Living Healthy

Dr. Domke reflects on The Living Healthy Podcast

Dr. Henry Domke is a Family Physician who has practiced in central Missouri for over two decades. He has always had a strong interest in disease prevention, health maintenance, patient education. After completing medical school at the University of Missouri-Columbia, he stayed on for their three-year Family Practice Residency. That innovative Family Practice program continues to be ranked second in the Nation. He is board certified by the American Board of Family Practice.

Dr. Domke's first podcast aired on October 29, 2005, and over the next year, he covered approximately 50 topics (see TOPICS on the right side of this page).

In this abbreviated "season finale," Dr. Domke reflects on the past fifty shows and talks about his hope that lots of future listeners will benefit from them.

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This podcast first aired on October 24, 2006.

Living Healthy Podcast #50: Henry Domke Fine Art

When I was in high school, I enrolled in an art school but, at the last minute decided I wanted to go into medicine instead. Today, as a family practice physician and fine artist, I've been lucky enough to combine both of my life's passions into two careers. I like to say I divide my time two-thirds to medicine and two-thirds to art.

I've always had an interest in art but didn't have time during my medical training to do much about it. In the 1980s, however, I saw a demonstration of Adobe Photoshop and began creating digital art on my Macintosh. I was getting a little frustrated with the computer techie stuff, though, and decided to pursue more formal training in the fundamentals of art. I worked with Annette Weintraub, art professor at the City College of New York, through a distance-learning independent study program, and with William Hawk, a painting professor at the University of Missouri-Columbia. He convinced me to enter a graduate art program at the university, which meant declining to take new patients in my practice and reducing my office hours. Although I painted a lot, I eventually went back to digital imaging, using a Canon 1Ds Mark II, a single lens reflex camera with lenses ranging from 16 to 600 mm. And I had the perfect subject for it- literally in my own backyard.

Back in 1970-the year of the first Earth Day and growing interest in environmentalism-my parents bought a beat-up old 180-acre farm near Jefferson City, Missouri. My father had taken a strong interest in the destruction of the North American prairie that was going on all around him and wondered if he could create a patch of prairie that would be enlivened by swamps, glades, savannas, and all kinds of woodland flowers that you don't normally see on a prairie. He spent decades plowing, bulldozing, burning off grasses, and trying to attract unusual bird species to a living prairie habitat. It worked: Last year, for example, a visiting ornithologist heard six Henslow's sparrows-a rare species-singing on our prairie. More to the point, the Prairie Garden Trust, as it's called, gave me the subject for my photography.

I had done a lot of digital printing, spending hours to get each print just right in framing and color, using an Epson 9600 printer and a fine-art mat paper combined with pigmented ink called archival ink. A healthcare designer named Carrie Heckstetter saw a print hanging in my sister's office four years ago and contacted me. I sent her a portfolio, and the interest in my work took off from there.

The prints I create are blown up quite large-2' × 3', 4' × 6', 4' × 9'-and occupy waiting rooms, offices, and corridors in hospitals such as the Cancer Center at Blessing Hospital in Quincy, Illinois; the Northwest HealthCare Center in St. Louis;  and the St. Louis Women's Surgery Center. These are fine prints of archival quality that won't fade, and now I offer large, archival canvas prints.

Going to a healthcare facility can be a frightening and disorienting experience for many patients. My goal is to provide a visual escape to the natural world, where people can find comfort and healing.

Now that my digital imaging is starting to gain attention, my patients are concerned that I might retire from medical practice. But I love medicine. I have patients and generations of patients' families I've taken care of for 20 years, and this is of real value to me.

I've heard that these images tend to make people stop and look and sometimes show a real response. I've seen it firsthand. I've had patients look at an image of a prairie creek hanging on my wall and ask, "Were you at my grandfather's farm when you took that? That looks just like it and brings back a lot of childhood memories." I like to hear that.

Text based on an article in HealthCare Design Magazine May 2005.

Henry Domke Fine Art
HealthDesign.org

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This podcast first aired on October 20, 2006.

Living Healthy Podcast #26: Diabetes

Diabetes means that you have too much of the sugar called glucose in your blood. Diagnosing diabetes is remarkably easy and cheap. Simply have your fasting blood sugar level measured. If the fasting blood glucose level is between 100 and 125 you have pre-diabetes. If the fasting blood glucose level is 126 mg/dl or greater, then you have diabetes. The key problem with having this extra blood sugar is that over time it damages the arteries and leads to early heart attacks and strokes. Diabetes can be treated with wide range of pills and shots, but for most diabetics the best treatment is simply loosing weight, exercising more and avoiding foods and drinks made with sugar. You'll find the basics at FamilyDoctor.org with additional information at the American Diabetes Association website.

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This podcast first aired on April 21, 2006.

Living Healthy Podcast #25: Taking care of your toenails

As an aspect of healthy living, toenails don't get much respesct. But ignore good toenail health at your own risk. This week Dr. Domke tells us how to trim our toenails to avoid the dreaded (and painful) ingrown toenail...and he discusses onychomycosis (say: "on-ee-koh-my-ko-sis"), a fungus that causes toenail or fingernail infection. This infection can make your nails thick and discolored. Your nails may also be brittle or change their shape. You may even have pain in your toes or fingertips. More on Ingrown Toenails at FamilyDoctor.org. Drawing by Dr. Domke.

Dr. Domke also answers a question from a patient: Should I consider getting a full-body scan for routine diagnostic purposes.

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This podcast first aired April 14, 2006.

Living Healthy Healthy Podcast #24: Poison Ivy and Ticks

Poison Ivy

Poison Ivy rash is caused by an allergy to the plants oil and routinely lasts 2-3 weeks. If you think you may have touched poison ivy, wash all exposed areas as soon as you can. 

It is critical to identify Poison Ivy. If you can identify it then you can avoid it. Identification tips for Poison Ivy:

“Leaves of three, leave it be" is good advice. It can be a woody shrub or a vine. As a shrub, it can grow about 6 feet high. As a vine, it can climb 40 feet up a tree. I tend to look for it in sunny areas, especially along fencerows or the edge of a garden.  Image from "Shrubs and Woody Vines of Missouri." Copyright 1997 by the Conservation Commission of the State of Missouri. Used with permission. [Larger image]

Ticks

Ticks are very common in Missouri once you get outside of the cities.  As soon as Spring starts Ticks become active. Remove ticks immediately. This is important because it can take hours for an infected tick to transmit disease. Ticks can transmit a variety of illnesses: Lyme Disease, ehrlichiosis and Rocky Mountain spotted fever.

However, there were only 41 cases of Lyme Disease reported in Missouri in the year 2002. It's much less common than most people think. And be aware that the diagnosis for Lyme Disease is not just a simple blood test. Many people are given the diagnosis incorrectly based on inaccurate interpretations of blood tests. Accurate diagnosis often means seeing an Infectious Disease Specialist. 

Prevention is key with ticks. If you're going to spend much time in tick-infested areas, here are a few things you can do to keep the ticks at bay:

• Pre-treat your long pants, shirt and socks with Permethrin. One brand name is "Permanone Clothing Insect Repellent"
• Wear long pants.  Best it tucked into boots or socks to form a mechanical barrier.
• Spray a DEET insect repellant onto the bottom of the pants, your socks and any exposed skin. 

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This podcast first aired on April 7, 2006.

Living Healthy Podcast #23: Hypertension

High blood pressure, or hypertension, affects one in four American adults. If not kept under control, high blood pressue increases the risk of heart attack and stroke. Regular exercise and following the DASH Diet can help prevent high blood pressure.

A blood pressure reading below 120/80 millimeters of mercury (mm Hg) is considered "normal." If your resting blood pressure is consistently 140/90 mm Hg or higher, you have high blood pressure. A reading of 115/75 is the level above which your risk of heart attack or stroke begins to increase.

High blood pressue is often called the "silent killer" because you can have it for years without knowing it. In fact, about one-third of the 50 million Americans with high blood pressue don't know they have it.

You may be able to lower your blood pressue with lifestyle changes. Start with the DASH Diet (a diet high in fruits and vegetables and low in fat and saturated fat...while decreasing salt and sodium intake). Then, make sure you get a least 30 minutes of physical activity on most days of the week. Lifestyle changes, however, are not always enough and medication is usually needed.

Omron and ReliOn are two good brands of blood pressure cuffs for monitoring your blood pressure at home. Your best bet is one that is battery powered and has an upper-arm cuff.

You'll find a good overview of high blood pressure at FamilyDoctor.org and more detailed information at the Mayo Clinic website.

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This podcast first aired on March 31, 2006.

Living Healthy Podcast #22: Allergies

Allergies of the nose and eyes are very common and annoying.  Common symptoms include: runny nose, watery eyes, itchy nose, eyes and roof of mouth and often sneezing. Often you can determine what you are allergic to if you are a good detective. If your symptoms start in mid-August and last till the first killing frost, there is a good chance you are allergic to Ragweed. If your allergies are always early spring, it is probably one of the trees. If the allergies are mid-to late spring this might be true Hay Fever (which is an allergy to grass pollen). Allergies to plant pollen tend to occur during the same weeks every year. Occasionally allergies are chronic and occur most of the year. This is often due to molds, dust mites and indoor pets.

There are four basic treatments for allergies:

• Antihistamines - these pills often help a lot. Use them only when you need them, not every day.
• Nasal Steroids - these are the most underutilized treatment and are remarkably safe.
• Avoidance of what you are allergic to is just common sense, but often people find it hard to do. If you are allergic to cats, get rid of the cat.
• Allergy shots - Very expensive and may take years of frequent shots for full benefit. Allergy shots should only be used by people who have failed medications.

Other resources:

• Allergies: Things You Can Do to Control Your Symptoms
• Nasal Sprays: How to Use Them Correctly
• The American Academy of Allergy, Asthma & Immunology is the professional medical organization of doctors who specialize in allergy care. 

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This podcast first aired on March 25, 2006.

Living Healthy Podcast #21: Alcohol and Alcoholism

What is alcoholism? Should all people avoid drinking? Is it true that alcohol can prevent heart attacks? Is alcoholism a moral weakness, or is it a chemical imbalance that is caused by genetics? I just drink beer, so I can't really be an alcoholic right? I don't drink every day, so I can't be an alcoholic, right? Dr. Domke answers these and other questions in LHP #21.

An alcoholic is someone who continues to drink when it is causing them problems. Not only health problems, but also legal, marital, job-related and financial problems. Drinking is a problem if it causes trouble in your relationships, in school, in social activities, or in how you think and feel. 

If you are an alcoholic, your key task is to learn to totally stop drinking.  This is often very difficult and usually needs the help of some organization like AA (Alcoholics Anonymous). Alcoholics Anonymous helps more alcoholics than all other treatments combined.

If you are not an alcoholic, and if you are not morally opposed to drinking, there can be benefits to moderate and light drinking for adults. That means no more than 2-drinks per day if you are a male and no more than one drink if you are a female. A standard drink is one 12 ounce beer, one 5 ounce glass of wine, or one 1.5 ounce shot of distilled spirits. Each of these drinks contains about half an ounce of alcohol.

Other resources: The Center for Disease Control has useful Alcohol Facts, and Brian F. Shaw's Addiction and Recovery for Dummies provides a simple yet accurate overview on alcoholism.

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This podcast first aired on March 18, 2006.

Living Healthy Podcast #20: Sexually Transmitted Disease (STD)

Sexually Transmitted Disease is too large a topic to cover in one half-hour podcast. You can, however, find most of what you need to know at the Center for Disease Control website. In today's podcast, Dr. Domke talks about three of the most common forms of STD: Herpes, HPV and Chlamydia. As for prevention, the best ways to prevent STDs are: abstinence or masturbation (best); reducing the number of sexual partners; and using condoms. 

• Chlamydia - 800,000 infections are reported in the USA each year with this bacterium. Because it is a bacterium it can be cured with antibiotics. It normally causes no symptoms, but it can damage a woman's reproductive organs resulting in infertility. Chlamydia also can cause discharge from the penis of an infected man.
• Genital Herpes (HSV-2) - One out of five adolescents and adults, have had genital HSV infection. HSV-2 is closely related to the virus that causes fever blisters near the mouth (HSV-1). This disease causes a lot of worry, but normally it is not dangerous. The key problem is occasional painful genital sores. However, if a woman is has sores of herpes when she gives birth, it can transmit the illness to her baby.  There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners.
• Genital Warts (HPV) Human papillomavirus - Most people who become infected with HPV will not have any symptoms and will clear the infection on their own. The virus lives in the skin or mucous membranes and usually causes no symptoms. Some people get visible genital warts, or have pre-cancerous changes in the cervix, vulva, anus, or penis. Very rarely, HPV infection results in anal or genital cancers. This viral infection commonly causes abnormal pap smears which requires more frequent doctors visits and might require a test called colposcopy. This is like having a pap smear test done with a microscope. At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives. By age 50, at least 80 percnet of woman will have acquired genital HPV infection.
• Gonorrhea - A kind of bacteria that can cause burning with urination or vaginal discharge. It can be cured with antibiotics.
• HIV and AIDS - A viral infection which remains incurable and is still deadly despite improvements in treatment. 
• Pubic Lice (Crabs) - This is an infection of the skin caused by small parasites. They cause itching in the pubic region.

Other resources:
How to protect yourself.
Common Symptoms and tips on prevention.

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This podcast first aired on March 10, 2006.

Living Healthy Podcast #19: Traveling Healthy

Nothing can ruin that big trip like getting sick. Here are some tips for staying healthy while travelling:

• Don’t get sunburned. Consider using a tanning bed for a couple months prior to going to start a tan.
• Sleeping pills can make a long flight (over seas) seem shorter.
• If you are going to a developing country where there is a risk of traveler’s diarrhea, avoid eating foods from street vendors, unpasteurized dairy products, and raw or uncooked seafood. Peel fruits yourself. Drink water from commercially sealed bottles or drink carbonated beverages. Avoid ice. Brush your teeth with bottled water.
• Use caution when driving. Wear your seat belt.
• Consider a visit with a Travel Doctor (typically an Internist specializing in infectious disease. There are even special "travel medicine" clinics.
• Immunizations. If it has been more than ten years since your last tetanus shot, get one. If you have not had a flu shot and it is fall or winter, get one.
• Carry enough of your regular medicines (in their original containers), along with extra prescriptions for them and also eyewear prescriptions.
• If you're going to a country with an increased risk of mosquito-borne disease, protect yourself against insects. Insect repellents that contain DEET work the best. Wear permethrin-coated clothing and use bed nets while you sleep. Talk with your doctor about using medication to prevent malaria.

The Center for Disease Control has more information about infections and travel. The American Association of Family Physicians website has tips for healthy international travel.

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 This podcast first aired on March 2, 2006.

Living Healthy Podcast #18: Sore Throat, Strep and Mono

Sore throats are caused by many things. Most often, a virus (the same thing that causes colds). but bacteria can also cause a sore throat, as can smoking, GERD (reflux), and allergies. Antibiotics are only needed if the sore throat is caused by a particular type of bacteria called Strep. This can be determined with a simple test in the office. You can stop by our office and have the test done without the need for an appointment or a doctor’s visit. 

Mono (mononucleosis) is a viral infection. It will not be cured with antibiotics. One of the main signs of mono is a sore throat that lasts too long (longer than 10-days). 

You'll find more information about sore throats, Strep and Mono at FamilyDoctor.org. As always, the Center for Disease Control has good information on both Strep and Mono.

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 This podcast first aired on February 25, 2006.

Living Healthy Podcast #17: Heartburn

Heartburn is a general term to describe an irritation of the stomach or esophagus. It is often relieved by eating or taking antacids. Sometimes it wakes people up at night.  Heartburn has nothing to do with your heart. Heart pain tends to be felt in the same location (the front bottom of the chest) but it is often worse with exertion and should not be helped by eating.  Heart pain is more often a squeezing pain, while heartburn is more often a burning feeling. 

A simple way to help see if your heartburn is due to ulcers is to:

• Stop taking any pain pills other than Tylenol
• Take Prilosec OTC  (available without prescription) for 14 days. 

How to prevent heartburn:

• Stop all smoking forever. If you don’t the heartburn is certain to return.
• Stop using pills which can irritate the stomach. Essentially this means all pain pills with the exception of Tylenol (acetaminophen). Tylenol does not cause ulcers. If you find that you have to stay on stomach pills long term, consider asking your doctor about trying antibiotics to help.

What You Can Do to Heal Your Ulcer? (familydoctor.org)
Peptic Ulcer Disease (Centers for Disease Control and Prevention)

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This podcast first aired on February 17, 2006.

Living Healthy Podcast #16 - Ear Pain

There are many causes for ear pain and it can be difficult to identify unless a physician takes a look. There are basically two kinds of infections: Outer Ear ("Swimmer's Ear") and Middle Ear (the common infection of young children following colds).

• Outer Ear Infection (Otitis Externa) - This is actually an infection of the skin of the ear canal. It's caused by having water staying in the ear too long. Having plugs of wax in the ear and putting things in the ear can trigger this. Scratching or itching the ear can also damage the skin. This is most common in people who are teens or adults.
• Middle Ear Infection (Otitis Media) - This occurs on the inside of your eardrum. It is very common between 6 and 24 months of age. It often occurs after a cold. At this point in time, most kids who get ear infections receive antibiotics. In fact, Acute Otitis Media (AOM) is the most common infection for which antibiotics are prescribed for children in the United States. However, The American Academy of Family Physicians and the American Academy of Pediatrics, in their first joint guidelines, recommend a treatment approach to acute otitis media that includes observation and pain relief before rushing in with antibiotics. This advice reflects increasing concern in the medical world about the overuse of antibiotics and the number of bacteria that are becoming resistant to antibiotics. Preventing Middle Ear Infections: Breast fed babies have fewer ear infections; eliminate exposure to tobacco smoke; influenza vaccine reduces ear infections by 30%.

Golden Rule of Ear Care: Never put anything smaller than your elbow in yor ear.

Additional resources: Middle Ear Infections; Outer Ear Infections; Dizziness

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This podcast first aired on February 10, 2006.

Living Healthy Podcast #15: Menopause - Should women take estrogens after menopause?

Menopause is the natural failure of the ovaries to produce the female hormones estrogen and progesterone. When this happens many parts of the body undergo changes. There may be hot flashes, thinning of the bones, vaginal dryness, and a lack of energy. The only way to reverse this is to replace the hormones that have suddenly disappeared. That is called hormone replacement therapy.

Hormone replacement therapy (HRT) involves taking estrogen alone or estrogen combined with another hormone, progestin. Some women have found that HRT can relieve symptoms such as hot flashes, vaginal dryness and some urinary problems. However, HRT is not for everyone. New information from recent studies suggests that for many women, the risks of using HRT may outweigh the benefits. 

Dr. Domke suggests taking a careful look at the risks and benefits as they relate to you. Because Estrogen slightly increases the risk of breast cancer, if you have a strong family history of breast cancer you probably don’t want to take HRT. If however you find yourself with horrible hot flashes and you are miserable and can’t sleep, you will want to seriously consider using HRT. This is a complex issue so get as much information as you can and talk with your health care provider.  More at FamilyDoctor.org.

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 This podcast first aired on February 2, 2006.

Living Healthy Podcast #14: The "perfect diet" for almost everyone

The DASH Diet is not a fad diet, rather a scientifically proven way to eat to stay healthy. DASH stands for “Dietary Approaches to Stop Hypertension” and it is the ideal diet for those with high blood pressure. But the truth is, that this is the perfect diet for the rest of us also.

Official DASH Website
National Heart, Lung and Blood Institute
Download the DASH Diet (PDF)

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This podcast first aired on January 27, 2006.

Living Healthy Podcast #13: Low Back Pain. The best care is minimal care.

What should I do when I get low back pain? Do I need an X-ray? Are MRI's better? Can a Chiropractor help? When is surgery indicated? Do pills cure low back pain? What exactly causes back pain? Just some of the questions Dr. Domke attempts to answer in this week's Living Healthy Podcast.

For the majority of low back pain, there is no evidence that treatment affects outcome. That means that treatment (Medical, surgical, pills, chiropractic, physical therapy, etc.) does not affect your recovery. Most back pain gets better no matter what you do. However, treatments of all kinds can make the pain slightly less annoying. 

For mild back pain of brief duration Dr. Domke suggests that you "pretend it does not hurt." Do not stay in bed and try to go about your normal daily activities. For acute low back pain, the best care is minimal care. Consider taking 1,000 mg of Tylenol three times a day to take the edge off the pain. Go about your business, but avoid movements that seem to make it worse.  Do not focus on finding an answer to the question: “what exactly is going on to cause this pain.” In most cases it is hard to know exactly and even experts will disagree.

It the pain persists beyond a few weeks, you should consider seeing either your Family Physician or perhaps a Chiropractor (if that is your preference). If your pain is overwhelming, you probably won’t want to wait a few weeks. If you have fever or cancer see your doctor sooner.  For patients with lingering pain I will often refer them to a Physical Therapist. If the pain radiates down the leg and at the same time you have weakness of the foot that persists for more than a few weeks, you may want to have an MRI and then see a back surgeon. 

One activity that can trigger back pain for some is lifting something heavy while twisting. If you are prone to back pain, try to avoid this. 

Here's some good basic information on Acute Low Back Pain from the American Academy of Family Physicians and the New England Journal of Medicine (This PDF file has a lot of technical language but is very comprehensive).

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This podcast first aired on January 19, 2006.

Living Healthy Podcast #12: PSA test for prostate cancer

Prostate cancer is one of the leading causes of cancer death in men. The (PSA) Prostate Specific Antigen test can identify the cancer before it can be detected in any other way.   Some authorities suggest that this be a routine part of an annual physical exam for men over the age of 50. Dr. Domke does not routinely recommend this test and he explains why. Dr. D goes on to provide a good overview of prostate cancer and the treatment options and issues. He also talks briefly about CA-125, the blood test used to screen for ovarian cancer.

The (PSA) Prostate Specific Antigen is a controversial test. The information is not in yet on whether it will be a worthwhile screening test. Within a few years the research on this issue should give a definitive answer. 

I do not suggest having this test for routine screening. However, if a patient (or their wife) asks for this test I will do it.   

Key issue: Does the (PSA) Prostate Specific Antigen test prolong life? There is no question that it detects prostate cancer, it is pretty accurate. The issue is, will doing this test help you beat prostate cancer. Just because we can detect a cancer early does not mean we can beat it. 

Lung cancer is the number one cause of cancer death in the US. It is fairly easy to screen for with a simple chest X-ray. However, most physicians do not screen for lung cancer because they know that early detection does not help with this particular cancer. With other cancers, such as colon cancer, early detection has been shown beyond a doubt to save lives. 

If we do the (PSA) Prostate Specific Antigen and the results come back elevated then at that point you will enter the medical system. There is really no other way to approach it. You will see a Urologist. You will have the test repeated and almost certainly have a painful procedure called a prostate biopsy.  The other issue is that knowing you have an elevated (PSA) Prostate Specific Antigen will make you worry. It will make you label yourself as sick. Why find out about an illness if there is no benefit?

The best information on which medical tests and procedures are worthwhile is found in the reports of the U.S. Preventive Services Task Force (USPSTF).  Here is a quote from them: “The USPSTF found good evidence that PSA screening can detect early-stage prostate cancer but mixed and inconclusive evidence that early detection improves health outcomes. Screening is associated with important harms, including frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient's health. The USPSTF concludes that evidence is insufficient to determine whether the benefits outweigh the harms for a screened population.”

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This podcast first aired on January 14, 2006.

Living Healthy Podcast #009: Insomnia

One of the keys to living healthy is getting a good night's sleep. In LHP #9, Dr. Domke talks about sleeping pills and why he doesn't like to prescribe them. And just how much sleep is "enough?" And he offers some tips for getting a good night's rest:

• Find some way to increase physical exertion during the day. The best predictor of a good nights sleep his how much exercise you have had that day.
• Have a regular wake time regardless of the duration of sleep.
• Avoid daytime napping
• Go to bed only when sleepy
• Use the bedroom only for sleeping and sex.
• Go to another room when unable to sleep in 15-20 minutes, read or engage in other quiet activities. Return to bed only when sleepy. Repeat if necessary.
• Try different methods of relaxing such as progressive muscle relaxation or imagining relaxing scenes.
• Make sure the bedroom and bed are comfortable and quiet. Is the bedroom at a good temperature?
• Avoid caffeine after noon. Do not use over-the-counter or prescription sleeping pills.

Online resources:
Insomnia (familydoctor.org)
Progressive Relaxation

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This podcast first aired on December 24, 2005.

Living Healthy Podcast #008: How to set up an exercise program

In LHP #8, Dr. Domke offers some suggestions for setting up a successful exercise program:

• People who exercise in the morning are more likely to stay with this long term.
• Daily (or twice daily) during the week is ideal- aim for 5-7 times each week.
• Start slow and gradually build, start with ten minutes each time. Within a few months try to up your time to at least 20-minutes each period.
• Walking is often preferred (but follow your inclination, you need to enjoy what you do).
• Treadmills are the most used of all exercise equipment. They are the least likely to collect dust.  Better treadmills (heavy duty, reliable and quiet) are more likely to be used. Landice is one of the best names.
• Having a "buddy" work out with you may keep you coming back. You don't want to let them down. Do whatever it takes to get into a habit.

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This podcast first aired on December 17, 2005.

Living Healthy Podcast #007: How to Stop Smoking

Does hypnosis work? How expensive are nicotine replacement products (gum, patch)? Can I just "cut back" without quitting? Are there prescription medications that can help me quit? Just a few of the questions Dr. Domke tackles in LHP #007.

He's also written articles on how to stop smoking: How to Stop Smoking if Everything You have Tried has Failed and Quitting Smoking - How to Increase Your Chance of Success

Tips on how to quit smoking:

• Pick a date to quit and write it down. Tell all your friends and family the date.
  Once you quit, never take one puff ever.
• Consider using Nicotine replacement for 6-12 months. Ideally you would use Nicotine patches every day for at least 6 months and keep nicotine lozenges in your pockets for emergency cravings.
• If at first you don’t succeed, try again and again. Don’t stop trying, this is difficult for most people, but worthwhile.

Other resources:

• Quit to Live - A special series on smoking and fighting lung cancer from ABC News
• Center for Disease Control

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This podcast first airerd on December 10, 2005.