Tag Archives: Dr. Jerry Saliman

Improving Your Memory

by on March 23, 2015

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“Memory is the mother of all wisdom.”
― AESCHYLUS

With advancing age, many adults worry not only about their health, but also about their memory. First, let us examine why we value our memory, and then look at some of the latest research in how to improve memory.

With the externalization of memory by cell phones, computers, digital photographs, books, and pencil and paper, one can wonder why we need our brains to remember anything at all. However, thousands of years ago the major way we passed along information was orally, which required focused attention and memory. Dating back 2500 years, the Iliad and the sequel, the Odyssey, were transmitted orally by the rhythm of the words. It is said that the Torah, or Five Books of Moses, was memorized by Moses, then taught to the leaders of the Hebrew people, and then passed on to the 1 million or so who left Egypt around 1500 BCE. The Torah chant or trope aided memorization, and may have even contributed to more precise interpretation. For 1000 years, not one word of Torah was recorded in the written word. The value of “knowing” the Torah in the mind was that it could be scanned quickly for reference and applied meaningfully to any life situation. Today, with the exception of some Torah and Talmudic scholars, few possess this skill. Although computers are useful memory tools, digitalized knowledge cannot be applied in situations requiring emotional awareness and response. For example, a musician who performs a piece from memory can evoke musical pathos or elation that extends beyond the printed notes.

There are scores of self-help books on improving memory. One that I recently enjoyed reading is Moonwalking with Einstein: The Art and Science of Remembering Everything by an investigative journalist, Joshua Foer. He states this about the process of improving his memory, “My experience has validated the old saw that practice makes perfect. But only if it’s the right kind of concentrated, self-conscious, deliberate practice.” The main technique he utilized was the “PAO system.” A specific person, action, or object is associated with a specific card in a deck, or a segment of poetry, or a number to be recalled. I won’t reveal the ending of the book, but the memory feat Joshua Foer was able to accomplish was quite extraordinary. Moreover, the tools he used can be learned by anyone.

There have been many medical studies to investigate memory loss and interventions to improve it. Despite early hopes that computerized brain games or taking gingko biloba could make a significant difference, follow up studies have not confirmed their long-term benefit. One novel medical study from UCLA (in the journal Aging, September 2014) showed actual Reversal of Cognitive Decline. In this study, 9 of 10 patients with early Alzheimer’s, or mild and subjective cognitive impairment improved within 3-6 months using a comprehensive program involving up to 36 interventions. The one patient who did not improve had advanced dementia. Patients who had quit their jobs because of poor memory were able to return to work. Notably absent from the regimen were prescription medicines. Although the program was personalized, here are some of the key components:

  1. Exercise 30-60 minutes, 4-6 times per week. (Exercise stimulates the growth of new neurons of the hippocampus, the memory center of the brain, and preserves existing neurons.)
  2. Eat a healthy diet. Eliminate simple carbohydrates, increase consumption of fruits and vegetables, and non-farmed fish.
  3. Reduce stress; meditate, practice yoga, or listen to music.
  4. Aim for 8 hours of sleep per night.
  5. Fast 12 hours per night including 3 hours prior to bedtime to reduce sugar and insulin levels. (The higher one’s glucose, the greater the risk for memory loss.)
  6. Supplements such as B12, Vitamin D, fish oil, and curcumin were individualized in this study.

Although none of the participants followed the protocol entirely, the results were still impressive. Dr. Dale Bredesen, the neurologist and author of the study, advises a full clinical trial to substantiate the findings.

I instruct my patients who have concerns about their memory to incorporate heart-healthy habits: “What is good for the heart is good for the brain.” Other measures that aid our memory that I have witnessed watching my 3-year-old granddaughters and 92- year-old mother include:

  1. Learn by song or rhyme. Think of the ABC song. Singing or chanting triggers additional nerve pathways to aid memorization and recall. Whenever I attend Shabbat services with my mother, chanting of a prayer aids her ability to remember it.
  2. When I observe my granddaughters learning a new word, they repeat the word out loud. When you meet a new person, try to state the name of the person 2-3 times to reinforce it in your memory bank.
  3. New experiences add links to memory circuitry. Socialize with others, take your children or grandchildren to the zoo, or travel to maximize the opportunity for memorable moments. Stay active.

In summary, keep yourself focused, exercise your mind, and practice a healthy lifestyle to stay sharp. Your personal memories are valuable because they define you. Protect them.

Jerry Saliman, MD is a volunteer internist at Samaritan House Medical Clinic in San Mateo. He retired from Kaiser South San Francisco after working there more than 30 years. While at Kaiser SSF, Dr. Saliman was also Chief of Patient Education. He received the 2012 “Lifetime Achievement Award” given by the Kaiser SSF Medical Staff.

Editing acknowledgement: Ellen Saliman

Neither the PJCC or our guest columnists provide medical advice, diagnosis, or treatment. Please make your health care decisions in partnership with your health care provider

Optimism & Your Health

by on February 5, 2015

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During medical training at UCLA, I had the good fortune to learn from Norman Cousins, a Jewish writer, editor, and adjunct professor of medical humanities. Despite being misdiagnosed with tuberculosis at age 11, he set out as a boy to “discover exuberance.” He believed that positive emotions were the key to fighting illness, which he exemplified in the telling of his own battle with a severe form of arthritis. In the book Anatomy of An Illness, he describes his victory over a potentially life-threatening condition by taking mega doses of vitamin C, and watching Marx Brothers movies and TV sitcoms. He relates, “Laughter is a form of internal jogging. It moves your internal organs around. It enhances respiration. It is an ignitor of great expectations.” His underlying belief was that positive emotions induce favorable biochemical changes in the body so that healing is more likely to occur.

Proverbs 17:22 states, “A joyful heart makes for good health; despondency dries up the bones.” So clearly, a correlation of cheerfulness with health has been recognized for centuries, but what is the supporting evidence? Do optimistic people simply take care of themselves better than pessimistic people, does being in good health by itself lead to optimism, or are both choices correct? The results of The Women’s Health Initiative study of 100,000 postmenopausal women showed that cynicism and hostility were associated with a higher risk of heart disease and cancer, and optimism led to longer life. In a large meta-review of 83 studies published in the 2009 Annals of Behavioral Medicine, optimism was found to be a significant predictor of positive health outcomes ranging from heart disease and stroke, pregnancy, cancer, and stronger immunity – even against the common cold. Benefits also included lower rate of depression and better coping in times of stress. My conclusion from reviewing these medical studies is that optimism leads to healthy behavior and outcomes, but also practicing healthy habits, in turn, leads to greater optimism.

One has to be careful about overgeneralizing the impact of optimism on health. If a person gets sick with heart disease or cancer, does that mean the illness was that person’s fault? Don’t assume that the root of all illness is negative thinking, and that thinking positively will provide the cure. Our emotions are only one determinant of our overall health, and whatever side of the optimism/pessimism spectrum you are on, it’s important to make appropriate health-wise decisions. For example, I have known patients who were pessimistic about having a heart attack because a parent died at an early age. This fearful attitude resulted in a strong devotion to avoiding cholesterol and to exercising rigorously. Some optimists think they will never get sick, so they shun vaccinations or screening tests for cancer. Others have had the unfortunate circumstance to have suffered trauma or loss of a loved one or suffering from clinical depression, so telling them to simply be optimistic is inappropriate. So whatever your outlook on life, it’s important to understand your own situation.

Most of us are born with a predisposition to seeing the glass half full or half empty, but my observations from treating hundreds of patients as well as observing behavior of friends and family have led me to believe that our outlook on life can be changed significantly. Here are some recommendations worth practicing to enhance one’s mood and outlook:

  1.  Express gratitude.
  2. Show compassion.
  3.  Exercise regularly to increase the pleasure hormones in your brain. Do something you enjoy such as walking, running, biking, or rowing a kayak. If your spouse orders you, “Go take a hike,” you both will be in better moods when you reunite!
  4.  Be forgiving of yourself, and laugh at yourself if you had an embarrassing moment.
  5.  Be playful. If you have young grandchildren, this is easier.
  6. Like Norman Cousins, entertain yourself with a humorous movie or sitcom.
  7.  Indulge yourself in a good novel, and share your insights in a book group or with friends.
  8. Play a musical instrument or sing, or attend a fine concert.
  9.  Enjoy a friendly game of bridge, scrabble, or poker with friends. Just don’t lose!
  10. Go to a play, especially a comedy.
  11. Volunteer. If you don’t already volunteer somewhere, you will be amazed what this does for your mood.
  12.  Eat a healthy diet and don’t drink in excess. (When alcohol wears off, it can act as a depressant.)
  13.  Surround yourself with supportive positive people.
  14. Pray. The mind-body connection is promoted by praying, helping to relieve stress and worry and indirectly improving your emotional and physical condition.

Conclusion
Whether you like it or not, our emotions affect our physical health. You do have some control over your life, and it’s never too late to practice behaviors that will help you see the glass at least half full. Oprah Winfrey, in her recent memoir What I Know for Sure, states, I continued to believe that no matter how hard the climb, there is always a way to let in a sliver of light to illuminate the path forward.

For more information about happiness and health, go to the Harvard School of Public Health.

Jerry Saliman, MD is a volunteer internist at Samaritan House Medical Clinic in San Mateo. He retired from Kaiser South San Francisco after working there more than 30 years. While at Kaiser SSF, Dr. Saliman was also Chief of Patient Education. He received the 2012 “Lifetime Achievement Award” given by the Kaiser SSF Medical Staff.

Editing acknowledgement: Ellen Saliman

Neither the PJCC or our guest columnists provide medical advice, diagnosis, or treatment. Please make your health care decisions in partnership with your health care provider

Norovirus – The Winter Bug

by on January 16, 2015

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Thanksgiving weekend 2014 was a time to forget for our family. My wife and I planned for the arrival of our children, their spouses, and four grandchildren for months. One of my granddaughters would Facetime daily to see what toys she would play with when she would eventually visit. The night before Thanksgiving, one son-in-law became acutely ill with a GI bug, and he wasn’t able to go to Thanksgiving dinner. The day after Thanksgiving, two of my daughters became acutely ill. By Thanksgiving weekend, the illness had ravaged through our entire family except for my wife and one granddaughter who was protected through the magic Continue reading

Depression — The Lowdown

by on December 2, 2014

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News of Robin Williams’ suicide was a shock. How could a man devoted to making others laugh take his own life? His death brought the disorder of clinical depression to the forefront.

Depression is a common mental illness that is manifested by prolonged sense of sadness, and other symptoms such as loss of desire to do pleasurable activities, irritability, insomnia or oversleeping, change in appetite, loss of energy, fatigue, difficulty concentrating, and sometimes thoughts of death or suicide. Depression affects 1 in 11 adults, and nearly twice as many women as men. Sadness and depression are different. Many people feel sad after losing a loved one, or losing a job, or ending a relationship. People who are depressed, however, can usually differentiate normal grief from the disabling continued weight of clinical depression. Although there is excellent treatment for depression, many people do not seek help because they mistakenly construe it as a personal weakness rather than a legitimate illness. Many celebrities have publically acknowledged their own battles with depression in hopes that others Continue reading

In Search Of Sleep

by on November 4, 2014

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But I have promises to keep, and miles to go before I sleep, and miles to go before I sleep.”  Robert Frost

A relative of mine, Stewart, (not his real name) was driving home from LA, and fell asleep at the wheel. Stewart was 18 years old at the time, and on winter break from college. He drove to LA in the morning, and then, after spending the day there, drove home that night. Although he knew he was drowsy, he made the decision to drive home. The last thing he remembered was listening to a 49er Monday night football game before he dozed off without warning. His new 1996 Toyota Corolla was totaled when the car crashed into a barrier on the side of the highway Continue reading

Hepatitis C – A Stealth Killer

by on October 14, 2014

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I recall my Great Uncle Sidney.  He loved to devour a delicious steak for dinner.   Eventually he had to undergo coronary bypass surgery for cholesterol-clogged arteries of his heart.   Within a decade he died!  His heart did not kill him.  He died of cirrhosis of the liver because of a blood transfusion contaminated with hepatitis C virus which he received during his bypass surgery.

Hepatitis C (HCV) is one of those conditions one hardly hears about because most people who have it don’t know they do.  Of the 3.2 million Americans who have hepatitis C, only 5-6% of them have been successfully treated.   It is 3 times more common than HIV in this country, and it is the leading cause of liver transplantation and liver cancer.  The mortality from HCV has Continue reading

The Meaning of Life – As Seen through The Eyes Of My Patients

by on September 3, 2014

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As we approach the High Holidays of Rosh Hashanah and Yom Kippur this month, I find myself becoming more reflective, particularly about what’s important in my life. Twenty years ago I was asked to complete a biographical survey for a physician newsletter about my personal interests, which included questions such as the latest book I read, my favorite movie, etc. There was one question that stood out, “What is the meaning of life?” My response, “God knows.” It occurred to me a few years later that I could delve into a better understanding of this existential question by probing my patients for their stories about what has been meaningful in their lives. You may wonder how during a 15-20 minute visit with patients I could have time for such a discussion. One cannot come out and say, “Tell me the meaning of your life,” but I felt I could approach the Continue reading

High Blood Pressure – The Hidden Killer

by on August 5, 2014

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On April 12, 1945, President Franklin D. Roosevelt was sitting in his living room having his portrait painted by artist Elizabeth Shoumatoff, who later became most renowned for “Unfinished Portrait” of FDR. Also present was Lucy Mercer, Eleanor’s social secretary, but most notorious because of her affair with the president. His dog, Fala, and two cousins were in the room as well according to biographer Doris Kearns Goodwin. At 1:00 pm, FDR complained of “traffic pain at the back of my head,” and collapsed, unconscious. His cardiologist quickly arrived and recognized the signs of a cerebral hemorrhage, a type of stroke. One could argue that one of FDR’s visitors that day triggered his stroke, but it is much more likely that years of untreated high blood pressure led to FDR’s demise at the age of 63.

High blood pressure or hypertension still remains a hidden killer at large. It is estimated that high blood pressure kills approximately 1000 Americans each day due to its effects on Continue reading

Monkey See, Monkey Do — How Behavioral Modeling Influences Health

by on July 1, 2014

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My 2-year-old granddaughter seemed to welcome her newborn baby sister with bland indifference. I observed her as she played with her blocks and other toys and did not appear to be perturbed by the presence of a new member in her family. After she had dinner, I was surprised when she set out deliberately for the couch, wrapped her mother’s pillow around her lap, lifted her shirt, and clutched her bear to her chest. It was dinner time for her bear! While it was fun to watch her precise imitation of breast feeding, it made me stop and wonder how we as adults subconsciously follow patterns of behavior that may not reach our cognitive awareness. Continue reading

HIV Awareness: HIV Testing Day is June 27

by on June 3, 2014

HIV-625My twin daughters were born in August of 1981, just two months after a publication from the CDC reported the first cases of a rare lung infection that eventually led to what became known as the AIDS epidemic. Because they were very premature, my newborn daughters required numerous blood transfusions from Irwin Memorial Blood Bank in San Francisco. One daughter received over 40 different transfusions. In 1985, the FDA approved the first blood test to detect HIV antibodies in the blood, and blood banks began their first screening of their blood supply. It was shortly thereafter that my wife and I received a letter from the Continue reading