By Kenneth A. Bartholomew, M.D.
 
Albert Einstein conducted thought experiments to figure out theoretical problems. Let’s do one of our own. Suppose that you fell and broke your left leg and had to be in a cast for eight weeks. Would you expect your left leg to be as strong as your right leg when the cast was removed? Of course not. You know that muscle that is not exercised gets smaller and softer. Secondly, would you expect that, by sitting in a recliner for the next two months, your left calf would magically grow back and strengthen to where it was before? Of course, you wouldn’t.
 
However, that is exactly what many of us do with our brains. We sit around passively and take our brains for granted. We don’t exercise the brain, yet we expect it to take care of itself. But all cells in the body need to be used or they suffer from what is called disuse atrophy. When body builders start lifting, they use muscle cells that were previously sitting idle. As these cells are exercised vigorously, they hypertrophy, the opposite of atrophy. We can do the very same thing with our brain cells, and the potential is enormous.
 
The human brain is composed of approximately one hundred billion cells, and neuroscientists using PET scans and other devices estimate that we only use about ten billion of these cells in our lifetime. That means that there are ninety billion cells just sitting on top of our shoulders waiting for something to do!
 
Different areas of our brains control different functions such as speech, walking, writing, music, math, and coordination. So, just as the body builder targets each muscle group with specific exercises, we must exercise all the different parts of our brains.
 
For example, balance is a function of multiple areas of the brain all of which can be strengthened by walking. When we walk, we strengthen the legs but at the same time we stimulate the nerves that signal the balance centers of the brain. These signals fire millions of times a second, coordinating our eyesight with inner ear and cerebellar inputs. By practicing walking in a straight line, we target the balance and coordination centers, making them stronger which can help prevent falls and that dreaded broken hip.
 
Our brains have incredible potential, but nothing happens by itself. It starts with us making the decision to exercise our brain. This decision itself originates in a different part of the brain and that, too, will get stronger with repeated use. The fact is, decisions we make daily, will change our brain every day for the rest of our lives. Decisions we make today will affect how our brain functions ten years from now.
 
We can make it happen. We can do math, balance our checkbook in our head then double-check it with our calculator. We can study history, explore music, take educational courses online or via DVD. We can learn a new language, do crosswords, read, read, read. The more we do now the better our brain, and in turn, our lives will be. 
 
Ken Bartholomew, M.D. is a contributing Prairie Doc® columnist. He practices in Pierre, South Dakota and serves on the Healing Words Foundation Board of Directors, a 501c3 which provides funding for Prairie Doc® programs. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central.   

By Mark E. Bubak, M.D.
 
Summer and fall are prime seasons for mold allergy problems. Mold spores are smaller than pollen grains allowing them to not only effect the eyes and nose of allergy sufferers, but they can infiltrate the bronchial tubes and cause asthma. If the allergy or asthma is combined with participation in sports or a rhinovirus cold at the start of school, it could result in asthma attack. 
 
Sudden asphyxic asthma is a condition during peak mold time in which younger patients with alternaria mold allergy can go from breathing well on their own to severe asthma on a ventilator in an afternoon. There are methods to be prepared and take steps to avert this situation.
 
Most mold spores originate outdoors. Staying indoors and keeping the house, office, and car closed is the main avoidance method. The air conditioner with its filter and dehumidification can help a bit more. Additional filters receive some anecdotal praise but are rarely proven clinically helpful.
 
We cannot stay indoors all the time. For most sufferers, topical corticosteroid nasal or inhaler preventative (controller) sprays must be started prior to the season. And always keep rescue antihistamines and bronchodilators on hand. Oral or injections of steroids may be needed. Allergy shots (immunotherapy) can be immensely helpful if avoidances and medications do not work well. Shots are the only treatment that makes the patient less allergic to the mold and thus reduce symptoms. Unfortunately, under the tongue immunotherapy has not been highly effective for mold allergy. More recently, new medications call biologics have arrived on the market and may be necessary.
 
Mold is a major contributor to fall allergy and asthma suffering, but the worst reactions are typically brought on by a combination of triggers. Getting your flu shot can make the flares of allergic asthma far less likely to happen. Washing your hands helps prevent colds and other infections which can exacerbate the problem. And, using your albuterol before sports activity can help.
 
If you suspect you may have a mold allergy, talk to your primary care physician first. Mold allergies can best be diagnosed with a thorough patient history and physical examination. If allergies are suspected, your doctor can refer you to an allergy specialist who can confirm the diagnosis with allergy testing. If confirmed, you and your doctor can work together to create an allergy and asthma action plan.
 
In the end, much of the responsibility for staying well is up to each of us. The best way to manage mold allergies is to be proactive, ask for help, then follow the prescribed action plan.
 
Mark E. Bubak, M.D. practicing in Sioux Falls, South Dakota is a contributing Prairie Doc® columnist. He is certified by the American Board of Allergy and Immunology to care for adults and children with asthma and allergies. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central.        

By Lauren Wood Thum, M.D.
 
Just because something is common does not mean it is normal. Many diseases are common nowadays, yet few would consider them normal. For example, while obesity and diabetes are rampant, none would argue that these conditions are normal or should go untreated. However, when it comes to problems of the urinary tract, this is often the case. Millions of individuals suffer from urinary incontinence – the involuntary loss of urine. Leakage can occur due to a strong “gotta go, gotta go” urge, activity such as coughing or laughing, or even without awareness. Few people seek treatment for these bothersome, yet very treatable, conditions. 
 
On average, patients wait six years or more to bring these urinary complaints to their physicians. And some never do. Many are under the impression that incontinence is a normal part of aging, or something one must simply live with. This could not be further from the truth. Leakage itself is rarely dangerous, however serious consequences can arise from incontinence. Waking frequently at night or rushing to the bathroom can lead to falls, which in turn can result in injury and even the need for nursing home care.
 
These situations, while dangerous, are oftentimes completely preventable. The first step is a careful history and physical examination by a specialist. People leak for a multitude of reasons, and successful treatment depends upon correct diagnosis. Most types of leakage can be eliminated or cured. Depending on the cause, often a trial of simple behavioral modifications can do the trick. These may include limiting fluid intake, avoiding bladder irritants or urinating on a set schedule. Pelvic floor physical therapy may also be an option. 
 
Some patients with a constant urge to urinate, frequent urination, or night waking may require the help of a medication. And not all medications have bothersome side effects. Fortunately, other options do exist. If medication does not work or is not appropriate, we have a multitude of office-based procedures in addition to minor surgical ones. For leakage with activity, a ten-minute procedure can cure leakage for years to come. Not every treatment option is appropriate for every patient, but the bottom line is that options do exist.
 
It saddens me to think of the number of individuals who suffer in silence with these and other very treatable complaints. And while these conditions affect up to half or more of all adults, they are not “normal”. If you are bothered by urinary complaints, be sure to let your doctor know and seek out the help of a urologist who specializes in pelvic medicine. Your quality of life could improve dramatically, and you will be glad you did.
 
Lauren Wood Thum, M.D. practicing urology in Sioux Falls, South Dakota, is a contributing Prairie Doc® columnist and guest on the Prairie Doc® television show. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central.        

By Mandi Greenway, M.D.

Last week I looked in the mirror and saw something I don’t usually see, a breakout of pimples. As a dermatologist I am fortunate enough to have the right tricks to keep my skin blemish free most of the time (some lucky genetics don’t hurt either). I’m also seeing a lot more acne and rosacea breakouts in my patients over the last few months. What might be the culprit? Wearing a face mask.
 
As the COVID-19 pandemic rages on, wearing a face mask is one of the most important ways we can prevent the spread of the disease. I urge you all to wear a cloth mask when you can’t social distance and when in public spaces. The data regarding face masks is clear, but our skin doesn’t always behave itself with frequent wearing. The good thing is that there are some simple steps you can take to keep your skin healthy while wearing a mask to protect those around you.
 
Skin issues from wearing masks can include dry skin, acne, and rosacea. Make sure to wash your face before and after wearing masks with a gentle cleanser. Cleansers are different than soaps and can clean the skin without removing normal oils. Apply a moisturizer that is tailored to your skin type: gel moisturizers for oily skin (or during those humid summer days), lotion for normal skin, and cream for dry skin. Try to get this moisturizer on after each time you wash your face as well as before bed. Dry lips are best treated with plain Vaseline.
 
If you’re going to be wearing a mask for longer periods of time it’s best to skip wearing makeup under the mask. Treat your skin gently and avoid harsh treatments like chemical peels or exfoliating. Some of the medicines we use to treat acne with can ironically cause more skin irritation while wearing masks, so be sure to discuss with your physician if you are having problems.
 
Lastly, be sure you are wearing the correct mask and washing them frequently. Cotton is the least irritating fabric and anyone with acne or rosacea should make sure that the layer that touches the face is cotton. Masks that fit well (snug but not tight) will be less irritating than masks that are too big and slide around on the face.
 
Hopefully, these simple tips help your skin stay healthy as you continue to wear your mask!
 
Mandi Greenway, M.D. is a contributing Prairie Doc® columnist. She practices dermatology in Mitchell, South Dakota. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPB most Thursdays at 7 p.m. central.