I usually don’t look forward to my required bi-ennual first aid class, but this year was different. I had a really engaging instructor named Elizabeth who had some computer problems, so basically had to do the whole presentation off the fly with make-shift mannequins and improvised demonstrations. 

I’m glad the video didn’t work, otherwise, I don’t think I would have written this.   

First Aid methods seem to always be changing every time I take the class, so I thought I would update you on what the latest research shows will help you save lives.  

CPR has extraordinarily been dumbed down (and for good reason)

Cardio pulmonary resuscitation (CPR) can be life-saving. (The whole goal of CPR is to circulate the blood to your tissues, namely brain, so you don’t get massive brain damage or die from lack of oxygen.) CPR is incredibly simple.  

If I had to sum up the whole class, it would be this: 

1.  Assess the scene (so as to make sure you don’t get electrocuted going into the puddle of water where the downed person is) 

2.  Assess the downed person and give a moderate shake (as they simply might have fallen asleep from exhaustion like pulling three shifts in a row.)

3.  Task someone around you with calling 911 and have someone get an AED.  An AED (or automated external defibrillator) essentially shocks the body to help establish normal heart rhythm.  If you have access to one and someone is in cardiac arrest, you should use it.  ​

If you find someone is unresponsive and they are not breathing, you need to do CPR. Don't worry about giving them mouth to mouth. Unless you have a face shield, it's generally not recommended (or unless it's a loved one.) 

Check out your favorite British tough-guy Vinnie Jones explaining how to do CPR:   

Here are some other interesting fun facts about dealing with nosebleeds, cuts, burns, and frostbite.  

​·AED device increases chances of living by 2-3 times.

​·Cut?  Assuming a band aid won't do, apply guaze to soak up the blood, apply a wrap, and make sure bleeding stops.  If it doesn't, go to the ER.  If it's obviously a deep gash, you need a tourniquet.  You can leave it on without interruption for 6-8 hours.  Do not take the tourniquet off until you get professional medical help. 

·Are you on fire (and not on NBA 2k18)?  Stop, drop, and roll still works.  

·Treating a burn?  Apply cool water, but not cold water. 

·"A person in good physical condition can perform CPR for maybe 10 minutes."  This is why I asked Elizabeth, the instructor, “why can’t we use our legs and feet for CPR work?”  She said placement could be a problem and regulating the depth of chest compressions could also be problematic. 

·Be assertive in a life or death situation!  If you don’t, a lot of people won’t do anything, run away, or gawk. 

·Removing ticks are simple.  Pinch the skin around the tick while pulling upward and hold this until the Tick let's go.  Don’t burn the Tick if it's attached.  They can vomit their contents into your body which can lead to infections. 

·Frostbite.  Soak in warm water, not hot water.  Go to the ER. 

·Ingest some weird berries or did your toddler get into the cleaning cabinet? Poison Control Center or the National Poison Control Hotline (1-800-222-1222). 

You should know the basics of what to do in dangerous situations without having to think.  You need to react. If you have a chance to take a first aid class, I highly recommend it. Often, they're free or pretty cheap.  If you ever hike, camp, or have kids, it's definitely worth it. 

​​I’ve had a ton of clients who have suffered from migraine’s.  For the most part, I see those migraine’s get better using the strategies below.  But, I’ve never seen a migraine sufferer not have at least one of these characteristics:  

Forward head posture.   I won’t get into the deep science, but suffice to say that every half inch your head is forward, the greater the stress is on the cervical spine.   (1)   Forward head posture is associated with greater tension-type headaches (which will usually contribute to a migraine).  

Trigger points.  Most of us have trigger points in our neck.  In my experience, most who suffer from migraine’s have major trigger points in the neck area.  This is backed up by a lot of studies which shows that individuals who have tension-based headaches will have worse trigger points than the rest of us.  (2)

Non-neutral shoulder position.  There is some evidence to support that higher tension in the upper traps (and potentially other muscles) is a contributor to tension-based headaches.  (3)  In my experience, this is reflected with elevated or depressed shoulders.  

Flexed torso posture in daily life.   You could have perfect neutral head posture, but if you are leaned over, you are over-stressing your neck big-time.  

Now that I’ve harped on all my migraine-suffering clients, let’s get to what works.  I’m surprised that more docs don't refer out to physical therapists for migraine’s, because the research shows physical methods work just as well as medications (if not better in some cases).  I'd argue the physical means will at least have a chance to prevent future headaches.   (4)
 
1.  Get out of forward head posture by using the stick test.  If you're reading this, you very likely have some degree of forward head posture.  Here's how to really tell.

Place a broom stick on your back where the stick touches your butt, mid-back, and see if it touches your head.  If it touches your head and you're not trying to touch your head to the stick, congratulations, you don't have a forward head posture.  if you have to bring your head back at all, you have forward head posture.  

Here's an overall good tutorial on neck position.  

If this feels like you are constantly trying to avoid someone punching you in the face, that’s good.  It should feel like that at first. 

​Over time, it will get easier, but you need to be really conscious of this.  You may also need to work on extending or straightening your thoracic spine if you are rounded too much.  Some clients just hate me when I am constantly putting the stick on their back and showing them their head is forward.  If you’re overweight or obese, the stick may not be appropriate for you, but the back edge of your ear should bisect the middle of your shoulder.   ​

2.  Get a massage.  My business partner, Matt Williamson is a master at identifying a ton of muscular, joint-based, and whole body patterns that tie into stuff like headaches.  Before any training session, I’ll typically have clients roll with a softball on their necks against the wall.  Often times, this will allow clients to stretch the neck muscles without them being aggravated. 

3.  Get your shoulders neutral.  If you have depressed shoulders, you need to get them elevated, and this could mean doing shrugs. If you have elevated shoulders, you may need to focus on doing scapula depression work which is effectively, a reverse-shrug.  Both ways relieve tension on the muscles, but you have to know which position you are in first.  If you’re not sure, send me a pic, and ask.   

4.  When sitting, sit vertically.   This sounds easy, but it is not.  Realistically, you’ll likely need to move some cushions around to make it actually comfortable, potentially have your computer or book higher, and possibly reposition your legs.  If you can’t be vertical or near vertical, you should have some head support.  

​I recommend patience with these evidence-based strategies.  You likely won’t notice an immediate improvement, but overtime, you hopefully will see some major improvement with your headaches. 
 
1.  Cailliet R. Soft Tissue Pain and Disability. Philadelphia: FA Davis Co.,1977
 
2.  Abboud J, Marchand AA, Sorra K, Descarreaux M. Musculoskeletal physical outcome measures in individuals with tension-type headache: a scoping review. Cephalalgia. 2013 Dec;33(16):1319-36. doi: 10.1177/0333102413492913. Epub 2013 Jun 26. Review. PubMed PMID: 23804285.
 
3.  Bendtsen L, Ashina S, Moore A, Steiner TJ. Muscles and their role in episodic tension-type headache: implications for treatment.Eur J Pain. 2016 Feb;20(2):166-75. doi: 10.1002/ejp.748. Epub 2015 Jul 6. Review. PubMed PMID: 26147739.
 
4.  Biondi DM. Physical treatments for headache: a structured review. Headache. 2005 Jun;45(6):738-46. Review. PubMed PMID: 15953306.

Here’s some quirky facts about alcohol which you might not all be aware of (and in honor of my business partner's wedding dance party tonight):

1. Even if you don’t get a hangover from alcohol, alcohol increases the effects of the sympathetic nervous system which means your fight or flight system is more activated. For those who are super-busy or have high stress, alcohol doesn’t make a whole lot of sense for you.  If you’re on vacation and chilling, go for it.  (1)

2. The rest and relaxation part of your nervous system, the parasympathetic nervous system becomes deactivated with alcohol.  Is this why binge drinkers tend to experience more anxiety, impulsiveness, and “sensation seeking”?  (2) 

3.  Hangovers happen with alcohol due to many factors including the type of alcohol you ingest, hydration status, sleep status, genetic factors, blood sugar levels, and inflammation pathways.   However, by eating healthy, drinking lots of water, and not drinking too much, you probably won’t get much of a hangover unless you really overdo it.  (3,4,5,6,7,8)

4.  Intoxication is accurate word for any alcohol use.  Alcohol is by the way a toxin.

5.  Alcohol contains 7 calories per gram.  However, it’s thermic effect of feeding (or how much energy is required to digest alcohol) is ridiculously high.  It’s even higher than protein which basically means your body needs to use a significant amount of energy to digest alcohol.  However, it doesn’t mean you can drink a 12 pack and not gain weight because…

6.  Beer guts are real.  (9)

7.  The amount of research on weight loss and alcohol is remarkably thin. However, alcohol appears to not affect hunger significantly.  But, alcohol also doesn’t really give much feelings of being full. This makes it easy to drink more calories and can make it harder to lose weight.  If you are trying to lose weight, I recommend seriously no more than one to two drinks per week. 

8.  Moderate alcohol intake improves heart health.  However, the cancer risk of organs above the waistline goes up if you consume any amount of alcohol on a regular basis.  Take your family history into consideration.   (10)

9.  Alcohol disrupts sleep, but can still help us get to sleep faster.  If you drink alcohol to get to sleep, you need to try other alternatives. (6)
 
I hate to break it to you, but most American adults should not be regularly drinking alcohol because we’re simply too busy and get don’t get consistent adequate sleep.  Remember, alcohol increases your sympathetic nervous system which is contraindicated for many of us (including me).   
 
However, if you’re retired, get great sleep, don’t have a major history of cancer in your family, and aren’t super busy, drink away… in moderation.  If you go on vacation, and can truly relax, I think drinking is fine. Since cardiovascular disease is still the leading cause of death in America, moderate drinking will help protect your heart. 
 
Most American adults should in my opinion simply smoke a lot more weed.  I’m totally kidding.  Most people need to stop looking for an external fix like alcohol or weed, and really focus on the basics like sleep, eating healthier, self-care practices, and connecting with friends, family, and community.  It’s not sexy, it’s challenging at times, but it gives by far the most bang for the buck in terms of health.  In other words, get your priorities straight. 
 
1. Grassi GM, Somers VK, Renk WS, Abboud FM, Mark AL. Effects of alcohol intake on blood pressure and sympathetic nerve activity in normotensive humans: a preliminary report. J Hypertens Suppl. 1989 Dec;7(6):S20-1. PubMed PMID: 2632716.
 
2.  Adan A, Forero DA, Navarro JF. Personality Traits Related to Binge Drinking: A Systematic Review. Frontiers in Psychiatry. 2017;8:134. doi:10.3389/fpsyt.2017.00134.
 
3.  Kruisselbrink LD, Martin KL, Megeney M, Fowles JR, Murphy RJ. Physical and psychomotor functioning of females the morning after consuming low to moderate quantities of beer. J Stud Alcohol. 2006 May;67(3):416-20. PubMed PMID: 16608151.
 
4.  Bendtsen P, Jones AW, Helander A. Urinary excretion of methanol and 5-hydroxytryptophol as biochemical markers of recent drinking in the hangover state. Alcohol Alcohol. 1998 Jul-Aug;33(4):431-8. PubMed PMID: 9719404.
 
5.  RUBINI ME, KLEEMAN CR, LAMDIN E. Studies on alcohol diuresis. I. The effect of ethyl alcohol ingestion on water, electrolyte and acid-base metabolism. J Clin Invest. 1955 Mar;34(3):439-47. PubMed PMID: 14354014; PubMed Central PMCID: PMC438648.
 
6.  Verster JC. The alcohol hangover--a puzzling phenomenon. Alcohol Alcohol. 2008 Mar-Apr;43(2):124-6. doi: 10.1093/alcalc/agm163. Epub 2008 Jan 8. Review. PubMed PMID: 18182417.
 
7.  Swift R, Davidson D. Alcohol hangover: mechanisms and mediators. Alcohol Health Res World. 1998;22(1):54-60. Review. PubMed PMID: 15706734.
 
8.  Kaivola S, Parantainen J, Osterman T, Timonen H. Hangover headache and prostaglandins: prophylactic treatment with tolfenamic acid. Cephalalgia. 1983 Mar;3(1):31-6. PubMed PMID: 6342813.
 
9.  Michael Jensen, MD, professor of medicine, Mayo Clinic, Rochester, Minn.Mayo Clinic web site.
Bobak, M., European Journal of Clinical Nutrition, 2003; vol 57: pp 1250-1253. 2010 Dietary Guidelines for Americans.
 
10.  https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html

“I don’t recommend you weigh yourself every day, otherwise, you’ll go crazy.” 

This is what I used to tell my clients. 

My biggest concern was that clients would get discouraged because they didn’t see their weight go down right away.  I would instead recommend that they weigh themselves every two weeks. 

Here’s the problem.  Weighing yourself everyday works pretty damn well.  At least, this is what some cool studies tell us. 

First, if you have lost weight already, daily weighing can help you keep it off.  (1)

Second, daily weighing can help you lose weight  (2)

Second, if you are not trying to gain weight (and maybe even maintaining your weight), weighing yourself daily can also help you.  By simply being conscious of what you weigh on a daily basis, you are less likely to simply gain weight. 

Unless you are prone to high anxiety, weighing yourself may not be appropriate for you.  Otherwise, daily weighing will likely increase your awareness of how your nutrition and exercise affects your weight. Should You Weigh Yourself Every Day? 

1.  168. Butryn ML, Phelan S, Hill JO, Wing RR. Consistent self-monitoring of weight: a key component of successful weight loss maintenance. Obesity (Silver Spring) 2007;15:3091. [PubMed]

2.  169. Gokee-LaRose J, Gorin AA, Wing RR. Behavioral self-regulation for weight loss in young adults: a randomized controlled trial. Int J Behav Nutr Phys Act. 2009;6:10. [PubMed]