Tuesday, 11.12.2018
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Dr De La Flor
Your questions answered
Dear Dr. De La Flor,
I keep hearing that vitamin D is really good for your health. But I'm also worried about skin cancer. I wear a hat and use sunscreen every day. So with all this coverage, can I still get Vitamin D by sitting or walking outside?
Sincerely, Sonia


Your questions answered

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Tenerife - 06.06.2011 - Dear Sonia

You pose an excellent question about gaining vitamin D by sunlight exposure vs. the risk of skin cancer. Sitting outside in sunlight will boost vitamin D levels but your skin must be exposed and free of sunscreen. However, it should be your priority to reduce the risk of skin cancer. You must also take into account your family/personal history, type of skin and our constantly sunny climate. Wearing sunscreen and a hat are recommended ways to reduce your skin cancer risk. If theres family history of cancer, you can use a vitamin D supplement to maintain adequate levels. You can easily get your vitamin D level checked by a blood test to know if you are vitamin D deficient. Based on the results you may need to have a high dose vitamin D supplement to increase your levels or a lower dose supplement to maintain an adequate existing vitamin D level. Ask your GP for further personalised advice. Have a fab summer!

Dear Dr. De La Flor,

Due to my job, I do plenty of physical work and for a few months my back has been bothering me on and off. I did suffer from whiplash about 10 years ago. Is there a way of knowing if a have a herniated disk?

Cheers, Adrian

Dear Adrian,

A spinal disk becomes herniated when the inside contents bulge out from a weakened portion of the disk and put pressure on surrounding nerves and other structures. The resulting pain may be local or can affect the leg, foot or hip if the slipped disk is in the lower back. A herniated disk in the neck can cause pain in the upper back and shoulders. Painful symptoms of a herniated disk tend to worsen: after you have been sitting down or standing for a long period; during the night; when you laugh, cough or sneeze; when you walk, even a short distance; when you bend over backward. Dont forget that the first thing to do is to rest, and it will be an excellent idea to do some imaging diagnosis to rule out other pathologies. Ask your GP for further advice and please do not let this type of pain linger and dont forget to use local heat and light stretching when you feel the tightness and over-the-counter painkillers for the pain. And by the way, body posture rules! Proper body alignment and proper postural awareness during the day is vital. Best wishes!





Dear Dr. De La Flor,

I seem to have a leaky bladder and its getting worse despite medication. Any advice?

Cheers, Sue

Dear Sue,

An overactive bladder (also called urge incontinence) should not have to cramp your lifestyle. In order to reduce the need to go often or suddenly to the bathroom, try some of the following tips:

Be sure you're not drinking too much - or too little. Drinking too little sets you up for constipation, which can lead to urinary tract infections. Not drinking enough also creates concentrated urine, which is itself a bladder irritant. The number one beverage for the bladder is plain water.

Try to identify and avoid your trigger food(s). Some top offenders are: artificial sweeteners, coffee (and caffeine generally, including tea), alcohol, chocolate, tomatoes, red peppers, spicy foods, acidic foods (citrus) or high-sugar foods.

Get the knack. The muscles that help hold back urine until it's convenient to go are both involuntary and voluntary. There's a moment before coughing, sneezing, lifting a box or dealing with other physical stressors when you can consciously tighten the urethra to help hold back the urine. This manoeuvre is called the knack. Because the knack manoeuvre is a voluntary movement, with practice you can teach yourself to do it at the moment you'll need it. Right before you cough or lift something (or whatever movement you know creates your urinary leakage), consciously contract your pelvic floor muscle. Do this often enough, and the habit will become a reflex!

Kegel exercises. Kegels build the muscles used to control urine flow. You can identify the muscles involved by stopping urine flow midstream. Do them regularly when you're not urinating. Its recommended to hold the contraction for a slow count of five, then relaxing for a count of ten. Repeat five times for one set. Gradually work up to ten sets per day or on alternate days depending on the severity of the leakage

Visualise a delay. Since its partly a signalling problem between the brain and the body, try using your mind to forestall an urgent need to urinate. Decide on a powerful mental image that you can turn to whenever you desire a distraction from urinating.

Nicotine matters due to the irritation on the bladder lining and smoking tends to produce chronic coughing, which triggers leakage.

Treat your bladder the same, seven days a week. Overactive bladder symptoms worsen at night because during the day, the person simply doesn't use the bathroom often enough, sometimes because of work/schedule constraints. The result: up all night with what seems like an overactive bladder. Put physiology first!

Review prescription medications with your GP. More than 100 different medications can cause incontinence symptoms. Best wishes!

Dr. De La Flor, licensed G.P./Family Doctor, holds certificates in coaching, nutrition and medical exercise from Berkeley University and the American Council on Exercise. His medical approach is highly influenced by Positive Psychology; an empowering, encompassing way of approaching patients through the study of their strengths and virtues to enable them to thrive and lead fulfilling lives, accept the past, find happiness in the present, and hope for the future. You can reach the doctor at 00-34-697.888.666 to schedule a consultation in his surgery or in your home/business.

 


This article appears in the print edition 644 of Island Connections



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