Monthly Archives: January 2017

Use Sleep Aids? Don’t Let the Wrong One Ruin Your Game

I guess it wouldn’t be fair if I told you the benefits of sleep without giving you advice on the best sleep aids available. There are a multitude of factors that lead me to believe that sleep aid use is quite common in the world of poker. They include: 1) the overuse of stimulants such as caffeine, Red Bull, Amp, Adderall, etc 2) the long duration of poker games, some lasting until the next morning 3) the increased play of on-line poker, lasting well into the night. I would imagine that poker players have their sleep schedules pretty screwed up. I’d even bet that their own circadian rhythm is probably a little off tilt. Don’t worry though. Hopefully after reading this section, you’ll be able to choose the right sleep aid for you so you can experience all of the great benefits of a good night’s sleep. You may even win more often.

Sleep aids

The majority of sleep aids are relatively safe and effective. Some are controlled substances, however their abuse potential is minimal compared to other controlled substances. The most important concept concerning selecting the best sleep aid is residual drowsiness. The last thing a poker play wants is to be drowsy the next day at the table. Too many bad things can happen if you’re sluggish. You need to pay attention to the sleep aid’s half-life. Half-life is really just a fancy medical term that describes the time it takes the body to eliminate half of the original concentration of the drug. Usually, it takes anywhere from 5-7 half-lives for the drug to be entirely eliminated from the body. Thus, if the original concentration of the drug was 10mg and has a half-life 2 hours, then after 2 hours the new concentration would be 5mg, and after 4 hours the new concentration would be 2.5mg, and so on. I’ll briefly discuss the most common sleep aids below. I’ve grouped them into the drug classes based on their mechanism of action. At the end, I’ll tell you my recommendations.

Prescription sleep aids

Non-benzodiazepine (non-BZN) sleep aids

These all work the same way. They bind to the benzodiazepine 1 receptor in the brain. The side effect profile is also similar. It includes drowsiness, dizziness, amnesia, headache, and GI problems. The difference between drugs in this class is their duration of action and potency.

Ambien is the most common sleep aid prescribed today. The half-life of Ambien is around 2.5 hours. Thus, it takes around 10 or so hours for it to be completely eliminated from your body. It’s pretty good at getting you to sleep and keeping you asleep. It’s also generic so it’s very cheap compared to some of the other sleep aids. If you’re looking to get a good night’s rest of at least 8-10 hours, this is my drug of choice. Its effectiveness and price make it the best of all of the sleep aids. However, if you’re in a tournament and may only get 5-7 hours of sleep, there is a strong possibility you may have some residual drowsiness the next day.

Lunesta is a relatively new sleep aid. The half-life is around 6.5 hours. Thus, it’s going to take a long time to get out of your system. It also does not have a generic so it’s pricey. Because of its long half-life and high probability of residual drowsiness, I don’t recommend this drug for poker players. The only time you should use this drug is if you can sleep for a couple of days straight.

Sonata is my drug of choice for this class. Its half-life is around 1 hour. Thus, it will be out of your system in 5-7 hours. It may not be as strong as Ambien or Lunesta, but it should do the job. If you’re unsure of how much sleep you’ll be able to get, you should select this drug. The chances of residual drowsiness are the least of any of the other drugs in this class. Because of its short half-life, it can also be used if you wake up early in the night and have trouble getting back to sleep.

Benzodiazepine sleep aids

These drugs are not as selective as the non-BZN sleep aids. They bind to not only the BZN1 receptor, but also the BZN 2 receptor. Thus, there is a higher likelihood of side effects. Side effects include drowsiness, decreased concentration, cognitive impairments, anterograde amnesia, daytime anxiety, and rebound insomnia. The differences in drugs in this class are time to onset of action, duration of action, and potency.

Restoril is the most commonly prescribed BZN sleep aid. However, it’s probably the worst one for poker players. The half-life is between 10-15 hours. Because its metabolites are also active drugs, if used for consecutive days, the half-life of the drug will actually increase to even more than 15 hours. Thus, there’s a strong likelihood you’ll experience daytime drowsiness. Even though it is cheap, I recommend staying away from this drug. The half-life is just too long.

Triazolam isn’t prescribed much anymore, however it’s primarily used for insomnia. Because it’s more fat soluble than Restoril, it’s onset of action is quicker, and its half-life is only around 2 hours. It’s good at getting you to sleep and keeping you asleep. In fact, this was the drug of choice by my professor of pharmacology. Side note: This guy was involved in the creation of Gatorade. His memory was unbelievable. He never used one note during his lectures. The problem I have with triazolam is its high incidence of anxiety and amnesia. Because it’s so fat soluble, it is in and out of your system leading to a higher incidence of side effects. Still though, if I had to use a BZN sleep aid, I’d choose this one over Restoril.

Other prescription sleep aids

These sleep aids don’t fall into any of the above categories.

Trazodone was originally used to treat depression. However, because of its unfavorable side effect profile and the introduction of more effective and safer antidepressants, it’s mostly only used for insomnia. The half-life is between 4-5 hours. Because of its long half life, and its ability to cause cognitive slowing, I recommend staying away from this if you play poker.

Rozerem is the newest sleep aid available. Because of that, it’s pretty expensive. It works a little differently than the other sleep aids. It actually binds to and stimulates the melatonin receptors in the brain. It’s been nicknamed melatonin on steroids. Its half-life is between 1-3 hours. It’s really only used in patients who have a history of substance abuse because it has zero addiction potential. In my opinion, there’s cheaper and better sleep aids available for poker players.

Non-prescription sleep aids

Melatonin is probably the granddaddy of OTC sleep aids. It’s a hormone that is secreted by the pineal gland at night. It’s thought to help regulate a person’s circadian rhythm. Its secretion is stimulated by darkness, and inhibited by light. It’s commonly used by people who experience jet lag or midnight-shift workers. Because poker players may have a screwed up circadian rhythm, it would be beneficial to include between 0.5-5mg nightly. Why the wide range of dosage? Some people sleep fine just using 0.5mg and actually experience stimulation on doses of 3mg. However, others need 5mg to help sleep. Find the dosage that’s right for you. If you experience drowsiness the next day, you probably used too much. I recommend the controlled-release melatonin over regular melatonin. In my opinion, those poker players that stay up late at night, and sleep well into the afternoon could greatly benefit from melatonin.

Valerian root is thought to have a similar effect as BZN’s because it inhibits the metabolism of GABA. Because it is not as potent as BZN’s, it’s onset of action is a little longer. You should take it about 2 hours before you go to bed. Because of this inconvenience, I don’t know how beneficial this will be to a poker player. If you do purchase some valerian root, look for supplements that contain 0.4-1% valerenic acid. A typical dose is between 400-900mg 2 hours before bedtime. If you’re looking for a natural supplement to reduce anxiety and help you sleep, this is definitely your best choice.

Magnesium is probably the hidden jewel when it comes to OTC sleep aids. It not only calms your nerves, it also helps improve the quality of your sleep. The majority of the US population is deficient in magnesium. It’s involved in hundreds of chemical reactions in the body, everything from anxiety to heart problems. Entire books have been written about the benefits of magnesium. Like fish oil, this should be a staple in every poker player’s nutritional regimen. Do not buy magnesium oxide due to its poor absorption. Take anywhere from 400-600mg of magnesium citrate or glycinate an hour before bed. Orange juice, apple juice, or tomato juice increases magnesium’s absorption while calcium or other diary products decrease its absorption. I cannot stress enough how important magnesium supplementation is.

Benadryl and other sedating anti-histamines should not be used by poker players. The increased likelihood of residual drowsiness and the lack of efficacy of improving sleep quality make these a poor choice for poker players. There are too many other sleep aids out there that are more effective.

I just wanted to give you an overview of some of the most commonly used sleep aids available. There are hundreds of others out there. There are plenty of Chinese teas and herbals that are purported to help improve sleep. My best recommendation is to read the science and research for yourself. You may even want to try a couple out. Only you will know if it works for you.

Summary

Hopefully you’ll take the above recommendations to heart. Remember, my recommendations are based on not only real-world feedback, but also on research. These aren’t just opinions. If you have any questions about anything I’ve said, please ask.

So the bottom line is to avoid sleep aids with long half-lives because the likelihood of residual drowsiness is much greater. Also, one thing I forgot to mention. If you take any of the above sleep aids with a meal high in fat, it’s going to take longer for the sleep aids to work. Fat actually slows down digestion.

My recommendations

If you think you’ll get less than 8 hours of sleep: Sonata

If you think you’ll get 8-10 hours of sleep: Ambien

If you’re circadian rhythm is off from too many late-nighters: Controlled-release melatonin along with a sleep aid.

The drug everyone should take: Magnesium citrate or glycinate

Remember, don’t take multiple sleep aids. When taken by themselves, they are relatively safe. However, when combined, they can be deadly such as the case of Heath Ledger.

The 4 Elements of Fitness

Most people want to be fit but that raises a question. What does it mean to be fit? The answer is fairly simple. To be fit, one must have physical capability in four areas: aerobic capacity, muscular strength and endurance, flexibility and body composition.

1. Aerobic Capacity. Aerobic capacity, which is also known as cardiorespiratory fitness, refers to the health and function of the heart, lungs and circulatory system. Simply stated, aerobic fitness is the ability of the cardiorespiratory system to deliver an adequate supply of oxygen to exercising muscles. As your aerobic capacity increases, your ability to participate in more intense and longer lasting exercise also increases (e.g., walking, running, swimming and bicycling). It can be argued that aerobic capacity is the most important of the four elements of fitness because of the health benefits it bestows. According to the American College of Sports Medicine, increased aerobic capacity leads to reduced blood pressure, decreased total cholesterol, increased HDL (good) cholesterol, decreased body fat, increased heart function and decreased risk of Type 2 diabetes.

2. Muscular Strength and Endurance. Muscular strength is the maximum amount of force a muscle or muscle group can generate during a single contraction. Muscular endurance is the number of repeated contractions a muscle or muscle group can perform without tiring. Both are important components of overall fitness because increasing your strength through various types of resistance training (e.g., weightlifting) leads to increased bone strength, decreased bone loss, decreased muscle loss, increased tendon and ligament strength, increased physical capacity, improved metabolic function (e.g., burn more calories at rest), and decreased risk of injury.

3. Flexibility. Flexibility is the range of motion within a joint. Increased flexibility provides a variety of benefits such as decreased risk of injury, increased flow of blood and nutrients to joint structures, increased neuromuscular coordination, decreased risk of low back pain, improved posture and reduced muscular tension.

4. Body Composition. Body composition refers to the relative percentage of body weight that consists of body fat and fat-free mass (everything other than fat such as muscles, organs, blood, bones and water). Generally speaking, the lower your body fat percentage the better because of the diseases linked to excess body fat such as heart disease, diabetes, hypertension, arthritis and sleep disorders. I am often asked, “Can you be fat and fit?” The answer is an overwhelming NO. A significant element of fitness is the possession of a healthy body fat percentage because increased fat leads to decreased athletic performance and increased risk of disease (although it is possible to be overweight and healthy since health is merely the absence of disease or illness). According to the American Council on Exercise, the average body-fat percentage for men is 18-24%. For fit men the percentage is 14-17%. The average percentage for women is 25-31%; however fit women will be in the range of 21-24%. Body-fat percentages above 25% for men and 32% for women are considered obese.

How to Speed Healing After Surgery or Accident

If you have recently had or are about to have surgery or if you have been injured in an accident you can improve your chances of a quicker recovery. Although surgery is sometimes necessary to help improve your health, or save your life, recovering from it can be very stressful on many levels. There are always factors to consider. Be certain to communicate with your medical team. Ask your doctor if there are any restrictions regarding movement, diet, climate, medications, requirements for at home medical assistance, or complementary therapies. They can help you lay out a recovery plan or wellness program. Beyond the typical recovery routine that may include medications, physical therapy, or visits with a counselor or nurse, your body will need to get all of the supportive nutrients that are required for complete and speedy recovery. The following list will give you some idea of all that can be added to your health recovery regime—with the approval of your physician.

1. Rest and immobilization as required by your doctor.Be sure that your room has adequate fresh air as ionization helps recovery time; having an oxygen rich environment and sunshine are important – again unless restricted by your medical team.

2. Bathing or showering as allowed – at least warm sponge baths to remove toxins being eliminated by your skin.

3. Fill the room with fresh flowers and plants to uplift your mood.

4. Watch TV programs and movies that make you feel good – and if you are allowed to laugh definitely watch movies that keep you laughing and giggling often. Improving your mood is definitely important to healing. In fact, there are now hospital humor programs where personnel are trained to help make you laugh. Laughter is very healing!

5. Allow only those visitors with a positive mental outlook; people that make you feel happy when you see them.

6. Keep your bowels moving. Some medications have side effects that include sluggish bowel movements or constipation. Drink purified water at room temperature unless you are really warm and cool water feels better to you. However, digestion is always best without too hot or too cold water in the digestive tract. Stay away from coffee because caffeine may be dehydrating. Consider the proper diet to help yourself heal well

7. Your diet (again check with your personal physician to be certain these suggestions are appropriate for you) should be filled with foods that are nutrient rich. And every bite and everything you drink should be as valuable as possible. That means that you should eat foods that are whole, grown without herbicides, pesticides, unchanged by man. Avoid processed foods and drinks. Get close to nature. Sometimes baby foods are required if you cannot swallow easily or have compromised digestion or loss of appetite. If not, just follow some of the suggestions below:

Clear broths either chicken, beef or veal are good for healing. Soups that start with a clear brother and contain fresh vegetables as well are important. When you are ill or injured your body will not readily produce the enzymes it needs to complete digestion. We will talk about digestion enzymes a little later.

Having sufficient protein is critical to healing. As protein is assimilated it is broken down into amino acids, often called the building blocks. So, if you are unable to eat foods such as fish, chicken, turkey, veal, portk, eggs, cheese, tofu, beans, nuts and seeds, you may need to purchase protein powders and mix them with soy milk, almond milk, regular milk, or just room temp water. Ionized whey powders are probably the easiest to assimilate in small quantities, but again chew the shake (I know that sounds weird) because it would be similar to eating a steak without chewing it–very concentrated and not easily absorbed even in powdered form if you are ill. Sip on the shakes that you drink–some people enjoy adding fruit like berries or bananas.

Eat more fruits and vegetables for starters. Avoid sugars, too much salt. Avoid snacks and lifeless foods that rob your body of energy. Avoid sodas, alcohol, white flour breads, cereals, pancakes and pastas. Avoid candy and cakes unless just occasional.

Buy organically grown and made foods if possible. Instead of drinking fruit juices eat the whole food. However, if you can get organically grown fruits and vegetables you can make delicious juices (save the pulp for soup) by combining dark green veggies with carrots and beets and pear juice or pineapple or cherry or apple to make it more palatable. Fruits and vegetables are loaded with life supporting nutrients such as antioxidants, vitamins and minerals. If you have a juicer that’s terrific, if you don’t you can just use a food processor or a blender to pulverize pulp and some seeds. Be sure that you chew the juice, do not just swallow it. Your digestive system will work best if you don’t just swallow foods even when “juiced.” Chew to begin the signal to the brain that you will need enzymes for complete digestion.

Beets and beet tops, dandelion greens, parsley, argula, mustard greens, carrots and tops, and fresh lemon juice are wonderful to support liver function. Supporting your liver is extremely important as it will help you to purify your blood. The liver will help to remove toxic residue from anaesthesia and other medications. It helps to flush away waste products of all kinds so it is very important to give the liver all that needs to do its job well.

8. Vitamins/Minerals/other nutrients: Giving your body a multi-vitamin/mineral formula is integral to healing. Concentrate as well on anti-oxidants such as Vitamins A,C,E, + Zinc. Add to that a formula that includes other protective elements such as grapeseed extract, green tea (not if you have high blood pressure because it is stimulating) berries,…many anti-oxidants available today in combination formulas. A separate bone building formula that includes, Vitamin D, Calcium, Magnesium, Potassium, Boron, is important. (ask the doctor again because certain medications may be conflicting here) important to rebuilding bone.

9. Exercise and rehabilitation routinely help to strengthen muscle, ligaments, tendons and bones. Circulation is integral to wellness. Do what you are allowed to do. Check into “rubber stretch bands” to help initiate mobility if allowed –really good and gentle on joints for starters. Rebounders are also good for circulation as you become more mobile. These are mini trampolines and you can gently bounce while watching TV or listening to music–very enjoyable experience and good for you. Let your physical therapist, nurse or aid instruct you here.

10. Homeopathic remedies can also be beneficial to stimulate your body’s immune system and healing response time. Please seek the advice of an MD who practices homeopathic medicine. Go to www.vithoulkas.com to find highly trained classical homeopaths in your area.

11. Stress relief measures such as Yoga, Bio-Feedback, Meditation: Learning how to quiet and clear the mind of stressful thoughts, worries, and fears can add much to your healing program. When your body stops getting disturbing signals from your brain it can more readily attend to physical healing. Do whatever seems to soothe you most. If allowed soaking in a warm tub might help reduce aching muscles and calm the nerves. Aromatherapy is also good for soothing your senses. Try lavender under your pillow, or vanilla candles to bring tranquility. Music is also wonderful for the nervous system. Choose calming classical music, new age flutes and bells, easy listening tunes to help stay relaxed.

12. Massage therapy and acupuncture or acupressure can complement your healing program. Bringing greater circulation to an injured or ill body can speed healing. Ask your physician if this is allowed. Sometimes having circulation cuffs on your legs are recommended by doctors after surgery or injury. This might be a good way to speed healing with limited exertion.

13. Digestive Enzymes help you assimilate and absorb nutrients that are important to healing. A product such as AbsorbAid that has been clinically tested and scientifically proven to increase the absorption of vital nutrients by up to 71% can really help speed recovery time. AbsorbAid is a 100% plant based enzyme formula that works well for most all individuals–if you can eat fruits and vegetables you can take AbsorbAid Platinum. It is so safe the original AbsorbAid has been used in feeding tubes in nursing home trials with excellent results at increasing protein utilization. Amino acids are the building blocks so adding AbsorbAid digestive enzymes can really be beneficial.

14. Visualization: Visualize yourself totally well, doing whatever it is that you most enjoy in your mind first —I used to tell my patients to See, Feel and make it Real! The joy you get from imagining yourself completely well and up doing what you most enjoy can uplift your spirits and speed healing. Guided imagery tapes are readily available today.

15. Prayer and Faith: have a profound effect on healing for many people. When you believe that you will be well it can elevate your body’s responses. There are many documented cases of people healing when they are certain they will! So prepare yourself for recovery and get excited about it!

Wishing you a speedy recovery!

Why Use Socratic Seminars in Your Health Education Class?

What is a Socratic seminar? A Socratic seminar is a formal discussion based on a topic where the leader asks open-ended questions. Throughout the Socratic seminar students will listen closely to the comments of others, think critically, and articulate their own thoughts and their responses to the thoughts of their peers. Students will learn to work cooperatively and ask questions intelligently and civilly. The Socratic seminar allows students to apply practical methods of a topic being discussed and enables the students to view certain points from several different perspectives. Throughout the discussion the teacher should minimally intervene, and when doing so it should be to lead the students to a specific topic or ask an additional open-ended question about a topic already being discussed. Giving the students the freedom to participate in a Socratic discussion will increase student involvement and student learning.

A Socratic discussion can be utilized in any subject including history, language arts, sociology, etc. but I would like to discuss the use of a Socratic discussion in a health education class. Incorporating a Socratic seminar in your health education class will be prevalent in most topics such as living a healthy life, building good character, physical activity, nutrition and health, managing stress, emotional problems, relationships, obesity, drug use, environmental health etc. this is because these topics are very relevant to your students everyday life. You can lead your students into a discussion with these topics with a current event article, after a discussion lecture, after watching a you tube clip, and relating it to something that may be going on or happening in your school. In addition these are all topics that I’m sure your students have interest in, hear about, and participate in on an everyday basis. With a proper questioning technique by the leader (teacher) you will be able to generate a very scholarly discussion among your students, you may be surprised how passionate some of your students are about specific topics.

The key to getting your students to participate and really get involved is to ask the right questions that will generate discussion. Once you are on a specific topic in class begin a Socratic seminar by asking a question on that topic, once a few students have responded start asking questions such as what do you mean by that? How does this relate? Could you give me an example? Could you explain further, what is he/she assuming? Why do you think that right? What lead you to that believe? What’s an alternative? Are you implying this? Etc. Again you may be shocked how some students may passionately agree with some of their peers responses and comments, or disagree and begin to debate which may be a good learning experience for the students because they will begin to view the topic/discussion from multiple perspectives which may enhance the learning experience.

The purpose of a Socratic seminar is to get your students engaged in a higher level of thinking to promote learning. Incorporating Socratic seminars into your class will lead your students in discussion, debate, critical thinking, acquiring greater interests, and the ability to apply practical methods. “He who learns but does not think is lost” Confucius (551-479 BCE).