By Doctors Michael Roizen and Mehmet Oz For The News-Sentinel
Q. I'm 59 and have suffered from anxiety/panic attacks all my life. In the past nine months, I've developed chronic insomnia and a fear of going to bed. I don't like the silence or darkness. I've been prescribed sleeping pills, but they no longer work. What would you suggest to help me overcome my chronic insomnia? - Anna, Brooklyn, N.Y.
A. Sleeping pills are a short-term bandage and don't get at the basic problem. You should see a panic-attack specialist. There are effective therapies that often combine information and medications with cognitive and behavioral treatments. Many people are greatly helped by simply understanding exactly what panic disorder is. Then, changing your way of thinking (cognitive restructuring) helps you replace those thoughts with more realistic, positive ways of viewing the attacks. You'll also identify possible triggers, because knowing the panic attack is separate and independent of the trigger often makes the trigger lose its power. Another approach: A desensitization process similar to the one used to cure phobias. In this case, it focuses on the physical sensations that someone experiences during a panic attack. Specialists have many tools; your problem may be easier to get rid of and your life better than you can imagine after getting treatment.
Q. My husband recently retired at age 65. He has a pinched nerve in his elbow and neck, and even swimming and light exercise hurt him. He's overweight and doesn't watch his diet. I've told him I love him and want him to take care of himself, but I just can't get him motivated. What kind of doctor should he see? - Emily, Cincinnati
A. Your husband may be depressed. Does he enjoy anything anymore - even TV? Retirement can be a real challenge; he needs to approach it like a new job, or like he did learning to hit a baseball or ride a bike 60 years ago. In other words, he needs to figure out how to make retirement fun and interesting. If he is depressed, he may need to see a psychologist or psychiatrist for a short time. If he isn't, then he needs a tough internist who loves challenging patients the way we You Docs do. Getting a health smackdown from a doctor is always more effective than getting one from anyone else! Call some M.D.s and find out from the office manager if the doc is willing to give some tough love.
Q. I can't believe that I let myself get so heavy. I'm 44, 5 feet 4 inches tall and weigh about 224 pounds. What is the best, healthiest and quickest way to get my weight down to a respectable 145 lbs.? - Cyndi, Chillicothe, Ohio
A. Everything good takes time. Fad diets that promise fast weight loss do not help. You need a lifestyle change, and that starts in your mind, because belief systems can be a powerful assistant in weight-loss efforts. You also need to walk at least 30 minutes every day; eat healthfully; and enlist a support buddy you can call or e-mail every day. Here's how to keep extra pounds farther away than kids from Brussels sprouts:
1. Think of your ideal weight as a 6- to 8-pound range, not a single number. This allows for natural weight fluctuations. If you focus on one arbitrary number (like 145), when you're not at it, you'll feel like a failure.
2. Don't just measure weight loss, measure health gains. Give up the scale and adopt the tape measure to track your waist size. Belly fat is one of the strongest predictors of health risks associated with obesity. Men should aim for a waist measurement of less than 36 inches; women should aim for less than 33.
3. Have a plan for when you slip up - because you will. Remember, it isn't the first cookie that does you in. It's saying "what's the use?" and finishing the bag. Use these steps to make a You-turn and get back on track:
?Relax and say something positive to steer yourself back on course. Be confident. You can overcome the slip.
?Do something physical right away, such as taking a brisk walk or doing a yoga stretch (Dr. Mike recommends the downward-facing-dog posture). This will help you refocus on your goals.
?Eat something nutritious. If stress eating made you slip, then choose foods like carrots and apples. These can help counteract stress, probably because they're crunchy and a touch sweet.