An ongoing series of informational entries
An ongoing series of informational entries
Immune Boosting Tips
Immune Boosting Tips
July 31, 2020
- As Covid-19 continues to surge in our region there are some things we need to remember that are just as important as face masks and social distancing. A major underlying principle of integrative medicine is our emphasis on broad well-being. Coronavirus has brought to light even more clearly the importance of healthy lifestyle. We have seen the majority of people succumbing to the virus in the elderly population and those with coexisting chronic conditions such as hypertension, obesity and diabetes. Although there is much research still to come on prevention and treatment of this virus, one thing we do know is that the overall health of the immune system plays a critical role.
- Get enough sleep! Sleep has a significant impact on how well our immune system functions. A persistent lack of sleep has been associated with a greatly increased risk of becoming ill when exposed to a virus.
- Reduce Stress! Stress increases our risk of illness from respiratory illness to cancer. Although we may not be able to eliminate stress we can modify how we react and how we prepare ourselves to deal with stress. We too often keep our nervous systems overly stimulated and we have a difficult time down-shifting into relaxation mode. Make a daily practice for stress management by utilizing techniques such as yoga, tai chi, guided imagery, meditation or deep breathing. This will allow your nervous system to downregulate and reset.
- Eat well! What we eat has a big impact on the inflammatory levels in our bodies. Follow the foundations of the anti inflammatory diet. Eat omega-3 fatty acids from fish, minimize blood sugar spikes by avoiding processed foods and simple carbs and eat lots of fruits and vegetables to obtain anti oxidants and anti inflammatory agents.
- Consider adding supplements Some supplements have evidence to support their use in prevention of illness and immune support. Although there are no direct results from studies of COVID-19, we can use the information we have obtained from studying previous coronaviruses. Vitamin C , zinc, and melatonin may help to reduce the virus' ability to enter the cell, attach or replicate.
- As we await more targeted medications and/or a vaccine specific to coronavirus, consider adding the above to your daily regimen to help you and your loved ones decrease your risk of succumbing to this virus.
Back Pain and OMT
Back Pain and OMT
June 11, 2019
Low back pain is the fifth most common reason for physician visits in the United States (Hart, 1995; Deyo, 2006). I see this every day in my practice. Often pain is not even discussed until a patient is questioned about it because they become frustrated with a lack of improvement in treatments previously tried. Direct health care costs attributable to low back pain derived from actual billing costs were $30.5 billion in 2007 (AHRQ, 2015). Many patients are lured into invasive treatments due to advancement in imaging. With imaging such as MRI available we can find abnormalities, such as herniated discs. Unfortunately many times pain may or may not be related to a specific injury and if it is may also heal on its own with either time or conservative treatment. Routine imaging does not appear to improve clinical outcomes and exposes patients to unnecessary harms (Chou, 2009; Hansen, 2016). In addition to exposing the patient to radiation, unnecessary imaging can lead to unnecessary procedures. It can also lead to labeling and impact the patient's beliefs about his or her pain. I see many patients who have the belief that if they have a herniated disc on MRI they will not improve without invasive intervention.
Along with invasive procedures we have gotten into a bad habit of over-prescribing opioids for acute and chronic back pain. A growing body of research suggests that treating non-cancer related chronic pain with opioids may be harmful. Recent research suggests that chronic opioid use decreases the pain threshold through the development of opioid-induced pain sensitivity, a process known as opioid-induced hyperalgesia (Chen, 2009).
There are multiple non-invasive, non-opioid treatments that can be used to treat acute and chronic back pain that will help the majority of patients. Active techniques such as yoga, tai chi, exercise and dietary interventions should be initiated as soon as possible to a patient's tolerance level. In addition, passive techniques such as heat, massage and Osteopathic manipulative therapy (OMT) may also add some benefit in speed of healing.
Non-thrust manual therapies include techniques such as muscle energy, strain-counterstrain, myofascial release, spine mobilization and craniosacral therapy. These "indirect" osteopathic techniques have shown benefit for patients with both acute and chronic low back pain (Bronfort, 2010). In a meta-analysis that appraised 8 randomized controlled trials involving patients with back pain, the authors found a significant overall reduction in pain rating in the OMT group, when compared with subjects who received various control therapies (Licciardone, 2005).
I have been practicing OMT for more than 15 years and I am fortunate enough to offer this to every one of my patients for not only back pain but systemic healing. Give us a call and find out more about how osteopathic manipulation can help you.
- Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine 20(1):11-9 01 Jan, 1995
- Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002. Spine 31(23):2724-7 Nov, 2006
- Agency for Healthcare Research and Quality. Total Expenses and Percent Distribution for Selected Conditions by Source of Payment: United States, 2007. Medical Expenditure Panel Survey Household Component Data. Generated interactively. Feb 9.2015
- Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet 373(9662):463-72 07 Feb, 2009
- Hansen BB, Hansen P, Carrino JA, Fournier G, Rasti Z, Boesen M. Imaging in mechanical back pain: Anything new? Best Pract Res Clin Rheumatol 30(4):766-785 Aug, 2016
- Chen L, Malarick C, Seefeld L, Wang S, Houghton M, Mao J. Altered quantitative sensory testing outcome in subjects with opioid therapy. Pain 143(1-2):65-70 May, 2009
- Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropr Osteopat 18:3 25 Feb, 2010
- Licciardone JC, Brimhall AK, King LN. Osteopathic manipulative treatment for low back pain: a systematic review and meta-analysis of randomized controlled trials. BMC musculoskeletal disorders 643 2005
May is Better Sleep Month
May is Better Sleep Month
May 2, 2019
Insomnia and poor sleep is a problem I see every day in my practice. This issue is becoming more and more common in society and good restful sleep is so important to our health, both mentally and physically.
There are so many reasons why we are not getting good sleep nowadays and being aware of some of the things that we may be able to change may help us get on the path to more restful sleep.
Probably the most important is mind noise. During our stressful days we are constantly multitasking and using machines that stimulate our brains with blue light, such as computers, TV's and smart phones. Taking breaks throughout the day to slow down the mind can be helpful to maintain a balance in our nervous system. Also, cutting out stimulating activities, especially anything that involves blue light at least 1-2 hours before bed time is key to slowing down the nervous system and getting out of that hyper-stimulated state.
What do I mean when I say balance of the nervous system? Our central nervous system controls everything we do. It has a stimulated side ( sympathetic nervous system) so that we can get stuff done, and it has a relaxed side (parasympathetic nervous system) so that we can rest and digest. When we constantly push ourselves into overdrive our nervous system has a harder time getting back into that relaxed phase. The more we practice good habits and take time to slow down and smell the roses, the more balanced our nervous system will be and therefore more easily switch into that relaxed state when we want it to at bedtime.
So what are some ways to practice calming of the nervous system? Breathing exercises can be one of the most simple and effective ways to bring your nervous system quickly into a more relaxed state. Breathing is one of the only physiologic actions that can be both controlled by the body (autonomic nervous system) and also can be controlled voluntarily (somatic nervous system). When you are in a stressed or hyper state your body automatically increases your breathing rate, along with other functions such as your heart rate. Your breathing becomes more shallow. By purposefully slowing and deepening your breath you can literally send a message directly to your central nervous system to slow down. This will also slow down the messages controlling the rest of your organs as well, such as your heart rate. By doing this regularly you can literally reset the tone of your autonomic nervous system. You can do this anywhere, anytime and most people will not even notice you doing this. The more you purposefully take deep breaths into your diaphragm, the more often you will help to slow down and balance your central nervous system.
If you don't know how to do breathing exercises there is a good technique I learned from Dr. Weil called the 4-7-8 breath. You breathe in deep into your belly for 4 seconds, hold your breath for 7 seconds and breathe out all the way for 8 seconds. Repeat this a few times and you will feel your body calm down. The more you do this the more calm you will feel and it will be much easier to get your mind into a restful state. Other practices that help to balance the nervous system include, meditation, yoga and guided imagery.
Some other things to consider when trying to improve your sleep include eating a healthy diet low in sugar and caffeine. Stimulants in your diet can make it difficult to get your mind into a restful state. Regular exercise can be helpful but you want to avoid strenuous exercise at least 2 hours before bedtime. Make sure you are not taking any medications that interfere with sleep. As far as prescription sedatives, most of them actually give you a "false" sleep or put you into an induced hypnotic state rather than an actual sleep with good healthy REM cycles. They may make you think you got sleep but your body and mind will not get the rest they need to function well. Speaking of REM sleep, a good way to know if you are getting healthy sleep is to be dreaming. A way to promote healthy dreaming is to wake slowly in the morning which may help to improve dream recall and use a dream journal.
Finally, make sure your bedroom is a sanctuary for sleep. It should be stress free and work free. Keep the room dark and cool and do not have a clock facing your bed. Consider using a diffuser with relaxing essential oils such as lavender.
Sleep is so important to our health and we should be getting at least 8 hours every night. Insomnia and poor sleep are signs of poor health so, hopefully these tips can help you get back to good health.
January 31, 2019
"The key to growth is the introduction of higher dimensions of consciousness into our awareness. ” ~Lao Tzu
Although it seems easy in concept, quieting the mind can be challenging in practice, and often requires learning new skills.
There are several ways we can quiet the mind through "mind-body techniques, such as prayer, mindfulness meditation, guided imagery and self-hypnosis, journaling...
We actually have 4 decades of scientific data that supports the use of mind-body techniques for improved health and wellness. Mindfulness has been shown to improve psoriasis, chronic pain, tension headaches, anxiety and depression just to name a few. It has also been shown to increase telomerase. What is telomerase? Telomerase is the enzyme responsible for increasing the length of your telomeres. What the heck is a telomere? I like to refer to these as the ends of a shoelace on your chromosomes. As we age and get sick our chromosomes shorten or fray. a decreased length in our telomeres has been related to a decrease in life expectancy. Anything that can increase our telomeres is a good thing.
We've all heard of left-brain and right-brain. Recent studies have shown that increased electrical activity in the left vs. right brain is related to optimism, creativity, joy, vitality and alertness, whereas, increased activity in the right brain vs. the left is related to depression, anxiety, distress and worry (Urry et al. 2004). Well, how can we get some more of that left brain working, because we could all use a little more joy and vitality? Mindfulness has been shown to increase left vs. right brain activation. Great, well if your not a monk can this really help? ...YES! A recent study of biotech employees split into groups of control vs. employees taking an 8 week mindfulness based stress reduction course showed significant improvement in left brain activity vs. right just after the course and even 4 months after the course (Davidson, Kabat-Zinn, et al 2003). So if biotech employees with no previous exposure to mindfulness techniques can show improvement, anyone can.
So if you're looking to reduce stress without changing your job your family or your life, consider adding a daily practice of meditation. I typically recommend this practice just before bed to help quiet the mind, but it can be done whenever you can find even 15 minutes in your day.
Here are several meditation resources I recommend. A quick "Google" search will turn up a huge variety of further resources if you don't see anything here that you like.
-Audio CD's ~ Meditation for Optimum Health: How to Use Mindfulness and Breathing to Heal Your Body and Refresh Your Mind by Jon Kabat-Zinn and Andrew Weil.
-Audio CD's ~ Awakening Compassion, by Pema Chodron.
graphic: Beginning Meditation
-Audio CD's ~ Meditation for Beginners, by Jack Kornfield, MD
-Podcasts of guided imagery available on kaiserpermanente.org:
1. Urry HL et al. Making a Life Worth Living: Neural Correlates of Well-being. Psychological Science (2004). Jun, 15(6):367-72.
2-Davidson, RJ, Kabat-Zinn, J et al. Alterations in Brain and Immune Function Produced by Mindfulness Meditation. Psychosomatic Medicine (2003). Jul-Aug;65(4):564-70.
Vitamin C and the Common Cold
Vitamin C and the Common Cold
January 4, 2019
We are in the heart of the winter season, with weather changes from warm and rainy to cold and dry. We have also just finished the holiday season and I am sure that most of us have not been following our usual healthy habits. When we don't take in enough fruits and vegetables and the environment is bringing harsh weather, our bodies can find it hard to keep up. With this, our immune system may have a harder time fighting off a virus when we are exposed. It is always best to eat 5-6 servings of fruits and veggies daily, but when we are not keeping up sometimes supplements can help us. Vitamin C is something that a lot of us have used to help get through the winter and prevent the common cold, but we may wonder if it is doing anything.
Let's review how it may help.
While there remains controversy as to whether vitamin C intake can help with the common cold; the majority of studies support evidence that high doses of vitamin C, 1,000-3,000 mg daily, during a cold can reduce symptoms by 1-1.5 days.
Remember that the tolerable upper level of intake is 2,000 mg for adults. This means that doses in excess of 2,000 mg daily increase side effects such as gastrointestinal upset or diarrhea. Therefore I recommend sticking with doses of 1,000-2,000 mg daily for either prevention through the winter or during a cold to help reduce duration.
Vitamin C is not produced in the human body and, therefore must be ingested. Some good sources of vitamin C include citrus fruits, including oranges. I always recommend the whole food source first, but you can also take this as a vitamin supplement. An easy way to get a whole food source as a vitamin capsule is through juice plus supplements. Check out my link at dilks.juiceplus.com to find out more about these antioxidant power-packed supplements.
Take care of yourself this winter!