11 Reasons To Never Get A Job


Dr. Guy Mayeda interviewed for MSN Health & Fitness article, “11 Reasons To Never Get A Job”.

The daily grind. It’s no surprise heart attacks occur most frequently on Monday mornings, when it’s time to leave the weekend behind and get back to the work. Studies report that up to 20 to 40 percent of employees hate their work, says Guy Mayeda, MD, a cardiologist at Good Samaritan Hospital in Los Angeles. “Dissatisfaction with one’s job can lead to unhealthy lifestyle choices such as overeating, consuming foods higher in fats and sugars, avoiding exercise and even smoking.” Here are other ways the 9-to-5 grind hurts your health.

Inflammation usually occurs as a response to something such as an infection, chronic irritation or an injury. Studies show that sitting for long periods of time is linked to an increased level in inflammatory biomarkers, particularly for women, says Kristine Arthur, MD, an internist at Orange Coast Memorial Medical Center in Fountain Valley, Calif. “Over time, chronic inflammation weakens the immune system and can disturb organ systems leading to problems like kidney failure, joint disease and heart and lung disease.” Prolonged sitting has been linked to a higher risk of heart disease, diabetes, cancer and death. Arthur adds that people may also have more subtle symptoms of chronic inflammation such as fatigue, chills and an overall lousy feeling.

Swapping out your office chair for a stand-up desk eases some of the problems of sitting but creates other ones, namely back pain, says Neel Anand, MD, clinical professor of surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles. “Any position done in excess may be bad for your back, especially ones that puts weight on the spine. It is not just standing, it also matters what one is doing while standing.” Standing and leaning forward put stress on spinal discs and are worse if you are simultaneously lifting weights or transferring objects. “This done repeatedly or for a prolonged time is likely going to take a toll on the discs and the back,” says Anand.

The same work stress that increases inflammation is also behind the increased heart attack risk on Mondays, says cardiologist Mayeda. “Stress adversely affects the immune system and has been related to increased levels of circulating white blood cells and the release of stress hormones such as norepinephrine and cortisol.” Mayeda noted that these physical changes could lead to a state of chronic inflammation, a major contributing factor to sudden heart attacks caused by plaque rupture in the coronary arteries.

Highly contagious, the norovirus (often called the “stomach flu) can infect anyone through food, water, contact with an infected person or contaminated surfaces. Office break rooms make it easy to spread this sickening germ. “The community coffee pot, microwave and handle of the refrigerator can all be toxic sites,” says Michael Schmidt, PhD, a microbiologist at the Medical University of South Carolina. “Plus, while we wash our hands before eating, we often forget to wash them when we return our leftovers. Thus, the door contaminates us as we grab our lunch or snack.” Coffee cups can also carry the virus, especially since coffee isn’t heated to boiling.

A hunched over posture, loose abs, forward-tilted head, tight hip flexors and and a host of other issues add up to “office bod.” It’s not only unattractive but could lead to a variety of health issues over time, says Pete McCall, senior advisor for the American Council on Exercise (ACE). “If the hip flexor muscles tighten, they inhibit the ability of muscles on the other side of the joint to contract, which reduces both muscle tone and strength.” In addition, you’re more likely to gain weight. “When you don’t use your muscles you end up with lower levels of the enzyme lipoprotein lipase,” says McCall. This enzyme helps convert fatty acids into fuel for muscle contractions, so this lower level can lead to weight gain.

Whether you sit on a fitness ball or in an office chair, it’s easy to make bad posture a habit. Sitting with your head in a forward position (ears should align with your shoulders and hip joint and not jut forward) can lead to pain and tightness in the upper back, says McCall. “It can also affect your shoulder and neck muscles. In addition, this posture reduces the flow of oxygen to the lungs.” All these factors are potential causes for headaches and body pain over time.

Sitting through an hour-long PowerPoint slideshow is enough to put anyone to sleep. But research shows that simply sitting in a confined space with a number of people exhaling carbon dioxide not only makes you sleepy, but negatively affects decision-making skills as well. Normal levels of carbon dioxide concentrations outdoors are 380 parts per million and not usually higher than 1,000 parts per million indoors. Levels can reach as high as 3,000 parts per million or more inside enclosed rooms. In the study, students exposed to 1,000 parts per million carbon dioxide concentration decreased their performance in six of nine elements of a decision-making skills test. Those in the 2,500 parts per million test scored even worse.

Coughing and sneezing coworkers can be carriers of cold and flu germs. “If you are required to sit close to several other people or work in a large room with a number of people for many hours every day, this puts you at a higher risk for catching airborne germs from someone sneezing or coughing,” says internist Arthur.

“Work can be the perfect environment for spreading or catching germs.” No matter how well you wipe it down, your desk is likely to carry germs, she adds. Shared door handles and sink faucets can also be rife with cold and flu bugs.

Staring at a computer monitor for hours can cause eye strain and more, says Sandy T. Feldman, MD, ophthalmologist and founder of ClearView Eye & Laser Medical Center, San Diego, Calif. “Vision issues occur in over 70 percent of individuals who work on a computer for three or more hours a day.” Most notably, blink rate slows down when you’re in front of a computer screen. This leads to a feeling of dry eyes but may also lead to tearing and a burning sensation, says Feldman. “Dry eyes are extremely common and problematic and can cause blurred vision. Even people who wear glasses are prone to develop issues.”

It’s hard enough to stay on target with healthy eating habits on your own, but it’s much tougher when you’re the office party pooper who won’t celebrate with a slice of birthday cake. Or have a doughnut with the rest of the gang. And so on. “You’re constantly tempted by goodies brought in from coworkers, says Kari Ikemoto, RD with HealthCare Partners, Los Angeles, Calif. “Plus, the daily trip out to lunch can really add up. Meals from restaurants tend to be higher in fat and sodium with portion sizes that are often double what we’re supposed to eat.” Vending machine treats such as chips, cookies and soda also add up to excess calories and pounds around your waist over time as well.

Underhanded coworkers and other people who make life difficult for you to get the job done can have a significant adverse impact on your mental and physical health, says Elizabeth Lombardo, PhD, psychologist and author of Better than Perfect: 7 Strategies to Crush Your Inner Critic and Create a Life You Love. “One study showed that over 75 percent of those who had been bullied experienced anxiety and over half suffered difficulty concentrating. They also experienced sleep problems, hypervigilance and stress headaches.” In some cases, workplace bullying can lead to depression and even thoughts of suicide. “Even after the bullying stops, these symptoms can continue, which negatively impacts your work and personal life,” says Lombardo.

Heart Disease: Major Risk Factor for Many Rheumatology Patients


Dr. Guy Mayeda was interviewed by The Rheumatologist and quoted in their published article. An excerpt of the article by Vanessa Caceres is below. You may read the entire article here.

Rheumatic diseases, such as rheuma­toid arthritis (RA), systemic lupus erythematosus (SLE) and vasculitis, can affect the body in many ways, but perhaps the most serious is the increased risk of heart disease for many patients.

As the risk of atherosclerosis in autoimmune disease patients gains increased attention, rheumatologists and cardiologists are collaborating more often to refer patients to each other.

The ultimate goal is to decrease inflammation to control rheumatic disease and lower the risk for heart disease, says cardiologist Donna Denier, MD, Franklin Square, N.Y. “When you see a reduction in inflammation, you see a reduction in cardiac mortality as well,” she says.

Patients with RA or related diseases may not even know they are at greater risk for cardiovascular disease, but the risk is almost equal to the increased risk that diabetic patients have, Dr. Denier says. Additionally, cardiovascular signs may appear at an earlier age in these patients than in a normal patient population.

Another challenge is evaluating a patient’s medications that could further increase the risk for heart disease. For example, rheumatologists often prescribe steroids, which do not interact well with the aspirin or anti-platelet drugs a cardiologist might prescribe, Dr. Denier says.

When to Refer to a Cardiologist
Although it may have been common in the past to wait for a heart problem to emerge before referring a patient to a cardiologist, the emphasis now is on quicker preventive care, says cardiologist Guy Mayeda, MD, Good Samaritan Hospital, Los Angeles. He’s seen many patients who have damage to the heart or blood vessels but are not yet symptomatic. “The sooner they get referred to a cardiologist, the better the patient can improve with a collaborative effect,” he says. In that kind of patient, the cardiologist will recommend the rheumatologist prescribe aggressive therapy to get the inflammation under control, he adds. The cardiologist may also see early signs of such problems as a pericardial effusion, in which fluid accumulates around the heart and compresses it, leading to possible death if untreated, Dr. Mayeda says.

Four Essential Elements of a Healthy Doctor-Patient Relationship

Dr. Guy Mayeda’s interview with Fox News and was included in the following abridged article by Elizabeth Renter, who is a staff writer at NerdWallet, a personal finance website.

Dr. Mayeda, Dr. Economides and Dr. Fitzgibbons

It’s easy to focus on the basics when evaluating your doctor: Did he go to a good medical school? Does she have a good reputation with colleagues and patients? Is he in your insurance plan’s network? These questions are an important part of your calculations.

But there’s another equally important — and somewhat intangible — factor to consider: Will the two of you be able to build a relationship that works to keep you healthy?

Recent research shows a good doctor-patient relationship can improve health outcomes, so it’s worth investing the effort to determine how your connection with your doctor stacks up.

This process can take time, possibly several appointments. Whether you’re seeing a new doctor or evaluating one you’ve had for a while, weigh your exchanges against the following four elements, which are the keys to any healthy doctor-patient relationship.

  1. Communication: A Two-Way Street
    Communication with your doctor begins the moment she enters the exam room. Appropriate diagnosis and treatment depend on your ability to share your symptoms and concerns, along with her ability to listen. If she doesn’t listen, you may feel like she’s not interested in what you have to say and therefore say less. As a result, your doctor could end up making uninformed decisions.Likewise, your ability to understand and follow treatment recommendations depends on your doctor’s translation of complex medical topics into understandable, actionable advice. On both sides, if communication skills are lacking, the relationship suffers.
  2. Physician Empathy
    Empathy is the ability to share someone’s perspective, to mentally stand in their shoes and see the world from their point of view. Simply listening isn’t enough; a doctor who fully understands where a patient is coming from is better able to build trust and provide advice and treatments that align with the patient’s needs. Physician empathy is such a valuable part of the doctor-patient bond that some hospitals  are training doctors for it.
  3. Trust
    Even though only 23% of Americans have confidence in the health care system, more than two-thirds (69%) trust doctors’ honesty and integrity, according to a 2014 paper in the New England Journal of Medicine . Trusting that your doctor will deliver ethical guidance best suited to your particular health needs is another must-have in a healthy relationship.“As part of that trust, physicians need to present patients and family members with an honest assessment of the risks and realistic success rates with any recommended treatment or therapy,” says Dr. Guy Mayeda, cardiologist at Good Samaritan Hospital in Los Angeles.

    But your doctor must trust you, too, to follow her guidance, take your prescribed medications and follow up as needed.

  4. Professional Boundaries
    If you and your doctor need good communication, empathy and trust, should your doctor be your friend? Not so fast, experts say. Your doctor must walk a fine line between trusted confidant and friend, always keeping within professional boundaries.

Full article is available here.