E Cigs vs. Nicotine Replacement Therapies ((NRT)

UK national health system studied patients wanting to stop smoking either thru e-cig or NRT. I want to share the results today.

-You should know the effects of vaping having long-term consequence is not fully revealed.

Along with behavioral support participants received e-cigs or nicotine replacement therapies (gum, patch, nasal spray, lozenges)
Of note were side effects: for e-cig users -throat and mouth irritation and for NRT users- more nausea.

A year later confirm that e-cigarettes are an effective way for smokers to quit smoking. However, in this study, 80% of those who stopped smoking using e-cigarettes were still vaping 1 year later.

More to think about:
– e-cigs vapor has been proven to contain toxins that negatively affect human cells. I have blogged before on this very finding. #ListenDocknows

Blood Test For Alzheimer?

Blood Sample

Food and Drug Administration (FDA) just gave the ‘ Breakthrough Device Designation ‘for a blood test to screen for the risk of Alzheimer. (C2N Diagnostics)


Amyloid is a ‘starch like’ protein that can deposit and accumulate in our bodies, it is not good. Upon autopsies, the brains of Alzheimer suffers were noted to have a high accumulation of amyloid. It was the first abnormality noted.

Another hallmark is the presence of neurofibrillary tangles of a protein called tau.  The average ALS patient dies 2½ years after diagnosis.

To date, a Positron Imaging Tomography (PET scan,  nuclear medicine brain imaging tool) is used to make a picture of amyloid plaque accumulation within a person’s brain. A quote from recent articel in Scientific American ” .. recent studies on the value of PET beta-amyloid brain scans, supported by the Centers for Medicare & Medicaid Services, have shown that practicing “dementia expert” doctors misdiagnose Alzheimer’s in about 50 percent of cases and change their management and treatment of patients nearly 70 percent of the time when this test is used.”


To be used as a blood test to quickly ID a possible cause for those with memory complaints or dementia.

The cost saving for evaluating a dementia sufferer will be impressive. A safe radiation free quick inexpensive screening test can help early dementia diagnosis and treatment.

Carbohydrate Intake and Mortality

According to The Lancet Public Health, your odds of dying are higher if you switch carbohydrates for animal-derived fat or protein but longevity odds increased with the switch to plant-based protein.

Those who get 50-55% of their daily energy from carbohydrate saw a low risk of mortality.

A ‘U’ shaped curve was identified indicating that too little or too much carbohydrate affected mortality negatively. If less than 40% or more than 70% of your daily energy comes from carbohydrates in your diet you are at risk.

The study followed over 432,000 US adults age 45-64 over 25 years.

Bottom Line – measure, check not too much or too little and live longer and healthier.

No Alcohol for One Month – See Huge Benefits

Many of us enjoyed raising a glass of wine and or spirits during the holidays. Perhaps you do not customarily in vibe to that degree? Wither you overdid it or not with the alcohol I recommend that we all take to heart the recent study that shows taking a break from alcohol even just a month has lasting positive health effects. You might say it is a ‘no brainer’ since it is well known that drinking can contribute to health issues such as liver disease, cancer, cardiovascular problems, and others.

British researchers started ‘Dry January’ in 2018 and noted as they followed participants that higher energy level, and better weight. Participants were studied via a survey online and followed thru August 2018.

Not only did one month of abstinence lead to decrease number of drinking days later in the year but also did not drink to excess – drunkenness later in the year.

Other noteworthy immediate results included:

‘9 in 10 saved money, 7 in 10 slept better, 3 in five lost weight’.

Please have a read of the article for more benefits of just one month of no alcohol.

JOIN ME  doing a ‘Dry March!



Court To Decide If Obesity Is Impairment

I came across this in the National Law Review (January 21, 2019) issue and want to share.

Seventh Circuit Court of Appeals is set to decide whether obesity is an impairment in and of itself under the ADAAA. The American Disability Act Amendments Act of 2008.

As it stands now courts federal and state have held that obesity is a ‘physical characteristic that had to stem from an underlying physiological disorder to be considered an impairment under the ADA’.

A lower court found that obesity didn’t, on its own, qualify as impairment, and dismissed an employee who functioned as a bus driver.

Organizations including AARP are supporting the employee’s case that has as of this posting no schedule for Oral Argument and there is no timetable for a decision

Stay tuned!



The Brain -Use it or Lose It!

Every day even in your routine you should strive to maintain mental flexibility and brain fitness. Autopilot kicks in when we go thru our routine of brushing teeth getting dressed leaving the house -all predictable tasks.

Just like physical exercise for muscles, you lose it if you do not do it, memory loss with age can occur when not stimulated with mental exercise. Brain muscles need to be flexed, so perform different activities exercise your brain meeting new people talking on new topics

A set of brain exercises (created by Lawrence Katz, Ph.D., a neurobiology professor at Duke University Medical School in Durham, N.C.), ‘neurobics‘ challenge our brains abilities. “Presenting the brain with nonroutine or unexpected experiences using combinations of your physical senses—vision, smell, touch, taste, and hearing—keeps your thinking and perception active and growing,” -Dr. Katz.

Like creating and laying down a new track in the brain’s wiring allows for a quicker brain.

Brain exercises can be quick and simple. Having someone clean your area, or find something you misplaced robs you of the brain’s benefits of that task. Even using the mouse with your non-dominant hand!

Below are common actions that alone may not stave off dementia or Alzheimer’s disease but will ‘exercise’ your brain

These are a few suggestions, as easy brain exercises no matter your age: (from ‘Veterans Today’)

  • Use your non-dominant hand to write, brush your teeth, eat or dial the phone.
  • Wear earplugs when doing simple, routine tasks to strengthen your other senses.
  • When using the elevator, learn the Braille numbers.
  • Eat lunch with someone you don’t normally spend time with.
  • Take a different route to work.
  • Learn basic sign language.
  • Engage in a brain-challenging game like Sudoku or a crossword puzzle.



Message From Doc Handal

DocHandal shares symptoms, diagnosis and treatment essentials. The what if, what to do descriptions can save you from a preventable disease chronic disease.

Health is always on our minds. I have learned so much over the years from my patients. I continue to be a physician with a passion for sharing knowledge and experiences. Some are rules that will make you realize that our bodies speak to us – we must listen! There are lessons you should not have to learn the hard way. There are rules that unless followed your body will revolt.

The information on my website builds while respecting the individual’s intelligence to pay attention and recognize their bodies’ need.

Sleep and Safe Driving

Data from the National Sleep Foundation show 60% of US adults have driven while drowsy and around 33% have actually fallen asleep at the wheel.

Being awake is NOT the same as being alert!

Everyone knows the lack of sleep affects brain function, it, therefore, follows driving with minimal sleep will increase crash risk. Published in Sleep, researchers have quantified the relationship sleep deprivation and car crash risk. The following was concluded:

  • Less than 4 hours of sleep is like driving intoxicated (BAC .12g/dL). In the US, driving with a BAC of 0.08 g/dL or higher is illegal.
  • Less than 4 hours of sleep increases crash risk 15.1 fold
  • Less than 5 hours of sleep increases crash risk 2.1
  • Driving for 3 hours or longer without a break was also found to be at increased risk.
  • Shift changes (disruption in the body’s internal clock) combined with sleep deprivation, increase one’s risk of  a crash


You may not always need a cup of coffee you may just need a nap.