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Caffeine

Dear Dr. B: I have been using caffeine pills to stay awake and study for my exams. Is it a bad thing to do that?

Answer: Caffeine is a drug. It is naturally produced in the leaves and seeds of many plants such as tea leaves and coffee beans. It stimulates the nervous system to cause alertness. It makes the heart beat faster. Some people experience a temporary increase in energy and elevation in mood. It is bitter in taste but the processing of the drinks can hide the bitter taste. It’s also produced artificially and added to certain foods.

It is almost impossible to spend a day without consuming caffeine in some form or the other. Caffeine is in sodas, coffee-flavoured yogurt, coffee ice-cream, chocolate candy or iced tea. Many pain killers and over-the-counter medications have caffeine. Even decaffeinated coffee has some caffeine. Many energy drinks are loaded with caffeine to give a temporary boost to a person’s energy level.

Most teenagers get their caffeine through soft drinks which can also have added sugar and artificial flavors. Sixty eight per cent of Americans say they are hooked on coffee. Caffeine abuse by young people alarms some experts. In one study, researchers from Northwestern University in Chicago tracked calls to the Illinois Poison Center in Chicago for three years and they found that more than 250 cases of medical complications occurred from ingesting caffeine supplements and that 12 per cent of the callers had to be hospitalized. The average age of the callers was 21.

Besides boosting memory and improving concentration, caffeine can lower the risks of diseases such as Alzheimer’s, liver cancer, type 2 diabetes and Parkinson’s disease. It does not significantly increase the risk of heart disease or cancer.

On the other hand, caffeine does cause dependence and trying to go without caffeine may cause withdrawal symptoms. Once you get hooked on caffeine then you need more and more caffeine to feel the same effect. Too much caffeine can raise blood pressure and blood sugar level, decrease the bone density and cause muscle soreness because the body loses calcium and potassium and recovery time after exercise is delayed. Caffeine has a mild diuretic effect (increase need to urinate) which can cause dehydration. Caffeine increases irritability and anger.

Too much caffeine will cause insomnia, tremors, nausea, vomiting, chest pains and palpitations. Caffeine is not stored in the body and it is excreted through the kidneys. In some individual the after effects of caffeine may last up to six hours.

How much is too much caffeine?

This is difficult to define as individual sensitivity to caffeine can vary a lot. A cup of coffee or tea can keep one person awake whole night while it may not have any effect on a second individual. Some experts say that people should consume no more than about 100 milligrams of caffeine daily. That equals to one espresso which contains about 100 milligrams of caffeine.

Other examples of caffeine contents of common drinks are:

-Coca-Cola 355 ml. has 34 mg. of caffeine
-Diet Coke 355 ml. has 45 mg. of caffeine
-Pepsi 355ml. has 38 mg. of caffeine
-7-Up 355 ml. has no caffeine
-Iced tea 355 ml. has 70 mg. of caffeine
-Brewed coffee 150 ml. has approximately 115 mg of caffeine

Depending on your sensitive and tolerance level, caffeine in small amounts and in moderation may not hurt you. You have to know your limit. Personally, I don’t see the need for taking caffeine to stay awake and study. In my life time I have been through many exams and I didn’t have to rely on caffeine to get results. I believe in power naps. If you are sleepy then your body is asking you to rest. Take a nap instead of drugging yourself with caffeine.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Mould

House Calls
By
Dr. Noorali Bharwani

You have just invested your life’s savings in a dream home. You have inspected the house thoroughly looking for possible problems. But you forget to check for mould.

It is said that virtually all buildings contain moulds, but some are mouldier than others. Moulds love the interior of the buildings where they can adapt to dry conditions but moulds cannot survive without some moisture. You wonder where the moisture comes from. The source could be a leaky basement, a dripping pipe or a roof in need of repair.

Painted walls and certain types of wallpapers can become overgrown by certain fungi, particularly in humid places such as showers. Moulds can be found in other places in the house. Sometimes you open the fridge and find mould spread over bread and cheese. Mould can be found on books and files as well.

Usually it is hard to know if your house is mouldy until somebody in the house complains of persistant allergies, headache, nausea or respiratory symptoms. A mouldy building can be a serious health hazard.

This brings us to the subject of fungus. Mould is a kind of fungus. Fungi are all around us. Not all fungi are harmful. The American Heritage Science Dictionary defines fungi as any of a wide variety of organisms that reproduce by spores, including the mushrooms, moulds, yeasts, and mildews. Spores can remain dormant for years. Some of the characteristics of fungi are:
-fungi absorb food by excreting enzymes that break down complex substances into molecules that can be absorbed into the hyphae
-the spores of most fungi grow a network of slender tubes called hyphae that spread into and feed off of dead organic matter or living organisms
-fungi can live in a wide variety of environments, fungal spores can survive extreme temperatures and fungi exist in over 100,000 species, nearly all of which live on land
-they can be extremely destructive, feeding on almost any kind of material and causing food spoilage and many plant diseases
-although fungi were once grouped with plants, they are now considered a separate kingdom.

The fungus grows best in moist, damp, dark places with poor ventilation and on skin that is irritated, weakened, or continuously moist. Most of the fungi are very helpful in the natural environment and only a few cause diseases in humans, plants and animals.

Candida is yeast like fungus which may cause athlete’s foot, vaginitis, thrush, or other infections. It can thrive in moist skin fold areas under the breasts, overhanging abdominal adipose tissues, groins, between fingers and toes, in the armpits and in the anus. Some of the fungi are dermatophytes which cause parasitic infections of the skin, hair, nails and adjacent mucous membranes.

Systemic fungal infections occur when spores are touched or inhaled. Such infections are most often in people taking antibiotics which kill off the bacteria that normally keep fungi at bay. This is also the case in people with endocrine disorders, immune diseases, and other conditions such as obesity, AIDS, tuberculosis, major burns, leukemia, and diabetes mellitus. Patients with systemic infection may have no symptoms or may have flu-like symptoms – coughing, fever, chest pain, chills, weight loss, and difficulty with breathing.

Certain fungi, such as mushrooms, can produce poisonous toxins that may prove fatal if ingested. Certain moulds can be highly toxic to humans. A condition called egotism is caused by eating bread prepared from rye infected with the fungus

Skin infection with fungus can be treated with antifungal skin ointment. Systemic fungal infection requires oral antifungal pills. Fungal infection can be prevented by keeping our body and the environment clean and healthy. And make sure your leaky roof is fixed.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Germ Warfare: Fungus

Dear Dr. B: What is a fungus? What are the common fungi which cause illnesses in humans?

Answer: The American Heritage Science Dictionary defines fungi as any of a wide variety of organisms that reproduce by spores, including the mushrooms, moulds, yeasts, and mildews. Spores can remain dormant for years. Some of the characteristics of fungi are:
-fungi absorb food by excreting enzymes that break down complex substances into molecules that can be absorbed into the hyphae
-the spores of most fungi grow a network of slender tubes called hyphae that spread into and feed off of dead organic matter or living organisms
-fungi can live in a wide variety of environments, fungal spores can survive extreme temperatures and fungi exist in over 100,000 species, nearly all of which live on land
-they can be extremely destructive, feeding on almost any kind of material and causing food spoilage and many plant diseases
-although fungi were once grouped with plants, they are now considered a separate kingdom.

Fungi are all around us. The fungus grows best in moist, damp, dark places with poor ventilation and on skin that is irritated, weakened, or continuously moist. Most of the fungi are very helpful in the natural environment and only a few cause diseases in humans, plants and animals.

Candida is yeast like fungus which may cause athlete’s foot, vaginitis, thrush, or other infections. It can thrive in moist skin fold areas under the breasts, overhanging abdominal adipose tissues, groins, between fingers and toes, in the armpits and in the anus. Some of the fungi are dermatophytes which cause parasitic infections of the skin, hair, nails and adjacent mucous membranes.

Systemic fungal infections occur when spores are touched or inhaled, or there is an overgrowth of fungi in or on the body. Such infections are most often in people taking antibiotics which kill off the bacteria that normally keep fungi at bay. This is also the case in people with endocrine disorders, immune diseases, and other conditions such as obesity, AIDS, tuberculosis, major burns, leukemia, and diabetes mellitus. Patients with systemic infection may have no symptoms or may have flu-like symptoms – coughing, fever, chest pain, chills, weight loss, and difficulty with breathing.

Certain fungi, such as mushrooms, can produce poisonous toxins that may prove fatal if ingested. Certain moulds can be highly toxic to humans. A condition called egotism is caused by eating bread prepared from rye infected with the fungus.

Moulds are often found spreading over bread, cheese, books, and other things in the home and may be a menace to our health. Painted walls, particularly in humid places such as showers, can become overgrown by certain fungi. Certain types of wallpapers also serve as a source of nutrition for some moulds and may prove to be harmful. Virtually all buildings contain moulds depending on the amount of moisture present in the building. Moulds can cause headache, nausea or respiratory symptoms amongst the occupants of the building.

Skin infection with fungus can be treated with antifungal skin ointment. Systemic fungal infection requires oral antifungal pills. Fungal infection can be prevented by keeping our body and the environment clean and healthy.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Doctor, heal thyself first

There are plenty of resources across Canada to help physicians stay healthy

Yes, physician health matters because physicians are a valuable human resource.

From Nov. 30 to Dec. 2, 2006, I was in Ottawa attending the 2006 International Conference on Physician Health. It was organized by the Canadian Medical Association (CMA) and the American Medical Association (AMA) and was attended by delegates from Canada, the United States, Europe, Australia, New Zealand and many other countries.

This year’s conference was 18th in the series since its inception in 1975. This year’s theme was Physician health matters: preserving a valuable human resource.

The delegates at the conference heard about the latest research on physician health, about new skills to survive and thrive in their careers, and learned about the progress is being made around the world to protect the health of physicians.

The organizers of the conference say that by raising physician health issues at an international policy level, the conference seeks to promote a healthier culture of medicine and decrease the stigma associated with physician ill health, thereby decreasing barriers to physicians seeking timely personal care.

In 2003, a survey conducted by the CMA found 46% of Canadian physicians were in an advanced stage of burnout. Physicians feel they have to work harder and longer hours because there is a shortage of medical manpower. With information overload there is a significant pressure on physicians to satisfy the demanding public, and there is constant political battle within our health-care system to obtain a fair share of resources to provide good patient care. All these factors do affect physicians’ personal and mental health and their capacity to deliver good patient care.

In order to help physicians understand the importance of looking after their own health, the CMA set up a Centre for Physician Health and Well-being. Since then, every province in Canada has established programs to help physicians and their families cope with the stresses of work and encourage healthy behaviours within the physician population as a whole.

At the conference, I was pleased to learn that every physician in Canada has access to a physician health program. In Alberta, it is called Alberta Physician and Family Support Program. The program has a toll-free number and a physician or a family member can call this number for help 24 hours a day.

As we know, prevention is better than a cure. In the last few years, medical students, interns and residents have been in the driving seat promoting ideas on physician health and well-being. They are educating themselves at an early stage of their professional lives to look after themselves and their families. They have learned to reduce the hours they work, they have learned to say “no” when they are tired and they have learned to balance their lives.

I belong to a foolish generation of older doctors who took pride in working round the clock. Readers of my newspaper columns in Medicine Hat, Alta., and those who have read my book, A Doctor’s Journey—an emotional and humourous look at life through the eyes of a doctor—are well aware of my trials and tribulations with my own health. I learnt my lesson too late. In the last four years, I have tried to change my practice and find a better balance in life.

It is hard to break old habits. After all, work is a kind of addiction. It takes about one to two years to “detoxify” oneself. During this process, one needs an understanding health-care administration, understanding colleagues, good friends and a devoted family. Count yourself lucky if you get all four groups rooting for you during your down time.

As one door closes, another one opens. So be brave, doctor, remember to heal thyself first.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!