End the Negative-Thinking Game

A constant inner dialogue runs through your mind on a daily basis. Our minds don’t place any value on the content of these thoughts but does weigh them by volume. Unfortunately, research shows that humans have an inherent negativity bias that shapes perceptions about a variety of tasks and psychological situations.

This bias often creates intrusive and repetitive negative thoughts commonly referred to as Automatic Negative Thoughts (ANTs). A baseball player who repetitively tells himself that he is “no good” or “letting his team down” every time he makes a fielding error is being bitten by ANTs.

An ANT is an intrusive idea or theme that often accompanies considerable negative emotion. The aforementioned baseball player likely leaves the field feeling frustrated, tense and apprehensive after making errors simply because of the feedback loop playing in his brain. The truth is that these thoughts rarely contain any validity.

Retro Vintage Motivational Quote Poster. No Negative Thoughts Allowed. Grunge effects can be easily removed for a cleaner look. Vector illustration
Research shows that negativity can affect your health.

Health Effects

Negative thinking can affect performance as well as overall health. Considerable evidence exists that negative thinking and negative emotions contribute to increased inflammation via a release of pro-inflammatory cytokines, which can make individuals more susceptible to illness and injury and slow healing.

Automatic and repetitive negative thinking also can affect the amount and quality of sleep. Research has shown significant deficits in college students who engaged in chronic negative thinking patterns.

Common Thought Patterns

Identification of your thinking patterns and uncovering ANTs is helpful in the reduction or elimination of these cognitive habits. While somewhat similar, these thought patterns fall into certain categories:

  • Overgeneralization is a skewed thought process where one negative event is extended beyond that single event. For example, being late to work produces thoughts like, “I can’t seem to get anything together; I’ll never be successful.”
  • Filtering is a bias toward only negative feedback. “My boss thought my report was good except he said I needed to check a couple numbers. He probably thinks I’m incompetent.”
  • Emotional reasoning is mistaking feelings for facts. For example, when someone “feels fat,” they automatically assume that they are overweight.

Strategies for Tackling Negativity

Do you ever have thoughts like these? Let’s take a look at a few strategies to change your cognitive approach and your health for the better. While these thought patterns may have some commonality, solutions are not necessarily “one size fits all.”

  • Mindfulness entails having an awareness of what you are thinking and feeling and beginning to look at thoughts and situations as just that. Thinking “I am worried” or “I am embarrassed” is a first step. I work with patients to teach them to accept feelings as they are and refocus on the task at hand in that moment.
  • Decentering acknowledges that we have negative thoughts, but we also have ones that are positive and neutral. We can learn to choose which thoughts to attend to and which ones don’t matter. Put the more helpful ones front and center while decentering what doesn’t actually belong. I suggest keeping a journal and reviewing the meaning, or lack thereof, of thoughts on a certain subject.
  • Restructuring recognizes an ANT or negative idea and disputes its validity; basically finding evidence or lack thereof for this belief.

The content and quality of one’s thoughts affects your overall outlook and well-being. I challenge you to start incorporating more positivity and mindfulness into your days. It just may improve your health.

The benefits of exercising your brain

Have you ever wondered why exercising your brain is important and how you can exercise it to keep it healthy? Research indicates that exercising the brain is like exercising the heart; when we keep blood flowing, we keep ourselves fit.

I spoke with Dr. Mario Dulay, neuropsychologist at the Houston Methodist Neurological Institute, who gave us two important factors on how to keep your brain healthy and in shape, and why doing so is good for you.

Use it or lose it

The more you test and use your brain, the better it will perform. Dulay says that any cognitive stimulation is better than none, so staying physically, mentally, and socially active allows your brain to function better than a less active person.

Brain training featured image
Mentally-stimulating activities reinforce brain cells and the connections between them, and might even create new nerve cells.

According to the Alzheimer’s Association, mentally-stimulating activities reinforce brain cells and the connections between them, and might even create new nerve cells. Such stimulating activities consist of games, educational activities and social activities.

Practice makes perfect

Cognitive compensation refers to the idea of practicing tricks to improve cognition. Examples include using mnemonics to remember people’s names, or using a calendar to improve the likelihood of not forgetting.

Dulay says people become more forgetful and lose cognitive abilities as they age. By compensating with tricks or reminders, we help maintain our independence and decrease stress.

In addition, compensatory activities may provide mental stimulation that can improve cognitive function and increase cognitive reserve, or the mind’s ability to resist damage to the brain.

Brain training is all about picking something you love so you'll do it consistently Click To Tweet

Dulay also emphasizes that it’s not just about doing anything; it’s about doing what you love and doing it often.

Here is a list of some suggested activities you can do to help exercise your brain:

  • Read
  • Volunteer or mentor
  • Learn something new; a new instrument, hobby, language, etc.
  • Explore a region or culture of the world that interests you
  • Brain teasers or word games
  • Write a blog
  • Attend a cooking class
  • Play with your grandchildren

Each of these activities can help stimulate your brain; but remember, it’s important to find something you enjoy doing and will consistently do.

6 effective ways to alleviate allergies

I will never forget the day I underwent my first allergy prick test. My primary care physician recommended I see an allergy specialist after he had treated me for multiple sinus infections over the course of a year.

I scoffed and said “I don’t have allergies!” But I scheduled the appointment with the otolaryngologist nonetheless. A few weeks later, as I sat there with my arm and back on fire, nose running like a fire hose and eyes feeling like I’d been hit with pepper spray, I thought, “Hmm … maybe I do have allergies.”

What’s followed since that day is a constant battle against my many year-round allergies. Outside of medicinal remedies, there have been many tricks I’ve learned over the last few years that have helped me alleviate allergies.

1. Get informed. I have a little app on my phone that I check every day to check what allergens are in the air and what their level is. It may seem like a no brainer, but since I know ragweed is my mortal enemy, if ragweed levels are high, I know not to spend too much time outdoors. Most television weather forecasts also include allergen information.

2. Be prepared. Until I win the lottery (fingers crossed!), I’m going to have to mow my own lawn. Being allergic to grass I’ve learned that wearing a protective mask, immediately showering after I come inside and throwing the clothes I wore to mow the lawn in the washer all help keep my grass allergy in check as much as possible.

3. Be clean. In addition to taking a shower before I get to bed to get any allergens out of my hair and off my body (lest I take them to bed with me), I also make sure to wash my bedding once a week in hot water. This helps prevent allergens from building up, including dust mites, which some people are allergic to.

Washing your bedding once a week in hot water can prevent allergens from building up Click To Tweet

4. Seriously, be really clean. High Efficiency Particulate Arresting (HEPA) filters may help keep the air in your home a bit more breathable. Do your homework as you could spend a small fortune on these if you’re not careful. Make sure you change them regularly. Rugs and carpets can become cesspools for allergens. If you have a choice, go with bare floors. You may also want to make sure you dust regularly, especially in places like mini blinds and fans that seem to get dusty very quickly.

5. Drive carefully. That’s always good advice, but I mean be smart when driving. Keep your windows up and make sure your air conditioner is recirculating air and not drawing it in from outside the car. If you’re car has cabin air filter (most newer cars do), make sure you change it at least once a year or as suggested by your car’s manufacturer.

6. Talk to your doctor. If I hadn’t had a conversation about this with my primary care physician, I wouldn’t have gotten that allergy test. Now that I know what I’m up against, it’s been easier to stay healthy.

These are just a few things that others have shared with me over the years that have helped me cope with my allergies. Until NASA starts selling space suits to walk around in, I’ll keep fighting the good fight against allergens.

Gut health: Exploring the rainforest within

Imagine a lush tropical rain forest filled with a rich diversity of plant and animal life. This represents the complexity of our gut microbiome, an ecosystem residing in our digestive tract. Scientists are only beginning to unravel the far-reaching effects of gut health.

With surprising roles ranging from influencing our waistline and mood to promoting dental health and a clear complexion, the microbiome is a promising new frontier in medicine.

Increased awareness of how certain foods keep gut flora flourishing has sparked shifts in grocery store shopping and there’s a rising demand for probiotic-powered foods. Here’s what you need to know to nurture your gut microbiome.

Know the difference between probiotics and prebiotics

This dynamic duo has a harmonious relationship in the gut, working together to promote digestive health. Prebiotics are power food for probiotics. Probiotics are beneficial, living organisms that improve our immune system by helping to crowd out bacteria that can make us sick.

In addition, probiotics enhance absorption of nutrients from food and even help make energy-producing B vitamins.

Prebiotics are fibers in food that resist digestion in the upper digestive tract but are used as fuel by probiotics in the lower digestive tract. Probiotics rely on a steady supply of fuel from prebiotics so they can flourish. The best way to ensure that your probiotic population is happy and well-fed is to load up on fiber-rich plant foods.

Top sources of prebiotics include bananas, garlic, onions, leeks, artichokes, asparagus, whole grains and legumes like lentils, beans and peas. Be sure to gradually incorporate these foods into your diet and drink plenty of water to help your digestive system adjust to the increased fiber intake as it helps move things along.

Separate health from hype when shopping

Foods that are cultured or fermented naturally contain probiotics, but food companies are adding probiotics to processed foods such as energy bars and frozen yogurt. The potency of probiotic cultures can be drastically weakened when they are removed from their original source and added into these processed foods.

Kefir has diverse probiotic strains that may improve lactose digestion among those who are lactose intolerant.

Sip the champagne of dairy

Cultured dairy products such as yogurt and kefir reign supreme as the most potent probiotic sources. Known as the champagne of cultured dairy because of its slight fizziness, kefir is a low-lactose, creamy drink made by adding “kefir grains” to milk, which cause a very unique fermenting process. 

Originating centuries ago in Eastern Europe, keifer has only recently become commercialized in the United States. While yogurt and kefir both contain beneficial bacteria, kefir hosts a more diverse population of probiotic strains, meaning it could offer added probiotic benefits, such as improving lactose digestion among those who are lactose intolerant.

Check the yogurt container

To make sure your yogurt really does have probiotic power, check for the “Live and Active Cultures” seal. Yogurts that say “heat treated after culturing” on the label mean the yogurt was pasteurized after the live strains were added, which deactivates the beneficial bacteria.

Check sugar content since sugar can work against probiotic benefits. Flavored yogurts that list sugar as the first or second ingredient can pack more sugar than a candy bar.

Choose food over supplements

Think twice before choosing a supplement over food. The journey probiotic supplements make from the lab to the gut is long and full of variables. The best and least expensive option for promoting good gut health is to enjoy foods that naturally contain live cultures.

Know when to go: ER vs. primary care

When you or a loved one needs medical attention, you want to make the right decision and fast. Do you need to go to the emergency room? Will an urgent care clinic be able to help? Or can you wait and make an appointment with your primary care provider? It’s important to understand all of your options before it’s an urgent situation, so you don’t waste time during a medical emergency.

20% of Americans visit the ER at least once a year. With those odds, you need a plan. Click To Tweet

I recently spoke with Dr. Miles Varn, Chief Medical Officer of PinnacleCare, the world’s leading private health advisory firm. Dr. Varn is also a board certified emergency physician who spent 15 years at Inova Fairfax Hospital, a level 1 trauma center in Northern Virginia to get his advice on how to decide which treatment path to take.

There can be cost and time implications to going to the emergency room, which has a higher out-of-pocket deductible than a doctor visit. But in a life-threatening emergency, an emergency room (either hospital-based or freestanding) is your best option. Emergency rooms are always open, and have access to specialized care not available elsewhere. So when is it really worth it to head to the ER?

Don’t Wait

If someone is choking, has stopped breathing or is severely burned, call 9-1-1 and take an ambulance to the ER. The same is true for someone suffering from a head, neck or spine injury, or electric shock.

You should also head to the emergency room for severe chest pain or pressure, which could indicate a heart attack. Stroke symptoms – sudden numbness or weakness, confusion, blurred vision, dizziness, loss of balance or coordination – necessitate an emergency room visit. Seizures, deep wounds, severe allergic reactions, or poisoning are also best treated in the ER. 


Schedule An Appointment

If you think you have a common illness like the flu or an ear infection, or a minor injury, there is no need to go to the ER. In addition to the higher out-of-pocket cost, you’re likely to spend a long time waiting. Emergency rooms prioritize patients based on the seriousness of their situation. Those patients described above will need immediate attention. You and your ear infection will be forced to wait.

If you have an established relationship with a primary care provider, you can always call your doctor if you’re unsure about what to do. Even after hours, you should be able to speak with a doctor on call.


While we can all hope to never need to make that call to 9-1-1, the truth is that roughly 20% of Americans have at least one emergency room visit in any given year. With those odds, it’s a good idea to think ahead and have a plan in place.

To find the nearest Emergency Room, click here. To schedule an appointment with a primary care physician, click here.

Home remedies to beat any cold or flu

It’s been a brutal winter. On top of the bone-chilling, frigid weather, many people are on their second bout with a cold this season.

You might have gone to a doctor and received the usual, sensible advice: expect to have symptoms for 7-10 days; get lots of rest; drink plenty of water; and treat the symptoms. Antibiotics do not help in this case, and they can cause side effects.

Now you’re stuck at home, sniffling and feeling crummy. You have a runny or stuffy nose, maybe a sore throat, you’re sneezing and coughing. You undoubtedly have that resting and water-drinking down, so let’s talk about treating the symptoms.

With all this time on your hands you can try some cold and flu home remedies, time tested and grandma-recommended. Some may work for you, others not so much. Recently we tried a handful of these home remedies and asked Houston Methodist primary care physician Dr. Natalie Dryden to assess each one.

First we tried a hot toddy, a mixture of warm water, honey and whiskey or rum in small but roughly equal amounts, topped with a bit of lemon juice. “Warm beverages can soothe a sore throat and many patients find them useful,” Dryden said. “Adding alcohol in small amounts is not likely harmful but more than one alcoholic drink a day can suppress the immune system.”

Avoid alcohol when sick, as it suppresses your immune system, prolonging recovery Click To Tweet

Then we heated up some chicken soup. “It may help, as it can act as a mild anti-inflammatory and helps temporarily speed the movement of mucus,” Dryden said.

Next it was time for a hot, steamy shower. The doctor said, “The steam may help moisturize mucous membranes and temporarily ease congestion.”

Neti pot
While Neti pots can be effective for treating cold and flu symptoms, make sure you fill them with bottled or distilled water.

We also tried a nasal irrigation system, with a Neti pot and saline. Dryden said these are typically safe to use and effective in clearing congestion and stuffiness. “Some people find the saline to be a nasal irritant so it may not be for everyone,” she added. If you do use a system of this kind, remember to use distilled or boiled water to prevent infections.

Gargling with salt water helped our throat discomfort temporarily, and we also tried a warm compress for sinus congestion.

Dryden stressed that the success of any one of these strategies will depend on the person. “If it doesn’t help,” she added, “at least it won’t hurt.”

We paid a visit to the drugstore and took a look at some over-the-counter cold and flu remedies. The sheer number of products available made our head spin.

First question: antihistamine or decongestant? “Antihistamines can reduce runny nose and sneezing but used alone these tend to have more side effects, such as sleepiness and dry mouth, than benefits,” Dryden said.

An medication combining antihistamine with a decongestant (pseudoephedrine, found in the product Allegra D) can be effective in reducing congestion, runny nose and sneezing. This may not be for everyone; it can raise blood pressure, so those with hypertension should avoid this compound.

An antihistamine/decongestant combo can reduce cold symptoms, but may raise blood pressure Click To Tweet

Dryden said expectorants and cough suppressants both have shown medium benefit and medicated nasal sprays (containing cromolyn sodium or ipratropium bromide) also have shown some benefit and can be a substitute for pseudoephedrine.

She cited studies that showed that vitamin C/D/E supplements have no effect on colds. Zinc has been controversial; it showed a reduction of symptoms in some trials but had some serious side effects. So serious, in fact, that the FDA has issued warnings about zinc products and Dryden does not recommend their use.

There’s a lot of winter left, and much more cold and flu to come. If you haven’t been infected, congratulations. Keep washing your hands, eating healthy foods and laying off the alcohol. Get a flu shot, too.

How do you tell the flu from a cold or allergies?

You usually notice it as you pour your morning coffee. The guy in the next cubicle or office doesn’t sound so good. He’s coughing and sniffling as he types away, hoping you won’t notice. You ask him if he’s doing OK even though you know what he’s going to say.

“I’m great. It’s just allergies,” he says with a hoarse voice in between coughing fits.

Those “allergies” turn out to be the flu and before you know it you’re burning four sick days (or worse, vacation days) because Larry couldn’t self-diagnose and refused to go to the doctor.

Don’t be that guy.

It’s important to get your annual flu shot and to wash your hands regularly Click To Tweet

I asked primary care physician and general internist Dr. Natalie Dryden for advice on how to distinguish between a cold or allergies and the flu – for which you should go to the doctor immediately.

“Distinguishing between allergies, a cold and the flu is not always easy,” she said. “While two are infectious illnesses (colds and flu) caused by viruses and the other is an immune response to some environmental trigger, the body often has overlapping and similar responses, so symptoms can be similar as well.”

Here are five clinical features that may help you tell the difference:

  1. Fever: The flu generally causes high fever fairly consistently, while viral colds don’t often cause fever, and if they do, it’s generally a low-grade fever. Allergies should never cause fever.
  2. Body aches: They tend to be very pronounced with the flu, and while they can occur with a common cold, they are typically mild. Body aches are not a common feature of allergies.
  3. Cough: A flu cough tends to be more severe than with a cold. Like a fever and body aches, a cough is much less common with allergies.
  4. Runny nose: Can occur in all three.
  5. Sore throat: Common with colds and flu. Typically people with allergies report having an itchy throat and not actual pain.

Keeping an eye on the seasons can also help clue you in on what may be going on. While all three conditions can occur year round, flu season typically occurs fall through spring in the United States. If you don’t believe me, just check the Centers for Disease Control and Prevention’s national flu map. Dr. Dryden says to keep in mind that people who travel abroad might be exposed to the flu since flu seasons occur at different times throughout the world.

CDC flu map
The CDC keeps an up-to-date map that shows which states have the highest number of flu cases.

Common colds mostly occur in the winter and allergies occur often with changes in the season depending on what a person is allergic to. Some people (like me, sadly) have then year round. Allergy symptoms tend to last as long as a person is exposed to an allergen or trigger while viral infections will usually last between a few days to two weeks.

It’s important to get your annual flu shot and to wash your hands regularly; especially during flu season.

The next time you feel an itchy throat and dull body aches coming on with a fever, consider what might be ailing you before you go to work and get your co-workers sick. Visit a doctor immediately. Your office mates will appreciate it and you’ll be back on your feet faster.

7 questions for an ER nurse

hen minutes count, it’s best to be prepared. Sharon Tatum, a nurse in the Emergency Department, answers seven questions about knowing when to go to the emergency room and how to get the most out of your visit.  

Q: When should I come to the Emergency Department as opposed to an urgent care?

A: There are some conditions that require time-sensitive treatment to improve your recovery (example – stroke and heart attack). In situations that are serious or life-threatening, it is best to go to the ED.

In situations that are serious or life-threatening, it is best to go to the ED Click To Tweet

Q: What can I do to speed up the process?

A: When you arrive, have your identification ready as this allows us to link you with the correct medical record and start a record for your care. It is important to know your history, including allergies, past medical conditions and surgeries because the more we know, the quicker we intervene.

Q: What can I expect when I arrive?

A: You will be greeted by a nurse who will ask you if you are seeking medical attention. This nurse will determine your level of care based on your medical complaint.

Q: Why am I getting tests/treatment done before I see a doctor?

A: The Medical Director has designed protocols to help speed up the care when the ED is busy. Protocols are tests/treatment that can be completed before you are placed in the room. Examples include X-rays, CT scans, intravenous fluid and medication for nausea.

Q: What should I bring with me?

A: It is important to have a list of the medications that you are taking (including herbal supplements) with the name, dose, how often you take the medication and the last time you took the medication. 

Q: I got here first, why did they take someone before me?

A: Patients are brought back to a treatment room based on the medical complaint, test results, type of treatment needed and the type of room available. Please note that a patient may be taken back for X-rays and blood work then return back to the waiting area until a room becomes available.

Q: What is the busiest time? Least busy?

A: Historically the middle of the week tends to be busier and after 11 a.m. Waiting can be difficult, and wait times are dependent on how many patients are in the department and how many diagnostic tests are required for your care. Please know that we are working hard to expedite your care and apologize for any inconvenience it may cause. We are dedicated to keeping you informed of your plan of care.

What exactly is prediabetes?

According to the CDC, 1 in 3 Americans over the age of 20 has prediabetes and for those over the age of 65, it’s 1 in 2. Up to 30% of those with prediabetes will develop type II diabetes within 5 years unless they make lifestyle changes including weight loss and increased physical activity.

30% of those with prediabetes will develop type II diabetes within 5 years Click To Tweet

What does prediabetes mean?

Though not recognized as an official medical diagnosis, prediabetes is a term used when a person’s fasting blood glucose (fasting plasma glucose) and hemoglobin A1c are higher than normal but aren’t high enough for a formal diabetes diagnosis. Fasting blood glucose and hemoglobin A1c are two tests doctors use to assess glucose control and diagnose diabetes. Normal fasting blood glucose is below 100, but diabetes isn’t typically diagnosed until fasting glucose reaches 126mg/dL or higher. Glucoses in between 100-125 are typically considered prediabetic results. For the hemoglobin A1c, normal results are 5.6% or below, while diabetes is typically diagnosed at 6.5% or higher, so someone with lab results in between 5.7-6.4% may be told he or she has prediabetes.

Fasting Blood Glucose levels

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A1C levelsScreen Shot 2015-01-27 at 1.21.35 PM

What are the symptoms of prediabetes?

Unfortunately, many people with diabetes or prediabetes don’t experience symptoms. Having your doctor run a fasting glucose, oral glucose tolerance test or a hemoglobin A1c is the best way to determine your current risk.

What are the risk factors?

Knowing the risk factors for developing diabetes is also helpful in preventing the progression of prediabetes to diabetes. Risk factors include age, gender, family history, physical activity level, body weight, pregnancy history and race.

Every decade over 40 increases your risk for diabetes and men are at higher risk than women. If your family history includes an immediate blood relative (parent or sibling), then your risk also goes up. If you’re getting less than 150 minutes of exercise per week and are overweight or obese, had gestational diabetes or birthed a baby weighing more than 9 pounds, those are additional risk factors. And while prediabetes rates don’t differ across racial groups, diabetes is most common in Native Americans and Alaskan Natives, then non-Hispanic blacks, Hispanics, Asian Americans and non-Hispanic whites respectively. Certain medications, like statins, and other health conditions like polycystic ovarian syndrome can also increase your risk for diabetes, so be sure to talk to your doctor about any concerns. Click here to take the American Diabetes Association’s risk assessment test.

How can I lower my risk for diabetes?

Fortunately there are many things you can do to take control of your health. Make sure your doctor is running a hemoglobin A1c so you know your results. Start exercising, aiming for at least 150 minutes a week, and get to a healthy body weight where your BMI is under 25. You can calculate your BMI by going here. Even losing just 10% of your current body weight can make a big difference! Make sure to eat lots of fruits and vegetables and limit refined carbohydrates like white rice, white pasta, sodas, sweet tea, crackers and desserts. Cut back on portions and find an activity you enjoy that gets you up and moving around. Feeling short on time? Research has shown three 10-minute walks a day can be just as effective as one 30-minute walk, so split up the time if needed. If you smoke, consider joining a tobacco cessation program. Put yourself in control of your health and be encouraged to know that you have the ability to change from having prediabetes to experiencing normal, healthy blood glucose levels.