slow steady weight loss

A 60 year old patient of mine has been losing 2-3 pounds every two to three weeks by portion control and exercise. SHe keeps a written log of her calorie intake and her exercise. Once every two week we review her progress. SHe has lost 11 pounds in 6 weeks since july 29, 2015. SHe remarks that her clothes are looser and she can feel the weight loss by the ease in which she can get into her clothes.

Her committment to the program by documenting her intake and her exercise is one of the main reasons for her success.

myfitnesspal.com for calorie and fitness logging.

For free, myfitnesspal.com enables the user to log in the number of calories they are eating. It can be used for weight loss and you can print out your results and review them with your health care professional

I have had several people bring me their results, and we are able to fine tune their eating habits and make recommendations based on their printouts.

You can also log in your activity and water.

Summaries include, calories from carbohydrates, protein, fat and amount of sodium in the diet.

Eating healthy on a budget

eating healthy on a budget

Here is a blog that I share that has many healthy suggestions on how to eat healthy while on a budget. It includes preparing foods instead of buying convenience food,

It also includes buying foods in season and freezing for later use.

Reflux, irritability and spitting up in infancy

Today a 6 month old with irritability and reflux came to the office. He is most irritable after large feeds, when laying down. Mom says he doesnt sleep for more than two hours at a time. He arches his back when irritable and in pain.

He takes 32 ounces of formula a day. He gets one teaspoon of oatmeal in 6 ounces of formula.

In the last 10 days he cries during feeding. He seems to have an aversion to feeds. During burps he spits up. He cries for 1-2 hours secondary to gas. No bile or blood in vomitus. Mom has noted thick clear spit up.

He is uncomfortable and arching his back at night as well. . He is not comfortable during a nap time during the day.

He is on nutramagen. When taking soy, he vomits worse.

He presently gets 6 ounces of formula every 4 hours 6 times a day for a total of 32 ounces a day

MY SUGGESTIONS TO HER WERE AS FOLLOWS-

To treat infant reflux, and irritability:

Food is better tolerated than liquid

Add one teaspoon of oatmeal to each ounce of food-

4 ounces would equal 100 calories

Needs 800 calories a day for growth

will get 100 calories from thickened food ( 4 ounces)

Then he needs- 4 ounces formula with one tablespoon and one teaspoon of oats

give 4 ounces of the above mixture every 3 hours 7 times a day.

SMALL THICKENED FEEDS are a treatment for reflux-

it keeps the food in the stomach

Upright at least one half hour after feeds, one hour is best.

Head of bed elevated 45 degrees.

Super overweight

Recently I saw an 11 year old boy who was 100 pounds overweight for his age. Besides getting a school lunch, he eats when he gets home from school, and eats right through playtime and dinner. Mom goes to work at 6pm so he stays indoors supervised by grandmother. He was referred to me because of overweight and high cholesterol.

In the office, upon questioning the mom, she said she was powerless to control his eating habits. He sneaks food when no one is around. He is not physically active.

When I suggested he not eat before dinner and go outside to play, he became visibly upset. He cried when it came time to examine him because of his large breasts which he did not want me to look at.

In the end, I suggested to mom to start with small changes. For example, no fruit juicesat school or home. He is eating enough that he doesnt need the sugar drink they offer at school. They are empty calories.

Mom will try to keep him outdoors now that the weather is nicer.

Lyme and Crohn’s

About four months ago a 12 year old girl who had crohn’s and was in remission came to see me because she had a relapse of her crohn’s after two years in remission. She presented with severe abdominal pain ( like 10/10 in severity). Her evaluation in the possible causes of her relapse yielded a positive Lyme titer- showing exposure. She was treated with Doxycycline and now a few months later dad reports that her abdominal pain is minimal.

Take home lesson- One of the triggers of what we call Crohn’s disease, can be lyme and its coinfections which include bartonella, mycoplasma, ehrlichia, anaplasma, and rocky mountain spotted fever. In a person with a predisposition to autoimmune disease and a family history of autoimmune disease, these infections could trigger the autoimmune process.

Dont Monkey around when you read this

A guy walking down a street one afternoon passes an old man sitting on the side of the road with a large sack.

The younger guy says to the old man, “Watcha got in the sack?”

The old man responds, “I got some monkeys in that there sack.”

The younger man asks, “If I guess how many monkeys you got in the sack, can I keep one?”

The old man replies, “Son, if you guess how many monkeys I got in this sack, I’ll give you both of ’em!”