A unique private medical practice with a modern take on prevention.
Physicians spend a lot of time detecting and attempting to “fix” patients’ health issues. Over time, I have retrained myself to focus on reframing health goals to include not only the absence of disease, but the importance of living optimally and vibrantly.
Continue reading “Approaching Wellness through Salutogenesis”
After receiving my initial cancer diagnosis, I became acutely aware of making my day-to-day life more manageable, both mentally and tangibly. I feel very grateful for the advice and discoveries that helped to navigate my experience as a cancer patient and to live intentionally.
Continue reading “Surgical Success: Connecting Mind and Body”
Whether it’s an aging parent, a spouse, a coworker, a sibling or a friend, it seems we all know someone who has experienced cognitive decline. And it makes sense, as Alzheimer’s disease (AD) is the most common form of dementia and currently affects more than 5 million Americans and 30 million people worldwide. This devastating disease, along with its precursors, mild cognitive impairment (MCI) and subjective cognitive impairment (SCI), have become the most significant healthcare problems both nationally and globally.
Fortunately, progress is being made. Dr. Dale Bredesen, a neurologist who has spent more than 30 years researching Alzheimer’s disease, has created training on its treatment and prevention, known as the Bredesen ReCODE (Reversal of Cognitive Decline) Protocol. Treatments for Alzheimer’s disease and dementia have been largely ineffective thus far because they fail to slow disease progression, but through Dr. Bredesen’s teachings we are seeing evidence that shows the symptoms of Alzheimer’s Disease may be partially reversed, even in advanced cases, and have returned many patients to their pre-diagnosis levels of cognition.
So, what is the process? By applying key concepts of functional medicine, identifying lifestyle factors, administering tests and designing customized treatments for patients, the Bredesen ReCODE Protocol recognizes some 150 factors that contribute to Alzheimer’s disease. Specific tests are used to measure underlying factors that cause the disease, and a comprehensive plan, personalized for each patient, addresses lifestyle factors such as diet, sleep, stress management and exercise, as well as gut health, hormonal balance, environmental exposures, infectious triggers and more. The relatively simple and often low-cost solutions to treatment and prevention of aging-related mental disorders includes direction on factors such as nutrition, supplements, mental and physical exercise, stress reduction, intermittent fasting. Following this organized, multifactorial protocol, symptoms of mild cognitive impairment and early AD may often be reversed within six months after treatment. Radiologists have reported that MRI tests, which previously showed typical symptoms of Alzheimer’s in the brain, have returned to normal and research has shown patients returning to work, resuming driving and living as they did prior to mental decline.
Following this organized, multifactorial protocol, symptoms of mild cognitive impairment and early AD may often be reversed within six months after treatment.certified ReCODE Provider
Alzheimer’s is something that I am acutely passionate about, having lost my father to the disease and witnessing first hand its devastating path. And so, I am honored and excited to announce that I have completed the Bredesen training and am now a certified ReCODE Provider. As a functional medicine practitioner, studying this method of treatment is a natural next step for me, and I so look forward to sharing my knowledge with those in need and implementing what I have learned to begin the process of bringing hope to Alzheimer’s, SCI and MCI patients. Through this encouraging research and treatment, I am confident that we will continue to make great strides in reversing cognitive decline.
Fall is upon us, and along with its glorious gifts comes a change in the weather and in the light. Here in Rochester, one of the country’s cloudiest cities, with so few hours of sunshine and shorter days, we strive to move mountains before sunset. But adhering to nature’s light switch may not be advantageous for everyone, as research shows that each individual has an internal chronotype that determines when we truly shine.
In short, it is an individual difference characteristic reflecting the time of day at which we are at our best. We all have a master clock in our brain and many subsidiary clocks ticking throughout our bodies, and not everyone’s clocks run at the same pace. Our chronotype controls our clock, or circadian rhythm, which is a series of behavioral, mental and physical changes that follow a 24-hour cycle. So if you consider yourself an “early bird” or a “night owl,” believe it or not your body is programmed for this classification, based upon your chronotype. And once you know your chronotype, you can work with your body to achieve maximum productivity.
What’s your chronotype? Take the quiz. <<
The assessment of individual chronotypes is important not only for the diagnosis and treatment of sleep disorders and for predicting the ability to adapt to specific schedules, but also for improving daytime performance and matching sleep schedules to our biology. Extreme evening individuals are at higher risk than morning people of not obtaining sufficient sleep and of performing poorly due to the difference between their circadian rhythm and the social demands of daily schedules. There is also research to show that people have more difficulties in maintaining sleep when their sleep is scheduled at adverse circadian phases.
The good news is, knowing our chronotypes can inspire us to take preventative measures such as using light therapy, or exposure to bright artificial light that mimics natural outdoor light. This therapy has long been recommended for Seasonal Affective Disorder, which results in changes in mood, sleep and even eating habits during the fall and winter months, as well as other health issues such as fatigue, memory-related disorders, low energy and more. By taking the chronotype assessment, we’ll know the optimal time to use light therapy according to our individual circadian rhythms and feel more energized throughout the day.
So, while we may not have a say when it comes to Mother Nature, business hours and school bells, knowledge of our chronotypes will definitely determine the ideal time of day to focus on important issues, complete daily tasks, exercise, achieve goals and, ultimately, live more fulfilling lives.
October 8: THE SCIENCE BEHIND FOOD CRAVINGS
October 9: HEALTHY HIJACKS FOR TEA AND COFFEE
October 24: EXPLORE THE LINK BETWEEN NUTRITION AND SLEEP STRUGGLES
As the children go back to school and parents begin to juggle work, carpools, sports and homework help, it’s easy to become overwhelmed and experience difficulty in maintaining focus. And this applies even more intensely to those dealing with such ailments as ADD, ADHD, mild cognitive impairment and decline, anxiety, past concussions and the like.
A healthy lifestyle that includes plenty of sleep, regular exercise, minimal screen time, ongoing organization and reduced stress, which can be aided by meditation or listening to classical music, are just a few. In addition, focus can be supported by adhering to a diet rich in Omega 3, Zinc, Iron, Vitamin B, and other nutrients.
Below is a list of supplements that may help us manage focus and, ultimately, support good mental health. For those currently receiving treatment for a diagnosis, these may be taken in conjunction with medication. As always, please consult your physician prior to starting a regimen of supplements.
Choline is a vitamin-like nutrient essential for optimal brain development and it influences cognitive function in later life. Choline is produced in the liver, and the amount that the body naturally synthesizes is not sufficient to meet human needs. While we obtain some choline from our diets, many of us don’t get the amount recommended by the medical profession, which is 550 mg per day for men and 425 mg per day for women. Choline supplements should be taken in the morning to improve attention and cognitive function throughout the day.
Alpha GPC by Jarrow: 300-1200 mg per day.
Citicholine by Jarrow: 250-500 mg per day.
L-Theanine is an amino acid found in green tea that can help with focus, reduce stress, promote relaxation, and is especially helpful for those with anxiety.
L-Theanine by Vital Nutrients: 100-200 mg, 2-3 times per day.
Bacopa is an outstanding herb used in India for the young and old that promotes mental focus and clarity, and has antidepressant and anxiolytic activity for those who experience mental fog, ADHD and learning disabilities.
Bacopa Extract by Planetary Herbals: 1-2 tablets, 2-3 times per day of whole leaf extract.
Kids Daily B Centered provides a range of B vitamins, along with zinc, bacopa, lemon balm and L-Theanine. This is ideal not only for those suffering from ADD and difficulty focusing, but it also serves as a calming agent.
Kids Daily B Centered Nutrient Booster Powder by MegaFood: 1 scoop per day.
September 27: MEMORY MAINTENANCE AND MENDING
November 6: MEMORY MAINTENANCE AND MENDING
Whether you’re working up a lather by exercising or merely perspiring in the heat, sweating has thus far been perceived as healthful. But what do we really know about the process of perspiring? While its benefits have been touted from the Roman baths and Aboriginal sweat lodges to Scandinavian saunas and Turkish baths, there is much more to explore.
Sweat is 99% water, with the remainder made up of minerals such as sodium, potassium, calcium, magnesium and lactic acid. We sweat because our bodies include a mechanism to stay at a consistent temperature, so as sweat evaporates, the body temperature is lowered. How much we sweat is variable and depends on factors such as one’s genetics, age, weight, percent of body fat, distribution of sweat glands, the time of day and even, for women, the menstrual cycle.
We also know that sweating is unique to humans, as we are the only mammal that relies on secreting water to the surface to cool ourselves, and that it may be affected by environment: Studies by Japanese scientists in the early 1900s demonstrated that where one spends the first two years of life dictates one’s number of the sweat glands and how many will be become activated. So, keeping your children in an air conditioned environment is going to affect their ability to thermoregulate later in life (which may explain the differences in my household, as my husband spent the first few years of his life in India, while I grew up in Canada).
If you’ve worked up a sweat and want to continue to sweat, wiping moisture with a clean towel will prevent a cooling effect and may help to maintain sweating. It may also help to remove any toxicants from your skin. Traditional and Finnish saunas call for cooling off in a tepid shower or experiencing any icy plunge. What’s most important is to rehydrate to replace water and electrolytes, using 1⁄2 liter of water (not from a plastic bottle, please) for every pound lost. In addition, refrain from putting chemicals on your skin, such as personal care products, and from using towels laundered with chemicals and dried with dryer sheets.
The main way we eliminate toxins is via the kidneys and through bile/stool. Research shows, however, that we can also detect a range of toxicants in sweat, but we don’t know if this is a preferential way to measure or rid of toxins. According to Dr. Donald Smith, Professor of Toxicology at UC Santa Cruz: “By forcing your body to perspire through heat exposure or heavy exercise, you can cause your kidneys to save water and actually hang on to any toxins that may be circulating in your system.” More research is needed in this area.
I am not convinced that sedentary sweating, or sweating without exercise, is a path to losing weight. Claims of burning calories by sitting in a sauna are exaggerated, as most, if not all, weight loss from sauna use is water weight and should be reversed by hydrating. However, sauna use may assist in weight loss via stress reduction and improved circulation.
A number of studies demonstrate the benefits of sauna use on cardiovascular disease, but at this point we are not sure why. We do know that there is a relatable impact on vasculature post MI, congestive heart failure, and dementia/alzheimers disease. A traditional Finnish sauna shows best results when taken four to seven times per week, and this study proves prospective evidence that sauna bathing is a protective factor against the risk of SCD, fatal CHD, fatal CVD and all-cause mortality events in the general male population. We also know that frequent sauna bathing can expand the air passages, reducing the risk of chronic and acute respiratory conditions, including pneumonia. In any event, even though further studies are needed, they currently suggest that sauna bathing is a healthy habit, whether due to sweating or merely taking the time to relax.
The effects seen with incorporating sauna use and hot baths are similar to those seen when we exercise, including an increase in blood levels of epinephrine, norepinephrine, interleukin 6 (IL-6), growth hormone,and HSP72 (a heat shock protein). There is also improved insulin sensitivity, and a small study showed improved blood sugars, sleep and a general sense of well-being.
In certain instances, hyperthermia can be used as an adjunct cancer therapy, but at this time we cannot extrapolate the benefits of hyperthermia treatment to sauna use, as the body cannot achieve the core temperatures via a sauna or heating blankets. In supplementing cancer treatments, hyperthermia needs a higher core/tissue temperature and must be medically induced, which cannot be achieved at home.
As always, consult with your physician before preparing a program for perspiration, as there are some conditions in which sauna and heat exposure may be harmful, such as high risk pregnancy, diabetes, recent myocardial infarction and aortic stenosis. However, once given the green light, it may be beneficial to incorporate a bathing program three times per week, if your schedule allows, or head outside this spring and begin a regimen of vigorous, sweaty sessions.
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Human excretion of bisphenol A: blood, urine, and sweat (BUS) study.
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Kunutsor SK1, Laukkanen T2, Laukkanen JA3. Frequent sauna bathing may reduce the risk of pneumonia in middle-aged Caucasian men: The KIHD prospective cohort study. Respir Med. 2017 Nov;132:161-163. doi: 10.1016/j.rmed.2017.10.018. Epub 2017 Oct 23.
Jari A.”Laukkanen,”MD, PhD Tanjaniina”Laukkanen,”MSc1; Hassan”Khan,”MD, PhD2; Francesco”Zaccardi,”MD3; et al. Association Between Sauna Bathing and Fatal Cardiovascular and All-Cause Mortality Events. JAMA Intern Med. 2015;175(4):542-548. doi:10.1001/jamainternmed.2014.8187.
Chikako TOMIYAMA1, Mayumi WATANABE2, Takashi HONMA3, Akihiro INADA3, Takayoshi HAYAKAWA3, Masae RYUFUKU4, and Toru ABO5 The effect of repetitive mild hyperthermia on body temperature, the autonomic nervous system, and innate and adaptive immunity. Biomedical Research (Tokyo) 36 (2) 135-142, 2015.
Kowatzki D1, Macholdt C, Krull K, Schmidt D, Deufel T, Elsner P, Fluhr JW. Effect of regular sauna on epidermal barrier function and stratum corneum water-holding capacity in vivo in humans: a controlled study. Dermatology. 2008;217(2):173-80.
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Karagülle M1, Kardeş S2, Dişçi R3, Karagülle MZ2 Spa therapy adjunct to pharmacotherapy is benecial in rheumatoid arthritis: a crossover randomized controlled trial. Int J Biometeorol. 2018 Feb;62(2):195-205. doi: 10.1007/s00484-017-1441-y. Epub 2017 Sep 7.
Santos I1,2, Cantista P1,3, Vasconcelos C1,3, Amado J4. Balneotherapy and Rheumatoid Arthritis: A Randomized Control Trial. Isr Med Assoc J. 2016 Aug; 18(8):474-478.
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Nurmikko T1, Hietaharju A. Effect of exposure to sauna heat on neuropathic and rheumatoid pain. Pain. 1992 Apr;49(1): 43-51.
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Naumann J1, Grebe J2, Kaifel S2, Weinert T2, Sadaghiani C3, Huber R2. Effects of hyperthermic baths on depression, sleep and heart rate variability in patients with depressive disorder: a randomized clinical pilot trial.
Each year, we hear about new trends in do-it-yourself health care. Some are worthwhile, while some are a waste of time and money, even dangerous. Lately I have noticed that patients are utilizing essential oils, so I thought I’d take a moment to set the record straight on these popular potions, which claim to cure everything from acne to anxiety.
Essential oils are highly concentrated oils which have been extracted from plants, and are deemed “essential” because they contain the “essence” of the plants’ fragrance and characteristics. Due to their concentrated nature, however, these oils should be used with care and respect, as misuse can potentially cause harm. Here are a few facts to keep in mind prior to dabbling in a potentially slippery slope.
Currently, there is no independent medically-accepted body that regulates or certifies oil quality, so buyers must beware. There are false claims regarding quality and touting the use of “therapeutic grade,” a meaningless term created and registered by one of the largest distributors of essential oils. For example, 43% of the commercial examples of tea tree oil do not have the appropriate chemical components, and some actually contain contaminants. It is important to purchase from a known distiller who harvests the oils at the correct time, using knowledge of peak growing conditions. Buying organic (but not raw) is important and substitutes are dangerous. A few recommendations to consult prior to purchasing are the National Organic Program (NOP), the USDA or EcoCERT. My rule of thumb: If the price is too good to be true, you are probably purchasing a lesser quality product.
While there are several causes of adverse reactions to essential oils, the most common can be easily avoided: Do not put drops of essential oils into a bath and step into it, as oils do not mix with water and will float on the top, creating a not-so-soothing experience. In addition, contact with water makes oils evaporate less quickly, increasing the body’s absorption of unwanted elements such as parabens. In an effort to avoid health hazards, I highly recommend researching safe ways to dilute essential oils prior to using them.
Unless recommended by a trained practitioner, essential oils should not be ingested. They may be harmful to the body’s microbiome, delicate mucosa of the mouth and gastrointestinal tract.
It is not advisable to directly and intensively inhale essential oils for longer than 15 to 20 minutes. The ideal concentration of essential oils should produce a faint scent rather than bombarding the room with bouquet. In addition, constant use of diffusers may harm your pets, as they have sensitive systems that cannot tolerate long periods of inhalation. Remember: Less is more.
Many of the claims and recommendations made regarding essential oils are false and provided by untrained practitioners. For example, patients have asked me recently about Frankincense Essential Oil due to misleading and confusing information on websites and in blogs. At the root of the problem is knowing the difference between Frankincense Essential Oil and Frankincense, which is a resin that contains a promising ingredient, Boswellic acid, that is actually not found at all in the essential oil form. The bottom line is, multi-level marketing companies are selling their products with exaggerated claims and deceptive marketing, so do your homework whenever possible to make sure you’re on the right track.
If you are interested in using essential oils or have already purchased them and are seeking further information, my advice is to use caution when buying, research advice from only trained practitioners and use the oils safely and in moderation. It may be a bit more time consuming, but in the long run it’s best to make sure that what you’re buying and how it’s used is indeed essential to your health.
Every day our bodies experience circadian rhythms, or mental, physical and behavioral changes that are based on our response to the light and darkness in our environments. The best example being sleeping while it’s dark and performing our daily functions while it’s light outside. But these rhythms relate to far more complex brain and body functions, and are suffering in today’s society, as we are living less and less according to the natural cycle of the seasons.
Our bodies have become accustomed to the dim artificial light provided in our work places, found while running indoor errands, and again at home, when we are relaxing by watching television or sitting in front of our computers. But there’s a bright beam of hope: Researchers are making great strides in understanding the impact of light on our health and wellness, and there is now emphasis on the importance of getting enough of the right kind of light, which is bright light. It is called Light Therapy.
Symptoms of SAD: Difficulty waking, Decreased energy, Increased sleep, Carbohydrate cravings, Difficulty concentrating, Withdrawal, Depression, Anxiety, Irritability
Light therapy, or exposure to bright artificial light that mimics natural outdoor light, has long been recommended for Seasonal Affective Disorder (SAD), a form of depression that occurs mainly in the fall and winter months, causing chemical alterations that result in changes in mood, sleep, even eating habits.
The benefits of light therapy continue to grow as this treatment is more widely utilized and studied. And while its one-time cost and quick results are an attractive prospect, even more impressive are recent studies and results: Data has shown that light therapy is as effective as antidepressants for depression and other disorders and, when used in addition to medication, accelerates improvement and symptoms.
Of course if you are interested in purchasing a light therapy box or lamp, there are guidelines for the best results, such as purchasing a light that provides 10,000 lux of illumination at a comfortable sitting distance, brands that have been tested successfully in clinical trials, a white light rather than a colored light, as “full spectrum” and blue lamps provide no known therapeutic advantage, and more. There are minimal, if any, side effects stemming from light therapy, mainly headaches, eye strain or edginess.
As always, it is best to consult a physician before purchasing or beginning a new therapy. In this instance, the timing of the light is important, and it is not recommended for everyone, especially those with retinal issues or eye disease. I often give light therapy a glowing review and hope you’ll look further into its advantages or contact me for a consultation so we can determine if it might benefit your winter blues.
Well, here’s a rousing thought: Your performance and attitude may, in part, be attributed to your method of awakening. But no need to hide under the covers, as even though that harsh alarm and the resulting wide-awake jolt may set the tone for the day, there’s a simple solution, known as dawn simulation.
Simply put, it’s a natural alarm clock that involves timing lights in the bedroom to come on gradually, over a period of between 30 minutes and two hours before your preferred time of awakening. The concept was first patented in the late 1800s, with the realization that light enters through the eyelids, triggering the body to begin its wake-up cycle, including the release of cortisol, a hormone that regulates immune response, so that by the time the light is at full brightness, sleepers wake up on their own, without the need for a traditional alarm.
Your performance and attitude may, in part, be attributed to your method of awakening.
Research shows that, when compared with waking in dim light, the 30-minute sunrise not only left subjects feeling more refreshed and alert upon waking, but reflected an increase in agility, cognitive performance, response time and improved mood. In addition, cortisol levels were reported as significantly elevated, resulting in better overall hormone balance throughout the day.
Dawn simulators, also known as wake-up lights or natural light alarm clocks that gradually transition you from a state of slumber, differ from other light therapies, as the treatment is complete prior to awakening, making it a convenient alternative to post-awakening bright therapy. The process is a lower intensity, and not considered a therapy for Seasonal Affective Disorder (SAD), but can certainly be used in addition to treatment.
In my house, we’ve fully embraced waking to a gradual dawn rather than the jolt of an alarm, especially living in Rochester, NY, where 83% of our days are cloudy—a tad lower than Seattle’s 84%. I hope that you, too, will give dawn simulators a try and reap the benefits of this truly bright idea for rising and shining.
– John Burroughs
I go to nature to be soothed and healed, and to have my senses put in order.
I confess I am a nature-lover/tree-hugger/environmentalist – whatever you want to call someone who loves to be in nature. Nature is healing for me, as it has been for so many others throughout time. Now there is research that validates this, and raises questions whether the lack of exposure to nature could aggravate or even cause certain conditions such as ADHD. Do we need nature for our bodies as well as our souls?
In 1984, Science magazine published a landmark article by Roger Ulrich showing strong evidence that nature promotes healing. Patients hospitalized in rooms with a view of nature had shorter hospital stays and used less pain medication.
For people with chronic conditions who reside in restricted environments, simple exposure to a garden dramatically decreases anxiety, agitation, and social withdrawal. For patients who can enter into natural spaces and gardens, the amount of psychiatric drugs decreases. According to Clare Cooper Marcus, (UC Berkeley), being in nature puts the mind in a meditative state: we stop obsessing and worrying and start living in the present moment, which in turn decreases stress, improves hypertension, and increases immune function.
We are influenced by our environment in more ways than we are aware. Research from Richard Ryan at the University of Rochester shows that paying attention to nature can affect social values and actions — exposure to a natural environment leads people to value community and close relationships.
Ecopsychology is a new field of study that asks, “If exposure to nature is beneficial, what happens when we withdraw from it?”
Richard Louv identified Nature Deficit Disorder in his popular book Last Child in the Woods, asserting that children are spending less time outdoors which results in a wide range of behavioral problems. Nancy Wells found that being close to nature improves a child’s attention span, and research by University of Illinois shows that children in a greener setting experience more relief from ADHD symptoms.
The loss of natural space is becoming a public health issue, yet we are less aware of the disappearance of green spaces around us. To improve the “nature” of your life:
I go to nature to be soothed and healed, and to have my senses put in order.