Tag Archives: Primary Care Associates AK

Fashion Fads, and 13 unintended health consequences

‘Light Reading for Sick Rooms and Parties’

Unhealthy Fashion Fads:

1. Hair pullback:   Severe and under tension hair pullback will yield an enlarging forehead. It permanently  damages hair, causing hair loss.  So does wearing hair extensions for long periods. Tight ponytails, headbands, and braids can cause headaches.

2. Hair on forehead:  Bangs in adolescence are associated  with aggravation of acne via the oiliness of hair in contact with the skin.  Hair should be held off the forehead during sleep.

Remember ‘Hands, Hair, and Hydration”.   The dirtiest part of our bodies are our hands:  keep them off your face.  Get hair off the face too, at least during sleep.   2/3 of your body is water; skin is your largest organ.  Help your skin by staying well hydrated (70-90 ounces/day)

3. Tight belts, tight pantyhose:  can cause numbness in the leg by pressure on the lateral femoral cutaneous nerve that runs from the abdomen to the outer thigh. A similar problem occurs with policemen and journeymen who carry guns or equipment on their hips.

Symptoms includes numbness on the side of the leg, back pain sometimes radiating into the buttocks or hip. A fat wallet carried in the hip pocket is a common culprit for symptoms as well.

Victorian style corsets  could crush ribs and interfere with digestion;  today we have  too tight jeans. “Tight Pants Syndrome” coined in 1993 can cause abdominal discomfort, distention, heartburn, and belching especially after eating. Also possible:  low back pain, yeast infections in women and a condition known as lipoatrophia simicircularis (horizontal skin changes around the thighs, much more unwelcome appearing than cellulite).

4. Spanx and other “body tamers”:   can cause nerve compression, digestive issues, and painful welts.

Compression wear for the abdomen can prevent full expansion of the lungs and cause lightheadedness.

5. Tight collars, or ties: can reduce circulation to the brain, increase pressure in the eyes, decrease range of motion of the neck.

- 67% of men buy shirts that are smaller than their necks. Ties are seldom cleaned, can carry infection.

- Lingerie experts say 75% of women wear the wrong size bra.  If too big it give no support which causes pain and back strain.

6. Tight bike shorts: can raise temperature of the testes, reducing sperm production.

Also, allergies occur more often with synthetics and blends than cloths that are all wool, silk or cotton. People who develop rashes  from clothes are reacting to dyes and fabric softeners that can include formaldehyde. Washing new clothes a couple of times before wearing can reduce that.

7. Socks with tight elastic:  can cause raised reddish welts around ankles.  The marks are harmless but can last for years.

They can also occur around wrists from tight mittens.

8. Shoes with heels hight than two inches:  are linked to bunions, hammer toes, stress fractures and ankle sprains.

Bony protrusions on the back of heels (“pump bumps”) can also develop, along with nerve damage between the toes (neuromas), and circulation blockage causing foot bones to die.

Do your shoe-buying after 3 or 4 in the afternoon when your feet are most swollen.  Remember that one foot is larger than the other and size your shoes to that foot.

9. Years of wearing high heels: shortens the Achilles tendons making flat shoes uncomfortable.

Flats can lack support and lead to plantar fasciitis (pain that feels like you are stepping on a nail when you get up in the morning) .

10. Flip flops are worse: Wearers have to clench their toes to keep them on, leading to foot fatigue, sore calf muscles and an altered gait which could cause long term ankle and hip problems.

11. Heavy handbags and book bags:  throw the back out of line, causing back and neck problems.  Don’t carry more than 10% of your weight on a shoulder, and don’t do it long term without sharing the burden equally on both shoulders.

12. Body piercings: Over 20% of body piercings  get infected. In my experience 80% of naval and nose piercings get inflamed or infected.

Also nickel allergy is common, and nickel even in very small amounts is included in rings, earrings, and watchbands.  People who have no allergies to their jewelry can develop an allergy when exposed to citrus (e.g. lime or lemon).  It is the combination of the acid in contact with  nickel in the jewelry,  and the allergy becomes a permanent one even without future exposure to the citrus. Sometimes the jewelry can still be worn if a layer of protection (e.g. fingernail polish) is applied to that part of the jewelry that contacts the skin (e.g. the back of a watch or ring).

13. Fingernail extensions and appliques:  very, very frequently develop bacterial, and more often  fungal infections.

Have a Care;  Buyer Beware.

Bruce Kiessling, M.D.





‘Just a G.P.’

Testosterone Replacement – Part Two

Men have become more comfortable asking about erectile dysfunction ever since rhino horn and toad stash were replaced with the relentlessly advertised Viagra and Cialis.

These medications are very effective, but the symptom of erectile dysfunction often belies (50% of the time) an underlying blood flow problem to more than just the genitals. The penile artery is 3 mm; the coronary artery is 5 mm. If there are problems with blood flow to the penis, 50% of the time there are problems with blood flow elsewhere-from untreated high blood pressure, abnormal lipids (cholesterol), and/or diabetes.

Frequently the issue of disappointing erectile function prompts a man’s visit to the office where these important medical problems can be diagnosed and should be treated, along with the help provided via Viagra, Cialis, or Levitra.  In other words, don’t risk buying Viagra from an uncertain source; find out if there’s more to your problem.  Also if you are happy with the results of Viagra or Cialis, you’re not doing your buddy a favor by sharing; encourage him to get checked out as well while reassuring him that they really do work.

Performance problems not corrected by these medications, when stress, distraction, a marriage in conflict are ruled out, make us consider low testosterone as a possible contributing cause.  Libido, the interest in sex, is mediated by emotion and physiology and therefore low testosterone can lower a man’s interest in sex just as it often does with women after menopause who have lost 50% of their testosterone levels with the disappearance of ovarian function. Viagra and Cialis need not only adequate blood flow, but also a sufficient supply of circulating testosterone. Women in their forties and fifties have asked their doctors about their symptoms and relationship to menopause since… well, at least since the1940′s and 50′s.

Men on the other hand almost never ask about the “andropause” (a flawed term meant to describe declining testosterone levels).  It is likely this will change and men will begin to ask more about their testosterone levels with their physicians now that several branded topical testosterone preparations are available, all of which are very profitable to the pharmaceutical companies and which explains the extensive advertising. Yet legitimate testosterone replacement has been available at very low cost for decades. 

Men 40 and under ask about testosterone almost always because of their goal to build muscle mass and strength, usually associated with athletic and competitive ambitions. When tested they are similarly almost always in excellent, normal range and are inappropriate candidates for testosterone replacement.  Frustrated, they may seek illicit sources of questionable composition. By flooding their system with anabolic steroids (testosterone being only one of several illegal chemicals in this category) they risk many side effects, permanent organ damage, and toxicity.

A male in his 50′s could very well be noticing the lack of speed and endurance he had once enjoyed.  But this is nearly always due to an abnormal weight and de-conditioning (‘out of shape’). Middle-age inflation gathers round the gut for men, and on the butt for women.  Fat is not attractive in either locale but cradled over and under the belt it becomes an obnoxiously persistent metabolic parasite impairing availability and function of important hormones (including testosterone, insulin, and others).

In short,

▪ a man who is concerned about testosterone levels should get to ideal weight, or nearly so before being checked.  Losing the weight makes every hormone he produces more available to do their job, and often raises testosterone levels in the process as well.

▪ he should also embark on a judiciously advanced fitness program (after being cleared by his physician if he’s been inactive for awhile, or has health risks).  Fitness enhances the feel good hormones (endocanabinoids) and the effectiveness of circulating insulin and testosterone.

But we are a culture of immediate gratification and the sweat equity required to lose weight and get in shape is a tough sell when two thirds of our population is overweight, obese, and de-conditioned.   My professional opinion (from 40 years of experience and study) is that offering testosterone replacement without a nutrition and fitness plan carried out beforehand, or at least simultaneously with replacement  (and never above high-normal levels) is dangerous nonsense.  It is trading an aging Volkswagen idling in the driveway for an elderly Ferrari also idling uselessly in the driveway:  it is expensive, high maintenance pollution, and the touted benefits will neither be attained nor appreciated by the individual.

“Light reading for sick rooms and parties”




by B. Kiessling, M.D. “just a G.P.”

Founder/Medical Director, Primary Care Associates

To learn more about this topic, or to ask Dr. Kiessling questions directly, be sure to tune into 650 KENI tomorrow at 12:30 pm (AK time) or listen live online. You can also call in at (907) 522-0650.

If you can’t breathe, nothing much else matters.

Recently this site highlighted in “What you can learn from ‘Dancing with the Stars’”  the frequently observed “geezer chicken neck” and how it not only makes your neck stiff and sore, but it also reflects compromise of your lung capacity.

Years of working in flexion (leaning over your computer, your desk, your work, etc) creates habits difficult to break.  A simple exercise done every day, and for the first couple months perhaps more than once a day, can strengthen the muscles that help bring your upper back and neck in alignment. This will help open your chest and improve your breathing and lung capacity.  It will also help preserve your neck’s range of motion, turning side to side.

And, it will do even more.

Have you ever seen an advertisement for the military with a slumping  Marine?

The perfect posture is not just to look good in a uniform; it improves performance.

How often have you seen a slouching Yogi in lotus position?

Yoga includes many things, but it is fair to say that awareness and control of breathing is front and center. The properly aligned chest and neck allows the calming, slow and deep, diaphragmatic breathing.

Here is a simple exercise to consider doing daily: “Hold ups”

  1. Start by standing, back towards the wall with your heels against the wall, shoulder width, and with your knees soft (bent 10-15 degrees; knees bent is very important)
  2. Press your tailbone against the wall and tilt your pelvis forward to press your lower back against the wall. (flatten the lower back and push it against the wall; you should not be able to pass your hand between the wall and the small of your back;  this is the most important technique detail of this exercise)
  3. The spine, from the tailbone to the shoulders, should be in contact with the wall.
  4. Try to press the back of your head against the wall as well.  If you cannot when you first try this, then push your head back as far as you can.  (a bit of history here: measurement of distance from the wall to the back of the head was, before we had bone density tests, a measure of osteoporosis risk and  upper vertebral collapse in women).
  5. Now lift your arms, with elbows bent, palms out as though you were following instructions to “show me your hands” (hence the name of the exercise “hold ups”) and try to bring the back of your forearms to the wall.   (Important:  if you cannot bring your head or your forearms to the wall without keeping your low back pressed against the wall, then bring them back only as far as keeping proper form allows i.e. keeping your low back in contact with the wall).
  6. Now slide the back of your forearms against the wall, at shoulder height, up and down.  About a foot up and down with your arms is all the movement you need, and don’t bring your arms much above shoulder height.

Try to get in a set of 100/ day.  60 looking straight ahead and 20 with your head turned each way,

Again, getting only so close to the wall that you do not lose contact with your low back pressed against the wall.

You will find this exercise challenging precisely because it isolates those muscles that help pull the spine of your upper chest and your neck into proper alignment;  muscles you are not accustomed to using, much less strengthening.  You likely will not be able to bring both your head and your arms flat against the wall without your low back wanting to curve away from the wall.  Keep your low back pressed against the wall and, over a period of weeks or months, you will be able to get your head and forearms closer to the wall.  Be patient but persist.

Once in the habit of doing this exercise you’ll find it takes only 3 minutes of your day.  Bringing your head back over your chest which you have opened up by bringing your shoulder blades back will feel nearly as good as a great morning stretch.  And you can revisit that good feeling throughout the day.

If you have questions about this exercise, or other medical issues, please call into my radio program on Tuesdays on KENI at 12:30p.   Also, click this link and you can download or listen to previous “Just a G.P.” radio show podcasts.