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BEST PRACTICES

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SLEEP

Sle

This is the time to renew, recharge, and rejuvenate.  90% of healing occurs while we sleep.

SLEEP HYGIENE

for most people (who do not work nocturnally or aviators on long haul flights) works well for those who have sleep problems (including insomnia, hypersomnia, trouble falling asleep, awakening from sleep), consult doctor if any sleep problems

Behavioral Treatment is paramount (allow 2-4 weeks for results)

  • awaken and sleep at routine time, when possible synchronize activity with sunlight and if not possible then bright light

  • 7-9 hours (more if young, old, sick)

  • wear comfortable clothing and lie down flat

  • dark and quiet bedroom, use only for sleep and sex

  • no electronics prior to sleep

  • no caffeine in PM

  • no late exercise

  • no alcohol (reduces deep REM sleep, worsens insomnia over time)

  • no clock watching

  • no napping

GASTROINTESTINAL

Limit: smoking, gum, caffeine, alcohol, non-steroidal anti-inflammatories such as ibuprofen, fat, stress, spicy, milk, chocolate, carbonation

Eating habits: eat 3-6x daily, eat upright and stay upright for 1 hour, chew carefully, cut food into small pieces, drink liquids to dilute food bolus, eat slowly, lubricate with sauces, small bites

SHOES: use ergonomic shoes for your daily routine

From a medical standpoint, your shoe is the most important past of your outfit and the part that most touches the earth. It is important to protect your joints and body with good cushion. However, while flip-flops are fine inside the home, outside the home they can put subtle repetitive strain on the body to keep them on your feet. For best results your usual and every day shoe should be well-cushioned and secure on your feet so you are strapped in. Invest on good shoes.

Ergonomic Shoes: Clarks, Ecco, Hoka, MBT, On Cloud, Skechers goga

Shoe Stores with variety of brands: Road Runner Sports, Comfort Wide Shoes & Orthotics

DO NOT PUT COTTON SWABS IN EAR CANALS

Cotton swabs actually stimulate ear wax production and pack it against ear drum.  Wax is a natural anti-infective against bacteria, virus, and fungus.  >90% of the people who have ear wax, have it because they are using cotton swabs or other things in the ear canals.  Use may damage the ear drum and cause hearing loss and/or tinnitus.  Therefore, there is a warning on your cotton swab (Q tip box telling you not to use it in the ear canal.  DO NOT PUT ANYTHING SMALLER THAN YOUR ELBOW IN YOUR EAR.

WHAT TO DO INSTEAD

Dab the outside outside (not the inside) of ear canal with tissue then allow the canal to air dry.

PROTECT YOUR HEARING

Limit loud noise exposure.  If necessary, wear sound proof ear muffs.

When using a headset, if the information is not private, consider the use of bilateral bone conduction headset.  It sounds like a bilateral whisper in both ears simultaneously.

HEARING AID

Hearing aids are often not used because it is a silent disability and often so gradual that it is not even noticed so often the patient with hearing loss may not even notice that they are missing out on anything.  Furthermore, they are usually expensive.  For those trying to communicate with them this can escalate into strained discussions which escalate into shouting and exposure to loud television.  This hearing aid is a high quality (not an amplifier) and affordable comparable to most expensive options.

DENTAL CARE

Brush teeth 2+ times per day and use mouthwash.

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