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Lara K. Butler, M.D. is a Harvard trained, board-certified Dermatologist and Mohs Micrographic Surgeon. She also specializes in reconstructive and cosmetic surgery. She is a diplomate of the American Academy of Dermatology, and a fellow of the American College of Mohs Surgery and American Society of Dermatological Surgery. Following her Dermatology residency, she completed a fellowship in cutaneous oncology, Mohs micrographic, and reconstructive surgery with the Harvard Medical School Department of Dermatology at the Lahey Medical Center. She has been a researcher at the Johns Hopkins and Mount Sinai Hospitals and has published numerous articles and chapters on skin cancer, scar revision and cosmetic surgery in leading medical journals. She has taught at the Harvard Medical School Department of Dermatology, and is a lecturer on complex reconstruction techniques after Mohs surgery.

Mallika Marshall, MD, is an Emmy-winning journalist and physician. She is Medical Director at WBZ-TV in Boston, and a practicing physician at MGH's Chelsea Urgent Care Clinic and MGH Revere Health Center. Marshall is a Contributing Editor for Harvard Health Publishing and host of HHP's e-learning courses. She has nearly 15 years of media experience. She graduated cum laude from Harvard College and received her medical degree with honors from UCSF. She is a member of the Alpha Omega Alpha Honors Society and various medical associations. She has served on the Board of Trustees for the Urgent Care Foundation and the Board of Directors for Dress for Success Boston. She was an Associate Editor of the Harvard Medical School Family Health Guide.

Katie Morganti Stewart, CNP, MS, is a nurse practitioner in the Cardiovascular Performance Program (CPP) at Massachusetts General Hospital, specializing in the cardiovascular care of athletes and highly active individuals. Katie works closely with patients along the continuum of their care, from initial screening to longitudinal follow-up, and is a program coordinator for the Athletes with Arrhythmias Clinic. Katie completed her Bachelor of Science in Nursing at Boston College and then earned her Master of Science degree at the University of California San Francisco. She is nationally board-certified by the American Nurses Credentialing Center (ANCC) as an acute care nurse practitioner. Katie is dedicated to health and wellness, both personally and professionally, with a passion for yoga and cycling. When she is not engaging with patients in the CPP, she delights in spending time with her husband and three young children. 

Dr. Dean Xerras is from the greater Boston area and attended Tufts University, where he majored in Spanish and received his medical degree. He completed his residency at Beth Israel Deaconess Medical Center and currently practices general internal medicine at MGH Chelsea Healthcare Center, where he has been the medical director since 2009. He is also an assistant professor of medicine at Harvard Medical School and is active in various committees, including the Partners HealthCare Engagement and Communications team of the NIH's All of Us Research Program. Awarded a National Health Service Corps Scholarship, he is committed to reducing disparities in healthcare delivery, evidenced by his 15 years of service on the Board of Health in Chelsea, MA, where he helped develop stricter tobacco and trans fat regulations.

Infectious Disease Physician, Brigham & Women’s Hospital  

Dr. Cindy Chang is a specialist in primary care sports medicine with almost 3 decades of experience. She has served as head team physician at UC Berkeley, chief medical officer for Team USA in 2008 & 2012 Olympics, and assisted in the WNBA COVID "Wubble." Chang takes an individualized approach to care, seeing athletes of all ages. She is Program Director of UCSF's Primary Care Sports Medicine Fellowship, board of trustees for the American College of Sports Medicine, chairs the Sports Medicine Advisory Committee for the California Interscholastic Federation & National Federation of State High School Associations, and past president of the American Medical Society for Sports Medicine. She earned her medical degree from Ohio State Univ. College of Medicine, followed by a residency in family medicine at UCLA Medical Center & a fellowship in sports medicine at Ohio State Univ. Medical Center.

Hey Andrew, this is Dr. Baggish. Your question, what uncommon or controversial fitness practice do you believe are highly effective? Really caught my attention, and I wanted to share with you my thoughts. As someone that has the opportunity to work with a lot of high level athletes who are coached by some of the world's best coaches, one of the things I see, not practice with nearly enough attention is the concept of annual periodicity. And this is really stepping back and thinking about a full year calendar and as it relates to performance as well as health. The rough rule of thumb we use in our practice is that when you think about a 12 year calendar, at least three months out of that 12 month year should be spent in a phase of active recovery, which we define as decreasing both volume and intensity by at least 50%. The truth is that most fit people do the same thing over and over, day in day, out week in week out. And while this may help maintain some baseline level of fitness, it really is not the key to optimizing performance nor is it the key to long term health. So in essence, stepping back and thinking about the full year and designating times of high volume high intensity as well as times of rest and recovery is really one of the most controversial and uncommonly practiced things I see. I hope that helps and keep the questions coming.

Annual periodicity, or taking a step back and thinking about a full year calendar as it relates to performance and health, is an uncommonly practiced fitness practice that is highly effective. Designating times of high volume/high intensity as well as times of rest and recovery is key to optimizing performance and long term health.

What uncommon or controversial fitness practice do you believe are highly effective?

Discover the Uncommon Fitness Practice for Optimal Performance

One uncommon and controversial fitness practice that I believe is highly effective is the concept of annual periodicity. This involves stepping back and considering a full year calendar in relation to both performance and health. In my experience working with high-level athletes and top coaches, I've noticed that not enough attention is given to this practice.

The general guideline we follow is that out of a 12-month calendar, at least three months should be dedicated to active recovery. During this phase, both volume and intensity are decreased by at least 50%. Many individuals tend to do the same workouts repeatedly, day in and day out, week after week. While this may help maintain a baseline level of fitness, it is not the key to optimizing performance or long-term health.

Taking a step back and strategically designating periods of high volume and intensity, as well as periods of rest and recovery, is a controversial and uncommonly practiced approach. However, I believe it is highly effective in achieving optimal results and maintaining long-term health.

I hope this insight helps, and feel free to ask more questions.

Hi there. Thanks for the question. Are electric toothbrushes better than manual toothbrushes? I would say they are. The reason being is that electric toothbrushes take out the human error in brushing. If you brush too hard or incorrectly, you can cause damage to the tooth structure in the form of abrasion or the gum line in the form of recession. The electric toothbrush allows the person who's using it to just go from tooth to tooth and the brush does the work for you. A manual toothbrush isn't necessarily bad, but if you're not using it correctly, you can cause that damage that we just spoke about. If you're using a manual toothbrush, please review with your dentist or your hygienist the proper brush technique. And remember, consistency is key. Always brush twice a day every day.

Electric toothbrushes are better than manual toothbrushes because they take out the human error in brushing and help to keep your teeth healthy.

Are electric toothbrushes better than manual brushes?

Electric toothbrushes: Say goodbye to human error!

Electric toothbrushes are generally considered better than manual toothbrushes. The reason is that electric toothbrushes eliminate the potential for human error in brushing. When using a manual toothbrush, brushing too hard or using incorrect technique can lead to damage to the tooth structure or gum line. Electric toothbrushes simplify the process by doing the work for you as you move from tooth to tooth.

While manual toothbrushes aren't necessarily bad, using them incorrectly can cause the aforementioned damage. If you prefer a manual toothbrush, it's important to consult with your dentist or hygienist to learn the proper brushing technique. Regardless of the type of toothbrush you choose, consistency is key. Remember to brush twice a day, every day.

So the American Academy of Dermatology recommends sunscreens be broad-spectrum, UVA/UVB coverage, that is an SPF of 30 or higher. And what that means, SPF of 30, is that it blocks about 97% of the sun's UVB rays. And UVB is what's responsible for burns and skin cancer. When you get up to an SPF of 50, you're blocking about 98%. And when you're at an SPF of 100, you're blocking 99%. So certainly that higher SPF is going to give you a little better blockage. But what we found is that these higher SPFs of 100, give people a false sense of security. And then they end up in the sun longer, and then they do get more sunburns. So what's important to know, regardless of the SPF, you need to reapply every 2 hours. If you have an SPF of 100, that doesn't mean it will last longer. Every 2 hours, you need to reapply an SPF 30, an SPF 50, or an SPF 100. So you know, pick your whatever sunscreen you're actually going to use, whether it's a lower number or a higher number at least 30 or higher though, and just reapply every 2 hours.

The American Academy of Dermatology recommends using broad-spectrum sunscreen with an SPF of 30 or higher. An SPF of 30 blocks about 97% of UVB rays, and an SPF of 50 blocks about 98%. An SPF of 100 blocks 99%, but giving people a false sense of security as they may stay in the sun longer and get more sunburns. It is important to reapply every 2 hours regardless of SPF.

Is there any point in using sunscreen with spf greater than 50?

The Truth About Sunscreen: SPF 30 or Higher Recommended, Reapply Every 2 Hours

The American Academy of Dermatology recommends using sunscreens with a broad-spectrum, UVA/UVB coverage and an SPF of 30 or higher. An SPF of 30 blocks about 97% of the sun's UVB rays, which are responsible for burns and skin cancer. As the SPF increases, the blockage also increases, with an SPF of 50 blocking about 98% and an SPF of 100 blocking 99%.

However, it's important to note that higher SPFs can give people a false sense of security, leading them to stay in the sun longer and potentially experience more sunburns. Regardless of the SPF, sunscreen should be reapplied every 2 hours for optimal protection. An SPF of 100 does not mean it will last longer than lower SPFs.

The key is to choose a sunscreen with an SPF of at least 30 and reapply it every 2 hours, regardless of the specific SPF number.

There are a number of things you can do to prevent memory loss. The most important thing is to exercise. The goal is to exercise for 30 minutes five times a week. It's also important to eat right. Avoid overeating, and avoid excessive alcohol. Stay mentally active and socially engaged. It's always good to challenge yourself with learning new activities. Staying socially engaged helps you prevent loneliness and depression, all things that can affect your memory. It's also very important to get a good night's sleep. Sleep is actually a restorative time for your brain. It helps your body reset. So four simple things to do to prevent memory loss is to eat right, exercise, stay active, and get a good night's sleep.

To prevent memory loss, exercise for 30 minutes five times a week, eat right, stay mentally active and socially engaged, and get a good night's sleep.

What is the best way to prevent memory loss?

Exercise, Eat Right, Stay Active, Sleep Well: Prevent Memory Loss

To prevent memory loss, there are several effective strategies you can adopt. The most crucial one is regular exercise. Aim for 30 minutes of exercise, five times a week. Additionally, maintaining a healthy diet is important. Avoid overeating and excessive alcohol consumption.

Keeping your mind active and engaged is also key. Challenge yourself with new activities and continuously learn. Social engagement is equally important as it helps prevent loneliness and depression, both of which can impact memory.

Lastly, prioritize getting a good night's sleep. Sleep is a restorative time for your brain and allows your body to reset. By focusing on these four simple actions—eating right, exercising, staying mentally active, and getting sufficient sleep—you can help prevent memory loss.

So lightheadedness is a really common complaint in internal medicine and the causes can range from benign to serious. I will encourage you to get checked if this is a new symptom that you have. But maybe just describing an approach that many physicians take to it will be helpful. The language you use is really important. When we say dizziness, your health care provider usually thinks of dizziness as an altered relationship in space. And vertigo is the description of a motion sensation that's often described as spinning, either the room is spinning around a person or the person is spinning around in a room. And those causes of dizziness and vertigo are separate than lightheadedness. Now lightheadedness really has three main causes in internal medicine. One is orthostatic hypotension, your blood pressure dropping as you go to a sitting or standing position. The second is cardiac causes, so the heart's just not able to respond appropriately to get enough blood to the brain and you get symptoms of lightheadedness. And that can be due to an arrhythmia or to a valvular abnormality. And the final one is vasovagal syncope, which is actually quite common. And we have a nerve in our body, the vagus nerve, that when stimulated can really slow down the heart rate and cause symptoms of either almost fainting or fainting itself. And a number of things can stimulate your vagus nerve such as pain. So when people that faint, when they get their blood drawn, it often makes you think of vasovagal syncope. Thank you very much and keep the questions coming.

Lightheadedness is a common complaint in internal medicine, and can have three main causes: orthostatic hypotension, cardiac causes, or vasovagal syncope. It is important to get checked if this is a new symptom for you.

Unveiling the Three Main Causes of Lightheadedness

Lightheadedness is a common complaint with various causes, ranging from benign to serious. If you are experiencing this symptom, it is advisable to seek medical attention. Physicians typically approach lightheadedness by considering different factors.

When discussing dizziness, healthcare providers often think of it as an altered spatial relationship. Vertigo, on the other hand, refers to a sensation of spinning, either of the room around a person or the person spinning within the room. These causes are distinct from lightheadedness.

In internal medicine, lightheadedness is commonly attributed to three main causes. The first is orthostatic hypotension, where blood pressure drops upon sitting or standing. The second cause is related to cardiac issues, where the heart is unable to adequately supply blood to the brain, resulting in lightheadedness. This can be due to arrhythmias or valvular abnormalities. The third cause is vasovagal syncope, which is relatively common. It occurs when the vagus nerve is stimulated, leading to a slowing of the heart rate and symptoms of near-fainting or fainting. Various factors can stimulate the vagus nerve, such as pain or blood draws.

If you are experiencing lightheadedness, it is important to consult a healthcare professional for a proper evaluation.

Hey, there. I just wanted to talk a little bit about blood in the stool. Certainly, when you see it, it's scary. And, you know, the first thing you need to kind of consider is when you see something that's red in the stool, is it blood? Sometimes you can see red stool and it's from diet. Sometimes you can eat beets and they can actually cause your stool to look like there's blood in it. So you want to make sure that it is blood. There are tests you can buy to kind of confirm that in the pharmacy. Certainly, when you see red stool or something that you think is blood, give a call to your doctor. They need to evaluate you. But the most common cause of blood in the stool, actual blood in the stool would be a hemorrhoidal bleed. So when you have hemorrhoids, it's a dilated vein in the in the anus or the rectum, they get dilated from increased pressure, increased intraluminal pressure in the colon. Sometimes that's related to dietary changes from you know decreased fiber content. So when you're constipated, you kind of push that vein to kind of get swollen. It's called a hemorrhoid and it's the most common cause of blood in the stool. Other causes would be infection. You can get an infectious diarrheal illness that can cause blood in the stool. That's one other relatively common cause. And then another cause, but not as common, would be cancer. So anytime there's blood in the stool, you need to go give your doctor a call. They need to do some tests to evaluate you. But by far the most common cause of blood in the stool would be a hemorrhoid. Thanks for the question.

Blood in the stool is scary, but it is usually caused by hemorrhoids, which are dilated veins in the rectum or anus. Other causes of blood could be an infection or cancer. It is important to call your doctor if you see any signs of blood in your stool.

What are some common causes for blood in your stool?

Unveiling the Mystery: Common Causes of Blood in Stool

When it comes to blood in the stool, it can be a concerning sight. However, it's important to consider a few factors. Firstly, determine if the red color in the stool is actually blood or if it could be from something in your diet, such as consuming beets. To confirm if it is blood, there are tests available at pharmacies.

If you do see what appears to be blood in your stool, it's crucial to contact your doctor for evaluation. The most common cause of blood in the stool is a hemorrhoidal bleed. Hemorrhoids are dilated veins in the anus or rectum that can occur due to increased pressure in the colon, often related to dietary changes or constipation.

Infection is another relatively common cause of blood in the stool. An infectious diarrheal illness can lead to this symptom. While less common, cancer can also be a cause of blood in the stool.

Regardless of the cause, it's essential to reach out to your doctor for further evaluation and necessary tests. Remember, hemorrhoids are the most frequent cause of blood in the stool.