose the ability to regulate these systems, which leads to inflammation, hormonal changes, and shifts in metabolism.

Not All Diabetes Are the Same

There are two different types of diabetes that we know about: type 1 diabetes and type 2 diabetes. Type 1 is most commonly seen in children and occurs when the body’s immune system attacks its own insulin-hormone-making cells. As those cells die, the levels of insulin in the body drop, which means the body has no hormone to control the levels of sugar in the blood. These individuals need that insulin replaced for the rest of their lives because those cells don’t ever grow back. Without insulin, their blood sugar will swing between sky high and rock bottom, which can be incredibly dangerous.

Type 2 is almost a completely different disease. While both are related to blood-sugar regulation, their causes are different, which means the treatment is also different. So far as we can tell, type 2 diabetes results when the body’s cells lose their sensitivity to the insulin signal. The pancreas cells that make insulin are pumping the hormone out, but the body isn’t responding the way it should. It eventually picks up on the signal, but it gets more and more sluggish over the course of the disease. Medications are available that both help the pancreas pump out more insulin to meet this greater demand and make the body more sensitive to the insulin it’s already making.

One last point here is that no two people with diabetes are alike. I’ve found that everyone thinks of their health differently and manages their health differently. Different medications work for different people for different reasons. This why it’s so important to have a good relationship with a doctor you trust if you have diabetes: it might take a while to find the right formula, but when you do, the results can be life changing and lifesaving.

Knowing Your Numbers Is Key

One of the hardest parts of ype 2 diabetes is that it’s a mostly invisible disease. It creeps up on you over years and years of poor health. Fortunately, we have great tests to measure what’s going on in your blood keep an eye on what’s going on before symptoms even appear. Asking your doctor about your diabetes risk is the first and most important step. He or she can walk through your risk factors with you and figure out whether further testing is a good idea.

For those who do have diabetes, remember to regularly checking your blood sugars. There’s no way around this. If you aren’t checking your blood sugar regularly, you’re flying blind when it comes to your health. Discuss how often you should be checking with your doctor and ask for prescriptions for the needed medical supplies.

It Often Comes Down to Diet and Exercise

While doctors have a wide range of effective medications within their reach to treat diabetes, diet and exercise are the real heavy hitters when it comes to sugar control. Exercise helps to push up your body’s sensitivity to insulin, essentially acting to reverse the disease. It also works in a variety of other ways to reverse the other components of metabolic syndrome by helping to fix your cholesterol levels, lower your blood pressure, and keep your weight under control.

Diet also makes a huge difference when it comes to diabetes. Dropping your carbs and replacing them with more fruits and vegetables is a great place to start. You can also replace simpler carbohydrates, like white bread or rice, with more complex ones, like whole grain bread or quinoa. Like exercise, boosting the health factor in your diet fights diabetes while also cutting your cholesterol, blood pressure and weight.

Remember to Stay Positive

While it can be hard to believe at the initial diagnosis, people do beat diabetes. They change their diet, start exercising, and find medications that work for them. Their blood sugar problems may not get better overnight and may never completely disappear. But their control of the disease means it probably won’t give them heart disease, lead to blindness, or cause them to lose a leg. They live with their disease and thrive in spite of it. Seeing diabetes as an unchangeable part of your future only sets you up for failure. While it might not feel like it at the time, many have told me that their diagnosis was the warning sign they needed to turn their health, and their lives, around.

So take some time this month to learn about diabetes, to check your risk factors, and to renew your pledge to better health.

Weighing Your Options When Choosing a Scale


My old bathroom scale broke the other day and I was faced with the challenging task of having to buy a new one. I thought the process would be easy at first until I actually got online. After years of using an old analog dial scale, I hadn’t really realized how the options for measuring your weight had exploded recently. I had a look through some of the different types available and wanted to share my thoughts on the process with you in hopes that it might help you get a scale that fits your needs. Read more  »

Why You Need a Primary-Care Provider


When you become a doctor, you get used to answering all sorts of questions from friends and family. Sometimes it’s a new bunion that’s appeared or a rash that won’t go away, but recently a friend asked me whether or not they really needed a family doctor. When I was growing up, having a family doctor was a no-brainer and your family had often been going to the same one for decades. But now, with so many specialists to choose from even within the primary-care fields, it can be tempting to think that having a primary-care doctor isn’t so necessary after all. I’d like to spend some time this week discussing why you need a primary provider and what sort of care you should look for. Read more  »

Watching Out for Weakening Bones

Woman Drinking Glass of Milk

We often take our bones for granted. While a lot of the health information out there focuses on how to boost your liver function or keep your heart healthy, your bones are the hidden scaffold that holds all of your organ systems together and it plays a crucial role in everything from protecting your organs to regulating your blood chemistry. Unfortunately, the luxury of ignoring your bones only ends as you leave your youth. As you age, so do your bones and the opportunities for bone loss and damage can increase with every birthday if you’re not careful. So what can you do to ensure you have healthy and strong bones well into old age? Here are a few things you should know. Read more  »

Dropping the Stigma of Mental Illness


Mental illness affects us all. As a young physician, I didn’t fully appreciate how widespread illnesses like depression or schizophrenia were. Most of the mentally ill I saw were severely sick and looked nothing like the people I encountered on a day-to-day basis. But years of experience with countless patients and guests on the show have shown me that mental illness is common and affects people you’d never expect. In spite of that, mental illness still hides in the shadows, often shrouded in shame because of the stigma attached to saying you have a mental illness. In the spirit of Mental Illness Awareness Week, I want to pull the curtain back on some of the common myths and misperceptions about mental illness. Read more  »

Uniting to Face Addiction

The storm blared onto the news on Thursday with the fury of a thousands suns… All hell was breaking loose and the East Coast was starting to panic as Hurricane Joaquin tore through the Bahamas. But by Sunday I was looking out on a crowd of thousands peacefully singing their anthem of recovery and smiling.


“This is the day When the Truth will shine… On broken chains we found peace of mind.”

Their lives too had been a raging hurricane. They had gathered on the national mall in the first event of its kind to celebrate the storm’s passing both literally and metaphorically. A hurricane had raged and pass through the ocean, much like their personal journey to recovery from drug and alcohol addiction.

Before the day started I walked the grounds and talked to dozens of people. Some of the best musical talent in the world was here but this was not the vibe of a major rock concert. Most had on t-shirts on with pictures of loved ones they had lost. They held signs with portraits of their children, their siblings. I would look at someone and before we spoke I knew they needed a hug. They would tell me their stories of how their son, daughter, brother, sister, and friends had been lost to a drug overdose. I was floored at the sheer volume of portraits. I was frozen by the collective mourning.

But my sadness at their stories was also tempered by the joy in other faces as smiling people shared their personal stories of recovery. Person after person would tell me they were in long term recovery from addiction and were proud to stand with the thousands to end the silence that surrounds this fatal disease. It took an event like to today to start this national conversation, and it couldn’t have come at a more crucial time.


Soon it was time to take the stage and launch in to the anthem that was written for the day. I spoke with the crowd and welcomed them, telling them how flattered and humbled I was to be in their company on such a special day at such a seminal turning point. I then turned and gave the stage to legendary composer Paul Williams who had written songs for everyone from the Carpenters to Barbara Streisand to Daft Punk. His classic song “Rainy Days and Mondays” is a poetic take on the depression and melancholy that takes root in out lives and wrecked havoc in his. His own personal battle with alcoholism had led him through despair, desperation but then 24 years of joyous sobriety which he stood sharing through song with the audience.



The faces backstage and on stage were a who’s who of pop culture and our country’s leadership. Steven Tyler stood with me and we danced to Joe Walsh as he sang “Life’s Been Good,” his humorous take on the excesses of fame and active addiction. But he also sang his song “One Day At A time,” which was one of the first songs he wrote after finding sobriety. He told me afterwards that once he found sobriety 20 years ago, he struggled through writer’s block and then this song emerged. That phrase is borrowed from the language of 12 step and has been a mantra for those living a life of sobriety. Walsh sang it loud and proud and the entire crowd sang along with him. It was a privilege to be part of it.



The United States Surgeon General, Dr. Vivek Murthy was also there. Normally its unusual to see a White House official member joking with a member of Aerosmith, but this day was a coupling of pop stars, government leadership and average people who have formed a cooperative trifecta – the first organized national response to addiction in this country’s history. The Surgeon General commissioned the first ever Surgeon General’s report on alcoholism and addiction from the stage. This wasn’t a policy speech in Congress; this wasn’t a press release; this was the populist way that history is made.

The reason is obvious when you see the hundreds of portraits scroll on the jumbotron – overdose is now the leading cause of accidental death in people under 50 surpassing traffic accidents. 24 million people are in the acute chronic stages of this fatal disease and desperately need help. There is help available and treatments work. The thousands singing along to the anthem are proof – so are the 20 million people in recovery in this country. We must bridge this gap between suffering and salvation. We must celebrate those that have found recovery so those suffering and their loved ones know good treatment is available and works. We must end the silence.