When your doctor wants to check the function of your heart, he will use an electrocardiogram and often an echocardiogram to measure how your heart is working.
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Category Archives: Dr. Jorge Bordenave
Diet Soda
The debate over diet soda is reaching something of a peak. Many now believe that it actually can cause weight gain. There are several theories making the rounds, but whatever the findings, soda really has no place in a healthy diet because it contributes nothing nutritionally.
As Physicians, We Still Don’t Get It
I have read the AHA/ACC Statin Guidelines, as well as many of the tidal wave of articles printed both for and against the new recommendations, most written by equally respected expert physicians.
Is it just me or has something drastically changed with the practice of medicine in the U.S.?
I realize that medicine has transitioned from a most noble profession to a business, but it is mind boggling to notice such a wide diversity of expert opinions that differ and contradict each other. Most of those in favor of the new recommendations are cardiologists. After all, the American College of Cardiology and American Heart Association put out the recommendations. One prominent cardiologist even wrote he was surprised at the standard therapy for those 75 or older, with no statin recommendation for primary prevention in the elderly. Others, including the American Association of Clinical Endocrinologists, are so opposed to the new guidelines, that they will not endorse or follow the new recommendations.
If this isn’t concerning enough, two months later, the new BP Guidelines from JNC-8 were released. Raising of target BP to a systolic of 150mmHg and the elimination of previous target systolic pressure of 130mmHg in diabetics and those with chronic kidney disease. Most controversial and embarrassing still, was the defection of 5 of the 14 members that formed the panel, each of whom came out in opposition to the conclusions after its release.
Let’s forget about the methodology used to create the guideline. Forget about the recommendations, and forget about the reasons why so many experts are in disagreement. What I see as the real issue is a complete shift in what is important to us as physicians.
It seems that there is an obsession with guidelines. We have so many guidelines that there is a guidelines clearinghouse to store them. There is also concern with the way guidelines are developed. A process with little or no transparency, made up of experts from a diverse body of special interests whose goal it seems is self-promotion for himself or herself or the organization they represent.
As a practicing physician, I am guide-lined to death. What’s worse is that very few physicians individualize the recommendations as they should, instead applying them equally to all patients, in a “one size fits all” model.
A serious problem arises for all of us when the recommendations by one medical group are not recognized or accepted by another medical group.
When there is disagreement and opposition among the members of the guideline panel that releases recommendations anyway, then in my opinion we have a severely damaged and broken system.
We have experts that can’t agree on much and the patients and physicians who don’t know what to believe in or who to trust.
“First do no harm.” Maybe guideline panel members should continuously remind themselves of that phrase while they are formulating new guidelines.
It seems that in medicine there are too many “experts” giving too many recommendations that only cause confusion. It’s a disservice to patients and physicians. It needs to stop before we loose what little credibility we have left as physicians.
Science fails medicine not through lack of competence, but through lack of vision. Not for the lack of curiosity, but for the limit of things we are curious about. Not for the lack in the ability to investigate, but for the narrowness of the scope of things it is willing to investigate.
I am still waiting for the day that guidelines are published, that deal with the cause of chronic disease instead of the treatment. When all medical organizations, health groups and wellness stakeholders can unite in agreement demanding better quality and a more affordable food supply for the entire U.S. population. We need to start subsidizing organic produce and farming, stop the routine use of antibiotics and hormones in livestock, limit chemicals in our foods and improving the water supply. We should have nutrition education that starts in elementary school and we should begin reinstating physical education periods. This is what is needed, not more guidelines that push more drugs on a country overdosing in drugs.
This isn’t being an idealist, this is being a responsible physician.
Despite all the guidelines published and the increased use of statins, we spend $60 billion a week in healthcare and all we have to show for it is being in 46th position in healthcare outcomes and quality, behind Iran and ahead of Serbia.
Maybe its time we remember to put patients ahead of other interests.
This article has been written by:
Jorge Bordenave MD FACP ABIHM
Integrative Cardiologist
Miami Integrative Medicine
Using a Mix
Combining the best that science can offer, along with thousands of years of experience is what integrative medicine achieves. Using general internal medicine and complementary medicine provides a patient with overall better results.
The Debate over Sugar Substitutes
The first artificial sweetener, Saccharin, was actually discovered in 1876 by accident when a research team was researching something totally unrelated. However, it didn’t make it to market until the 1950s when it was hailed as a boon for those trying to loose weight as they could give up table sugar (sucrose) and its calories. Being 300 to 500 percent sweeter than sucrose, it only took a drop in your coffee rather than several teaspoons to get the desired sweetness – that is if you could get past the bitter aftertaste.
Cancer Scare
A study in 1960 claimed that high levels of saccharin caused bladder cancer in rats. In 1977, Canada banned its sale based on the U.S. animal research. The U.S. however, rather than banning the substance, delayed the ban and instead called for a warning label on the substance packaging and directed that more research be conducted.
Eventually, further research showed that the cancer danger did not translate to humans. Based on critical differences between species that take place in the bladder, the threat of cancer to humans was misplaced. However, the damage was done and several countries still ban the substance.
Other Sugar Substitutes
Since the appearance of saccharine, there have been numerous artificial sweeteners created. The sugar substitutes Sucralose (Splenda), and aspartame (Equal, NutraSweet), are artificial sweeteners. The more recent to market stevia (Truvia) and mogrosides (Nectress, made from monk fruit) are derived from plants and are considered to have a natural basis, rather than something created in a laboratory. Although Truvia and Nectress are naturally derived, they are generally lumped in with artificial sweeteners simply because they are not “sugar.” Most sugar substitutes are many times sweeter than regular table sugar. Stevia, for instance, is 250 times sweeter than sucrose.
Other substitutes include maltitol, sorbitol, xylitol and many others. Maltitol and sorbitol are often present in mouthwash, toothpaste and foods that are “no sugar added.” Xylitol is what is usually added to sugarless gum because aside from having no calories, it also prevents cavity causing bacteria from sticking to teeth.
Sugar Substitute Debate
Few people would argue about the benefits of non-caloric sugar substitutes. Although mostly touted as a weight loss tool, they are highly beneficial to diabetics as it allows them to enjoy sweets without worrying about sugar levels in their blood.
To date, the biggest debate over sugar substitutes is about their safety for human consumption. Detractors question the ability of the human body to process food products containing ingredients created in the laboratory, or overly processed natural products, without there being negative health consequences.
So far, medical information has not proven any derogatory or cancer causing effects of sugar substitutes. Aspartame has been the most widely studied and tested of all food ingredients up to this point. Time after time however, peer reviewed articles and independent government regulatory bodies continue to find that aspartame is safe.
Possible Cause of Weight Gain
Although attempts to show that sugar substitutes are the cause of disease, there is growing belief that it may actually cause weight gain rather than help people to loose weight.
The epidemic of obesity in the U.S. that is contributing an upswing in coronary heart disease, may bear out this belief. Although people have the capacity to consume fewer calories with the proliferation of sugar free, calorie free, sweeteners, they are apparently consuming more, leading to obesity and resultant heart disease.
The effects of sucrose (table sugar) on the body are well documented, but the effects of sugar free sweeteners are not. Current research is showing that sugar free sweeteners produce the same responses as sucrose, but without the same results. Sweetness triggers an increase in insulin production, along with hormones that trigger a feeling of fullness and reward, along with the release of dopamine. When the promised calories repeatedly don’t come along, the body stops responding the way it should, thus increasing the desire for more food that will produce the desired results.
At Miami Integrative Medicine we can help you better understand how food and nutrition can affect your health and wellness. With the right diet and moderate exercise, you can reduce or eliminate your need for sweeteners of any kind. With the combination of general internal medicine, complementary medicine and effective cardiology, good health can be achieved. Contact us today for a consultation. Dr. Bordenave, a triple board certified physician in Internal Medicine, Cardiology and Integrative Medicine, will be pleased to have you visit.
Published by Axiom Health Care Marketing
Prevention
A large part of cardiovascular disease could be avoided simply by following a healthy lifestyle, diet, and stress reduction; something that most of us, unfortunately, don’t follow in today’s world.
Acupuncture Benefits
Although science hasn’t figured out how it works, more and more mainstream doctors suggest acupuncture of some types of pain.
Aromatherapy
Research has shown that aromatherapy can be beneficial for relieving stress. Smelling scents such as lavender are known to be soothing and relaxing.
Massage
There is nothing quite like a massage to relax tight muscles. Even if it’s a shoulder rub from a friend, the warm contact can melt away the stresses of the day.
Learn About Acupuncture
The practice of acupuncture is carried out most often by placing very small needles into the skin to stimulate certain places in the body. Acupuncture originated with the Chinese and has been a part of traditional Chinese medicine for many centuries.
The Flow of QI
The earliest written record of the use of acupuncture is dated as far back as 200 BCE, but there are other indicators and artifacts that put the practice of acupuncture as far back as the Stone Age. One explanation for the practice is that Han Chinese doctors noticed that soldiers who were wounded in battle by arrows became cured of other afflictions.
Acupuncture is used to correct the flow of QI. Traditional Chinese culture believes that every living creature has QI, a natural flow of energy throughout the body. QI is often interpreted as “natural energy,” “energy flow,” or “life force.” A literal translation is “breath,” or “air.”
This idea that there is a vital energy throughout us is not confined to the Chinese. Many other cultures, such as the Hindu, Hawaiian, Hebrew and Tibetan Buddhism hold similar beliefs. The idea is represented in Western culture in the popular Star Wars movies as “the force.”
It is believed that an imbalance in the flow of QI is what causes pain, illness and disease. QI flows through meridians in the body and the practice of stimulating specific parts of the body, acupuncture points, fixes the imbalance and allows QI to flow properly.
There are meridians for the different parts of the body, such as one for the lungs, one for digestion, heart, hands, feet, head, etc. Placing acupuncture needles along a specific meridian will allow QI to flow and relieve the illness.
Science Meets Chinese Medicine
For decades, science has been trying to determine if acupuncture actually works, and if it does, how it works. Studies have come up with mixed results. Normal testing procedures are difficult to use because of the nature of acupuncture and coming up with a placebo. Finding an explanation for such things as acupuncture points, meridians and QI is also eluding researchers.
However, research is showing some glimpses into how acupuncture might work. Studies conducted with animals and humans shows that multiple biological responses take place when acupuncture is used. Responses have shown locally, near the application site and at a distance from the site through sensory neurons within the central nervous system. This leads to pathway activation that affects physiological systems in the brain and periphery.
There is a great deal of evidence that shows that opioid peptides are released by acupuncture. Acupuncture’s analgesic effects are partly explained by their release. It is also thought that acupuncture stimulates the hypothalamus and pituitary gland. It has also been documented that secretion of neurohormones and neurotransmitters, and changes in blood flow regulation are altered. In addition, immune function changes have also been noted with the use of acupuncture.
Uses for Acupuncture
Despite the inability of science to produce unequivocal proof that acupuncture works, it has been gaining popularity, not only among patients, but also among the medical community. The medical community, on the whole, is beginning to see the benefits of holistic medicine as a part of complementary medicine practices to help patients achieve health and wellness.
It is accepted that acupuncture is effective in treating nausea and vomiting in adults after they have had chemotherapy or surgery. It is also effective in treating post-operative dental 
pain. Use for relief of osteoarthritis pain in the knee is highly successful with acupuncture. Relief of pain is one of the main uses for acupuncture, including pain from migraines and low back pain. It is also used for many other medical problems such as asthma, epilepsy, heart disease, addiction and insomnia. A list of diseases that are treatable with acupuncture has been created by The World Health Organization.
Acupuncture has very few, to no, side effects and is safe when sanitary practices are followed. Use of needles is regulated by the government. Acupuncture should not be used as an alternative therapy to the exclusion of contemporary medicine, but should be used as part of an integrative medicine plan. Following general wellness practices, eating a good diet and practicing relaxation techniques can help you live a happier, healthier life.
Dr. Jorge Bordenave of Miami Integrative Medicine invites you to learn more about acupuncture and integrative medicine to see how a more natural approach can help your feel your best. Give us a call today.
Published by Axiom Health Care Marketing