Dr Gary Brewton Earns National Recognition for Patient-Centered Care

Dr-Gary-Brewton-Award-National-Committee-for-Quality-Assurance

I’ve got some breaking news for you… We’ve just been awarded the top quality award (Level 3) from the National Committee for Quality Assurance (NCQA), based in Washington, D.C. This Patient-Centered Medical Home award measures the quality of our evidence-based medicine and patient-centered care.

I’d like to thank our staff, our colleagues at Memorial Hermann Hospital and most of all — our patients — for your support over the years.  This award goes to each of you! 

It represents well-deserved recognition for all of your efforts, and it’s a testament as to how we’ve been able to work together as a team in pursuit of better health.

Read the press release about Dr Gary Brewton’s NCQA award.

 

How Houstonians Can Prevent Getting Mosquito Diseases Like West Nile, Chikungunya and Dengue Fever

Female Aedes aegypti mosquito hard at work feeding off a human host. This daytime biting mosquito is the primary vector for transmitting Flavivirus Dengue (DF) and Dengue hemorrhagic fever (DHF). Image courtesy CDC / James Gathany

Female Aedes aegypti mosquito hard at work feeding off a human host. This daytime biting mosquito is the primary vector for transmitting Flavivirus Dengue (DF) and Dengue hemorrhagic fever (DHF). Image courtesy CDC / James Gathany

Which Mosquito Diseases Do We Need to Worry About in Houston?

We want to scare you, just a little bit. At least just enough to take mosquito-borne diseases and mosquito control seriously.

That’s because we are now have three different mosquito-borne diseases that are of concern in Houston: West Nile virus, Chickungunya virus and Dengue virus.

Mosquito Diseases: West Nile Virus Activity in Houston and Harris County

Since first arriving in the U.S. in 1999, West Nile virus has established itself in many areas of the country, including Texas. The Center for Disease Control (CDC) has created an online mapping tool, called ArbotNET, which tracks areas where West Nile is active. We’ve made a screen shot using the mapping tool to show the total number of West Nile cases in our region.

doctor-gary-brewton-physician-houston-downtown-west-nile-virus-map

The West Nile Virus Can Cause Two Different Human Diseases

The first is called West Nile neuroinvasive disease (WNND). It’s the more severe form of the illness; it can cause headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness and paralysis.

The second disease caused by West Nile virus is West Nile fever (WN fever). Symptoms of WN fever include (obviously!) fever as well as headache, body aches, and occasionally a skin rash on the trunk of the body and swollen lymph glands. According to the Texas Department of State Health Services,

The Texas Department of State Health Services released its own update on September 16 with a detailed breakdown on West Nile virus activity in Houston. To date, they report that Harris County has had twenty confirmed cases of WNND and five confirmed cases of WN fever so far in calendar 2014.

We will look at West Nile in more detail in a future update.

Mosquito Diseases: Dengue Virus Activity in Houston and Harris County

Dengue virus is a huge problem world-wide. The CDC estimates as many as 400 million people contract the virus each year, primarily in the tropics. Below we have another screen capture taken from the CDC Disease Mapping tool showing where Dengue virus (DENV) has been detected.

doctor-gary-brewton-physician-downtown-houston-dengue-fever-map

If you look closely, you will see the active selection on the mapping software is set to DENV(imp). This selection show cases believed to be “imported” by visitors or tourists who contracted the virus elsewhere (generally in the tropics) and brought it with them to the Houston area (rather than having contracted it by local mosquito infection).

Visitors to Puerto Rico, Latin America, Southeast Asia and the Pacific islands need to be especially alert for these areas are high risk for the disease.

The CDC has not yet identified any locally acquired Dengue virus infections in Texas during 2014. There is in fact some debate among area health officials whether Dengue virus may now be sufficiently established in the Houston region to enable transmission via local mosquitoes. Most agree that if it’s not the case today then it’s only a matter of time.

 

Both the Dengue virus and the Chikungunya virus (discussed below) are transmitted by Aedes mosquitoes (as shown in the photograph at the top of this article). These type of mosquitoes are active during the day, so you shouldn’t drop your guard and only worry about mosquito protection during the early morning and dusk hours.

 

 

Like West Nile Virus, the Dengue Virus Can Cause Two Different Diseases in Humans

The most common disease is Dengue Fever, also commonly called breakbone fever. This disease can bring on symptoms like fever, headache, muscle and joint pain, as well as a skin rash that looks similar to measles. To date there is no vaccination to prevent or medication to treat Dengue virus diseases.

Less common is a more severe, life-threatening disease called Dengue Hemorrhagic Fever. Patients who contract it can bleed and lose blood plasma as the skin and organs develop hemorrhages.

We will investigate Dengue in more detail in a future article.

Mosquito Diseases: Chikungunya Virus Activity in Houston and Harris County

Like the Dengue virus, Chikungunya virus can cause fever and debilitating joint pain. The virus — once limited to Southeast Asia and Africa — reached the Caribbean islands toward the end of 2013, where it has since infected thousands of people.

Chikungunya virus has also reached Texas this year for the first time. However public health officials contend that all cases of Chikungunya virus infection in our area have been imported from elsewhere, e.g. those who contracted the virus did so outside of the continental United States.

To date, the CDC disease mapping tool hasn’t been updated to include Chikungunya virus infections. But the Texas Department of State Health Services announced on September 9th that they had identified 19 cases of Chikungunya across Texas, with 4 cases confirmed in Harris County and one each in Brazoria County and Montgomery County.

Indicative of the heightened level of concern about this new disease, the U.S. Defense Advanced Research Projects Agency (DARPA) is conducting a contest with a $150,000 award for the best epidemiological / mathematical model predicting how this mosquito-borne Chikungunya virus will spread across the Americas.

Checklist on How to Avoid Getting Infected by Mosquito-Borne Diseases

1. Avoid Bites from Mosquitoes in Daylight Hours too, Not Just at Dusk

Back before West Nile virus arrived in Houston, you may have learned that mosquito bites at dawn and dusk were the ones to really worry about, because the mosquito species active in the evening and early morning were considered the most likely to transmit encephalitis and malaria. This is true. But since the arrival of West Nile virus we have to worry about daytime mosquito activity too. Many types of mosquitoes can harbor West Nile virus, including Aedes aegypti, which is active in the day. Now that we are at risk for Dengue and Chikungunya, both of which are transmitted by Aedes aegypti, it’s even more important to avoid mosquito bites during daylight hours.

2. When Outside Use Mosquito Repellent and Wear Protective Clothing

The CDC has a guide for effective mosquito repellent use. They recommend choosing products with one of the following ingredients: DEET, picaridin, IR3535, certain varieties oil of lemon eucalyptus or para-menthane-diol.

 

Caution: Do not use permethrin products (not on the list) on your skin.

 

Wear socks, long pants and long-sleeved shirts when possible. This will help prevent mosquito bites. If some of these are made of thin fabrics, the mosquito may bite anyway, so apply mosquito repellent to thin fabrics.

3. Analyze Your Environment and Think Like a Mosquito

While the shorter-lived male mosquitoes are feeding on flower nectar and sweet juices, the female mosquitoes are searching for blood to nourish the eggs they develop. They use chemical sensors to detect carbon dioxide and lactic acid (and sometimes sweat) up to 30 yards away.

They are on the lookout for movement — this indicates you are alive! And, if you wear clothing that contrasts with your surroundings, you’ll be a more noticeable target to mosquitoes as well.

Finally mosquitoes can detect heat sources from a distance — they can sense warm-blooded animals, like us humans.

 

So if you have been working in the yard, you are a prime target due to exhaling Co2 and sweating! If you plan on working for a long time, it would be ideal if you could take a break partway to rinse off in the shower, change clothes and re-apply mosquito repellent before going out to work again.

The female mosquito needs to find still standing water to lay her eggs, which can total up to as many as 500 during her lifetime. The water needs to be still for about a week for the mosquito larvae to develop into young adults.

If You Were a Mosquito, Where Would You Look for Still Water?

You’d look for still water in the alley — discarded car tires are the best mosquito hatchery ever devised. Or maybe you’d find still water in mud puddles, stopped up drains or gutters, flower pot drip plates or even large upturned magnolia leaves lying on the ground. All are ideal locations for mosquito reproduction. Think like a mosquito and drain the water from these areas at least once a week.

If you can’t drain the water for some reason (like a rain-barrel collecting water from your gutters example), consider some other options:

  • Buy a couple of goldfish who will gladly eat the larvae that hatch
  • Add a pump and fountain to make the water flow
  • Use non-toxic mosquito ‘dunks’ in the water
  • Add a little vegetable oil to the the surface of the water to prevent mosquito larvae from hatching

Concerned About a Mosquito Bite? Give Dr Brewton a Call for an Appointment

It’s hard to avoid getting bitten by mosquitoes even with these tips from the CDC. So if you have a concern about a mosquito bite, call us at (713) 529-9224 and schedule a same day doctor appointment. We are open Monday through Friday from 8:30 a.m. to 5 p.m.

As always, if you are having an urgent medical emergency, call 911 immediately.

 

Everyone’s Getting Flu Shots Early This Year

Now is the time to get a flu shot! Stop motion photo of a sneeze in progress shows just how far germ-carrying droplets travel -- so cover your mouth when you sneeze or cough and call us to get your flu shot.  Image courtesy CDC / James Gathany

Now is the time to get a flu shot! Stop motion photo of a sneeze in progress shows just how far germ-carrying droplets travel — so cover your mouth when you sneeze or cough and call us to get your flu shot. Image courtesy CDC / James Gathany

Winter is Coming, We Promise. Flu Season is on the Way too.

Even though we’ve had a few weak cool fronts visit the Houston area, it’s still hard to feel like Winter is on its way. Yet according to the Farmer’s Almanac we’re in for a record-breaking cold Winter across the nation — and our area will be ‘Brisk and Wet’ — a perfect recipe for a miserable flu season ahead.

Be Prepared This Time. Get your Annual Flu Shot Today.

We have the latest flu shot in stock at the office. Get your flu shot appointment today and get extra protection and peace of mind for the upcoming season.

Not Sure of the Need for a Flu Shot? This Study May Convince You.

A study released this past week at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) demonstrated the speed that viruses spread around the workplace.

Researchers used samples of bacteriophage MS-2 to simulate the spread of human norovirus. (The MS-2 phage has similar characteristics to norovirus making it suitable for testing but unlike norovirus it doesn’t make human subjects violently ill.)

It turns out that when a just a couple of test samples were placed on either a door knob or a table surface, the MS-2 phage spread widely across an entire office in just two to four hours time. That’s fast!

Specifically, researchers found the sample virus had spread to between 40% and 60% of:

  • people working in the facility
  • commonly touched objects (light switches, telephones, tables, sink taps, etc.)

all within the first two to four hours!

Flu Shots and Good Hygiene: A Good Combination for Avoiding Getting Sick

Step One is to get a flu shot for increased protection against this season’s flu virus.

Step Two is to wash your hands throughout the day, and each time your use a co-workers keyboard or you visit the office break-room or kitchen mess. These are ‘hotspots’ for transferring organisms.

Step Three is to rethink how you clean. We urge you to avoid using regular kitchen sponges to wipe up spills and clean surfaces. Unfortunately sponges are very effective at spreading pathogens from one area to another.

Forget using sponges. Instead, consider switching to disposable wipes like paper towels, or, for even more protection, you might want to follow the advice of the researchers in the study. They recommend using Quaternary-based, EPA-approved disinfectants, particularly on commonly touched surfaces in a public environment.

What’s a Quaternary-based Disinfectant?

Many of the worst illness-causing bacteria and virus organisms have a negative surface charge on their outer membrane. Quaternary-based disinfectants (also known as Quats) have been formulated with positive-charge surfactants, making them especially attractive to the negatively-charged pathogens. (Think of the positive and negative poles of two magnets — they want to pull together thanks to their opposite magnetic fields).

As a result, the active ingredients of Quat disinfectants can attach themselves quickly to the surface of the pathogen organism’s outer membrane. Once they are in position, the disinfectant chemicals breaks down the cell walls, effectively destroying the virus or  bacterium pathogen in just a matter of minutes.

If you are looking for products to clean your office or public spaces where many people gather, Clorox has a line of quaternary-based professional products for sanitizing healthcare facilities.

 

Healthy Recipe for Smoked Eggplant Curry

Different eggplant varieties at Houston markets inspired this healthy recipe: A Smoked Curry Eggplant that's sweeter thanks to Asian and Baby White Eggplant. Upper left: Asian Eggplant. Lower left: White Eggplant. Right: 'Regular' Eggplant. Image courtesy J. E. Fee.

Different eggplant varieties at Houston markets inspired this healthy recipe: A Smoked Curry Eggplant that’s sweeter thanks to Asian and Baby White Eggplant. Upper left: Asian Eggplant. Lower left: White Eggplant. Right: ‘Regular’ Eggplant. Image courtesy J. E. Fee.

We came across a bountiful selection of eggplant at area markets in the past week. 99 Ranch Market (1005 Blalock Rd on the north side of Katy Freeway in Spring Branch) had a big selection of bright purple Asian eggplants; they are longer and thinner than the dark variety normally on sale. They also taste very sweet. Canino’s had a shipment of baby white eggplant, which we also wanted to try in a healthy recipe.

You might recall we’ve suggested an eggplant pizza recipe before but this time we wanted to try something new.

We found an excellent healthy recipe from VeggieBelly, which is in turn adapted from Sanjeev Kapoor’s book, How to Cook Indian. As the website name suggests, this is a vegetarian version. We used all three types of eggplant when cooking this recipe — the long bright blue Asian variety, the eggshell white variety and the regular aubergine eggplant — and the result was a bit sweeter and more delicate than using the regular eggplant alone.

 

Main Ingredients Quantity
Tomatoes 3 medium whole tomatoes
Cashew Nuts 6 whole nuts
Butter, Ghee of Vegetable Oil 1 tablespoon
Eggplant 1/2 pound white or purple
Ginger Paste 1/2 teaspoon
Garlic Paste 1/2 teaspoon
Garam Masala 1/4 teaspoon
Chili Powder 1/4 teaspoon or to taste
Whole Lemon 1 medium, to make 1 teaspoon juice

 

If you want to add the smoked flavor, you’ll need access to a BBQ or a gas stove and these items:

Optional Ingredients
Quantity
Charcoal (must NOT have additives or be self-igniting) one large piece (lemon-size)
Vegetable Oil 1 teaspoon

Of course if you are going to be barbequing other foods on a charcoal grill, you won’t need to purchase anything additional, just place the cooked eggplant dish on a low heat area and ‘borrow’ the smoke while you cook your other items.

 

Cooking Directions
Boil whole tomatoes in water. When the skins start to blister, remove from heat, drain and set aside to cool off. Peel the skins, remove the core, then add them to the blender. Add the cashew nuts. Puree and set aside.

Peel the eggplant (optional) then cube into 1″ squares. Heat the butter/ghee or oil in a skillet until it melts and shimmers, then brown the eggplant for 4 minutes. Add ginger paste and garlic paste. Stir 2 more minutes on medium heat. Add garam masala and chili powder and cook for a scant 30 seconds more. Then pour in the tomato puree from the blender and add an (optional) touch of salt.

Boil mixture in the skillet for up to 7 minutes or until the eggplant is cooked and the sauce thickens. If the eggplant is not cooked but the sauce is thickening too fast, add a bit of water.Turn off heat and taste curry. Add lemon juice (squeezed from whole lemon) to taste.

Optional Smoke Flavor:

If you are barbequing outside, you can take this mixture and set it inside your grill for a few minutes away from the heat to add a smoked flavor.If you are cooking inside, you’ll need a gas stove. Separate the cooked eggplant in the skillet to make room for a small metal bowl. The bowl needs to be shallow enough to cover the skillet with a lid (to hold in the smoke). Turn on your exhaust fan and hold a piece of charcoal (use pure charcoal, not the kind with self-igniting chemicals!) with long tongs over an open flame until it gets red hot. Then drop it into the small bowl inside your skillet and add a touch of vegetable oil so it starts smoking. Cover the skillet with a lid and let the smoke infuse the curry for 5 minutes or so. Remove the piece of charcoal — dowse it with water to cool it completely before discarding.

Serve your smoked curry eggplant with rice, naan or roti!

 

 

 

Healthy Living Houston – Swimming Your Way to Better Health

We take a look options for Houston swimming -- from lessons for beginners to the adult master level swimming -- in this edition of Healthy Living Houston.

We take a look options for Houston swimming — from lessons for beginners to the adult master level swimming — in this edition of Healthy Living Houston.

Now that the kids are all back in school, there’s room for the rest of us to get back into the swimming pool for some good healthy exercise and stress relief.

The Center for Disease Control  (CDC) has a special section outlining the benefits of water-based exercise. Quick version: It’s a very healthy form of exercise. For example, a 2008 study indicates that swimmers have a big advantage over those who lead an inactive lifestyle: swimmers have about half the risk of death!

Houston Swimming is Great Exercise for Your Whole Body — Especially for Your Joints

Not only does swimming help you relax, swimming can help with certain health conditions too. It’s very good exercise for those with diabetes and heart disease. It’s also an ideal form of exercise if you have joint pain issues, including various types of arthritis, such as rheumatoid arthritis and osteoarthritis. Swimming can also maintain or improve bone health of post-menopausal women.

Houston Swimming:  A Powerhouse on the Rise?

According to the U.S. Census, swimming is the fourth most popular sport in the U.S. What about here in Houston, the fourth largest city in the U.S.?

It looks like interest in swimming is way up in our region. The number of swim clubs and places to take water-based exercise classes and swimming lessons continues to grow, as we’ll see in our list of resources below.

And we can’t forget at the 2012 Olympic games held in London, two local Houstonian swimmers made the U.S. Olympics team:

Erica Dittmer competed in the 200-meter individual medley. Erica was born in Houston, grew up in Spring and is a Klein High School graduate.

Cammile Adams, who was born in Houston and graduated from Cypress Woods High School, competed in the 200-meter butterfly event.

Both Cammile and Erica enrolled at Texas A&M University in College Station.

Houston We have a Problem! I Don’t Know How to Swim!

Learning to swim as an adult is not hard and there are plenty of resources at area pools. Here are some links to adult swim classes that can help you get started:

Masters Swimming in Houston: It’s Not Just for Experts

Don’t let the term Masters put you off. While the term Masters does occasionally refer to the more advanced swimmers, that not always the case: Masters literally refers to an adult age swim team, e.g. those aged 20 years and up.

Here are couple of resources to help you find adult Masters swim groups in your part of town:

In addition Rice University has its own Masters group as does the Houston Swim Club.

Get an Up-to-Date Physical When Starting a New Exercise Program

If you are considering a major increase in your physical activity — that great! We recommend you also make an appointment with Dr Brewton to have an up-to-date physical and to get some advice on how to transition to a more active lifestyle, such as swimming regularly.

 

 

 

Fight Sleep Insomnia: 5 Ways to Sleep Better at Night

Mark Twain in Bed. Photograph by Van der Weyde.

Mark Twain in Bed. Photograph by Van der Weyde.

We keep learning more and more about the benefits of a good night’s sleep.

Sleep is something you need to take seriously for your health. Long-term problems with insomnia are associated with weight gain, heart disease and type 2 diabetes.

How can you sleep better?

Here are five ways to improve what’s known as your ‘Sleep Hygiene’. Try these key guidelines for a few weeks and see if you don’t begin to sleep better at night.

Sleep Insomnia – Key to Better Sleep #1: Cool It in the Bedroom

It’s hard to imagine living in Houston without air-conditioning.

So how did people sleep during Houston summers in the time before air-conditioning? Probably not that well. It’s hard to sleep at night when it’s hot and humid.

One of the strategies for keeping cool was the screened ‘sleeping porch’, often built on the second floor to capture any faint mid-summer Gulf coast breezes. You can still see ‘sleeping porches’ on historic homes in Houston’s original neighborhoods, like the Museum District, Midtown, Montrose and the Heights. Today you’ll notice that many of the original screened openings are enclosed with glass windows or walls — all thanks to modern air-conditioning.

It turns out that keeping your bedroom cool not only helps you sleep better but, according to a recent study published this June by the American Diabetes Association, it can also help increase your metabolism — if you keep your bedroom very cool.

Study subjects who slept in a bedroom chilled down to 66 degrees burned more calories while increasing their amount of internal brown-fat. Brown-fat, unlike white-fat, is now considered ‘good’ for maintaining an active metabolism level as well as possibly reducing the incidence of diabetes.

If you are sleeping in a bedroom that’s too hot, try to keep it cool with a fan — or consider using a portable room air-conditioner. These new models only require a small opening in a window for the exhaust heat vent tube.

Sleep Insomnia – Key to Better Sleep #2: Turn off All Electronic Devices

It’s not just for airplanes… electronic devices interfere with sleep as well.

We love our electronic devices, probably too much. We even take them into the bedroom, and use them in bed. A study in the UK indicates that over 90% of 18-24 year olds used electronic devices during the two hours leading up to bedtime.

While that iPhone or iPad or Kindle may seem like a modern replacement for reading old-fashioned hardcover books in bed, sleep researchers have discovered electronic devices are a major cause of insomnia.

Yes, that’s right: using electronic device before bedtime actually prevents your body from falling asleep.

How can this be?

Let’s consider the normal sleep cycle, before modern electronics and artificial light sources. The sun goes down at dusk, casting a warm amber glow. Your body naturally responds by producing the sleep-inducing hormone melatonin. You drift into a long, undisturbed natural sleep. The sun rises; with its blue morning light that announces it’s time to awaken. The body responds to the slowly increasing amount of light and adjusts its hormones accordingly. You wake up.

So how do electronic devices interrupt the natural sleep cycle?

Electronic devices emit blue light, which is not the natural color of light at night.

While we’ve had wood fires burning at night for millennia, oil lamps for thousands of years and Edison’s electric filament light bulb since 1879 — all of these emit a primarily orange wavelength light, which is the body’s internal signal to begin the sleep cycle.

What’s new is the appearance of modern electronic devices — like tablets, smart phones, flat screen TVs and LED lighting. It turns out these devices emit a strong blue wavelength light component, which is associated with ‘waking up’.

So, what to do? The simplest answer: avoid using your electronic devices for two hours before bedtime. If you must use them, consider turning down the brightness to the lowest level and hold them at least 12 inches away.

Wearing amber-tinted glasses that block blue light is another solution. While this may sound odd, amber-tinted glasses may become just another thing we wear to help us fall sleep, not unlike using ear plugs to control background noises.

You think this is crazy stuff, right? Well another scientific study released last month indicates there is a connection between dim light at night and the growth of cancer tumors in rats. Dim light also appeared to reduce the efficacy of the anti-cancer drug tamoxifen. Scientists suspect dim light at night suppresses production of melatonin in the body.

Bottom line: You’ll sleep better at night by avoiding use of electronic devices two hours before bedtime, turning out all the lights in your bedroom, and getting some old-fashioned solid, light-blocking curtains to cover up your bedroom windows from outside lights.

Sleep Insomnia – Key to Better Sleep #3: There is a Time and Place for Everything

Go to bed at the same time each day.

It’s bedtime! Most of us have an idea when we should go to sleep. Pick a time that’s right for you and stick to it. Even on the weekends. Use an alarm clock.

Get up at the same time each day.

Waking up at the same time each day helps improve the quality of your sleep in the long run. But wait? What if I woke up in the middle of the night? Shouldn’t I sleep in and catch up on sleep? The answer is no. Sleeping extra hours will only make your next night’s sleep more problematic.

Weekends can cause major sleep issues.

Going to bed late on Friday and Saturday nights with the intention of ‘catching up’ on sleep Saturday or Sunday mornings doesn’t work. You can’t ‘bank’ sleep hours. Try keeping regular sleep hours — including weekends! — for a month and see if you don’t feel more rested.

Caffeine intake has great influence over your sleep patterns. Limiting consumption to mornings only can help with sleep insomnia. Courtesy Amanda Mills, CDC.

Caffeine intake has great influence over your sleep patterns. Limiting consumption to mornings only can help with sleep insomnia. Courtesy Amanda Mills, CDC.

Caffeine before Lunch, Not After

If you are having difficulty sleeping at night, change your eating and drinking habits. Limit your coffee, tea and other sources of caffeine to the mornings only. Have a bigger breakfast and lunch then a lighter dinner, preferably by 6 p.m. Don’t drink alcohol in the late afternoon, evening or nights. Avoid smoking entirely.

What about Naps?

If you are having trouble sleeping at night, skip naps entirely for now. It’s more important to establish proper rest at night. Eliminating regular daily naps may make you more tired in the short term (due to a temporary sleep deficit) but over the long run it will help you sleep better at night.

Once you are sleeping well at night, you can try naps. A short 10-30 minute nap in the mid-afternoon has been shown to reduce stress and fatigue, as well as improve your mood, alertness and creative thinking abilities.

Sleep Insomnia – Key to Better Sleep #4: Reduce Allergens in Your Bedding

It’s estimated that a third of us are allergic to house dust mites, which lurk in our beds and pillows. They are also a primary trigger for asthma attacks. You won’t be able to see them unless you are looking through a 10x microscope. But if you wake up with a runny nose or itchy, watering eyes, you might be having an allergic reaction to house dust mites in your bedroom.

Remember our First Rule about Keeping the Bedroom Cool?

Keeping your bedroom cool not only increases your metabolism, it has an important secondary benefit: it dehumidifies the bedroom. This in turn helps reduce (though not entirely eliminate) the population of house dust mites hiding in your bedding, mattress and pillows.

Carpets are Problematic; Tile and Wood Floors are Ideal

You’ll have to remove your carpets and rugs from the bedroom if you have a serious allergic reaction to house dust mites. The good news is they can’t live on hard surfaces, like tile and wood floors.

New Microfibre Materials

Of course, if you remove your rugs, then the house dust mites will migrate to your bed.
If you want to protect your bed from dust mites, you can cover (or encase, as they say in the bedding industry) your mattress and pillows with sealed covers. The old style covers were very uncomfortable and ‘sweaty’ because they didn’t ‘breathe’. But now there’s a new generation of woven microfiber fabrics available that allow air to breathe while restricting passage of allergens.

What about Pillows?

If you don’t like the idea of covers on your pillows, an alternate strategy is to buy lower-cost synthetic pillows — wash them once or twice, and then replace them. At Target stores, for example, you can look for a very tall rack stacked with standard size polyester-filled bed pillows, priced for as little as $5 or $6 each.

Tips for Washing and Disinfecting Pillows and Bedding

To keep the pillows balanced in the washer, wash two at a time. Use less detergent than for regular clothes. Unless you have a special washing machine which can superheat the water to 140F, high heat in the dryer is actually more effective at killing organisms than your washer. Use the dryer’s medium setting (aka Permanent Press) or higher (approx. 135F) for the maximum drying time and you can skip adding chlorine to the washer.

Important: Keep an eye on your dryer when drying synthetic bedding and pillows on high heat. You don’t want the dryer to catch fire when you are out.

You can also let nature sanitize your bedding. On bright sunny days, put your pillows and bedding on the clothes line and let the sun’s UV rays do the work for you. Finally, it sounds very odd but you can also put your bedding or pillows in a freezer for 24 hours; the cold temperatures will kill house dust mites.

Sleep Insomnia – Key to Better Sleep #5: Exercise and Relaxation

Brisk exercise, such as walking at least 20 minutes each day, will improve your health in many ways, including improving your sleep.

But for many people, exercising right before bedtime can itself be a cause of insomnia. If that could be the case for you, try scheduling your exercise program in the morning or mid-day. If you can only exercise after work, try to finish at least four hours before your regular bed time.

If you have a lot on your mind, try making a list of things you need to do the next day as part of your routine before going to bed. This can help ‘put your mind at rest’ and reduce anxiousness which might contribute to insomnia.

There are many other relaxation and meditative techniques to try. Here’s an example: Try relaxing — from your head to your toes — by squeezing each of your muscle groups in sequence.

Begin by smiling to squeeze your face muscle for two seconds, and then relax. Repeat this several times. Then move to your jaw, then the neck. Repeat this muscle-by-muscle contraction and relaxation technique. Start with one shoulder, and then continue down one arm, working your upper and lower arms, hands and fingers. After doing both arms, tighten and relax your chest, then your stomach/abdomen and buttocks. Then move down each leg, tightening and relaxing your thighs, then calves, feet and toes. Still not sleepy yet? Keep this up for 45 minutes and you will probably be relaxed enough to fall sleep.

That sounds a lot like yoga and tai chi, doesn’t it? It turns out that according to some health studies both yoga and tai chi have been shown to reduce insomnia. We plan to look at yoga in a feature article in September.

Sleep Insomnia Postscript: Uncovering Signs of Sleep Disorders

If you’ve been having mild insomnia, we hope these five guidelines to improve your ‘sleep hygiene’ will help you sleep better at night. But how do you know if you have a more serious problem that requires medical attention? If you experience these issues, call us at (713) 529-9224 and schedule a consultation:

  • You fall asleep unexpectedly in the middle of the day.
  • You fall asleep during the middle of a normal activity.
  • You can’t move right away after waking up.
  • You feel like you have weak muscles after laughing, or getting excited or angry.

Important: If any of these symptoms are urgent, dial 911 for emergency responders.

Sleep Insomnia Medical Evaluation: Three Primary Ways to Assess your Sleep Health.

When you visit Dr Brewton’s office to discuss sleep insomnia, you may be asked to participate in sleep evaluation tests; sleep evaluations usually fall into these three categories:

The first way to evaluate your sleep insomnia is for you to keep a Sleep Diary, in which you document details of your sleep each night over a one to two week period.

Next is an Actigraphy test, which involves wearing a monitor on your wrist that detects motion at night, which in turn provides a record your sleep patterns. This information is typically recorded over a period of several nights.

Finally, there is a formal sleep test, or Polysomnography, which measures your movement, breathing, brain activity and other bodily functions during sleep. In some cases, this can be done at home with a portable sleep monitor; more thorough tests require an overnight stay at a sleep lab.

Healthy Living Houston: The Stars at Night are Big and Bright

Dramatic composite photograph of Perseid Meteor Shower activity in 2010. Image courtesy Michael Menefee.

Dramatic composite photograph of Perseid Meteor Shower activity in 2010. Image courtesy Michael Menefee.

The stars at night are big and bright
Deep in the heart of Texas
The prairie sky is wide and high
Deep in the heart of Texas

Yes, that’s how the song goes, but if we’re being honest with ourselves, the truth is most of the time in Houston you can’t see many stars at all due to pervasive light pollution.

But did you know that there’s an observatory open to the public just an hour south of town where you can see those stars at night, big and bright? We bet you haven’t heard of it. In fact, most Houstonians have never heard of the George Observatory, even though it’s celebrating its 25th anniversary this year.

Our Healthy Living Houston Activity for August: Get Out and See Texas’ Stars at Night.

The Houston Museum of Natural Science (our neighbor across the street in here in the Museum District) operates the George Observatory, located about an hour south of downtown Houston, inside the boundaries of Brazos Bend State Park.

We recommend you get out of town and enjoy some fresh air in the park and take in some stargazing during some of the interesting astronomical events coming up. These two videos from NASA will give you a good overview of what you’ll be able to see in the August skies.

August’s Perseid Meteor Shower is a Great Time to Visit the Houston Museum of Natural Science’s George Observatory

The free Planets app for iOS devices like iPhones and iPads is a helpful learning tool.

The free Planets app for iOS devices like iPhones and iPads is a helpful learning tool.

 

There will be a special stargazing event the evening of Tuesday August 12 from 7 p.m. to 2:00 a.m. to watch the annual Perseid Meteor Shower, so you might want to check that out.

Saturdays nights during the summer are also a good bet as local astronomy club members will be available to chat with you about stargazing.

If you have an iPhone, you might also want to download the free ‘Planets’ app for iOS devices like iPhones and iPads.

It’s a very useful tool for learning about astronomy and it will help you get the most out of visiting the George Observatory at Brazos Bend State Park.

Just point your iPhone up towards the sky and the app identifies which stars and planets are visible from your location.

Other Things to See and Do When Visiting Brazos Bend State Park

The Houston Museum of Natural Science’s George Observatory is just one of the attractions within Brazos Bend State Park.

Spanish Moss on Live Oak trees at Brazos Bend State Park, home of the Houston Museum of Natural Science's George Observatory. © Texas Parks and Wildlife Department.

Spanish Moss on Live Oak trees at Brazos Bend State Park, home of the Houston Museum of Natural Science’s George Observatory. © Texas Parks and Wildlife Department.

With more than 5,000 acres, Brazos Bend State Park offers Houstonians nearby access to biking, horseback riding, canoeing and kayaking, fishing, birding, camping and of course, stargazing. The park is situated on the west bank of the Brazos River. It preserves some of the original coastal prairie as well as hardwood forests and marshes, making it an important bird refuge. More than 300 different species have been seen in the park. The Nature Center and Gift Shop are open on weekdays from 11 a.m. to 3 p.m. and from 9 a.m. to 5 p.m. on weekends.

Brazos Bend State Park Entrance Fees

Adults and children over 12 years old are $7 per person; children under 12 are free.

American Alligator at Brazos Bend State Park. Photo courtesy Brian Frazier, © Texas Parks and Wildlife Department

American Alligator at Brazos Bend State Park. Photo courtesy Brian Frazier, © Texas Parks and Wildlife Department

Tickets for the George Observatory Telescopes are Sold On-Site, on a First-Come First-Served Basis

Once you are inside Brazos Bend State Park, you can drive to the parking area for the George Observatory. It’s a good ten or twenty minute walk to the observatory station; the walk takes you past a large, picturesque lagoon. With so much water around, we recommend wearing long pants, socks and maybe even long-sleeved shirts at dusk to fend off mosquitoes. Bring some Deet-based mosquito repellant as well.

Tickets to view through the big telescopes at the George Observatory are sold on a first-come, first-served basis in the George Observatory Gift Shop, located in the lower level. Telescope tickets cost $5 per person, and they are well worth it. It’s a good idea to bring cash in case there are problems with their credit card machine.

Combine Your Trip to the George Observatory with an Afternoon Visit to the Varner-Hogg Plantation

If you want to make a full day trip, you could start your outdoor adventure at the Varner-Hogg Plantation, which is located 20 miles further south. (See our related article for tips on touring the Varner-Hogg Plantation, Ima Hogg’s family home.)

After visiting the childhood home of Houston’s patron of the arts, Ima Hogg, you can head back north to discover the Brazos Bend State Park in the late afternoon and then stay into the evening for stargazing at the George Observatory. Or you can turn it into an overnight trip if you want to camp at one of Brazos Bend’s campsites.

Useful Links

Houston Museum of Natural Science George Observatory: Saturday Night Star Gazing

Houston Museum of Natural Science George Observatory: Special Perseid Event

Brazos Bend State Park Volunteer Organization:  www.brazosbend.org (website)

Texas Parks and Wildlife:  Brazos Bend State Park (website)

Texas Parks and Wildlife:  Brazos Bend State Park Activity Guide (PDF)

 

Healthy Living Houston: Ima Hogg Lived Here

Ima Hogg's legacy as a patron of the arts still touches us today here in the Museum District. She donated many major artworks to the Houston Museum of Fine Arts as well as Bayou Bend, her home in River Oaks with its priceless collection of American antiques. For our Healthy Living Houston activity this month we suggest a trip to Ima Hogg's birthplace, an hour south of Houston at the Varner-Hogg Plantation.

Ima Hogg’s legacy as a patron of the arts still touches us today here in the Museum District. She donated many major artworks to the Houston Museum of Fine Arts as well as Bayou Bend, her home in River Oaks with its priceless collection of American antiques. For our Healthy Living Houston activity this month we suggest a trip to Ima Hogg’s birthplace, an hour south of Houston at the Varner-Hogg Plantation.

The First Question People ask about Ima Hogg

It’s usually the first question people ask about Ima Hogg, the First Lady of Texas:

Did she know her name was – shall we say – a little unsuitable?

The answer is unequivocally ‘yes.’ Miss Ima Hogg, whose philanthropy still resonates in the heart of Houston’s Museum District and across the State of Texas and beyond, was most certainly aware of her problematic name. So much so that she went out of her way to avoid using it, preferring to be called simply I. Hogg or Miss Hogg. And before you start spreading more rumors, there is no truth to the story she had a sister named Ura Hogg; Ima had three brothers, no sister. Despite her rather unfortunate first name (chosen by her father Texas Governor James Stephen “Big Jim” Hogg after a poem written by her Uncle Thomas) Ima lived a most remarkable life — spanning from the Victorian era to the 1970s.

Governor ‘Big Jim’ Hogg’s Oil Gamble Paid Off — Long After Meeting his Final Reward

Governor Big Jim just knew they’d strike oil one day on land he bought an hour south of Houston. Turns out he was right. Big Jim’s property — known today as the Varner-Hogg Plantation — produced one of Texas’ largest oil fortunes ever. Unfortunately for Big Jim, he had already been dead and buried for twelve years when, in 1918, they finally struck oil. Soon the burgeoning number of oil wells crisscrossing the land Ima and her three brothers inherited from their father began to produce unimaginable wealth — reportedly $225,000 each month — in 1919 dollars. Now a rich Texan oil heiress, Miss Hogg went overseas to study piano with the European masters of the day. Later in life she returned to Houston to embark on a lifelong pursuit of philanthropy in arts and culture. Among Miss Hogg’s many accomplishments:

  • She established the Houston Symphony Orchestra
  • She donated her John Staub-designed Bayou Bend home in River Oaks with its priceless collection of American antique furniture as well as rare paintings by Chagall, Picasso, Klee and Matisse to the Houston Museum of Fine Arts
  • She help establish the Kennedy Center in Washington D.C.

And that’s not really a comprehensive list of all her philanthropic achievements.

So our healthy living Houston suggestion for this month is to take a short road trip to the Varner-Hogg Plantation, located about an hour south of Houston in West Columbia, Texas. Tours of the plantation home last for about an hour and you might want to spend another hour walking on the grounds (65 acres in total) to see the sugarcane mill and rum distillery ruins, the pecan orchards and original outbuildings. It’s a beautiful site. Admission to the park is four dollars per person; they’re open Tuesday through Sunday from 8 to 5 p.m. Tours of the inside of the home ($4 additional) are offered at 9:00, 10:00, 11:00, 1:30, 2:30 and 3:30 pm. Call 979.345.4656, ext. 31 for more information.

The Varner-Hogg Plantation, an hour south of Houston, is the birthplace of the First Lady of Texas, Miss Ima Hogg. We suggest an outing to this historic site as part of visit to the Houston Museum of Natural Science’s George Observatory, located in Brazos Bend State Park.

The Varner-Hogg Plantation, an hour south of Houston, is the birthplace of the First Lady of Texas, Miss Ima Hogg. We suggest an outing to this historic site as part of visit to the Houston Museum of Natural Science’s George Observatory, located in Brazos Bend State Park.

Planning Your Trip to the Varner-Hogg Plantation? Why Not Combine Your Visit with a Trip to the George Observatory?

You can easily combine a mid-day or afternoon trip to the Varner-Hogg Plantation with a late afternoon or evening visit to Brazos Bend State Park, home of the George Observatory. They are about 20 miles (30 minutes) apart. See our related article on stargazing at the Houston Museum of Natural Science’s George Observatory, located in Brazos Bend State Park.

Useful Links

Varner-Hogg Plantation:  visitvarnerhoggplantation.com (website)
Texas Parks and Wildlife: Varner-Hogg Brochure (PDF)
Texas State Historical Association: Varner-Hogg Plantation (website)

 

Healthy Recipe for Gazpacho Soup

For August's Healthy Recipe we present two versions of Gazpacho Soup: Pepa's Gazpacho from Almodovar's film Women on the Verge of Nervous Breakdown (minus the sleeping tablets of course !) and Rachel Ray's Smoked Paprika Gazpacho

For August’s Healthy Recipe we present two versions of Gazpacho Soup: Pepa’s Gazpacho from Almodovar’s film Women on the Verge of Nervous Breakdown (minus the sleeping tablets of course !) and Rachel Ray’s Smoked Paprika Gazpacho

This month for our healthy recipe, we’ll look at two different ways to make Gazpacho Soup.

If you are a fan of films by the famous Spanish movie director Pedro Almodovar, there’s a good chance that any time you hear someone mention Gazpacho Soup, you probably think of one of his films. If so, you are not alone.


 

Pepa’s Gazpacho Soup Recipe

In fact, we found an online video recipe for Pepa’s Gazpacho Soup. It’s based on the Gazapacho Soup concocted by Pepa (played by Carmen Maura) which plays a pivotal role in the convoluted plot of Almodovar’s film Mujeres al Borde de un Ataque de Nervios. (Our recipe is minus the sleeping tablets of course!)

 

That’s a good, simple version of classic Gazpacho.


 

Smoked Paprika Gazpacho Recipe

We also tried a fancier version, called Smoked Paprika Gazpacho, which is based on a Rachel Ray recipe. This one has a very complex flavor, one that you might enjoying trying.  It makes about six servings and it’s very high in vitamin C. But watch the salt content, especially if you are on a low sodium diet. In that case look for tomatoes and tomato juice with no added salt.

 

Main Ingredients Quantity
Diced Fire-Roasted Tomatoes 1 28 ounce can (or two 14.5-ounce cans)
Tomato Juice (or V8 Juice) 1 cup
Vegetable Broth 3 cups
White Bread 2 slices, torn
Celery 4 small ribs, chopped, from the heart
Red Onion 1 medium red onion, chopped
Roasted Red Pepper 3 roasted red peppers, chopped
English Cucumber 1/2 cucumber, chopped
Fresh Garlic 1 clove garlic, grated or finely chopped
Sherry Vinegar (or Dry Sherry) 2 tablespoons sherry vinegar or dry sherry
Lemon (or Lime) Juice of 1 lemon or 1 lime
Extra-virgin Olive Oil 2 tablespoons
Sweet Smoked Paprika 2 teaspoons

 

Optional Ingredients
Quantity
Salt Season to taste
Ground Black Pepper Season to taste
Jumbo Shrimp (optional, for dipping) 6 – 12 Jumbo Shrimp, cooked and chilled

 

Directions
We’ll start with the main ingredients. Combine the main ingredients in a large bowl.
Using a spoon, mix them up a bit so the ingredients are evenly distributed before we use the food processor or mixer. We’ll do this in three batches.
Scoop out a third of your main ingredients and pour into your food processor or mixer.
Blend until smooth. Transfer to a large pitcher.
Repeat processing the two remaining batches.
Stir the mixture in the pitcher to make sure it’s evenly combined.
Give it a taste.
If you used salted tomatoes or V8 Juice, you probably won’t need to add salt.
Otherwise add a bit of salt and then add ground pepper to taste.
Gazpacho is best served chilled, so you might need to cool it down in the refrigerator.
Serve in a bowl, glass or dessert cup, or pour over ice in a tall glass.
Add the optional shrimp, either on the side or on the side of the serving bowl or glass.

 

Fire-Roasting your own Tomatoes on a Gas Stove Top

You might enjoy roasting a couple of your own tomatoes to add a little home-made pizzazz to Gazpacho Soup recipes. Did you know you can skewer whole raw tomatoes and roast them over the gas flame on your stove? It’s basically the same technique as toasting flour tortillas on the open flame, or preparing poblano chiles on the gas stove for chiles rellenos, again over the open gas flame on the stove.

But unless you’ve got a lot of tomatoes on hand, it’s probably more convenient to buy  fire-roasted tomatoes already prepped in a can. In the recipe list above we’ve linked to the Muir Glen brand, it’s organic and gluten-free. Target and other local retailers carry it.

What about Purchasing Spices in Houston?

If you happen to be shopping for vegetables at Canino’s on Airline just east of the Houston Heights, you should make a stop across the street at Flores’ Spice & Trading Company (2520 Airline Drive, Houston, TX 77009). Like Penzey’s Spices in the Heights (516 W 19th St, Houston, TX 77008), Flores carries at wide selection of spices if you need to stock up.

Healthy Living Houston: Visit Our Parks Along the Bay

doctor-gary-brewton-houston-physician-galveston-island-sunset

Dr. Anne Hecht, a Texas Master Naturalist, recommends discovering our bays, bayous and estuaries as our healthy outdoor activity for this time of year. Sunset on Galveston Island, photo by Brent Blackett

This month we got in touch with Dr. Anne Hecht, a Texas Master Naturalist, to get her recommendations about healthy outdoor activities for this time of year.

Anne had three great suggestions, all of them related to discovering our coastal bays and bayous.

Galveston Island State Park

First on Anne’s list is Galveston Island State Park (GISP). What’s particularly special about this park for nature lovers is it spans a full cross-section of west Galveston Island —  from Galveston Bay on the north to the Gulf of Mexico on the south. Admission is $5 dollars per adult, 12 and under free.

If you want to learn about the bays and marshes, meet at the Nature Center at 10 a.m. on Sunday mornings for a free bay walk tour (included with your $5 admission). If you want to learn about the beach, that tour is conducted on Saturdays, also starting at 10 a.m. at the Nature Center.

doctor-gary-brewton-houston-physician-galveston-island-state-park-2

Seining demonstration on the bay at Galveston Island State Park. Photo by Nathan Veatch.

New to GISP is a “Car/Hike or Bike Tour” developed by Frank Bowser, who is an active member of The Friends of Galveston Island State Park. Frank made a guide map showing how you can navigate the two miles of paved roadway and the five miles of manicured grassland hiking trails. So get ready for a scenic walk — or bring your bike — to discover all the interesting wildlife in the prairie grasses, brackish marshes and seaside dunes. The map and the companion computer disc are available at the Ranger’s Desk at the entrance to the park.

If you want a guided kayak tour of the bay side, once again Frank Bowser is your man. Give him a call at 409-737-5567 and he’ll get you set up on a kayak tour. Launch times are timed to hit high tide, so that determines when you go out.

Artist Boat

Anne’s second suggestion is to get in touch with another group of outdoor enthusiasts who go by the name Artist Boat.

Artist Boat has a really cool concept: they take kayakers out into the waters of Galveston Bay for an art lesson (painting for example) under the supervision of certified kayaking instructors — who also happen have a professional background in science or art.

If you have no experience kayaking, don’t worry. Most first time Artist Boat participants don’t have any experience either.

doctor-gary-brewton-physician-houston-artist-boat-galveston-bay

Artist Boat offers an exciting way to discover Galveston Bay: you can go out in one of their kayaks for an art lesson (painting for example) under the supervision of certified kayaking instructors. Photo courtesy Artist Boat.

All the instruction and gear is included in the price of your tour, which ranges from $35 for a short two hour experience (not enough time for an art lesson) to $60 dollars per person for 4 hours, which includes an open air art lesson.

Not only is this great fun, it’s for a great cause too. Not that long ago one of the very last significant tracts of un-built land on Galveston’s West End was slated to be turned into a housing development.

But when those plans fell through due to the recession, Artist Boat was able join forces with other organizations to acquire a 160 acre parcel of coastal property on west Galveston Island to establish a new Coastal Heritage Preserve.

So when you support Artist Boat, you are also supporting a worthy cause that is protecting open space along Galveston Bay. You can friend Artist Boat on Facebook and see more photos of activities they have going on.

Armand Bayou Nature Center

Anne’s third suggestion is the Armand Bayou Nature Center, which is along the west side of Galveston Bay. At 2,500 acres, Armand Bayou is the largest urban wilderness preserve in the entire United States.

We can enjoy it today thanks to a visionary campaign started in the late 1960s by Mr Armand Yramategui, a Basque electrical engineer who ran the Burke Baker Planetarium at the Houston Museum of Natural Science, right across the street from our Museum District office. In 1970 Armand (he went by his first name) was tragically killed in a what we would today call a ‘carjacking’ incident. The preserve opened in 1974, and Middle Bayou was re-named Armand Bayou in his memory.

doctor-gary-brewton-houston-physician-armand-bayou-pelicans

Armand Bayou is the largest urban wilderness preserve in the entire United States with over 2,500 acres. Pelicans gather on a tree stump along the bayou. Image courtesy Wikimedia

Armand Bayou has been celebrating its 40th anniversary this year. They received a grant from the Texas Parks and Wildlife Department to rejuvenate some of their hiking trails; this construction activity is nearly complete by now, but you might want to touch base with the office to get the latest details.

The three most popular trails– the Martyn Trail through the forest and along the bayou, the Prairie Interpretive Trail and the Discovery Loop Trail — will remain open during the construction work.

One great way to get an overview of the park is to ride the pontoon boat called the Bayou Ranger. These boat tours start early on Saturday mornings. Enjoy a light breakfast on board as you silently drift down the bayou and catch early morning activities of the park’s wildlife. The boat departs from Bay Area Park boat launch and costs $25 for adults. Become a member and save five dollars on your ticket. Make reservations at 281-474-2551 x10.

Another tip is visiting the park on the second Saturday of each month (next one coming up is July 12th, 2014) for two special programs: Photography and Canoeing

You can take a guided photography hike each second Saturday; the start times alternate between early morning and late afternoon. Reservations required, call 281-474-2551 x10 for more information.

You can also take a guided canoe trip (8 a.m. to 11 a.m.) on the second Saturday of each month. Reservations are required, so give a call on 281-474-2551 x10.

Useful Links for Planning Your Healthy Living Houston Outdoor Adventures

Galveston Island State Park

The Friends of Galveston Island State Park

Artist Boat

Coastal Heritage Preserve

Armand Bayou Nature Center

Houston Museum of Natural Science