beverly hills

Rethink New Year’s Resolutions

I really love this article by Dr. Anna Settle. Such a great perspective and very informative.
— Dr. Dale

At the outset of each year, we vow to be more intentional about making better choices for ourselves. However, at the close of January, the novelty typically wears off and people tend to place much less emphasis on achieving their goals than they do for the first month of the year.

Why do our goals seem to fade so quickly? Often, people make resolutions to lose a certain number of pounds, fit into a certain size, or earn a specific salary. These goals, while made with the best of intentions, are not the most psychologically savvy means of achieving long-term self-satisfaction.

The most impactful part of goal setting and achievement is the time and process that is implemented in order to reach the goal itself. The process of creating a method by which you will reach a goal, and then actually sticking to that journey, is the most psychologically sound method for making a long-lasting, self-satisfying change. So, while losing 10 pounds may be a relatively realistic goal, simply subtracting those pounds from your total weight will not lead to the meaningful outcome that you desire.

Typically, when people vow to lose weight, what their psyche is actually saying is that that they are unhappy as-is. Ten pounds will not cure unhappiness. Completing a marathon will not change how you fundamentally feel about yourself. It is the process by which these goals are achieved that actually contributes to increased self-esteem and well-being. Thus, the lifestyle change that is made when working to be healthier, and the camaraderie and teamwork that results from training for a race are what actually improve self-esteem and increase happiness.

As we strive to keep our resolutions in place for the entirety of the year, here are some tips for increasing self-esteem by creating meaningful, reachable goals that will render long-term happiness and self-satisfaction.

1. Don’t quantify your goals. Setting a relatively arbitrary number based on what you think is “successful” is going to leave you with short-lived happiness. 1) Losing 10 pounds, 2) closing five business deals, and 3) going to the gym three times per week — the successful completion of these goals is focused simply on the outcome. The more psychologically savvy way of stating these goals would be: 1) to eat more healthily as a means of feeling physically better 2) modifying your business strategy so as to make you a more influential consultant, 3) carving time out in your schedule for exercising in order to increase energy level and improve mood throughout the week. These goals are similar, yet the latter ones focus on the process rather than the outcome.

2. Don’t set goals in absolutes. For example, if your goal is to give up sugar yet you decide to eat cake at a party, then you have, by definition, failed to meet your goal. There are a few habits that are harmful even in small doses but, for the most part, indulging occasionally is not going to be detrimental. In fact, from a psychological perspective, if we allow ourselves to have the cake periodically, we are going to place less value on having it regularly. However, if we formulate a goal of absolutely no dessert eating, then we place more value on the “forbidden” behavior and crave it to a higher degree. Ultimately, the goal is not to give up sugar, the goal is to focus on including more nutritious foods in your diet in order to feel better and improve your health.

3. Make sure that your goals are your goals. So often, we set standards for ourselves based on what society tells us is important. Social media fuels the desire to keep up with others’ expensive vacations, airbrushed waistlines and trendy purchases. When formulating goals, it is imperative to spend time assessing the goal, the process and the outcome. Ask yourself, does this goal align with my values? Will this goal contribute to long-term happiness? Will the time and effort I put into this goal be a meaningful way to spend my life? Asking these questions on a larger scale may help with introspection and creating goals that are a reflection of how you want to spend your time and energy.

Ultimately, goals are tools for improving. They are not tests, nor are they pass/fail. Goals should be positive, encouraging, helpful methods of guiding us along a path that coincides with our values and mission. So, if we are able to use this framework to establish some goals for the upcoming year, at the very least, we will stay on track and be mindful of how we are choosing to spend our time. That, in and of itself, will contribute to being more psychologically healthy and content.


Dr. Anna Settle is a psychologist and relationship expert who has a private practice located on Music Row in Nashville. Visit and follow her on Twitter @drannasettle and

ADHD Common in Adults With Epilepsy

This is so interesting.
Ever think you have ADHD? Speak to me during your next visit. We can refer you to a specialist.
— Dr. Dale


ADHD Common in Adults With Epilepsy

Megan Brooks

January 19, 2015

Nearly 20% of adult epilepsy patients report symptoms of attention-deficit/hyperactivity disorder (ADHD), a rate much higher than of the general adult population, a new study shows.

Epilepsy patients with ADHD symptoms also have higher rates of anxiety and depression and worse seizure frequency.

"Little was previously known about the prevalence of ADHD symptoms in adults with epilepsy, and the results were quite striking," first author Alan B. Ettinger, MD, director, Epilepsy Center at Neurological Surgery, PC, in Lake Success, New York, noted in a statement.

"To my knowledge, this is the first time ADHD symptoms in adults with epilepsy have been described in the scientific literature. Yet, the presence of these symptoms may have severe implications for patients' quality of life, mood, anxiety, and functioning in both their social and work lives," said Dr Ettinger, professor of clinical neurology, Albert Einstein College of Medicine, New York City.

The study was published online January 15 in Epilepsia.

Screen for Psychosocial Troubles

The investigators surveyed 1361 adults with active epilepsy as part of the Epilepsy Comorbidities and Health (EPIC) study. A total of 251 (18.4%) were classified as experiencing significant ADHD symptoms on the Adult ADHD Self-Report Scale, version 6 (ASRS-6), a rate four times higher than the 4.4% rate of ADHD in the general adult population.

Adults with epilepsy who had ADHD symptoms were nine times more likely to have depression and eight times more likely to have anxiety symptoms than their peers without ADHD symptoms. They also reported lower quality of life and worse physical and social function and were more likely to be unemployed.

"This study reinforces the fact that we have to broaden our view of what epilepsy entails," Dr Ettinger said. "Our patients may also have psychiatric comorbidities, and screening for and treating these may make a great difference to patients in their family, school, and work lives."

"Physicians who treat epilepsy often attribute depression, anxiety, reduced quality of life, and psychosocial outcomes to the effects of seizures, antiepileptic therapies, and underlying central nervous system conditions," he added.

"Our findings suggest that ADHD may also be playing a significant role. However, we don't know yet if ADHD in epilepsy is synonymous with ADHD in the general population, which is often responsive to treatment," Dr Ettinger said.

"As a next step, we need to validate measures to screen for ADHD specifically in epilepsy and clarify the nature of ADHD symptoms in adults with epilepsy. This will lay the foundation for future trials of treatments that offer the promise of rendering major improvements in the quality of life of adult epilepsy patients," he said.

The study was funded by the Leslie Munzer Neurological Institute. Janssen Scientific Affairs provided data access. Data analysis was performed by Vedanta Research. Dr Ettinger has served on advisory boards for Upsher-Smith, Eisai, Sunovion, and UCB and as a consultant to Ortho-McNeil Janssen Scientific Affairs LLC. The original article contains a complete list of author disclosures.

Epilepsia. Published online January 15, 2015. Abstract

Medscape Medical News © 2015  WebMD, LLC 
ADHD Common in Adults With Epilepsy. Medscape. Jan 19, 2015.

11 Reasons Dehydration Is Making You Sick And Fat

I love this! Dehydration is often one of the leading causes of symptoms I see in my office. I hope this changes the way you view the importance of drinking water.
— Dr. Dale

Adverse effects from not drinking enough water include digestive, skin, bladder and kidney problems, fatigue, and even headaches. We need water as much as the air we breathe in! Keeping your body hydrated is not a joke.

Did you know that dehydration actually sets in just before you start feeling thirsty? Sipping water throughout the day is the best way to handle it. Always have a bottle or a glass of water handy! If you’re not a morning person, having two glasses of water right after you wake up will boost up your blood pressure to normal levels, and it’s way healthier than having your first coffee on an empty stomach.

Many of us believe that merely drinking fluids like sweetened juices, soda or tea will hydrate you as well as water does. This is not true. It’s actually the opposite! To deal with the excess sugar and salt you are taking in your body wastes immense amounts of precious water just to clean it out from your system. And if you love your coffee, make sure to drink one extra glass of water for every cup you have.

Drinking water regularly speeds up your metabolism and makes you feel more ‘full’. You will eat less once you start drinking more! It’s the safest and healthiest way to lose weight. Drink up!

Is Screening Colonoscopy Worth It?

Hey guys, 

As you prepare for fall... the jackets, scarves and pumpkin spice lattes are sure to keep you comfortable as Los Angeles attempts to drop in temperature.  As the new season welcomes leaves to your lawn, it's also a great opportunity to turn over a new leaf yourself, and end the year in tip-top shape.

Did you know?  Colon Cancer is the second leading cause of cancer death in America, responsible for 58,000 deaths per year.  Did you know that a colonoscopy screening can prevent over 90% of these?

Everybody age 50 to 75 should be screened for colorectal cancer.  Patients at high risk—notably those with a family history, a known genetic risk, inflammatory bowel disease or certain other disorders—should start earlier.  

What are you afraid of?  A lot of people are unaware of their need to be screened with a colonoscopy. And even worse, many know they need it, though they are afraid of the procedure.  

Please, don’t be scared.  And please don't be stubborn. Do yourself and your family a favor and strongly consider giving me a call so we can take care of you.  And if you're under the recommended age of 50, please share this and encourage a loved one.  

Let's check-off the "I'm healthy!" box as you close 2014 safe and sound.  

It's a proven lifesaver.  And I'll be by your side the entire time.

Live well, 

-- Dr. Dale



THIS IS GOOD NEWS!!!!! -- Dr. Dale



Dramatic Decline in CRC in US Attributed to Colonoscopy

The latest statistics on colorectal cancer (CRC) in the United States, which go up to 2010, show that both incidence and mortality rates continue to fall.

Overall, deaths from CRC have been falling at around 3% per year over the last decade (2001 to 2010). Overall incidence rates have also been falling, by an average of 3.4% per year, but there is a marked variation by age. Incidence is decreasing in adults over 50 years of age, with a particularly sharp drop in the over-65s, attributed to colonoscopy, but it has increased slightly in younger adults under the age of 50. And blacks still have the highest burden of disease; they are 25% more likely to be diagnosed with colorectal cancer and 50% more likely to die from the disease than whites.

The findings, by Rebecca Siegel, MPH, and colleagues from the American Cancer Society, were published online March 17 in CA: A Cancer Journal for Clinicians.

The team analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program and the Centers for Disease Control and Prevention's National Program of Cancer Registries, as provided by the North American Association of Central Cancer Registries (NAACCR).

Dramatic Decline in the Over-65s

The researchers highlight the "dramatic decline" in CRC incidence seen in older adults (over 65s); it was falling at a rate of 3.6% from 2001 to 2008, but this decline accelerated in the last 2 years for which data are available, to 7.2% from 2008 to 2010.

This fall is probably related to the higher screening rates in this age group, Siegel told Medscape Medical News. Adults 65 and older have fewer barriers to screening related to cost because they are eligible for Medicare, which has covered colorectal cancer screening even for those at average disease risk since 2001.

In 2010, 64% of adults 65 and older reported being current for colorectal cancer screening versus 55% of adults 50 to 64, she noted. Although there are several different tests available for CRC screening, the "dramatic declines in incidence in recent years have been largely attributed to the uptick in colonoscopy because it is the only test for which use increased from 2000 to 2010; use of fecal immunochemical testing and sigmoidoscopy declined during that time period," she explained.

Colonoscopy offers a double whammy in that it can both prevent CRC by detecting and removing precancerous polyps and detect the cancer in its early stages, when there is a better chance of successful treatment.

Stool tests are very good for detecting cancer early, but much less able to lower incidence by detecting precancerous lesions, Siegel told Medscape Medical News.

Used to Be Top Cancer Killer

Back in the late 1940 and early 1950s, CRC was the most common cause of cancer death, the researchers note.

Now it has dropped to the third leading cause of cancer death (after lung cancer and prostate cancer in men and breast cancer in women).

This is in part due to historic changes in risk factors (such as decreased smoking, decreased red meat consumption, and increased use of aspirin), as well as the introduction and dissemination of early detection tests and improvements in treatment, the researchers write.

"This is great news," Siegel commented. "Colorectal cancer is 1 of only 2 cancers that we can actually prevent through screening, with cervical cancer being the other."

"Unfortunately, many adults — 23 million Americans — who should be screened for colorectal cancer have never been tested. It's important to get the word out about how life-saving these screening tests are," she said.

This point was highlighted in a press release from the American Cancer Society (ACS). The continuing drops in CRC incidence and mortality "show the lifesaving potential of colon cancer screening," commented Richard Wender, MD, chief cancer control officer at the organization.

The data in the study show that colonoscopy screening (in adults aged 50 to 75 years) increased from 19% in 2000 to 55% in 2010.

Dr. Wender highlighted an initiative from the National Colorectal Cancer Roundtable that aims to increase screening rates to 80% by 2018.

Disturbing Increase in Younger Adults

While the overall incidence of CRC has been falling over the last decade, the researchers note a distinct age divide — with a decrease of 3.9% per year among adults aged over 50 years, but an increase in incidence of 1.1% per year among adults under 50 years of age.

This increase in CRC among younger adults was confined to tumors of the distal colon (increasing by 1.3% per year) and the rectum (1.8% annually).

"Although the cause of this increase is unknown, the rise in obesity prevalence and the emergence of unfavorable dietary patterns have been implicated," they write.

A similar trend has been reported in Norway, the researchers note.

"We were actually among the first to publish this disturbing trend in 2009," Siegel commented. "Although the obesity epidemic is the obvious culprit, the rise is the strongest for rectal cancer and a link between obesity and rectal cancer has not been firmly established in women."

"It's important to note that ACS guidelines do recommend colorectal cancer screening beginning at age 40 for adults with first-degree relatives who were diagnosed with 1 or more polyps before age 60," she said.


[Follow up is important] even in young adults who are unlikely candidates for the disease.


"It is also important that clinicians are diligent about follow-up of colorectal cancer symptoms, even in young adults who are unlikely candidates for the disease," she added.

Higher Burden in Blacks

The review shows blacks continue to have the highest burden of disease.

The incidence of CRC is highest in blacks (approximately 25% higher than in whites), and there is an even greater disparity for CRC mortality rates, which are approximately 50% higher in blacks compared with whites (29.4 vs 19.2 per 100,000 population).

"A higher prevalence of risk factors and lower screening prevalence contributes to both the higher incidence and mortality in blacks," Siegel commented.

"In addition, blacks have lower survival than whites even for similar-stage disease. This is because blacks are less likely to receive standard-of-care treatment, including surgery, adjuvant chemotherapy, and radiation," she explained. Studies show that for similar-stage disease, equal treatment results in equal outcomes, she added.

In the study, the researchers trace back the history of this disparity. CRC mortality used to be lower in blacks compared with whites in the 1960s, and the racial crossover occurred around 1970 for women and 1980 for men. After that, rates diverged rapidly over the next 3 decades. During the 1980s and 1990s, steep declines had begun in whites, but the rates in blacks were still increasing (in men) or were stable (in women). This mortality gap appears to have leveled off in recent years, the researchers write. From 2006 to 2010, annual declines in mortality rates were similar among black and white men, and slightly larger among black than white women.

"The good news is that the gap in mortality rates between blacks and whites appears to have peaked in the mid-2000s and may be slowly growing smaller," Siegel commented.

AIDS Healthcare Foundation gives hundreds of meningitis vaccines

By Anna Gorman, Los Angeles Times

Reacting to the death of a young West Hollywood lawyer over the weekend and growing concerns about the possible spread of bacterial meningitis, the AIDS Healthcare Foundation gave hundreds of free vaccinations to visitors who showed up Monday at its facilities.

The organization, which initially ordered about 1,000 doses and plans to acquire more, said it would continue providing the shots as needed.

Brett Shaad, 33, contracted meningitis and died several days later after attending a gathering of gay men in Palm Springs.

"We needed to do something," said Karen Haughey, one of the nurses who was administering the shots Monday. "We needed to step up now because we want to prevent an outbreak."

Bacterial meningitis can be transmitted by coughing and kissing, though it is not as contagious as the common cold. The disease is treatable with antibiotics but can be fatal.

Shaad's case is the only one reported recently to L.A. County health authorities and the federal Centers for Disease Control and Prevention. But public health officials said they were remaining vigilant and watching for more cases and continuing to examine the bacterial meningitis strain contracted by Shaad.

An outbreak of the disease in New York, primarily among gay men, has infected nearly two dozen people and killed seven victims in recent years. Officials do not yet know whether the cases in New York are related to the local one.

On Monday morning, dozens of men lined up outside the AIDS Healthcare Foundation's West Hollywood pharmacy.

Mark Chavez, a landscape architect who lives in West Hollywood, said he decided to get the vaccine after hearing about Shaad's death. Chavez said he feared the disease could spread and things "could get worse."

"You just don't want to take that chance," he said. "Gay or straight, everyone should be aware of it."

Allen Smith, a 21-year-old dance student, said he had a weak immune system and wanted to make sure he was protected against contracting the disease. News of the weekend death, he said, "reminded everyone how short life really is."

Eric Aronson, 41, of West Hollywood, said he was concerned that he could have been exposed to the illness during a recent trip to New York. He heard about the free vaccines over the weekend and showed up early Monday morning.

"It does make you worry," he said. "We could all be susceptible."

Brett Thompson, an art director who works in New York and Los Angeles, said he had been trying to get the vaccine for more than three weeks. "I couldn't find anybody who carried it," he said.

The disease is "really scary," he said. "You could get it on a Saturday and be dead four days later."

When he finally got in to see the nurse, Thompson, 56, learned the vaccine available was for people 55 and younger. He would have to come back another day.