health

Positive Resolutions Much Easier To Keep

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | January 27th, 2021

Dear Doctor: I saw on the news that there’s a new study about how to make a successful New Year’s resolution. My wife and I have the same list of resolutions every year, including to stop eating so much junk food and to quit sugar. And around this time every year, we give up on them. We would love to know why it’s hard to follow through.

Dear Reader: It wouldn’t feel like the start of a new year if we weren’t hearing from readers about their love-hate relationship with resolutions. On one hand, the calendar hands you a clean slate. It arrives after weeks of festivities during which overindulgence has been a guiding principle. We’ve eaten and drunk our fill, and we now find ourselves not only ready, but even eager, for a reset. On the other hand, we’re still the same people we were before Thanksgiving signaled the start of the annual bingeing season. All of the reasons we didn’t lose those 10 pounds last August, or didn’t quit our sugar habit in March, still hold true.

Research into the topic of New Year’s resolutions finds that many of us fall off the wagon surprisingly soon. An analysis of the online activity of more than 31 million people suggests that by the end of January, many resolutions are already in the rearview mirror. More rigorous studies from the University of Scranton tracked the slow decline of resolve. By the end of one week, researchers found that 23% of the study participants had already abandoned their resolutions. After three months, half had called it quits. When the researchers followed up two years later, about 20% of participants said they had been successful at keeping their resolutions.

In the study you’re asking about, published last December in the journal PLOS One, the researchers looked at what separated the people who managed to keep their resolutions from those who didn’t. They found that how someone states their goal can make a difference. People whose goals were of the “I will” variety had a higher rate of success than those who approached their resolutions with “I won’t.” Specifically, 59% of the 1,066 study participants with proactive goals considered themselves successful, while only 47% of those with avoidance-oriented goals felt they had succeeded.

In terms of your resolution to eat less processed snack food and to cut down on sugar, you might try flipping the focus. Instead of thinking in terms of what you’re going to eliminate from your diet, try making a specific decision about something that you will add. For instance, you might start with the resolution to eat one piece of fresh fruit at each meal. You can up the ante by agreeing that, before indulging in any kind of snack food, you first have to eat something good for you, like a fresh carrot. That way, even if you do waver in your resolve and slip into old habits with a bar of chocolate or a bag of chips, you’ve also kept your resolution. Change is hard, and even small victories can make it easier to stay on track.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Long-Haul COVID-19 Similar to Post-Polio Syndrome

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | January 25th, 2021

Dear Doctor: Your column about long-haul COVID-19 started a conversation at our house about why some viruses will keep getting you sick even after you’ve recovered. A friend of our family is having a hard time with something called post-polio syndrome. Is that the same kind of thing?

Dear Reader: You’re not alone is seeing the similarities between long-haul COVID-19 and post-polio syndrome. We recently heard from a reader in Bucks County, Pennsylvania, who wrote to say that people with post-polio syndrome have great empathy for COVID-19 long-haulers and understand the challenges that these people face.

As a recap, long-haul COVID-19 refers to the ongoing adverse health effects of coronavirus infection, which can last for weeks, and even months, after the initial phase of their illness has passed. Symptoms include persistent fatigue or exhaustion; ongoing shortness of breath; heart arrhythmias, including a racing heartbeat; pain in the muscles and joints; and headache. Many patients report difficulties with concentration and memory, which they refer to as “brain fog.” Some experience uneven recoveries in which they appear to be on the mend but relapse into illness again.

Post-polio syndrome, by contrast, arises years later, usually a decade or more after the initial illness. The condition makes itself known with a gradual weakening of the body as a whole, and of the specific muscles and muscle groups that had been previously affected by the polio infection. In some cases, the muscles may also begin to atrophy, or decrease in size. Physical changes to the joints may also take place. Some people experience trouble with breathing, become sensitive to hot or cold temperatures, and may develop sleeping disorders.

Both long-haul COVID-19 and post-polio syndrome occur only in a subset of survivors. There are believed to be about 300,000 polio survivors in the U.S., and from one-fourth to one-half of them may experience some degree of post-polio syndrome. Long-haul COVID-19 is so new that we don‘t yet know how often it occurs, but it may be as many as 20% of patients with COVID-19. People with either syndrome may experience only mild symptoms, or they can find themselves dealing with what is essentially a new and ongoing illness.

As for why these viruses continue to affect people after the initial infection has passed, the answers are not yet clear. When it comes to post-polio syndrome, one theory suggests that the patient’s recovery from the initial paralysis involved the regrowth of new nerve pathways, which then become overtaxed as the years pass. Newer thinking suggests that the polio virus may go dormant within the body, and then, for reasons that are not yet understood, reactivate years later.

With long-haul COVID-19, new research from scientists at the University of California, Davis, suggests that the ongoing respiratory and cardiac effects arise from lung damage sustained during the initial illness. In relapsing cases of COVID-19, it has been theorized the immune system is continuing to encounter fragments of the virus and mounting a defense that results in another round of symptoms. The hope is that, as research continues, effective treatments for long-haul COVID-19 will be found.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Magnesium Is an Essential Mineral, May Help With RLS

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | January 22nd, 2021

Hello, again, dear readers. We’re back with the second of our two bonus letters columns. Let’s dive right in.

-- After a column that referenced magnesium, we heard from a reader from Deltaville, Virginia, whose wife had been diagnosed with very low levels of the essential mineral. “What actually causes low magnesium levels?” he asked. “What can be done about it other than the four-hour infusion sessions she is going through?” Magnesium plays a role in hundreds of chemical reactions throughout the body and is crucial to heart, muscle, nerve and kidney function. Low levels arise from poor absorption, or excessive excretion, of the nutrient. Conditions such as chronic diarrhea; kidney disorders; and high levels of certain hormones, including thyroid hormones, can all increase magnesium excretion. So can the overuse of certain types of antacids. People with gastrointestinal issues, such as celiac disease or Crohn’s disease, are often unable to adequately absorb magnesium. Some medications can also interfere with absorption. Infusions are used when deficiencies are quite severe. As levels stabilize, a switch to oral magnesium supplements may be adequate.

-- Speaking of magnesium, a reader from Rye Beach, New Hampshire, wrote in response to a column about restless leg syndrome, or RLS, a condition that causes an irresistible urge to move the legs. “Please suggest a simple and inexpensive mineral that’s important to the whole body -- magnesium,” she wrote. Although it doesn’t work for everyone, some people with RLS do find that increasing magnesium in the diet can help ease symptoms. As with all supplements, check with your health care provider for guidance. Taken in large amounts, magnesium supplements can be unsafe and can lead to side effects such as heart arrhythmias, low blood pressure and impaired breathing.

-- In response to a column about persistent hiccups that last for weeks, or even months, a reader from Spokane Valley, Washington, shared an unexpected avenue of relief. “My mother had those hiccups,” she wrote. “A friend of the family suggested she go to a chiropractor. She did, and the hiccups went away and never came back.” Persistent hiccups, while rare, interfere with quality of life. We aren’t aware of any studies that back up a chiropractic approach to dealing with hiccups. However, there is anecdotal evidence from patients who say that visiting a licensed chiropractor has offered relief.

-- A reader from Fresno, California, asked for help with compression stockings. “I’m 89 years old, have poor circulation and am allergic to compression stockings,” she wrote. “I walk a mile every day, and the stockings would be helpful.” It’s possible that you’re allergic to latex, which gives many brands of compression stockings their stretch. The good news is that some brands of compression stockings are latex-free. We think it would be a good idea to give them a try and see if you have better results. Meanwhile, congratulations on your impressive fitness regimen -- you’re an example to us all.

Thank you to everyone who writes to us. We look forward to hearing from more of you, and will be back with our regular letters column next month.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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