Davis Square Family Practice Newsletter
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Issue: # 1 May 2009
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Dear Patients, 

This is the first issue of, what I hope will be, a regular feature of this practice. Marie Botte, NP and I hope to provide our patients with useful information on medical issues, news about our practice and have a forum for patient feedback. This issue is really a test run that is going out to a limited group of patients so we can use your feedback about how to make the newsletter useful to both You (primarily) and us. So, please forgive us for our flaws but be sure to let us know about them so that we can improve the newsletter.
 
Deb Bershel 
 Swine fluSwine Flu 
This is a health issue that is certainly in an everchanging state of flux as new data pours in on where the virus has spread to and just how dangerous it is. As you probably already know, this strain of flu appears to be no more dangerous than a typical influenza virus but there may be more of a tendency for it to hit young people (perhaps because older folks have been exposed to similar strains in prior years) - but no age group is without risk  Health officials are trying to decrease its spread by encouraging people who may be ill with the virus to stay at home.
 
Symptoms are high fever ( let's say 101 or greater),  cough, muscle aches, sore throat, (occasionally also nausea and vomiting and headache). The cough is usually dry or can be productive of a clear/colorless mucous. The flu should always have a cough and fever associated with it. Without those 2 symptoms you probably don't have the flu.
 
What does this mean for you? If you think that you may have the flu please stay at home and call the office. Either Marie or I will call you back. If we concur that it is a possibility that you have the flu and not some other illness then we will call in Tamiflu or Relenza for you. This should shorten the course of the illness or at least help make it milder.
 
If it is after hours you may - call the office to get hold of the covering physician or call me on my cell phone at 617-230-7988 (although I occasionally don't have the phone on).
 
Deb
WELLNESS
 WELLNESS LOGO
 
Our hope is to feature various issues that are important for our overall sense of health in the holistic sense of the word. In other words, knowing that your lab values are 'normal' doesn't necesarily mean that you are in good health.
 
A Different Way to View Obesity 
 
A lot has been written about obesity in the popular media lately and I think it might help to put things into perspective a bit.  There are two issues here - one is medical and the other is social.
 
In our culture, being overweight is associated with many negative things. Overweight people are made to feel like they are lazy, lack self-control and that they are not as attractive as they would be if they were slimmer. My opinion is that while almost anyone who is overweight can be slimmer, there is usually some genetic component to obesity. There is definitely some medical evidence to support this contention. I am very troubled by the cultural stigma of obesity and I believe that it is a unecessary source of depression for many people.  
 
On the other hand, being overweight is associated with significant health problems. BUT there is new evidence that we have been inaccurately determining who has a real physical health risk from being heavy. A recent study out of Europe that followed people of all ages for almost 10 years showed that the body mass index or BMI does not correlate with your weight-adjusted health risk as well as does the waist to hip ratio does. Basically, if you are pear-shaped (fat concentrated in the hips and buttocks) then you have no significant health risk from being overweight. If you have a 'beer-gut' then you have a problem.
 
Unfortunately, it seems like most Americans have the 'beer-gut' type of obesity. this means that they are at increased risk for heart disease, stroke, diabetes and some cancers. I have not been able to find the magic bullet that will help everyone lose weight. I recommend that you don't waste your time embarking on a diet that you cannot possibly stick with for the long haul - probably a lifetime. Interestingly, studies suggest that more restrictive diets are ironically easier to stick to. Loosy goosey diets that involve 'just cutting back a little here and there' tend to fail. Diet programs that involve outside support such as Weight Watcher's and Overeaters Anonymous can really be helpful for the long road ahead. Weight loss is rarely an emergency - it is a process.
 
Exercise, of course, is helpful to lose weight but you cannot usually lose a lot of weight with exercise alone. But if you embark on an exercise regimen you will improve your overall cardiovascular health even if you do not lose a single pound.
 
We are always interested in talking with you about wellness issues. So, if you are interested in making some positive changes in your life, paying us a visit is a sensible place to start.
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I hope you have found this email informative and promising. I am thinking that it can eventually lead to an interactive experience for our patients - so we can all learn from each other.
Sincerely,
 

Deb Bershel, MD
Davis Square Family Practice
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