Richard Bernstein M.D. F.C.C.P.
Trudy Trumpy P.A.
Internal Medicine,Asthma and Allergies, Well Women Care, Cosmetic Laser Surgery
133 Defense Highway Suite 109
Annapolis, Maryland 21401
410-224-5558
fax 410-224- 7321
www.drrabernstein.yoourmd.com
Board Certifications:
Internal Medicine
Pulmonary Diseases
Fellow American College of Chest Physicians
Member American College of Physicians
Member American Academy of Otolaryngology Allergy
Member American Academy of Laser Medicine and Surgery
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About Our Practice
While no one likes going to the doctor we are dedicated to providing the best clinical experience a medical practice can offer. Our core practice is Internal Medicine.
We are all going to age, thus our philosophy is to provide services that help prevent disease as well as treat them. We want our patients to live long and healthy lives, feel good about themselves and enjoy life. By incorporating lifestyle management strategies such as nutritional counseling we can our patients achieve these goals.
While not a medi spa we do provide cosmetic skincare for patients who desire these services. We look at the science of skin aging and we look at the whole person. We are able to help our patients achieve the goals they desire and do it cost effectively.
Dr. Bernstein has an extensive background in pulmonary diseases where his major area of interest was asthma and exercise physiology. Twenty-five percent of the population suffer from allergies. We are uniquely qualified to provide asthma and allergy services to our patients because of Dr. Berrnstein's pulmonary backround.
Most importantly we want to provide an environment that makes our patients feel comfortable. We view our patients as an extension of our family. That is why there there will always be someone to answer the phone, fit in emergency visits for same day appointments and we still make house calls.
Our staff is here to serve you. We encourage feedback both positive and negative so we can provide you the best quality care.
Richard A. Bernstein M.D.
Trudy Trumpy P.A.
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Highlights of Healthy Aging Seminar and Workshop (part 1)
First let me thank all of you who attended our healthy aging seminar. We appreciate you taking time out of your busy lives to spend a couple of hours with us.
The seminar was divided into two principal components.In the first half of the seminar, we talked about the current literature and how it relates to diseases of aging such as diabetes, heart disease, peripheral vascular disease, hypertension, and cancer. We talked about metabolic syndrome and the impact it has on the diseases of aging. We also spoke about the exciting area of kinase research, and how they are likely to influence the way the pharmacology of medicine is practiced in the future. In the second half of the lecture, we talked about practical applications of nutrition and lifestyle management, and how they can prevent and reverse diseases of aging.
Of the studies we cited, perhaps the most important is the H.A.L.E.study, which looked at the relative diets of Europeans age 70 to 90, and looked at outcomes. People age 70 to 90, who ate a diet high in vegetables, with fish as the primary source protein and moderate consumption of whole grains had an overall mortality that was 50% less than their compatriots who ate more of an animal foods based diet. This is an astonishing study, which demonstrates how our lifestyles can have a significant impact on preventing and reversing disease. If there was a pill that would reduce everyone's mortality by 50% and had no side effects, my guess is that everyone would be taking this medication. Essentially this study indicates that we have the tools right in our supermarkets to accomplish this objective. We looked at some studies which showed that a diet high in vegetables can be just as effective as an antihypertensive medication in helping to reduce blood pressure. We also cited studies,which showed that in people who are at increased risk for developing diabetes, lifestyle interventions were more effective than medications.
We spoke briefly about kinases. Kinases are small proteins that are located in all of our cells.They communicate with each other and have been associated with diseases as diverse as diabetes and stomach cancer. Currently,we have identified 540 different kinases in the human body. In particular,we spoke about the gsk 3 kinase which is involved in the development of metabolic syndrome. Metabolic syndrome a state of insulin resistance. When this happens, we have difficulty in utilizing sugar as an energy source. Having a high insulin state, causes excess sugar be stored as fat, often in the form of high triglycerides, fatty liver,and can result in a low HDL cholesterol, a high LDL cholesterol and can cause a decrease in muscle mass known as sarcopenia. It is a precursor to diabetes, 25% of the U.S. population has metabolic syndrome. We know,that the keys to down regulating the kinases associated with the metabolic syndrome involves eating a lot of vegetables because phytonutrients seem to be the key in down regulating this process and reversing metabolic syndrome. We also learned that certain supplements are now available that can help in kinase regulation.
We learned,about the glycemic index.The glycemic index relates to how food compares to table sugar. For example a bagel has a glycemic index of around one hundred which is the same as table sugar. String beans on the other hand have a glycemic index of about 20. We also learned that proteins vary in their ability to stimulate insulin. For example fish stimulates less insulin than does beef. This may account for why diets higher in fish protein are generally associated with healthier outcomes than are diets high in animal foods.
In the second half of the lecture, we spoke about dietary recommendations. A handout of our dietary guidelines can be obtained from our office. Essentially,we recommend a low glycemic Mediterranean diet. I recommend,eating nine fruits and vegetables a day. A good ratio is six vegetables and three fruits.Try and limit red meats, to one time per week. Increasing fish in your diet and making vegetables the mainstay of your diet instead of a side dish can have a significant impact on health. In our next issue we will review these recommendations in detail, review supplements and discuss the keys to an effective weight loss program. If you need more help, dietary counseling, is available from our office.
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Battling Insomnia
Keys to a good nights sleep
Insomnia is the perception of inadequate sleep in amount or quality. Insomnia can be associated with difficulty in getting to sleep or an inability to return to sleep after awakening at night. Depending on our individual needs our need for sleep can vary from 4 to 11 hours per night, but most of us require around 7-8 hours.
Insomnia can be situational involving acute stresses such as the death of a spouse or friend, stress at work or studying for a big exam. Chronic insomnia can be due to chronic stress, underlying depression, anxiety, pain, head trauma, drug use. Chronic preoccupation with the need to sleep creates an increased state of arousal which prevents the patient from being able to sleep. If one awakens form sleep and can not go back to sleep because their mind seems to be racing, this is known as monkey chatter. It creates a state of arousal preventing the patient from returning to sleep.
Addressing sleep hygiene is an important part of any sleep program. Steps include avoidance of caffeine (coffee, sodas etc), and going to bed at the same time each day. Writing down the next day's activities before going to sleep is helpful for one who awakens at night, because it can help prevent monkey chatter. One should avoid napping. Don't read, eat or watch TV in bed. Don't use alcohol to help you sleep.
Addressing underlying factors discussed above is important.
Drugs can be helpful but should only be used for short periods of time to consolidate sleep. Ambien and Lunesta both have the potential to be habit forming, and often lose their effectiveness over time. They can worsen sleep apnea. Rozerem is a new drug which is interesting because it addresses both melatonin 1 and 2 receptors which help with falling asleep and maintaining sleep. It does not appear to be habit forming, but is not a substitute for good sleep hygiene,
Supplements also have their drawbacks. Valeran Root is a sedative and is not without risk. Melatonin is a very complex molecule and difficult to manufacture. With no FDA oversight of the supplement industry contamination is a concern.
If you have more concerns about insomnia we invite you to schedule an appointment. |
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Our Newsletter comes out monthly. We will no longer be providing a separate skincare, allergy and primary care newsletter but will be provide one integative newsletter. If you have topics that interest you please contact our office so we can highlight these in future newsletters. We also ask that you set aside these dates on your calander.
Wed June 13th, 5:30 - 8 p.m. Skincare Open House
location: Our office
Wed Sept. 12th, 7:00-9:00 p.m. Asthma and Allergy Seminar and Workshop
location: Sajak Pavillion
For more information, please contact our office
Thank you for taking the time to read our newsletter.
Sincerely,
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Richard A. Bernstein M.D. |
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