Body Watch : Doctor’s Corner

A trip to the doctor’s office is usually limited to a discussion of whatever ails you--if you’re like most people. Neither doctors nor patients have much time to wax philosophical on other things one might do to promote good health. So we decided to do this for you--for free. We invited top health experts representing various specialties to give us their best tips for healthy living.

Women’s Health

Dr. Anita Nelson, obstetrician-gynecologist, Women’s Health Care Programs, Harbor-UCLA Medical Center, Torrance:

* Preconception health is the wave of the future. Make certain you are in optimal health before you become pregnant to ensure the best outcome possible. Achieve appropriate weight, eat a balanced diet, stop smoking and drinking and get a thorough health evaluation before conception. Folic acid supplements are also helpful.

* Health maintenance beyond the childbearing years should include the crucial role that hormone replacement plays in prolonging a woman’s life span and in improving the quality of her final years. Hormone replacement reduces osteoporosis, heart attacks, Alzheimer’s disease risk, and controls hot flashes and wrinkles.

* Themes throughout the years: Know yourself, participate in your own health care; do breast self-examination; commit to a healthy lifestyle and avoid smoking; exercise and control your weight, but avoid crash diets and excessive exercise; take control; practice safe sex, and don’t become a victim of domestic violence.

Men’s Health

Dr. Charles E. Shapiro, urologist, Kaiser-Permanente Medical Center, Los Angeles:

* Males in the 15- to 30-year-old category should be aware of their risk for testicular cancer. It can be picked up by doing frequent self-exam--monthly, for example, in the shower. Know what “normal” feels like so that you can detect any changes.

* Good sexual functioning can be maintained throughout the life span. A prescription for good sex function in later ages is to have frequent intercourse when you’re younger. You can’t wear it out.

* Prostate cancer is extremely common with age. But in older age groups the vast majority of men who are found to have prostate cancer will die with it rather than from it. Therefore, the decision about treatment for prostate cancer must be individualized according to your state of health and the information your doctor provides you about your options. Prostate cancer is a real problem because it’s difficult to identify how the disease will progress. Watchful waiting is a legitimate and reasonable option for many patients. Make yourself as well-informed as possible and take the time to think about the advantages and disadvantages of each option available. In general, prostate cancer is not an emergency.

Children’s Health

Dr. Barbara Korsch, professor of pediatrics at USC, attending pediatrician at Childrens Hospital, Los Angeles, specializing in child development and behavior, advises parents:

* Trust yourself. You know your child. Don’t be frightened by all the advice out there. General rules do not apply to everyone. Parents know more about their children than anyone else.

* Everyone has such high expectations for mothers. Nobody turns into a saint just because they become a mother. You may do things when you are tired and angry that you regret, but your child will survive.

* Take care of yourself. Somebody has to be good to you if you are going to be good to your child.

Eyes

Dr. Daniel Sigband, ophthalmologist in private practice in Huntington Beach and assistant clinical professor of ophthalmology at UC Irvine:

* Eye safety is very important. Wear protective lenses, such as safety goggles, when doing anything hazardous, whether it’s on the job or around the house or even playing some sports, such as racquetball.

* Wear sunglasses that have been certified for protection against ultraviolet light. Even young people should wear sunglasses. There is indirect evidence that ultraviolet light might produce cataracts and macular degeneration.

* Tailor your vision care to your stage in life:

--Families have to be aware that they can go to their pediatrician and have their child’s vision screened. Many conditions can be caught, such as amblyopia or lazy eye, preventing permanent vision loss.

--In early adulthood, continue to periodically see your eye-care practitioner. The need for glasses or contacts can and should be detected early.

--Age 40 is an excellent time to see an ophthalmologist for the first time to check for eye diseases, cataracts, glaucoma or retinal diseases.

--Over age 50, have ophthalmological examinations every two years.

--People with a family history of eye diseases as well as people with diabetes or high blood pressure are at higher risk for eye disease and should get regular examinations. African Americans are at higher risk of glaucoma.

Teeth and Mouth

Christine Dumas, dentist in Marina del Rey and spokeswoman for the California Dental Assn.:

* Expect more from dentistry. Americans have raised their expectations for their overall health, but their dental-care expectations have lagged. People have a 1950s view of what happens when they go to a dentist. A dentist now should check for oral cancer and jaw-joint problems, and do a periodontal exam and tooth-by-tooth evaluation.

* A lot of Americans avoid the dentist because of their fears of pain. You should know that, in 1994, you can expect to have dental care done painlessly and comfortably.

* Get regular dental care. You are not healthy if you are not dentally healthy. People in Southern California exercise and eat right, but they think their mouth is not connected to the rest of their body. Look for a dentist who is going to teach you things to keep you healthy.

* Watch who you kiss. Dental disease is transmittable. You can catch it from someone else. Your loved one may never go to the dentist while you go every three months, but his germs are jumping into your mouth.

Skin

Dr. Norman Brooks, dermatologist and director of the Skin Cancer Medical Center in Encino:

* Wear sunscreens regularly and avoid excessive exposure to the sun. Although sunscreens protect against UV-B rays, they don’t protect quite as well against UV-A rays, which are linked to melanoma.

* Use an alpha-hydroxy product. This is a major breakthrough in skin care. The main ingredient is glycolic acid. It reverses sun damage, such as the brown spots and rough areas that are common. They will disappear, and the skin looks better.

* The skin itself is a reflection of the health of the internal body. Good nutrition, regular exercise, perhaps a vitamin supplement can make you healthier and make your skin healthier.

Feet

Dr. Carol Frey, USC assistant clinical professor of orthopedic surgery . Director of the foot and ankle program at Orthopedic Hospital, Los Angeles: * Buy shoes that fit and know when a shoe fits. Shoes are the only part of your wardrobe that can cause health problems. Shop at the end of the day or after exercise when your feet are at their biggest. There should be a half-inch space from the end of the longest toe to the shoe. Finally, shoes should be comfortable the moment you put them on. It’s terrible advice when people say that shoes will stretch to fit. They only stretch because they have to.

* Trim your toenails. You only need to trim them once every six to eight weeks. Trim them straight across, not curved like fingernails. And don’t trim them too short. You should see a millimeter of skin when looking down at your toenails.

* Exercise your feet. We don’t really need shoes. The only reason we have to wear shoes is to protect ourselves from the human environment. But when you start wearing shoes, you lose strength in your feet, such as the ability to move your toes and keep them in alignment. Walking barefoot on sand is a good exercise. Do the marble exercise; pick up 20 marbles a day with your toes. Or run your fingers through your toes and spread them apart. Dancers do a lot of these things.

Heart

Dr. David A. Ciraulo, cardiologist, Daniel Freeman Hospitals, Marina del Rey:

* Don’t smoke, consume a lot of animal fat (especially if your lipid blood tests are abnormal) or ignore a high blood pressure problem.

* Do eat a more vegetarian diet and engage in regular exercise. As descendants of primates, and later, of hunting and gathering nomads, our bodies were designed to metabolize a high-fiber, high-starch, principally vegetarian diet, which was acquired by days of physically exhausting foraging. In the modern world, however, a rich diet is brought to us without physical exertion.

* Do derive pleasure from a more natural way of living. The modern urban environment is full of intellectual and emotional demands that tend to drive our nervous system to a state of frenetic overload. Type A individuals will allow themselves to be driven by such stress, while Type Bs learn to master this environmental energy to serve their own interests. The latter behavior results in less cardiovascular illness. But no one will give up the old lifestyle unless the new one is ultimately more fulfilling.

* Aerobic exercise should be a joy, not a drudgery. Play racquetball with friends or take regular walks with your spouse. Choose markets and restaurants that feature fresh fruits and vegetables. Take time to create sensible meals and then enjoy them leisurely with the whole family.

* Involve your friends and family in your new lifestyle. Make your life and theirs a sumptuous feast that all can savor from moment to moment, ignoring the fast-food, fast-lane imperatives of modern culture.

Nutrition

Evelyn Tribole, consulting nutritionist in Beverly Hills and staff nutritionist for “Good Morning America”:

* Remember: Occasional lapses from healthy eating are normal. One food, one snack, one meal, one day will not make or break the waistline.

* Cut the fat where you don’t miss it. For example, if you order a tuna sandwich, cut the mayonnaise on the bread. You won’t miss it.

* When you eat fat, sit and savor it. If it’s worth having, make it a worthwhile experience. You’ll have a satisfying eating experience and will not be left wanting more. If you are eating a doughnut and are feeling guilty, you are not enjoying it and you may still end up feeling deprived.

Psyche

Robert T. Scott, Ph.D., psychologist, Tarzana, president of the Los Angeles County Psychological Assn.

* Learn to manage and control stress. Did you know that three of the best-selling drugs in the country are used to treat stress-related illness? That 80% to 90% of all visits to health-care professionals are a result of stress-related illness and issues? That 70% of all accidents are stress-related? We need to take stress seriously. It’s killing us.

* Recognize the fact that you do have options and that you can change yourself or things in your environment so that stress doesn’t get the best of you. When you are getting stressed out, ask yourself: “Is it worth dying over?” Hang loose. Learn to meditate, take a yoga class, develop a fun hobby, learn guided imagery techniques, get a hot tub--whatever it takes to elicit the relaxation response in you.

* Exercise your mind and body. Physical exercise appears to be the most effective way of ventilating, or expressing, the stress response in a health-promoting manner. The physiological effects of exercise are talked about a great deal. But the psychological effects are also very powerful. The hormonal and neurochemical changes that take place after exercise result in a powerful psychological enhancement of mood as well as improved self-esteem and an enhanced sense of control.

* Exercise your mind and personality in the same way you exercise your body. That means trying new ways of being, testing new behaviors, continuing to grow--getting rid of the psychological flab and strengthening weaker areas.

* Learn to laugh and play. It may sound silly, but as adults we can learn a lot from children. They have a superb resiliency--they’re able to bounce back so quickly. Oftentimes they go right into their play as a means to cope and release stress. Laughter and play are powerful and healing activities. Research in this area suggests that laughter releases healing chemicals and hormones into our bloodstream and promotes a healthy, positive psycho-physiological state of being. Recent research on happy, successful marriages points to the use of humor and play as key factors.