Esketamine: a promising new treatment for depression

Depression is a mental illness. It is estimated that depression will affect 15 percent of all people at some point in their lifetime. The condition is caused by imbalances in certain brain chemicals called neurotransmitters. These neurotransmitters play an important role in controlling your mood. In addition to directly affecting depression, neurotransmitters have other bodily functions.

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Ten ways to add 10 years to your life

1) Get an annual physical examination. 

Make sure it is from a doctor you are familiar with, and try to maintain continuity of care by scheduling an examination with the same doctor every year. The examination should include the standard blood tests for your age including, but not limited to, the evaluation of blood sugar, thyroid and cholesterol.

Your physical examination should also evaluate blood pressure, weight, listen to your heart and lungs, and include a full skin exam. Women, specifically, should schedule a Pap smear and mammogram, if appropriate. Men, specifically, should have an age-appropriate prostate evaluation.

If you have not had a general medical examination in the past one year, it is time. Ask your doctor how often you should schedule future examinations. Don’t forget to ask your doctor about planning to evaluate your hearing, vision and dental health.

 

2) Keep total cholesterol below 200. 

This can be achieved with diet, exercise, and/or, if necessary, prescription medications. Have your doctor review your ratio of HDL/LDL cholesterol with you, too.

 

3) Keep blood pressure below 125/75. 

Your doctor may even recommend a slightly different number. This can be done with diet, exercise, and/or, if necessary, prescription medications.

 

4) Keep blood sugar below 100. 

This can be done with diet, exercise, and/or, if necessary, prescription medications.

5) Keep weight less than 20% of average of your height. 

For most men, this means keeping weight under 200 pounds, and for most women under 170 pounds. Your doctor can give you the exact weight figure most appropriate for you.

 

6) Exercise at least 20 minutes per day four to five times per week. 

The benefits of regular exercise are that it reduces cholesterol, improves arthritis, reduces gouts, prevents heart disease, helps diabetes, promotes circulation, improves energy and improves mental ability.

 

7) Do not drink or use drugs while driving, fishing, swimming, or boating.  

 

8) Do not smoke. 

This is probably the worst health habit that leads to more preventable health problems than any other single item.

 

9) Do not keep guns accessible to those who will misuse them.  

This especially means loaded guns that could lead to the death of children, grandchildren, spouses, or relatives. If guns are kept in the house, keep them unloaded and ammunition in a separate place or keep them in a secure safe.

 

10. Practice safe driving habits. 

Wear seatbelts at all times in the car, no matter what speed you are going, and do not take them off until the car is at a dead stop. Never text and drive.

 

Charles E. Crutchfield II, MD, is a graduate of University of Minnesota Medical School and has been a practicing obstetrician/gynecologist for 35 years in the Minneapolis/St. Paul area. He has been the president of numerous organizations, has served as assistant professor at the University of Minnesota Medical School, and has won numerous lifetime achievement and community service awards.  

Charles E. Crutchfield III, MD, is a practicing dermatologist in the Minneapolis/St. Paul area (Crutchfield Dermatology). He is a graduate of the Mayo Clinic Graduate School of Medicine and is a professor of dermatology at the University of Minnesota Medical School.

What is vitiligo, and why should I care?

Vitiligo is a condition where white patches occur on the skin. This was a condition that Michael Jackson had. It can be particularly troubling when patients have tan, brown or dark brown skin, as the spots are much more obvious. Socially and psychologically, vitiligo can be devastating and have profound quality-of-life effects.

What causes vitiligo? 

Vitiligo is a condition where the cells in the skin that produce color (melanocytes) either die early, or are inappropriately destroyed by the patient’s immune system. It can also be induced by environmental toxins and exacerbated by stress. Researchers have identified several genes that may be involved in vitiligo and continue to look for other involved genes.

Hand with Vitiligo
fingers with vitiligo

How common is vitiligo?

About one in 100 people will develop vitiligo in their lifetime. Unfortunately, when you are a person of color, vitiligo is much more obvious. As a result, some insurance companies have claimed that the condition is only a cosmetic concern, because in patients with lighter skin, it’s very difficult to see.

How is vitiligo diagnosed?

Vitiligo is most easily diagnosed by a board-certified dermatologist. This can be done by a special light examination called a “wood’s lamp” or by a skin biopsy.

Can vitiligo be prevented?

Vitiligo cannot be prevented; however, once it occurs, aggressive treatment can keep it from spreading.

Vitiligo body

How is vitiligo treated?

Vitiligo is treated by using topical prescription medications, meticulous sun protection, and special phototherapy light treatments. In extreme cases, when only a small patch of dark skin remains, the area can be lightened (depigmented). Sometimes small grafts of skin from normal areas can be transplanted into areas of vitiligo. Also, camouflaging skin (with make-up) can work well.

Emerging research indicates that medicines called prostaglandins may also be beneficial in treating vitiligo. Once all of the genes causing vitiligo have been identified, researchers may develop better treatments. The ultimate goal is to find a treatment that will permanently stop the skin from losing color.

Action steps for anyone with unwanted vitiligo

Be sure to get under the care of a board-certified dermatologist and learn about vitiligo (www.AAD.org). Also, join the National Vitiligo Foundation and participate in their local support groups (www.mynvfi.org/). In patients where vitiligo causes psychological and social problems, I would insist that the insurance company cover treatments as medically necessary. Your doctor can help you with this.

It is important to realize that vitiligo is a common condition, and you are not alone. There are many good treatments for vitiligo.

Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.

Does Vitiligo Cause Arthritis?

crutchfield dermatology blogQuestion:

Thanks for the great information on your website. I suffer from Vitiligo and was hoping you could help me with a quick question I can not find an answer for. My hands have been bothering me a bit with arthritic symptoms. Is arthritis a consequential condition that may develop from Vitilgo? Are there other common consequential injuries as well that I may develop or be concerned about?

Dr. Crutchfield’s Answer:

Arthritis and vitiligo are not connected. You should see your primary doctor to evaluate joint pain. Vitligo can develop in areas of injury or cuts on the skin.