tag:blogger.com,1999:blog-53240716955628035892024-03-12T19:19:39.632-07:00DrRic Patient -Frequently Asked QuestionsUnknownnoreply@blogger.comBlogger46125tag:blogger.com,1999:blog-5324071695562803589.post-51119168755792576882015-02-15T20:16:00.000-08:002015-02-15T20:16:48.104-08:00What's for breakfast?<div dir="ltr" style="text-align: left;" trbidi="on">
Sometimes the easiest way to introduce a new food into an unhealthy nutrition practice is to "wedge in fiber". My patients don't need an extra hour of food 101 and they can figure out what along the periphery of the grocery store has fiber in it-fruits, veggies and grain. Personally I have tried to move away from cereal and bread. I did do a gluten fast last year for about 2 months to experience what my patients go through and it was not too bad. Took a little planning ahead but truthfully, this is mindful eating. To have what I call a healthy nutrition practice really takes planning your meals for a day or two ahead. If you wait and try to satisfy last minute hunger cravings, the tsunami of hormones released by the brain to hunt for quick energy sources will drive you to the closest fast food chain. "Just this once", "I'll make up for it tomorrow", "I deserve it"......there is never an excuse good enough to trump- "Should have planned ahead". I have Go-Bags ready to go if something comes up and I can't prep my meals for the day. My bug-out meals are very no frills but satisfies my calorie requirements for the day and reminds me of the importance in prepping flavorful meals for the next day. <br />
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I used to move more toward "whole grain" or "multi grain" bread instead of the Wonder White Bread from my childhood, but realizing that most of the brown colored bread "grain" breads are just white breads with molasses for coloring. Even as I pay more attention to the healthy breakfast cereals that come in smaller boxes with Non GMO or Organic labels....sugar and carbohydrate content is still sky high. <br />
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<tr><td class="tr-caption" style="text-align: center;">NON GMO</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">NON GMO/Organic</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">My son's morning pick me up</td></tr>
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Sugar/high glycemic index foods/healthy wrapping. Sugar/High GI/kid wrapping<br />
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One of the good premises of the PALEO diet (popularized by Lorain Cordain) is that is cuts out sugar, white flour and refined carbohydrates. Unfortunately it also cuts out whole grains which I believe are helpful for fiber, lignans and some B vitamins. Likewise, no beans or legumes.....of which tempe, edamame, tofu and miso are excellent sources of plant protein found in the Okinawan diet, one of the highest concentrations of centenarians on the planet. <br />
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Going to a non pulverized grain is probably easy to find since you have to work with it. Clean and rinse, boil, then toast or sauté in oil/garlic to bring out an olive oil kinda nutty flavor with a hint of garlic. This with a protein source (fish/egg/tofu/lean meat) makes me satiated. So regarding finding a grain source....my Dad's oatmeal with some fruit in the am is not satisfying to me. I am used to eating with Jasmine rice so switching over to another whole grain source is easy. I think if you are used to eating cereal, McMuffins, Donuts, Croissants with a 20oz coffee splashed with dairy....it will be a tough switch. Bottom line is it has to start somewhere, 30-40 years of living the same way have put most Americans in the predicament of Pre Diabetes, High Cholesterol, White Coat Hypertension or the largest waistlines on the planet. Get used to eating healthful meals and sleep will be better: get used to sleeping better and work solving skills will improve: get more efficient with work and more free time will open up: with more free time you can develop a form of recreation therapy: with more activity you won't crave crappy food. The circle of life.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL7zTK7RwL98CPQajivJjTp4OEzyyABnHAAi8qpYizOkliI4ib0oQkrdnjIYEd2mqCRM7eVLFPasrn2ZlZVUOUo61hoIdPqNMRqaXA8r7x8xbZ8BMEdFwF5-2SCF7ZmMq0tFOKihXj7T5-/s1600/P2160113.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL7zTK7RwL98CPQajivJjTp4OEzyyABnHAAi8qpYizOkliI4ib0oQkrdnjIYEd2mqCRM7eVLFPasrn2ZlZVUOUo61hoIdPqNMRqaXA8r7x8xbZ8BMEdFwF5-2SCF7ZmMq0tFOKihXj7T5-/s1600/P2160113.JPG" height="300" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Clockwise from Black=Forbidden Rice, Millet, Farrow, Tricolored Quinoa, Buckwheat, Spelt, Barley Hulled<br />Center =Hemp, Jasmine Rice</td></tr>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-1867242704714381172015-02-01T10:14:00.001-08:002015-02-01T12:48:50.842-08:00Should you trust your doctor?<div dir="ltr" style="text-align: left;" trbidi="on">
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I remember in Family Medicine residency there was an ENT doctor who let us shadow him during his office hours. These specialists will take care of nose and ear issues but also splinter off to do head and neck surgery (cancer). During office hours he would have us come back to his room after seeing a patient to discuss the case......and then light up a cigarette!! He is still alive and practicing medicine but I'm not sure if the tobacco use led to anything bad (hope not). So comes the controversial idea, "should I listen to a doctor that looks unhealthy". Judging someone is never good by the way they look alone...there is always a back story. If what you uncover is someone that has an unhealthy lifestyle practice....you can decide on your own. As for me, I have seen the best surgeons in the area display horrible manners in the operating room, throwing instruments, shouting, temper tantrums....alot of bad energy while the patient is asleep. Also heard some counter arguments that the yelling in the operating room is for the benefit of the patient. Bullshit!! That is adult age bullying!! My energy healers will know the truth that practicing with poor compassion for a patient, staff, innocent bystanders....reveals true feelings/intentions from the heart. A doctor may have outstanding surgical skills or very specialized rare problem solving but would you trust your care to a healer or an "un-healer"?<br />
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Knowing a back story, is important: to find out what the obese doctor was in weight 5 years ago, or where the smoking doctor is going for counseling. Judging a book by its cover is poor practice but getting empowering advice from an unhealthy human seems bad practice as well. I like an ancient saying:<br />
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<span class="text Ps-139-23" id="en-NKJV-16263" style="-webkit-font-smoothing: antialiased; box-sizing: border-box; font-family: 'Helvetica Neue', Verdana, Helvetica, Arial, sans-serif; font-size: 16px; line-height: 24px; position: relative;">Search me, O God, and know my heart;</span><br />
<span class="text Ps-139-23" style="-webkit-font-smoothing: antialiased; box-sizing: border-box; font-family: 'Helvetica Neue', Verdana, Helvetica, Arial, sans-serif; font-size: 16px; line-height: 24px; position: relative;">Try me, and know my anxieties;</span><br />
<span class="text Ps-139-24" id="en-NKJV-16264" style="-webkit-font-smoothing: antialiased; box-sizing: border-box; font-family: 'Helvetica Neue', Verdana, Helvetica, Arial, sans-serif; font-size: 16px; line-height: 24px; position: relative;"><span class="versenum" style="box-sizing: border-box; display: block; font-family: Arial; font-size: 12px; font-weight: bold; left: -4.4em; line-height: 22px; position: absolute; top: 0px; vertical-align: top;">24 </span>And see if <i style="box-sizing: border-box;">there is any</i> wicked way in me,</span><br />
<span class="text Ps-139-24" style="-webkit-font-smoothing: antialiased; box-sizing: border-box; font-family: 'Helvetica Neue', Verdana, Helvetica, Arial, sans-serif; font-size: 16px; line-height: 24px; position: relative;">And lead me in the way everlasting. psalm 139: 23-24</span><br />
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I believe no one is exempt from living to your best potential (which starts with Thinking/Eating/Activity) but sometimes we have to be scrutinized by a "third party" and guided on living a better way -and this includes doctors. I don't like getting check ups, but I still go to providers to make sure I am doing the best I can (to prepare for my heart attack, stroke, or cancer.....I pray it's not diagnosed until my 90th birthday but if it comes up sooner, at least I tried my best). So ....should you take my advise about a diagnosis and start treatment-NO!. I always invite my patients to learn about their diagnosis by watching my educational videos, asking questions, and reading from the best authors. I invite second opinions all the time, but it has to be from someone with equal experience. Even if I send patients to cardiologists after an ER visit, I would send to a cardiologist who went the extra mile and trained in nutrition and complementary healing. Don't get me wrong, all MD's and DO's in the US have to pass a gauntlet of emotional distress, sleepless nights, poor nutrition, caffeine abuse and in some .....marriage failure (the reason I backed out of being a surgeon was the divorce rate of the residents was too high to risk losing my sweetheart from med school) Medical training is to learn an ocean of diseases and treatments, then fine tune knowledge and skills to match the population we are responsible for. Hopefully if you feel healthy, look healthy, have a strong family unit, contribute to society and get checked yearly- your doctor is expert in preventive medicine and will "lead you in ways everlasting". But what if the doctor looking out for your future, isn't trained in preventive health care.....or doesn't update him/herself with new information.....or the information s/he gets is biased and misleading. Then I have a problem with that. I don't have a problem with sharing normal range test results with patients, but I do have a problem telling an obese smoker the the chest X-rays and blood tests are OK this year so everything is "all clear" till next year. (Most patients that have bad habits, may not be willing to change at that point in time....but there will come a day in every ones life when the trigger to change present and there should be plan in place to start the emergency response-even if it just means, call when you are ready). I have blogged in the past - if you are a hammer, everything looks like a nail. I believe all doctors should better themselves with up to date information on the evolving horizon of nutrition and wellness. Just getting information updates from the good looking drug reps that give free lunch is not the way. In fact it is the opposite IMHO, the studies funded by drug companies are very biased to praise the drugs they sell. If only the Statin companies were forced to pay for promoting a whole food mostly plant based diet/ the Ritalin companies were forced to pay for nature/relaxation therapy/ the Weight loss companies were forced to pay for adult activity retreats. (Hey why not, we forced tobacco companies to pay for Truth advertisements and smoking cessation programs!!)<br />
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At the least, if doc listens, then they may be able to scrutinize potential problems and either design a lifestyle change or get you to the appropriate healers who can guide/construct/critique the current unhealthy trajectory. If there is no nutrition fund of knowledge, no time to listen and no healers to "outsource care"-your on your own. But short of the most remote portions of the US, I have a large family of well trained, well informed modern day healers just waiting to turn you around (<u><b><a href="http://integrativemedicine.arizona.edu/alumni.html" target="_blank">link to find a doc</a></b></u>)</div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-52984188502156010322015-01-30T14:37:00.003-08:002015-01-30T18:48:37.536-08:00Emotional Accelerators<div dir="ltr" style="text-align: left;" trbidi="on">
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If you have a rock solid spiritual practice, the things I call emotional accelerators will catapult you to a level of peace and nirvana that mimics the bliss of nature, birth of a baby, falling in love. On the other hand, if all you have is a solid stress response available, emotional accelerators will (by statistics) bring on early morbidity/mortality. Humans are born with fully functioning sympathetic (stress response) and parasympathetic (relaxation response) systems. It is in growing up, going to school, spending time with family that we cultivate both of these systems so they suit our needs as we age. Problem is American schooling doesn't support relaxation practice-used to be in some schools we would pray (a form of the relaxation response) but now it can only be found in catholic private schools. Detention is a way to embrace the relaxation response (quiet/solitude/reflection/writing words repetitively on the blackboard....oops...dating myself) but it is a punishment practice given to those with very aggressive stress response practice.<br />
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Does lack of relaxation practice hurt?.....in theory it does. No retrospective studies on this however about 10 years ago a study found 80% of those diagnosed with an auto immune disease were found to have been exposed to a form of abuse in younger years. (hints at an association between stress and disease). Some people will listen to the ego and claim stress response carried them to be CEO, top athlete, best in school.... if you take the argument that your personal reliance on stress response is what catapulted you to the current level of society, I still disagree. All the firefighters, police officers, military personnel, martial artists, athletes I have helped- hands down agree that the level of functioning amplifies when the relaxation response is developed. Accuracy improves, problem solving is better under stress, anticipation and reaction is quicker, listening to body cues during competition is heightened to know when injury is about to happen. <br />
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So what are negative emotional accelerators? <br />
-gun<br />
-angry mob<br />
-a vehicle (from Monday morning minivan to teenager in a loud 300+hp muscle V8)<br />
-social media<br />
-any weapon<br />
-alcohol<br />
-any drug<br />
-untreated mood disorder<br />
-terminal diagnosis (denial)<br />
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What are positive emotional accelerators?<br />
-friends<br />
-baby<br />
-a rescue team<br />
-group meditation<br />
-nature<br />
-meditation<br />
-arts and crafts<br />
-quiet<br />
-yoga<br />
-falling in love<br />
-serving your true purpose in life<br />
-terminal diagnosis (acceptance)<br />
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To become "bomb-proof" to negative accelerators takes practice (sometimes up to several years-I am coming up on my 5th year of practice via the Chopra Center and my Integrative Medical Training and I still feel like a beginner). Until one harnesses the infinite power of the relaxation response, I would try to avoid everything listed above as negative. Yes, if you go through the list, you will probably be losing weight, lowering cholesterol, bringing blood pressure down, improving sleep/sex and ditching the anxiety/depression medicines. There will be a little withdrawal from it all but the rewards are so heaven-sent once you realize what you have been missing. Bad habits seem to accumulate inconspicuously and we become so used to them, its as if they aren't so bad (...individually!) But if you looked at accumulated damage of where you are now and where you were in younger years....very depressing. <br />
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http://www.drweil.com/drw/u/ART00535/common-stress-triggers.html<br />
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In the corporate world its called Normalization of Deviance. You kinda look at the dust in the corner and figure, its OK, will take care of it later. This is what happened to the Challenger catastrophe. That multimillion dollar project and the lives lost all because of cheap o-rings (that where thought to be "enough") Or a mechanic that doesn't tighten the wheel lugs to proper torque....they just slowly get looser and looser until..... The pounds, the blood pressure, the cholesterol, the sugar, the falling hair, the postponed date nights, all become lower priority. It takes a little bit of a fast to get back to basics. I think of it as a News Fast, a Noise Fast, a Nutrition Fast, a Negative Neighbor Fast, a Non-Activity Fast. Just like the bible, you need to remove yourself from these things for a short time to realize the beauty of life without these crappy things. Once you get there, your gut works better, brain thinks faster, DNA fights stronger.....just like the times of youth, impervious to everything.<br />
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-71220106911987559262014-11-17T07:29:00.001-08:002014-11-17T07:29:15.550-08:00How do I become spiritual?<div dir="ltr" style="text-align: left;" trbidi="on">
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My best response can be found in the Deepak and Oprah 21 Day Meditation Challenge November 2014 - day 14:</div>
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<b>Oprah:<o:p></o:p></b></div>
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Hello everyone, here we are.
The end of week 2, already and may I say again, how honored Deepak and I
are to have you all share in this meditation experience with us. And I hope you feel it too, as we gather this
tribe of seekers and meditators from around the world. We continue our journey with day 14- Spiritual
Manifestation. .<o:p></o:p></div>
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So how do you know when you’re in the flow of spiritual
manifestation? Your desires arise from
your core self, from a place of pure awakened consciousness, that’s how. When you’re manifesting from your true self
you’re deeply connected to what your soul came here to do. Rather than your desires creating an outcome
of constantly doing and getting more and more and more; your desires are in
search of being and becoming more. And there’s a sense of contentment, of joy,
of harmony and love that abides in everything that you do. These
outcomes are exactly what the universe is waiting to have us all manifest. What an extraordinary gift you give yourself
and to the world when you allow your deepest, truest most cherished desires to
come alive and flow from you and to you and be realized. This is what spiritual manifestation is all
about. <br />
So today we are going to open our heart to everything that’s possible. Wow, that’s a big opening. As Deepak guides us into our meditation. <o:p></o:p></div>
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<b>Deepak: <o:p></o:p></b></div>
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Congratulations on completing week 2 of our meditation experience. This marks an important milestone. Everyone wants to attract better things into
their lives but now you’ve gone deeply into the art of desire and you know what
the mechanics of manifestation truly are.
This knowledge can benefit you for the rest of your life. The culmination of week 2 is to manifest your
spiritual desires. These include the
desire for inner peace. Direct
experience of the soul and connecting with God or however you conceive of the
divine. There’s a false belief that the
soul is separate from the body and that desire is there for low while spirit is
high. This separation is manmade. As far as your true self is concerned,
fulfilling your most cherished desires is totally spiritual. In fact, this is what the spiritual path is
all about. As you reflect on what you
want to manifest in your life, think of what you hope to feel when you achieve
it. If you know you’ll feel loving, kind
contented peaceful nourished and safe.
Your desire has its roots in spirit because these are qualities of your
true self silently awaiting to manifest.
As your consciousness awakens, the qualities of your true self awaken
too. Waking up simply means becoming
more self-aware. It is finding out who
you really are. The process is natural
rather than mystical. Open to everyone,
not just saints and sages. When you awaken
by practicing meditation you’re on the path for fulfilling spiritual longing,
love bliss and freedom. Learning to live
from this level of pure awareness, is known is Sanskrit as Sithi. The word may be ancient but the goal is
timeless. It exists for you, here and
now. Encountering your soul happens
without effort because your soul is just as eager to connect with you. As we prepare to meditate together let’s take
a moment to consider our centering thought: <o:p></o:p></div>
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<b><i>Fulfilling My Dreams/Fulfills My Spirit<o:p></o:p></i></b></div>
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Now let’s prepare for our meditation. Make yourself comfortable and close your
eyes. Begin to be aware of your breath
and just breathe slowly and deeply. With
each breath, allow yourself to become more deeply relaxed. Now gently introduce the mantra; <o:p></o:p></div>
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<b><i>Shreem Namah<o:p></o:p></i></b></div>
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This mantra helps to manifest abundance, that brings us
closer to spiritual fulfilment. As you
repeat the mantra, feel the integration of material and spiritual abundance in
your consciousness. Repeat it silently
to yourself, Shreem Namah. With each
repetition feel your body mind and spirit open and receive just a little
more. Whenever you find yourself
distracted by thoughts noises of physical sensations, simply return your
attention to silently repeating the mantra; Shreem Namah, Shreem Namah. Please continue with your meditation, I’ll
mind the time and when it’s time to end you’ll hear me ring a soft bell. Shreem Namah, Shreem Namah, Shreem
Namah. Just mentally….Shreem Namah,
Shreem Namah, Shreem Namah. <o:p></o:p></div>
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<br /></div>
<br />
<div class="MsoNormal">
“All life is a manifestation of the spirit, the
manifestation of love.” ― Morihei Ueshiba<o:p></o:p></div>
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<br /></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-53355526237712497922014-09-29T20:25:00.002-07:002014-11-17T07:25:20.059-08:00How I found Integrative Medicine.<div dir="ltr" style="text-align: left;" trbidi="on">
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<br />
I originally flipped a coin in 1994 (graduation from Family Practice residency) to decide what my next move was to be. The buzz then was to apply for a Sports Medicine Fellowship or Maternal Fetal Medicine Fellowship. I had a personal "calling" to fly to Arizona and train with this white bearded guy who was teaching about nutrition and supplements. The only catch to Andrew Weil's fellowship was you had to live in a house for 1-2 years while training with the man. I just had a daughter and the easier path was to apply to Sports Medicine in Chicago (4 fellowships available at the time). I was honored to be picked out of a group of docs and off I went. So cool to learn, be the team doc for DePaul, be on the field for the World Cup, be ringside for USA Boxing, USA Wrestling, Illinois Gymnastics and be one of the docs for the Chicago Marathon. Will always hold that year special in my life and valuable...I found out that my FP residency training was above average but yet paled in its content and training for musculoskeletal medicine and it's importance in medical disease management. <br />
I became the Sports Medicine consultant in a large group and it was cool seeing my own FP patients and getting referrals for injury and pain. Eventually the consults were so easy, I needed a little more challenge so decided to fix the weak link between diagnosing and treatment: the dreaded 3 page carbon copy insurance request form. Usually it took an average of 7 days to get approval followed by an appointment with PT or ortho. I decided to investigate Medical Acupuncture as a facilitator for pain relief while waiting for approval. Research brought me to Joseph Helms at UCLA. After 1 year I graduated and applied needles to my first acupuncture patient, Sheryl who suffered from chronic headaches for 10-15 years with no relief from meds and consults. After 20-30 minutes she had NO pain!!! For the first time in so long she had disappearance of headaches!!! I continued with using needles scattered throughout my day for tough pain patients and boy did I have great results...I ended up doing most of my acupuncture on Saturday (my time) since the use of moxa would smell up the clinic. Moxa is mugwort that supposedly had some "healing" properties to it. Needles for pain; burnt herbs for healing? Something in me was shifting.<br />
I continued to complement my practice with this alternative medicine and at the same time this store called "Whole Foods Market" opened in Danada Square in Wheaton. I would go there for lunch and hang out in the herb isle and watch people choosing expensive freshly made food and pouring roots and leaves out of glass containers into specially marked bags. What kinda hippy franchise was this?!?! Then I spotted newsletters written by Andrew Weil. Here is this beard guy appearing back in my life. I took some online courses for nutrition/menopause and funny, as I finished each online course, a patient would show up at my clinic with the same ailments I just read about. I was being called to follow my dharma. I thought I had more pressing issues with the change of administration at the hospital I was practicing in for the last 10 years. Through a series of head butting episodes (see my chapter "The Kick in the Ass" from Running Behind -due out fall 2015), I resigned from my position and moved to Orlando Florida. I thought my medical career was over, eventually bills piled up and I had to look for a job. After 18 months my restrictive covenant in IL ran out and I decided to return. I worked a series of Immediate Care jobs (no overnight call, no hospital rounds, at the end of shift you turn your phone/pager off) but all during this time, Integrative Medicine kept pulling me back. I had to deal with the trauma of "not being the Specially Trained Doctor with good bedside skills" and found yoga. I ended up taking a 200 hour teacher training course with Deepak Chopra and another 200 hours with Total Body Yoga in Mundelein IL. (couldn't get enough of this healing practice!!!) At the right time, I received a message from a representative from The Arizona Center for Integrative Medicine asking me if I would be interested to join the fellowship. That was how my Dharma found me again.<br />
Since then I have been able to ease the pain of pancreatic cancer for my Mama. Help my own healing and recovery from her loss.; find my way back to medical practice (I joined an "Integrative Group" practice in Arlington Heights 2012 -see my chapter "Quantum Moments" from Running Behind due out in 2015); and ultimately care for my Dad in his final years. Now my calling is to set my footprint of practice in Illinois and share this with individuals, families, communities and the health profession. I believe having a lot of hats to wear doesn't make me a weak jack of all trades who acts as a gate keeper to the world of medical drugs and procedures. The Universe has pulled me in the direction of western medical proficient, traditional chinese medicine experience, ayurvedic healing with yoga and using food as medicine/medicine as food. Administration has asked me, "how many hours of Sports Medicine do you want to practice?" My answer is I cannot separate sports medicine, acupuncture, yoga, nutrition or mind body medicine into different clinics.....it is all part and parcel of creating lifestyle changes for people wanting to be healthy and minimize suffering. </div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-92089100261046988542014-09-24T06:18:00.003-07:002015-01-16T17:14:00.969-08:00Nature Therapy<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="background-color: #783f04;">Dr Ric....how about grounding the body by walking barefooted on the ground, on the beach, or on the lawn?</span></div>
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<span style="background-color: #783f04;"><span data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.$author"><a aria-haspopup="true" aria-owns="js_96" class="UFICommentActorName" data-ft="{"tn":";"}" data-hovercard="/ajax/hovercard/hovercard.php?id=100002205275900&extragetparams=%7B%22hc_location%22%3A%22ufi%22%7D" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.$author.0" dir="ltr" href="https://www.facebook.com/DrRicSaguil?fref=ufi" id="js_97" style="color: #3b5998; cursor: pointer; font-weight: bold; text-decoration: none;" tabindex="0">DrRic Saguil</a></span><span data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:0"> </span><span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body">Hey Manny, American Indian folklore attributes improving the body's healing when surrounded by nature. On the flip side, when an individual has no practice of "grounding" then proceeds to submerge themselves in the frenzy of "tech", it acts as a gateway drug/lifestyle that throws every cell in the body into poor eating/poor sleep/ poor activity. (obesity/heart attack/stroke) This is how I force grounding into my schedule: stop by a forest preserve, place my toes in the sand, stare over a body of water or watch a sunset. I can feel the serotonin being produced/recharged by every cell. This is why I created DrRics Hiking Excursions- "force" patients and friends to disconnect with tech and reconnect with nature. (barefoot or hiking boots!)</span></span></div>
<div class="UFICommentContent" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0">
<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;"><br /></span></div>
<div class="UFICommentContent" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0">
<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;">Please review the lecture I gave at REI:</span></div>
<div class="UFICommentContent" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0">
<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;">http://www.slideshare.net/DrSaguil/drric-hiking-for-health-slide-share-edition</span></div>
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<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;"><br /></span></div>
<div class="UFICommentContent" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0">
<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;">and the Morton Arboretum:</span></div>
<div class="UFICommentContent" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0">
<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;">http://www.slideshare.net/DrSaguil/nature-therapy</span></div>
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<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;"><br /></span></div>
<div class="UFICommentContent" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0">
<span data-ft="{"tn":"K"}" data-reactid=".iz.1:3:1:$comment698703293546507_699778533438983:0.0.$right.0.$left.0.0.1:$comment-body" style="background-color: #783f04;">for ideas on how to "force" nature back into your life. </span></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-80636996757033121692014-07-03T08:43:00.001-07:002014-07-03T08:47:15.332-07:00Concierge vs Integrative Medicine<div dir="ltr" style="text-align: left;" trbidi="on">
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<br />
<br />
A Medical Insurance CFO said she understood where I was coming from when I discussed my practice and the fact that I don't enroll in and insurance plans. Being out of network/opting out of medicare has the benefits of not being required to purchase expensive electronic medical recording systems (and the tech necessary to maintain-I spent 2-3 hours negotiating a 30 minute compliance training slide show on Sherman Hospitals website just to maintain hospital admitting privileges...that was a chunk of an office day where I could have been paying bills!!!)<br />
She then went on to stab me in the heart by saying, she goes to a doctor like me, her concierge doctor. Then I thought....if she negotiates price points between large corporations and medical practices, sets policy for the doctors on what they get reimbursed, "wheels and deals" strategic plans to be the middle man but show a profit to her board of directors......then she herself goes outside the usual medical insurance limitations to maintain her health-what kind of message is that for the masses of people trying to decide which plan is good for their family during open enrollment while at the same time not taking too much out of the bimonthly paycheck. (see my blog on the <a href="http://herbal411.blogspot.com/2014/07/the-duality-of-healing-and-healthcare.html" target="_blank"><span style="background-color: white; color: #cc0000;">Duality of Healing and Healthcare</span></a>)<br />
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I am not a concierge doctor. I do not charge a retainer fee to "cherry pick" my most loyal patient and create and exclusive membership club. I destroyed my 401 K to study advanced techniques of mind body medicine, nutrition, acupuncture, yoga instruction so I could heal myself and my patients. I gave up a 10 year practice to break away from a Hospital in the Center of Dupage so I wouldn't be giving up more unpaid weekend time to go back and finish charts/answer phone calls and help my patients heal their suffering. (I was told at one point that since my acupuncture wasn't reimbursed by insurance....I had to do it on my own time.....you cant charge patients over and above the negotiated prices for evaluation and treatment if an insurance contract was signed by the hospital between provider and patient.....which makes me think a concierge retainer fee is illegal) I was working 50 hours a week, plus giving away community lecture time, I missed my daughter growing up....in fact I don't remember much from those 10 years except eating bad food in the morning, drinking alot of coffee in the afternoon, downing beer to force sleep to come....then getting shocked in the ICU to bring down my heart rate from all the crap I was doing. <br />
<br />
No question, the guys who do concierge medicine must have a knack for making patients want to come back and pay an annual fee over and above the co pays of insurance. But I have yet to see any of these docs do any further training in medicine above the usual requirements for maintaining board certification every 7-10 years. In fact most of them still refer out to the specialists, still follow standard prescription protocols, may or may not hand out nutrition information, don't use alternative medicine. To get off my soap box, there is a benefit of going concierge. You have one doc that knows your name, goes to the hospital to admit you, in the past they were supposed to offer going to the specialist consult alongside you (I believe that practice stopped), their back log of a waiting list to get in is supposedly short so you can get in same day. So $1000.00 a year to insure a spot on his/her list may be worth it. That is about the equivalent of a 12 week healthy lifestyle program with 3-4 coaches at your side. (I medically cleared a lady for a<br />
<span style="background-color: white;"><span style="color: #990000;"> </span><a href="http://firsthealthassociates.com/fitness---weight-loss/largest-loser-fitness-challenge.html" target="_blank"><span style="color: #cc0000;">Largest Loser</span></a><span style="color: #990000;"> </span></span>program who was able to get off medicine for high cholesterol, depression, high blood pressure and is now down to a body weight she hasn't experienced since college....now that would be a good way to spend "a doctor retainer fee")<br />
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You just have to ask yourself, do you want to be in an exclusive club and see your doctor or do you want to change your life, get healthy and not have to see your doctor?</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-92003339926622123192014-07-03T07:46:00.001-07:002014-07-04T04:05:33.784-07:00Make a grown man cry<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXrcNiMzky7Jmfk_NphI0gRN62MIozTm22mdCcXZBXKwsVkHE-KU7ywhc8QjfjTt9v2JnkmRkJPodPrQrfsTqThCqkGSuXxsilRpqiNdqNqyc_yE5JJ5yJToXnNZPikaDSoXz650BUIQaj/s1600/P6090010.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXrcNiMzky7Jmfk_NphI0gRN62MIozTm22mdCcXZBXKwsVkHE-KU7ywhc8QjfjTt9v2JnkmRkJPodPrQrfsTqThCqkGSuXxsilRpqiNdqNqyc_yE5JJ5yJToXnNZPikaDSoXz650BUIQaj/s1600/P6090010.JPG" height="240" width="320" /></a></div>
We often neglect our feet. Women purchase shoes that perk up their butts, men buy shoes that "insulate" from the elements (but weight 10 pounds), we buy cheapies with no arch support boldly stating "I don't need no stinking fashion". Then the foot pain starts, the ankle roll occurs, the knee swelling begins or the visit to immediate care for a back pain flare up. To show how important feet are in daily living, a guy came to see me for 10/10 pain, in ability to walk, back pain and loss of work. I investigated all his complaints then checked his feet. There was a tiny bump that looked sparkly. I proceeded to inquire where all his problems began....it started with a BBQ party. I took the smallest forceps I had to explore this shiny object. Bingo!!! this little sliver of glass came out! I had him walk and the foot pain left, had him stand upright and the back pain was gone, within 5 minutes, his face changed. Done!<br />
Many of the podiatrists I know create orthotics to change the arch of the foot. They are made to place in all your shoes and unfortunately some feet will wonder why did these comfy shoes change? What people don't realize is if the foundation is moved, the structure will also shift. There is a Q-angle that serves as an imaginary line from the front of the ankle to the point on the knee up to the front of the hip. If this angle is straight, the mechanical movement of the lower body is fluid and fast. When the angle is off (flat feet, bow legged, knock kneed, birthing hips) some friction points can develop. The areas of irritation are angles we have carried since childhood but the weight......oh yes, the weight we carry is not from childhood. It's from the pregnancies, the injury, the new job driving an 18 wheeler, the lack of sex, the alcohol, the persistent athletic appetite in the face of being a couch potato. This is when childhood angles get stressed, under stretched, over used and pushed to 10 hours of day. Time for disability, psychiatric evaluation, chronic pain clinic, diabetes/sugar monitoring, cholesterol medicine, blood pressure low salt and a scheduled orthopedic surgery. All this because we never bothered to care for our feet. Even in western medicine, orthopedic foot surgeons don't have time to make orthotics, they are too busy cutting, breaking and resetting.<br />
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The ancient practice of reflexology isn't well accepted in doctor offices due to this split of not being endorsed/supported/studied by big pharma. If there are not studies, it can't be valid.....what most of my colleagues say. If only they would experience the rush of serotonin after I place acupuncture in the ear or sing my crystal bowl or nebulize sandalwood/lavender essential oil.<br />
All this stuff does make a difference. Vanity plays in as well. Ignorance by physician community adds to it (docs are just too busy and untrained to help with weight loss/nutrition change/lifestyle modification). The feet are a foundation to locomotion, travel and socializing, hunter gathering....when we don't honor any part of our body, that body part will deteriorate and become a burden. Cutting it off, taking medicine, getting a handicap placard are not going to reverse the issue. Looking for the source of dysfunction is the key. Finding someone who will listen/brainstorm is crucial.</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-77538536847482965112014-05-14T21:22:00.001-07:002014-05-14T21:24:22.683-07:00I'm not Spiritual<div dir="ltr" style="text-align: left;" trbidi="on">
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Herb Benson said:<br />
-choose a word, phrase, thought or prayer and repeat it throughout the day<br />
Deepak Chopra taught:<br />
-repeat your mantra over 20-30 minutes twice a day<br />
Andy Weil gave me:<br />
-478 breathing<br />
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The common theme is to develop some form of repetition activity, verbal/auditory and eventually linked to breath. As Dr Weil Guided my fellowship class, breath/respiration is the easiest body system to control. (see video) As you gain control over the voluntary portion (taking a deep breath) of this system, eventually control comes over the involuntary system (breath/blood pressure/heart rate). Thus the reason why modern scientists have embellished breath work as part of high blood pressure treatment. The problem with delivery of modern treatment plans to newly diagnosed hypertension is time. It is faster to write a prescription than to teach relaxation response, meditation or just plain "living in the moment". It's also easy to crank up the heat over the phone....if the home blood pressure readings don't go down, increase the dose, maximize on the medicine then add another. If only the drugs from the pharmacy came with an instruction manual on the above techniques to be done when taking pills. <br />
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I have had to soften the idea of meditation (all 3 techniques in my opinion) to my patients for making it more appetizing a practice. If I say meditation - some people bite. If I say prayer - most adults mention being holiday church goers. If I say spirituality - lost and sometimes repulsed. Like the DrOz show, if the pathology of disease or treatment is illustrated visually in layman's terms, it makes understanding and initiation of treatment more empowering. My passion is being physical. I love running, cardio, yoga, hiking....nature. What better way to adopt a meditative practice than to combine it with a very tangible movement activity. I like to change the performance of classic weight training to a modern cross fit type of activity. I believe at any age we can adopt and perform repetition and link it to movement.<br />
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A little plug for hiking. A nice way to say walk. But walk is not associated with weight loss or exercise. Those of you who count steps and calories know 30-60minutes of exercise pales in comparison to the calories burned with total steps per day. Anyone who has calculated the calories burned on a treadmill with know moderate to intense running will burn a small amount of calories in an exercise session. Adding up walking before, after and during the day will lead to a bounty of weight loss after a 12 week boot camp. If walking steps helps with getting back health, repetition of mantra/breath/word should be easy to combine. Wouldn't it be nice to rev up a single action to make a bigger impact? <br />
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Thus was born <a href="https://www.youtube.com/watch?v=t9VPCeDaJd8" target="_blank">DrRic's Meditative Hiking</a>. I learned a walking technique while taking a Harvard course and it was breezed through in less than 15 minutes but the concept stuck with me. I found peace with hiking in Yosemite and but the Half Dome trail was long and tough <a href="https://www.youtube.com/watch?v=ME4WWIdef-Y" target="_blank">(and my first big hike)</a> so I added the breath finger technique and I credit that to getting me back down the 7 miles of return trail. I also felt astoundingly high (was it the summit of Half Dome or the meditative movement .....I don't know). Regardless of the for feeling good, why not do a little more intentional walking this summer, a little intentional breath/finger tapping (no one will ever know!) a little more "unplugging" and get out the blue sky brown trail and green foliage. Nature has a way of taking over after about 30 minutes <a href="https://www.youtube.com/watch?v=U1Xonak-3XI" target="_blank">(<u>Shin Rin Yoku</u>)</a> no matter what mood rules you upon entry.<br />
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Bottom line is no matter what your religious upbringing, spiritual diversity, time for exercise, feeling of being outdoors are; you can use standard medicine to lower your blood pressure numbers or you can incorporate and adopt lifestyle change to decrease risks for disease AND get rid of your medicine!</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-30720731126339700672014-04-29T18:53:00.000-07:002015-01-04T04:39:03.987-08:00DrRic's Out of Network Fee Schedule<div dir="ltr" style="text-align: left;" trbidi="on">
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Question: Which business model offers reimbursement after 90 days of submitting a bill?<br />
Answer: Medical insurance.<br />
Question: Which business model is guaranteed to reimburse you lower than what you charge?<br />
Answer: Medical insurance.<br />
Question: Which service-base-industry requires you to pay back for intellectual services rendered to a patient if the non medical person says you never rendered services regardless of what the patient reveals.<br />
Answer: Medical insurance.<br />
Question: Which industry does a 3rd party get between a healer and a patient then makes money from both?<br />
Answer: Medical insurance.<br />
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2014. Insurance based medical care requires lengthy documentation, expensive recording software, full time staff to communicate, submit and approve medical procedures. This is before a patient ever walks into an exam room. The only way to break even between bills and reimbursement is to see high volume. High volume leads to rapid diagnosis and generalized treatment plans. This is where people become "symptoms" and prescription medicines become "cures".<br />
2014. My wife's office manager dies from colon cancer at 56 years of age. She had the will to live but but was given a treatment plan that was based on generalized statistics. She actually died from a demoralized lack of hope, dehydration, starvation, and side effects of antibiotics.....the cancer didn't kill her. I watched Kathy go through the slow approval of medical therapy, the lack of compassion to her individual case and the poor knowledge of nutrition and alternative/complementary care that would have worked well with the non cancer complications she was going through. She did not have to suffer.<br />
2014. I embark on promoting individualized health care using my board certified training in Family Medicine, my alternative training in Medical Acupuncture, Yoga/Meditation Instruction and Integrative Medicine (Board Eligible). I utilize a 3rd party secure "Cloud" medical record system that costs an annual fee of $40.00+; I sell no supplements in my office and defer patients to reliable supplement stores in my area (where I shop); I design treatment plans utilizing what we can from covered benefits while at the same time initiating lifestyle changes that will hopefully be sustainable with as much natural change as possible. I have partnered with Advocate Medical Group to establish a footprint in the Bartlett area so there are many insurance companies that are contracted however designated days for Integrative Consults are once a week/standard medical visits ("speed medicine") apply for the majority of my office hours. I have to honor the healthcare group paying my salary by being financially profitable but at the same time I must fulfill my calling to teach/empower/change people with more than just prescription medicines. No matter how long we live or how many diseases we encounter, if we lived a healthy productive life-in the end there will be no regrets.<br />
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<span style="font-size: large;">Fees for face-to-face time are related to the complexity of your case:</span></div>
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<b><span style="font-size: large;">Consults at The Center of Healing </span><span style="font-size: small;">(Integrative Medicine/Medical Acupuncture)</span></b></div>
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<span style="font-size: large;"><b>60 minutes=$300.00</b></span><br />
<span style="font-size: large;"><b>45 minutes=$250.00</b></span></div>
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<span style="font-size: large;"><b>30 minutes=$150.00</b></span><br />
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<span style="font-size: large;">Acupuncture=$100.00</span><br />
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<span style="font-size: large;">Phone/Internet Consults (<u><a href="http://www.herbal411.com/drrics_online_office.html" target="_blank">Online Link</a></u>)</span><br />
<span style="font-size: large;"><b>60 minutes=$200.00</b></span><br />
<span style="font-size: large;">30-45 minutes=$100.00</span><br />
<span style="font-size: large;">21-30 minutes=$60.00</span><br />
<span style="font-size: large;">11-20 minutes=$40.00</span><br />
<span style="font-size: large;">5-10 minutes=$20.00</span></div>
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As an alternative to seeing me, I have fellow graduates who have been trained through the same program and take medical insurance-<u> </u><a href="http://integrativemedicine.arizona.edu/alumni.html" target="_blank">Integrative Medicine Physicians</a>. Realize there is only one fellowship in the US that prepares physicians to qualify for the Integrative Medicine Board..... my alma mater-The Arizona Center for Integrative Medicine.<br />
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-14858352560639935622014-04-10T17:56:00.000-07:002014-04-10T17:56:17.082-07:00House Rules<div dir="ltr" style="text-align: left;" trbidi="on">
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When my patients come to me for lifestyle change, they usually don't bring family members in. I love the process of creating steps to change but only assume everyone at home will be participating/supporting the steps. No two plans are the same, everyone has different likes, educational levels, adverse memories, food 't intolerance's, stressors or previous attempts. The one things I can't fathom is how the spouse and kids will react to the changes that are usually restrictive. <br />
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No question that if a parent is making a change the likelihood of the child having the same medical problem is high. Whether it is expressing itself now or later doesn't matter, disease always leads to a bad outcome. To make a major shift in bad habits, craving control or trigger avoidance will take a lot of energy and may lead to some emotional "PMS-ing" even if you are a guy! If your family and coworkers are unaware of your journey, relationships can be destroyed. If they understand, they too may be inspired to drop a habit. <br />
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Counseling should be a requirement for the journey since unhealthy coping skills have been adopted to get you to poor health. Excuses are abundant as to why the weight is high, cholesterol is in bold print, and kids tease you about body parts that belong in the zoo. As tight as we hold onto and defend our reasons for ill health, it will be the ultimate "stress response" to let them go. Think of an addict going through the shakes, irritability, hallucinations, vomiting and headache......and that is just from caffeine! If you are trying to let go of your "comfort food", your nightcap, your morning wake up, or any high risk behavior.....getting everyone to lend a hand would increase success. Family should always be for you unconditionally but just in case, the behavioral health profession is very good at listening and making suggestions that have worked for your predecessors.<br />
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Home should be sanctuary as it encompasses 1/3 of your life. During the worst times of your life, there should be a place to retreat away from stressors (work, traffic, cable TV, food industry). If you can't harness the support of family, they should be the ones being counseled. A happier/healthier you will exude positive energy, problem solving, creativity and love.....the law of attraction will bring positive results to those around you. (The House Divided Against Itself Cannot Stand )</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-91091517688911380332014-03-26T03:21:00.002-07:002014-03-26T07:06:08.660-07:00Is there anything natural for sleep?<div dir="ltr" style="text-align: left;" trbidi="on">
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The body should be able to regulate it's own circadian rhythm with proper care. That means if you are healthy, work in the fields, get up at dawn, sleep at dusk and eat right-the brain has ways of secreting hormones that signal time to wake up and time to fall into brain rest. The problem will come when we go over and above by watching TV for 24 hours, "sleeping in" for more than to consecutive days, eating poorly or with no regularity, taking stimulants like caffeine/bad carbohydrates/adhd prescriptions. When you participate in repetative poor scheduling, the brain will think you are in a different time zone and it will not know when dusk is so the quality of deep brain wave rest will be compromised. You will know by the mere fact that you wake up fatigued, fall asleep at the wheel, become irritable with problem solving, or memory is hampered. </div>
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Snoring is not good. We often attribute the sound of a child snoring to -"a good sleep". If the snoring is associated with pauses of apnea (not breathing) then the brain is not getting oxygen and sends impulses to the diapragm to gasp for air. It may sound funny on youtube (or annoying to the partner) but the heart also gets shut out from oxygen and it will suffer by sending out a stress response and turning on adrenaline and epinephrine.......two hormones that are not supposed to be floating around the blood stream during peaceful shut-eye. The only way to find out about if a loud snorer is going through apnea is a sleep study. Medical insurance will pay for sleep studies in the lab but you usually have to get a "Home Sleep Unit" from the lung specialist and wear it for 1-7 nights. This will document a problem and signal to your insurance doctor that a more formal and detailed test is required. The end result is a positive pressure mask or nasal canula to wear at night so the soft tissues of the nose/mouth/throat stay open at night to allow air flow in and out. (thus no obstruction) NOTE-usually if you lose weight the soft tissue that is blocking the passageway will shrink allow the breathing tube to remain open. Imaging that, a non surgical, non chemical way to get rid of sleep apnea!!!! Oh but weight loss isn't covered by insurance. What is covered by insurance is a nasty surgery called the <a href="https://www.youtube.com/watch?v=obEKNl8oqrg" style="text-decoration: underline;" target="_blank">UPPP (see link)</a> </div>
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If there is not apneic issue and you are just suffering from shift work sleep problems, sometimes you can do things naturally to help the brain drift off into a sleep rhythm again but it takes ritual pattern establishment over 21 days or longer. <a href="http://www.slideshare.net/DrSaguil/get-back-to-sleep-slide-share-edition" style="text-decoration: underline;" target="_blank">See my lecture on sleep</a> Today we have immediate access of over 100 channels of stimulating TV programs and usually a closet full of equally stimulating processed food. Run away! Run away like you are running from zombies!! It is too easy to open a package and say you will just have 1-2 bites but then feel guilty you ate 20 servings before the TV program finished!! It is hard to stay true to a diet when you are weak....that is usually about 10pm to 2am. (and in ancient healing like Ayurveda and traditional Chinese medicine-one is not supposed to be filling the stomach at these hours)</div>
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You can schedule your macro nutrients to assist in bringing the brain to bedtime, you can also keep your exercise to day time, you can practice the relaxation response to induce positive serotonin secretion to help in training the brain to establish a good circadian rhythm but if this doesn't work then there are hypnotic prescriptions that will force you to sleep but it usually results in poor dream state and an addiction to the medicine.</div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-66627646891975090012014-03-18T11:01:00.003-07:002014-03-18T11:11:01.392-07:00I feel fine, do I need a check up?<div dir="ltr" style="text-align: left;" trbidi="on">
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I was in an online meeting with Deepak Chopra and he announced current research projects regarding telomeres. These are the end caps of our chromosomes (DNA) that protect these delicate message carriers from chemicals, radiation, bad food, viral invasion....the external world. His research finds if you meditate regularly, your telomeres stay long. (when they get short the end is near-damage to DNA occurs and just a matter of time before mutation occurs and something grows the wrong way) He has even enlisted the expertise of Elizabeth Blackburn who is a Nobel Laureate who discovered telomerase, the enzyme that keeps your telomeres long. <br />
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<u><a href="http://www.pmri.org/research.html" target="_blank">Dean Ornish's Program</a></u> for Reversing Heart Disease has found reproducible results if people change to a mostly vegan diet, walk, practice stress reduction/yoga and go through group therapy. He took the same program and proved with Elizabeth Blackburn's help the the telomeres in early prostate cancer patients stayed long and the prostate cancer in some was reversed. Herb Benson and Jeff Dusek found the the more you meditate, the more genes change <a href="http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0062817" style="text-decoration: underline;" target="_blank">(published in PlosOne)</a> .....imagine, that is a positive effect and you don't even have to leave your bedroom! So now the problem is getting people to make changes like the above before disease occurs. VERY HARD.<br />
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Luckily the price for checking telomerase activity is available and decreasing slowly. The only company that offers the test to the public is Spectracell Labs. For 200.00$ you can find out if you compare to others in your age group. <u><a href="http://www.today.com/id/26184891/vp/43737929#43737929" target="_blank">(The Today Show) </a> </u> If your level is better than expected for age, it would be reinforcement that your lifestyle is probably healthy. The problem could come up if an obese smoker gets the test and it looks "ok"- this might serve as positive ammunition to continue with dangerous living. I think you would need 2 tests in time (spaced out by 5-10 years to figure if you are improving or worsening. <br />
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I would guide my patients to <u><a href="http://herbal411faqs.blogspot.com/2014/02/12-weeks-to-change.html" target="_blank">challenge</a></u> their lives by introducing healthy Thinking/Eating/Activity to their daily routine. It has to be a routine and you have to like it for sustainability. If you jump off the deep end and just commit to taking vitamins and "eating when you can".....NOT SUSTAINABLE. I believe every person has to construct their own template for change and often it is difficult to hold the microscope to yourself. An outside opinion would always be valuable. It is too easy to procrastinate the "Change" - something will always come up and we will reason our way out of our plans. I like the way the registered dietitian at <a href="http://firsthealthassociates.com/departments-providers/clinical-nutrition/tom-jordan--rd--ldn.html" target="_blank">First Health Associates</a> thinks. Tom likes to develop an <u><a href="https://www.youtube.com/watch?v=OKaMEubrp0c" target="_blank">"implementation intention" </a></u>when designing programs for weight loss. You set a goal (easy) and when you attain goal, you are triggered to go onto the next challenge. "Lets get you below 400 pounds first then talk about 395.". <br />
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Ultimately if you catch yourself saying, "I gotta stop this" or "I know what I am doing is bad"....every cell in your body has already unraveled the DNA, created a protein, changed the protein into a hormone, sent the hormone to your brain and created a message that "you have to change". If you choose to ignore the message, the only thing that gets damaged is your DNA and sooner or later it won't be able to form messages anymore. BYE!!</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-80985441526892080222014-03-01T21:22:00.003-08:002014-03-01T21:22:57.716-08:00Have one for me!!!<div dir="ltr" style="text-align: left;" trbidi="on">
Guy: How much alcohol intake is considered healthy?<br />
DrRic; That's a loaded question, what other medical problems do you have?<br />
Guy: Are you saying alcohol is a medical problem?<br />
DrRic: I believe it's effects can be used to "quiet emotional reactions" and some people can start out using it recreationally but end up depending on it like medicine "to get through occasional tough times"<br />
Guy: I saw on Dr Oz that red wine has resveratrol, an antioxidant to help fight cancer.....and I don't have any tough times in my life.<br />
DrRic: Reseveratrol does help as an antioxidant to neutralize dangerous life choices but you would have to take alot of volume and the toxic effects of alcohol on judgement, fatty liver, sleep and digestion make it more of a burden to the body.<br />
DrRic: Also, it's not the amount of tough times it's the learned reaction to them. Stressors are a part of all human interaction (inescapable), some react badly (generalized anxiety) and some react seemlessly (meditator). For every rise in adrenaline and cortisol the body goes through in a day, there will be less room for serotonin and oxytocin (love hormones/procreation). That would be akin to a proinflammatory life vs and antiinflammatory life. Developing a dependence on alcohol to neutralize the adrenaline/cortisol times will set you up for more alcohol as the challenges of life accumulate with age.<br />
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I have the above conversation with patients (mostly male) on a regular basis. I will always expect a defensive stance from the patient with what is supposed to be a rhetorical question to me- "What is your healthy alcohol intake?" (expecting I will fire back with stumbling words or some form of denial) Then I boldly say I don't drink. The reaction is raised eye brows and "really!". Then I mention my story about the last beer being after I finished the 10/10/10 Chicago Marathon. I decided to detach myself from this thing that no longer served me. Truthfully I began to feel brainwashed into thinking the only way to watch a sporting event, relax after work, or finish some sweaty endeavor like cutting the grass was to order two beers, (one for chugging now and the other if the waitress took too long to come back for my next request). <br />
Most who went to college know alcohol is a right of passage in starting to leave the nest and search for a life partner (or maybe just the next hook up) but it revolves around the keg party. THERE!....it IS synonymous with party!!! Somehow it transcends into middle and old age as well. Some people will use it as an excuse for doing lewd acts...."oh...I was drunk" or "you were so funny last night!"(intoxicated). So you can see how people can easily step on the throttle and increase consumption to deal with bigger life challenges. (when the right thing would be to tactically problem-solve with a clear mind). Those of you who just said to yourselves "..but I do think better with a glass in my hand" really should investigate other ways to problem solve and compare the difference. Be patient, alcohol is immediate (like xanax) vs techniques of controlling the stress reaction take a while to learn (I'm going on 5 years and I am still a novice). You just might be able to stop an addiction. I don't bother with candy coating the word dependence-I just reveal it as I see fit and I don't like the effects of drinking. <br />
It can be considered a drug that dehydrates. Alcohol and water don't mix. The more you drink, the drier every cell becomes. Athletes are told not to drink before competition as it decreases stamina, strength, and performance. I mentioned fatty liver before and this is one of the biggest contributors to the abnormal blood tests. When the body has to detoxify alcohol, it does so with the liver. This organ is already busy with high sugar foods, pesticides, GMOs and then we have a few drinks. The liver starts to suffer and back up, it's called hepatic congestion....I call it slow liver failure leading to cirrhosis. Reverse your ways now or you will be feeling the sharp end of a surgeons knife replace your liver. <br />
So are you if you are in training for competitive sports-don't drink alcohol.<br />
if you are adopting a new lifestyle change- don't drink alcohol.<br />
if you are trying to lose weight - don't drink alcohol.<br />
if you have a major medical problem and taking medication-don't drink alcohol.<br />
if you are being treated for any psychiatric problem-don't drink alcohol.<br />
if you are trying to detox your life-don't drink alcohol.<br />
if you have any history in the family of alcoholism-don't drink alcohol..<br />
You can find other docs who say it's ok to drink with any of the above but the fact that you had to look probably means you should consider abstaining. <br />
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-4383030952990820292014-02-24T16:47:00.001-08:002014-02-24T16:47:25.986-08:00NSAIDS<div dir="ltr" style="text-align: left;" trbidi="on">
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Should I take an anti-inflammatory? I work my regular paying job at Immediate Care/Occupational Medicine Clinic and the first thing we prescribe is an ibuprofen 200mg (3 tabs) 3xdaily for the life of the injury. There are some orthopedic surgeons that say don't interfere/reduce the inflammatory process that follows injury because it slows down healing of the injury. This thinking is based on the fact that a "normal healthy person", should be able to mount a response to halt inflammation and reverse the injury (assuming no further damage is added). Problem my orthopedic surgeons forget is that the inflammatory cascade that gets triggered with the smallest microscopic fiber exposure (torn fiber from a muscle, blood vessel, skin, bone....) starts a local reaction in addition to a systemic reaction. Those of you who are fibromyalgia sufferers, or chronic arthritis patients will know of how the rest of the body "kills" when you have only injured one joint. <br />The surgeons get to see the inside of joints that have been injected with steroid (cortisone) and they hate it. You can't repair mush after 'roids have been used and expect a good outcome for the graft you are inserting for rebuilding an ACL. So for the few joints that have multiple injections prior to surgical consult, I agree with the specialist. For the millions of others that suffer countless nights not being able to sleep, not being able to walk, where every minute of every day is "I am in pain"; I think relief is worth it. I would use over the counter anti-inflammatory first (just because anything over the counter is considered a "non-reportable" therapy-so employers don't have to claim it on insurance) but quickly go to prescription anti-inflammatory within 10 days if the first didn't work. <br />
The proper use of NSAIDS is to start with minimum dose at the interval of when the med will wear off. ( For aleve/naprosyn it would be twice a day; for ibuprofen/advil/motrin it would be three times a day) After 10 days if no response, increase to maximum dose of that same NSAID. After 10 more days with no pain/inflammation control we switch to different NSAID - I usually go for the prescription meds....I rely on the older ones that were around from when I did a Sports Medicine fellowship in the 90's (nabumetone, etodolac, meloxicam.....or older ones like clinoril, indocin, mefanemic acid). I have alot of options but most people would throw hands in the air if pain/inflammation isn't controlled by 2nd visit. Usually it's 2 diff NSAIDs and if no response, time for a burst of prednisone. OOOOHHH the "P" word!!!<br />
Yes, in some cases prednisone is necessary for controlling inflammation before we have spasm from compensating during walking, or trigger points flare up, or distant joints flare up due to the overall inflammatory response being turned on. Only 1 time in 20 years have I had weight gain in a patient given 5 days. There is also no literature that says steroid use for 5 days or less needs a taper (to prevent Addisonian Crisis) so when we give the medrol dose pak-6 days of decreasing dose.....it is a waste of 3 submaximal doses. Usually there is insomnia (thus the reason for morning dosing with my 3 tabs of prednisone for 5 days). It can also raise blood sugar for my diabetics. <br />
If the inflammation is not acute, I would highly suggest <a href="http://www.youtube.com/watch?v=oqyYiDm7xEA" target="_blank"><b>Turmeric</b></a> in capsule form (roughly 40mg of extract 4times daily) by GAIA, Source Naturals, Organic India-since they blend it with micronized pepper for better absorption. If you can afford it, curcumin (in nanoparticle) has great anti-inflammatory properties but if not distilled/extracted properly, you wont absorb the active ingredient without pepper derivative. <b> <a href="http://www.youtube.com/watch?v=77jsw6js7Qk" target="_blank">Glucosamine Sulfate</a></b> is a great intra-articular anti-inflammatory and can be used for 3 months and discontinued to still have effect lasting 3 more months.....so you can save 6 months a year!! and still have reported improvement in range of motion to an arthritic joint. <br />
Another option if you are between using herbal supplements to control inflammation and prescription use = <b><a href="http://www.youtube.com/watch?v=Z9Qjrnhbc9s" target="_blank">topical pain relief</a>. </b>Either herbal, over the counter or prescription/compounded medicine. From former to latter, price increases significantly. The benefit is less side effects if used topically. The compounding pharmacist can actually mix NSAIDs/Muscle relaxers together so you avoid taking a pill form and it cuts back on systemic side effects beautifully. <br />
The biggest problems with the NSAIDs I mentioned will be <b><a href="http://www.youtube.com/watch?v=wQWVYPJdeSA" target="_blank">reflux</a>.</b> There are other documented side effects like heart attack from Celebrex, liver congestion, kidney damage, bleeding. Aspirin is an anti-inflammatory that has been used for decades to control inflammation in the arteries. If you take an aspirin a day, wait for 2 hours before doing the NSAID or else the med you use for inflammation will turn off the aspirin heart protective effects. <br />
Most important is to work with a therapist (massage or PT) for moving the muscle tissue, maintain an anti-inflammatory diet during the healing process, do no further harm, get a second opinion if you are not progressing within a month with all the above (or switch to T<a href="http://www.youtube.com/watch?v=icd9uClUGKs" target="_blank"><b>raditional Chinese Medicine</b></a>).</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-61664903859946429662014-02-15T20:57:00.000-08:002014-02-16T03:11:36.398-08:0012 Weeks to Change<div dir="ltr" style="text-align: left;" trbidi="on">
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About this time of the year, people who have thrown in the towel with a New Years resolution are looking for another way to resolve (weight, medicines or attitude). Spring time junk mail usually brings on a flurry of products fictitiously endorsed by Dr Oz about detoxing. When asked, most of the diabetic, over weight, high cholesterol, hypertensive, low back pain, snoring, fatigued patients I run into say "I know what to do, I just cant do it". I disagree. If you knew what to do, it would have lasted a lifetime. The fact that it wasn't sustainable means it was too low in calories, too high in cardio, too many hours a day or too expensive. My idea of sustainability is to formulate a life change that resonates with the individual. This is the approach for Integrative Medicine, applying studied protocols in a personal individualized way that provides highest sustainable lifestyle change. (Like having an Uncle that owns a grocery to cherry pick the best items from each isle that he knows you would use and get the most out of.) <br />
So how to start: my suggestion is to hire someone you will be accountable to every week. The money spent will be worth every penny once you realize what you save from an annual contract with Lifetime Fitness, the prescription co pays, the non paid sick days you accumulate or the meals ordered online from outsourcing your weekly food. If you do all this on your own and fall into the statistics that most people fail within 12 months-you just wasted a year of money, effort, exercise and morale. Dead set on doing it alone? At least do things to increase success of sustainability. Get an over sized calendar, magnetize it to the fridge, note the start and end of 12 weeks and keep track of the weeks and your wins. Start writing jotting down notes at the end of your day on 3 daily positives. I would plan on having others in the house and at work know you are going through 12 Weeks to Change. (You may find a family member and/or relative who was thinking the same thing!) Having a quit buddy/group increases problem solving solutions when you hit the wall. Everyone hits the wall. Being prepared with maximizing on 'neutralizing stress response'/nutritional strategizing/compressing exercise <u>(<a href="http://www.youtube.com/watch?v=Y5X7mhWy7p4" target="_blank">DrRics Thinking/Eating/Activity</a>)</u> will get you to get back on target quick. <br />
I think the initiation of change is a detoxing. Giving the body the break it needs from toxins, bad food, inflammatory thinking and sedentary life is refreshing. The first morning you feel good about not having a "comfort food" craving, or your first "great" bowel movement, or think with creativity that's been missing since younger years will be glorious! Yes the feeling and energy of youth is what most can relate to (in memory) but we've been swallowed up by this concept that you have to work like a slave, eat like a king, and move like a wounded animal in order to be "someone". All the while we are in denial about the impending damage to our DNA we inflict with each drink of alcohol, puff of smoke or bite of synthetic food. What's worse is the concept of epigenetics says the damage we inflict on our own DNA is also passed to our children with the messages of uncoded disease glazed onto sperm and egg.<br />
The key is to make the detox effective; and plan ahead so it doesn't have to be so aggressive next time. The less disease you have, the less intense the detox. If you just have to stop buying candy at the check out - easy! If you have to lose 50 pounds for a wedding in 4 months - challenging! If you have to fight a diagnosis of metastatic cancer - probably should have started earlier but fight for your life!!! I believe most of use should be detoxing twice a year. Ayurveda (ancient healing from India) says before change of season, we detox the body to prepare for the new harvest. Different temperature requires different food, different harvest requires different digestion/preparation. Change requires a well grounded emotional state since most humans prefer stability and ritual. Especially now that we live in such a toxic environment, over dipping into food, inactivity, inflammatory relationships is such a daily activity we don't even notice how unhealthy we become; and accumulation is felt only when we are about to drown. Wiping the slate clean is what hunter gatherers are supposed to do with each change of season.<br />
I feel 12 Weeks to Change is slow enough to be subtle, but short enough to impact confidence and morale. Just in time for rejoicing changes and launching into the next pilgrimage to life goals. If you can see a doctor-good to attain baseline tests and make sure your body doesn't need extra monitoring. If you can hire a registered dietitian- good to initiate a nutrition plan and reformulate it as you get past milestones in your journey. If you can hire an exercise physiologist/yoga teacher/coach to move and inspire you when at your lowest you can avoid injury. I divide the time into 3-week-blocks concentrating on<br />
1-introducing walking breath work and supplement choices<br />
2-food knowledge and exercise rethinking<br />
3-detoxing, elimination, supplementation<br />
4-intense work on Thinking/Eating/Activity and then planning for the next goal<br />
If you cant hire the above, it's OK, keep your goals realistic, check off the days on the calendar, write your accomplishments in a bedside journal, add some form of meditation to the daily activity, try to avoid wasted time at the gym (shorten the rest times, speed up exercises, add walking to equal 130 minutes weekly) and try to follow my videos. <br />
Set your intention for success every day/Set you attention for living clean every day!<br />
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-80987477294513561972013-07-01T20:54:00.000-07:002013-07-01T20:54:31.263-07:00I lost alot of weight when I started dieting, how come I cant lose anymore?<div dir="ltr" style="text-align: left;" trbidi="on">
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Correspondence to the PCOS patient:</h3>
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Homework on how to get passed a <b>"PCOS"</b> plateau<br />
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-<b><span style="font-size: x-large;">Thinking</span></b>: try to incorporate some form of relaxation therapy (listen/watch 10 min of any meditation timer videos/watch Andy 478 breath video/rosary 10 min...anything undisturbed for 10 min every night before sleep) for 90 days<br />
<b>chastberry </b>in the am to help control the hormone surges of testosteron/estrogen from the "zombied" cells that are over producing <br />
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-<b><span style="font-size: x-large;">Eating</span></b>: keep on with basic concept of 30/30/30 but maximize on low glycemic index foods and high fiber content for the carbohydrate portion of your daily food intake for the next 12 weeks<br />
make sure your portions are spread out through out the day with 1 maximum volume meal to celebrate the day (I would suggest lunch since exercise is at night<br />
<b>gymnema sylvestre</b> in the late morning (1tab) when hunger can start as it helps to stop sugar craving<br />
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-<b><span style="font-size: x-large;">Activity</span></b>: continue with exercise to evening but of the average total time spent per session try to dive straight into high intensity exercise for the first 75% of the time then finish off with low intensity (stretching/breathwork/guided imagery audio) for the last 25%<br />
add <b>valerian </b>1 capsule<b> </b>to a pre-bedtime ritual for the next 30-90 days (see my slideshare.net lecture DrRic Good Night)<br />
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we will need a repeat insulin level, LH/FSH, testosterone, sed rate/ a new iron/ferritin level, b12 and you should be taking <b>vitamin d3</b> since march levels were low (1000IU am and pm with food or fat), omega 3 fish oil to help with inflammation from PCOS</span><div style="text-align: left;">
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-26718851724127076982013-03-31T05:31:00.003-07:002013-03-31T05:40:36.318-07:00Why do I get so much gas with my "healthy diet?"<div dir="ltr" style="text-align: left;" trbidi="on">
<a data-ved="0CAUQjRw" href="http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=emXIlAnYOLaCnM&tbnid=p3qwbU4NePog4M:&ved=0CAUQjRw&url=http%3A%2F%2Fwww.examiner.com%2Farticle%2Fdutch-oven-cooking-class-april-25th&ei=pixYUfbbNaSryQHLpoGYDA&bvm=bv.44442042,d.aWc&psig=AFQjCNGDSun9On4mm2Co4wJeYdlTZD2B5Q&ust=1364819482472538" id="irc_mil" style="border: 0px currentColor;"><img height="349" id="irc_mi" src="http://www.examiner.com/images/blog/wysiwyg/image/Dutch_Oven_Class(1).JPG" style="margin-top: 22px;" width="439" /></a><br />
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The Standard American Diet (SAD) is high in processed food. Quick meals, microwave meals, drive thru meals or meals heavy with government subsided fructose corn syrup (yeah.....the "first bail out" of the food industry that quietly continues to fatten our future adults while coming out of our weekly paychecks......causing people to claim disability and require expensive medication that again comes out of our weekly paychecks) I digress.....when the 36 foot digestive tract of a human is used to taking in low residual, processed meals, it sustains it's job of "melting down" food 3x daily and extracting daily requirements of energy needed by our bodies. The small intestine and colon house about 100 trillion "friendly" bacteria to help breakdown solid material we eat into the building blocks of protein fats and carbohydrates. Think of them as microscopic maggots. The bacteria that coexist in our gut are made up of a variety of species that usually cause no harm. Our first inoculation of the bacteria comes from the birth canal and breast feeding. Continued "inoculations" of bacteria continue while we age and originate from our water, our siblings/partners and our food (like yogurt). Most of these are friendly, every once and a while there will be non friendly inoculations like undercooked chicken, unfiltered drinking water, filthy bathroom faucets or the food handler who just coughed into her hand and proceeded to box your meal. When our gut gets invaded by a bad species of bacteria....it can usually produce white blood cells to kill the species that means to kill us. Occasionally the doctor prescribes antibiotics to "nuke" our bodies and destroy bad invaders....unfortunately the WMD will also destroy good bacteria. (This is why you get diarrhea you get after taking a course of antibiotics.....there is suddenly mass death to the good bacteria and the gut can't break down nutrition into protein, fats and carbs-so the food goes right through) <br />
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A similar scene occurs when a change is introduced to our daily regime of eat, breakdown, extract and poop. When the 100 trillion good guys are used to break down the SAD and suddenly get a high fiber plant source (tofu, fruits and veggies, whole food....) some of the bacteria will take the high residue fiber and create a byproduct of methane gas. It is these few species out of the 100 trillion that can also produce gas bubbles in pond scum, bad smelling air in a meat container or shoes that have been worn for 12 hours by a barefoot kid. The colon is just a transit tube of muscle that moves solid material from mouth to anus. It has a "usual" diameter of 2-3 inches but if the irritated species of bacteria is making extra gas, the colon inflates to maximum diameter- (goes from garden hose size to fire truck hose width accounting for your big belly and muscle cramps of IBS) All that gas has to go somewhere and it is usually noted in a car (nasty Monday car pool buddy), under the sheets (dutch oven) or when your relative making a healthy change helps you carry furniture and lets one loose "by accident". <br />
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There are ways to introduce a healthy lifestyle change without the bloating and room clearing gas problem: <br />
-Introduce the whole food, mostly plant based diet in slow increments over a scheduled calendar (the benefit of getting help from a registered dietitian!) <br />
-Rev up your digestive power by taking digestive enzymes with new introduction or difficult to digest meals (note that not all enzymes are needed and can cause irritation as well so please consider help from a naturopathic doctor!)<br />
-Smother your digestive tract with 300 billion bacteria in a bottle. Probiotics are a great source of stable, non methane producing bacterial species that will "crowd out" the few guys in your gut that cause problems with high fiber nutrition. (I don't like yogurt due to it's dairy base and it only contains a fraction of what you can get in a capsul/bottle)<br />
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Think of the probiotic this way, there are 20 apartments for rent and everyone that lives in the building goes to sleep early. The realtor brings in college kids and suddenly the harmony of the complex is destroyed by noise and trash until the tenant leaves. The neighbors avoid another noisy renter by flooding the realtor's office with older quiet people seeking a new place to stay. Harmony is reestablished. (<a href="http://www.youtube.com/watch?v=sYtLMyyHhvY" target="_blank">please click here to see my DrRic Tutorial on Probiotic Use</a>)<br />
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So you spouses who have to deal with inhaling the byproducts of healthy living....go out to your local Whole Foods Market or Fruitful Yield and ask which probiotics are the most affordable and popular for maintaining a stable marriage. For use with antibiotics, I suggest add the probiotic for 30 days at least. For introduction of a new diet, I suggest adding a probiotic and considering a digestive enzyme until the 4th month of your change (a harvest). For IBS sufferers, pre-biotics first then probiotics for life (and don't forget the crucial relaxation therapy). As always with any change I create a template for, you <strong>must </strong> introduce relaxation thinking and activity involving movement - your gut functions way better when emotions are stable and the heart is fine tuned to push blood and white blood cells to the organs that need it most. (<a href="http://www.youtube.com/watch?v=nNkZHoxVZhI" target="_blank">click here to see my discussion on DrRic's Antiinflammatory Lifestyle</a>)</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-67331616969066286092013-03-17T06:53:00.001-07:002013-03-18T08:47:20.266-07:00DrRic's Antiinflammatory Lifestyle?<div dir="ltr" style="text-align: left;" trbidi="on">
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A guru of mine popularized the phrase "antiinflammatory diet". Essentially a whole food mostly plant based diet. It goes with the concept that in the millennium, most disease has at its roots a form of inflammation. I contend that there is more to inflammation than just bad nutrition. I teach my patients that to get back to the "wholeness" of living disease free. In my treatment plans and lectures, I write prescriptions of changes to cosider in solidifying your ability to withstand the challenges that face every decade. <br />
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Thinking T<br />
Eating = E<br />
Activity A<br />
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You can have good TEA and increase the chances of living until 90-100years old with very little medicines and disease. <br />
You can have bad TEA and allow every bad gene known to the human species to express itself. It doesn't matter that everyone in you family tree has been without illness or early death. Living a full catastrophic life (as John Kabat-Zinn refers to) without remorse will only screw up the brilliant actions found in your DNA to live/fix/avoid danger. <br />
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Good TEA consists of;<br />
1-allowing the brain to let go of unnecessary reactions to our environment. When I have patients come to my office for the first time, 50% will have an elevated blood pressure and state they don't like doctors. This is probably an evolutionary reaction trained from when you grew up and expected every visit to end in a shot. Rational thinking should help you figure as an adult you can say you don't want a shot-but subconscious fear is a learned behavior hard to break. Furthermore, if sitting in a small office, waiting for a stranger and having someone know your "insides" makes the fight or flight/sympathetic system turn on and manifest a fast pulse and high blood pressure......imaging what being late for work, forgetting your lunch, getting billed improperly, having someone tail gait you at highway speed, or just getting bullied or intimidated.... does for your pressure. It is well documented that most heart attacks in the world occur on Monday morning. This would be where "thinking" part of TEA is involved but it's more of developing a way to let go of analyzing every millisecond of every encounter and possible outcome. Doesn't mean live like a hippy from the 60's in a commune but it does mean you have to invest in changing that "teenager-like" reaction of thinking irrationally and letting emotional tornadoes blossom from every stress event. (I remember someone with anxiety pushing me to come up with a treatment plan for them but "they didn't want pills, didn't believe in psycho therapy and don't have time to practice mind relaxing......this dude needs a referral to Dr Bob Marley)<br />
2-giving every cell in the body the basic building blocks of what they need to perform duties of existing. Those of you who remember science can picture a cell and its center called the nucleus. Within the this center, DNA does its magic of replicating for 90 years, cutting out bad genes that look like cancer, conducting the orchestra that takes place to chemically breakdown any toxin that you happen to ingest, recognize and kill any invading virus or bacteria that isn't helpful and keeping you moving/feeling/thinking happy and loved. Eating crappy food/alcohol/overindulging will tip the scale from "living till 90" to "just getting by" at 20, 40, 60 years and usually when the "Ferrari" is given low quality gas, it's engine will run but performance will be worse than a "Yugo" and it's engine will soon fail. <br />
3-movement, outdoors, laughter, breath/heart stimulation are all so embraced by your body. Everyone feels good when they are maintaining some form of activity...even the infants. If basic brain of a newborn feels joy in kicking feet and moving fingers....what more do we need to prove that stagnation is a bad thing. I remember watching this kid in the airport waiting for a flight-zoned into his computer. Didn't move a muscle including his eyeballs for hours......yet there was expression of movement with his left ankle/foot. It was nervously moving like it alone was on 5 red bulls. (The tell tale sign a police officer looks for in the admission of guilt via body language-this kids' leg was "hiding something") It was fascinating that his eyes and ears were getting stimulation but his body was trying to express its need for activity..... and he was ignoring it to continue pleasuring his eyes and ears. This 3rd leg of "DrRic's Antinflammatory Lifestyle" has it's challenges in that most people think of exercise as that feeble attempt at going to the gym and getting personal training from college years. "Goin to the Gym" is just one of an infinite form of movement activities. Instinctual activities that have been in existence since the dawn of man are walk and swim (biking was developed in the last few centuries) There are well established activities that have been utilized by ancient cultures like tai chi or yoga (and the cool thing is they take care of steps 1 and 3). Info mercials develop every 6-12 months- a new fitness machine guaranteed to change your life (until the next new fitness machine is purchased to replace the now basement delegated "lifechanging equipment") I believe it is cheaper to hire a guru/coach who can listen to your wants and needs and use experience to develop a sustainable series of activities you had no idea were out there. How is a patient with limited experience supposed to teach himself a sustainable method of living to turn around a failing body?....the <strong>Internet</strong>!!! (yeah right!) While your at it, teach yourself a degree in medicine and the human psyche so I can start sending you some referrals. Finding an activity you can embrace forever is possible on your own but takes alot of experimenting and direction that most humans don't have patience for (especially if you are unhealthy to begin with). <br />
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Bad TEA consists of the Standard American Dream (work alot of hours, make alot of money , you are #1-everyone else is beneath you!), the Standard American Diet (1 in 3 are obese and dying slowly) and the Standard American Pastime (TV)<br />
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Not everyone is ready to adopt this antiinflammatory way of living <u>(</u><a href="http://www.youtube.com/watch?v=nNkZHoxVZhI" target="_blank">click here to see a video describing <strong>DrRic's Antiinflammatory Lifestyle</strong></a>). It takes big commitment to initiate and a strong will to continue. In my opinion, making a change a little at a time is more difficult than being "all in". When someone shows me the signs that they are invested in "flipping over" to a better way of living, I give everything I can in planning and give them the best "coaches" to initiate and complete the plan. If they are being dragged in by a spouse, sitting with arms crossed and no intention to listen I try not to waste my time in preaching to deaf ears. What I know for sure is that everyone will "flip over" whether now or later at deaths door. If they aren't ready to "flip" now, it's ok I 'll be around for a while to help when it happens....it will happen.</div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-14614576467156438572013-03-14T09:41:00.002-07:002013-03-15T19:59:15.097-07:00Why can't I get a hold of my doctor?<div class="separator" style="clear: both; text-align: center;">
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I remember when just starting residency in '91, clinic days were limited to 6-8 patients daily. The model was to make sure the new guys weren't overwhelmed with learning the process as they developed interview and exam skills. Most important was to give enough time to take the patient case (all written down on paper) and present it to the overseeing doc/teacher. By the time 3 years passes, most of us in Family Medicine can see patients every 10-15 minutes. It seems this was the perfect balance of getting the biggest concern diagnosed (impossible to only have 1 medical concern especially medicare aged patients!) and being able to bill medical insurance and break even. Most family medicine clinics don't break even with seeing patients. In fact, over the last 20 years, when a bill goes to insurance, I usually see 3/4 of a reimbursement. Inflation is about 3% annually and yet medical reimbursement decreases every year. You see it on TV/Internet....spending cuts across the board for reimbursable medical expense by the government for medicare. What medicare pays for and denies usually is followed by all the medical insurance companies. Ultimately, medical office have to be really good with cutting corners and saving money. <br />
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So how do primary care medical clinics survive? They are usually large groups of several hundred doctors consolidated to save on administration and staff fees....."safety in numbers". Another popular option for young graduates is to join a hospital group. Hospitals have deep pockets and can help the neophyte doctor float for 1-3 years with base salary/malpractice coverage while s/he builds up a following. Hospitals know that if the doc orders tests/therapy or suggests surgery, BINGO.....lottery payment!!!!! Medical insurance reimbursement is procedure oriented so if you order a procedure it pays much better than keeping a person healthy with health education, lifestyle change and community/family bonding. It is very rare to see a primary care doc in a solo practice. There is no time to see patients in clinic, review and make decisions on test results, visit patients in the hospital, maintain a business (gotta pay for the multitude of staff necessary to maintain medical records, phone calls and scheduling/billing).....or <span style="font-size: large;">answer phone calls personally <span style="font-size: small;">6 phone calls daily =1 extra non reimbursed hour in the clinic</span>.</span> More economical to have the phone staff return the call with a preprinted answer. Then there is the poison of malpractice insurance increasing every year regardless of excellence of practice......I have been in practice for 20 years with no cases of suit but have to pay the same amount as a high risk-new graduate that has a fraction of my experience. (Maybe I should practice with abandonment!!!) Na....its not in my nature.<br />
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So now I have a private practice (solo) but it consists of tedious evaluation to identify weakness in the plans my patients have to get old and stay healthy. My "booked up" day is equal to 6 -8 patients. I have to laugh......its like watching 6 TV shows or 3 movies regarding comparative time spent-not the entertainment. The medical decision making is easy, with the training I have been privy to, diagnosis and planning is a breeze!!! (thanks Andy Weil) The challenge is making sure the teeny weeny reimbursement I get from medical insurance (remember I get 3/4 of what I charge) pays for the roof/staff/utilities/malpractice and my paycheck. (yes....my paycheck is exactly the same as what a new graduate gets fresh ....out....of ...residency!) No ....medical insurance says all docs are the same.<br />
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The only way I have found to maintain the balance between giving excellence of care and not going bankrupt. Working a second job. Here is the irony I was contemplating on the way to an interview 2 days ago.....I give excellent care with a knowledge base I have painfully paid for out of my own pocket to make people successful with healthy lifestyle change. I also am outstanding in time management when I run the immediate care centers I work for to supplement a "just barely getting by" private practice. (patting myself on the back) - I can run circles around the younger guys that are complaining "why are the patients in the waiting room and not in the exam rooms" (yet the neophytes are just sitting there not helping the front desk/triage folks!!!) Primadona pansy-grab a chart and do some work!!!<br />
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Yes....this means to be efficient at my second job.....I have to see patients for one diagnosis and get them out of the room in 10 minutes!!!! I have to be the doctor (in immediate care clinic) adding to the burden of society illness that I (in private practice) am trying to fix. What a polar opposite life I lead!!! I feel it is going in one direction though. You would think if I healed the world and made everyone successful at lifestyle change.....no one would be sick and the immediate care clinics would go out of business. Ain't gonna happen.....not everyone is ready for change and too many millions that are leading an unhealthy life.<br />
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Like scooping water out of the hole you dug at the seashore......the ocean is too large to bail out of your little hole. I will be "scooping out" for a long time so who can answer phone calls?!?!Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-40187372096017336662013-03-02T04:49:00.002-08:002013-03-05T05:24:40.054-08:00Should I get a check up?...I hate going to the doctor!!<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: Calibri;">“Your office makes no money but continue referring patients
for tests and procedures….”<o:p></o:p></span></div>
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<span style="font-family: Calibri;">“Every patient you see should walk out the door with a
supplement…”<o:p></o:p></span></div>
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<span style="font-family: Calibri;">“You need to be seeing more of these coughs and colds per
hour, oh btw this guy just has a possible brain bleed so just give him an
antibiotic….”<o:p></o:p></span></div>
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<span style="font-family: Calibri;">“She only had double vision, a swollen face, blood shot
eyes, and couldn’t stop crying, why didn’t you send her back to work….”<o:p></o:p></span></div>
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<span style="font-family: Calibri;">“We want you to encourage major lifestyle changes in chronic
disease sufferers but can you do it in 15 minutes……”<o:p></o:p></span></div>
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<span style="font-family: Calibri;">Doctor Innanoutinfive is paid per patient diagnosis.<span style="mso-spacerun: yes;"> </span>An insurance company decides how much the diagnosis
will be reimbursed.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Doctor speeds up visit by writing a drug
solution that has been found to “reverse” the diagnosis and ignores patients other complaints.<span style="mso-spacerun: yes;"> </span>Drug company pays for
studies that say their new drug can be used with less side effects than their
previous drug that just ran out of its patent.<span style="mso-spacerun: yes;">
</span>FDA gets ½ of its expenses paid for by drug companies and approves drug
by a fast track before human trials.<span style="mso-spacerun: yes;">
</span>Doctors sued by patient's surviving family given wrong diagnosis, delay in referring to
specialist, wrongful harm from prescribing "aggressive" new medicine.<span style="mso-spacerun: yes;"> </span>Malpractice premium increased to cover “bad” doctor.<span style="mso-spacerun: yes;"> </span>Doctor has to see more patients to pay for
higher malpractice.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<span style="font-family: Calibri;">Lady doesn’t like doctors so refuses to go.<span style="mso-spacerun: yes;"> </span>Lady cooks the way mom taught her all daily
meals on a budget from local ethnic grocery.<span style="mso-spacerun: yes;">
</span>Lady works 1-2 jobs but maintains marriage and raises kids through state
school.<span style="mso-spacerun: yes;"> </span>Lady attends funeral for kids
that died from chronic disease before age 70 diagnosed and treated by Dr
Innanoutinfive. <span style="mso-spacerun: yes;"> </span>Lady lives to 90 years,
natural causes, never takes any medicines.<o:p></o:p></span></div>
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<span style="font-family: Calibri;">Doctors are prescribing "<u><a href="http://herbal411.blogspot.com/2013/02/messin-with-god.html" target="_blank">snake oils</a></u>" that dont get you healthier, cost the government alot of money and avoid addressing the real cause of disease........this is true quackery!!!</span></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-25247427365370632312013-01-12T08:07:00.000-08:002013-01-12T09:13:32.606-08:00Get Nutrition Education<div dir="ltr" style="text-align: left;" trbidi="on">
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Sun Tzu says <strong>Know Your Enemy</strong> <br />
(DrRic says the modern food industry can be your enemy)<br />
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A basic premise in success. It is also a concept with making a lifestyle change that is imperative before starting any exercise program or fad diet. Science is awesome with the information being revealed on how macro nutrients effect emotion and metabolism. I think some people are still in the dark ages when it comes to initiating a change. I hear of people just cutting out lunch or breakfast hoping to sustain this form of "fasting" for 2-3 months. (It takes about 2-3 months to see effective lasting change) I don't know about you but for me to refrain from a ritual is hard over the course of just 1 day. How to expect keeping it up for weeks? No matter who you are, human nature loves ritual. We develop daily rituals and even if bad, they make the day go by faster. Breaking ritual and changing goes against our DNA and the brain will send all kinds of chemical signals into the blood stream when it wants to get back to the old way. Craving, irritability, poor sleep, anger, depression.....all can be felt during times of lifestyle change. <br />
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Some of these signals can be "modified" with the right choice and timing of nutrition. Science has helped figure how food can cause damage but also how food can be used to control damage. This information is out there for you to find and self educate but one has to be well versed in research and sifting through all the internet crap out in cyberspace. At the time of this blog, I searched on google for<strong><em> diet</em></strong> and 486,000,000 hits came up. By the time you find the correct study out of this search, your time on earth would be up. Short cut your efforts and increase the chance for success in making a lifestyle change by enlisting the experience of someone that reads through information like this for a living. Registered dietitian's, research fellows, scientists all have to keep up to date so why not pick their brain. Not to boast but I spent 2 extra years of post graduate training with Andrew Weil just to be "comfortable" with talking about nutrition since your average doctor only gets about 2 weeks in medical school. How are we supposed to teach about a topic we no nothing of? Hint: we're not, it is just bypassed and substituted with prescriptions or surgeries. Hippocrates said let food be thy medicine and although archaic, still a basic concept in making sustainable lifestyle change. <br />
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At First Health Associates I have the luck of bouncing questions off of Tom Jordan, a registered dietitian. He has a passion for changing lives and runs our wellness department. He has alot of success stories with weight loss patients in addition to his love of marathon running. It pains me when I have to write multiple prescriptions to young people in order to control disease. On the other hand, I feel great when Tom tells me they were able to stop meds with lifestyle change in only a few months!<br />
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Don't do it alone, weigh the odds in your favor. Going cold turkey is soooo 1960's....it does not work for the majority of Americans who try it. Making a change in life is not supposed to be a annual thing. The Saguil Approach is to initiate a change, exercise then overload, prepare for hitting the wall then re-establish new goals and power through. I see a repetitive failure in people that Push Crash (as Aimee Weber our exercise physiologist put it)....driving the body/mind too hard and suffering severe consequences that force abandonment of the entire effort. I feel that having someone to be accountable to will act as a 3rd eye to make sure goals are not too extravagant, methods are trustworthy and most of all you don't waste money! </div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-16928061313786794532012-12-25T21:27:00.001-08:002012-12-29T15:52:19.269-08:00Re-restarting an exercise program<div dir="ltr" style="text-align: left;" trbidi="on">
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With the coming new year, there is an inspiration to begin something new. Resolutions are usually made to fix something that needs fixin. So guess what is the number 1 thing in the US? According to a small article out of Journal of Psychology this month-#1 goal is weight loss. The study showed how greater than 50% will maintain the resolution for 4 weeks then the numbers drop steadily with a minority of well wishers continuing up to 6 months. It is fitting that weight concerns are at the top of any wish list seeing how 1 in 3 Americans are obese (followed by the usual high blood pressure, high cholesterol and high sugar). This speaks to that "spark" of an idea for getting back to high school weight always floating around somewhere in the frontal lobe of most US citizens. Along side the thought bubble is the self defeating notion that "it's too big a task". This negative feedback loop of failure to maintain change will become the dominant idea in greater than 50% of Americans who embark on the quest to look, feel and perform better in the New Year. <br />
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The <strong>Saguil Approach</strong> to stack the odds of success in favor of the metabolically challenged well wisher is simple; Invest!! Unfortunately, this 6 letter word has been associated with "stealing" in the last few decades beginning with vitamin/snake oil pushers, car salesmen, real estate investors, home mortgage officers, and wall street firms. Taking away the greasy outer layer of this nugget of an idea will yield the essence of what I am proposing. Taking something of value, placing it in a safe spot and increasing it's value with time. Try now to translate the idea of 'value being monetary' to instead being in excellent health. Imagine a pill you take 1-2 times a day that would <strong>insure </strong>a permanent high, no clouding of judgement, improved physical endurance and a perfect digestive system guaranteed weight loss without any side effects! I think that most people would at least try the pill hoping for a way into a life that is only thought to exist in fiction. <br />
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Investing in a lifestyle change is tough. Where to start? All my patients have "been there and done that" whether a virtual program or membership. I see the frustration in going through another round of the "same ol failed routine" but the challenge is try not to generalize. A DVD box set of changing exercise routines will probably be the same technique in a different package every year you order it.....there is only so much a charismatic trainer can do via recorded media. A <strong>hired</strong> teacher/trainer is totally different experience. You have a personal coach that cannot be paused, you have someone that dynamically changes the program based on what they see your likes and tolerances are. Essentially, there is a human being paid to specifically fit a program into you and not the other way around. A sustainable lifestyle change is one that you will want to do daily, one that will provide a sense of accomplishment and one that will leave you feeling like you are missing part of the day if not performed. Sounds too good to be possible? Maybe, most people hit a plateau and stop making gains....at that point, revisit an expert and redesign another program to catapult to the next pinnacle. Nothing lasts forever but if brainstorming with someone who 'changes lives for a living' increases the chance of you keeping a resolution.....it is worth the investment.<br />
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The next argument is affordability. I will end the debate this way:<br />
-<strong>solution B</strong>; don't make a lifestyle change, work as is, pay bills continue with unhealthy living, accumulate diseases, have a retirement fund but poor health, burn up the fund paying for medicines, surgeries, therapy or visits to every specialist in the doctor alphabet after you get on medicare. Be well known by the ER staff not for the company you owned but for the frequent visits to the department...it will be a bad sign when the ER attendings call the residents in training to take a look at you and behold how a text book disease looks. <br />
-<strong>solution A</strong>; give up something you love now in order to pay for the beginning of a change, maintain the change, reevaluate the next path to a pinnacle, get used to not having so many material things, love healthy food, embrace exercise, improve work performance, see the beauty of your immediate family, scale down the house, get a clean bill of health from your doctor to travel to Mt Everest in your late 60's, do volunteer work teaching the next generation how to work and live all the while keeping happiness in your heart. <br />
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The 2 solutions are at opposite extremes with a large grey area between but should suffice for assisting in the picture of where most of my people who make excuses end up. Postponing change will lead you to pay in the end with your health followed by your savings. So where to start? This should be where your health care team jumps in. If your doc has helped to change lives in the past, he will have a collection of names and ideas from successful and charismatic facilitators. The range will be from meditation gurus to exercise physiologists, to registered dietitians, lifestyle coaches, instructors in ancient practices like Qi Gong, Yoga, Tai Chi...even to other doctors who may serve as the first stepping stool to improve suffering before your journey. Bottom line is it will take a few attempts. One failure just means you are closer to a success. To exclaim you have tried that and it doesn't work is just setting you up for solution B. Don't feel bad if in group B; western medicine does work to control symptoms but usually at the price of getting farther from the cause of your problems. I cannot tell you how many times I used to see patients on medicare coming in with a long list of medicines often with interactions to each other because no one physician knew who was supposed to monitor the list. <br />
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This New Year, commit to making a change, seek out someone who has helped others, set the intention of where you want to be in 6 months, 12 months, retirement. Don't sweat the details of the whole journey, just take some baby steps. Martin Luther King said "you don't have to see the whole staircase, you just have to take the first step".</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-16818565127725900932012-10-30T08:37:00.000-07:002012-10-30T08:37:48.699-07:00Should I see a specialist? pt 2<div dir="ltr" style="text-align: left;" trbidi="on">
So lesson from last time -"trust your gut feeling when someone hands you a bogus answer". I expect my consultants to give an expert opinion on a diagnosis, then I expect them to get back to me. Used to be in the 90's a phone call would be made after an evaluation and plan created. I understand with low insurance reimbursement that docs have to move patients like cattle to pay the bills, call me old fashioned, I still expect when the door is closed, full attention to whom ever I send for second opinion . <br />
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Here is the flipside: my patients know I spent extra time after family practice residency in a sports medicine fellowship. There are a handful of teaching centers in Illinois that many graduates apply for but only few get in. Most of us in primary care sports medicine are dedicated athletes or just love the musculoskeletal part of healing/health. I think it's fantastic to know how to prevent asthma attacks with changing shoulder and upper back strength or improve post partum sex with pelvic therapy. (It aint just knowing how to test for an ACL tear or pop a shoulder back in) Anyway.....I remember taking a state written exam one year with a bunch of docs, saw an old friend who graduated a year ahead of me. I was psyched about my sportsmed fellowship and mentioned....."you should consider it as well for more clinical experience" (your average family medicine residency entails 3 years of training and most programs offer 1 month of orthopedic assisting in surgery or a sports medicine rotation"). His reaction was "a sprain is a sprain". I honored his opinion but thought to myself, no way am I going near his clinic with any body ache, sprain, tear or dismemberment. It's good to know first aid, RICE and how to write a note for work/school ...but......spending 4 weeks with splints/narcotics and a pending second opinion vs just 1 week with a handicap when the injury should have been rehab-ed from the start is a gia-normous waste of time!!!!! On top of that, after 2 weeks of time off the body has now deconditioned, gained a few pounds, developed constipation and drowsiness from the meds plus a little reactive depression from not being able to exercise. My job as a doc is to help compress the time frame of healing. Every case is a little different, every personality with its individual desires, every brain has its own tolerance to pain so not all treatment plans fit each person. (I scoff at hand-outs that say do this 20 repetitions 3 times a day as the sole basis of "rehab") It does make a difference to see a well trained doc for the symptoms suffered. <br />
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Obviously I cant speak enough for the specialty of primary care sports medicine. Even if you aren't an athlete, kinesiology/musculoskeletal medicine/disease pathology all play into designing the best way to get someone to optimal health. (ie....if I have an out of control diabetic who is obese, I wont just say "lose weight by starting a walking program" ... I'd get physical therapy involved, make sure his/her nutrition knowledge is maximized for her activity, then steer her toward and exercise physiologist for brainstorming a sustainable fun calorie burning activity.) True sports medicine looks deeper than just exercise injuries. So how to choose a doctor:<br />
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1-Primary care sports medicine fellowship trained (just ask the office if the doc completed a fellowship)<br />
2-Orthopedic surgery is different in that all specialist can "cut". I like sending my patients to an orthopod that has trained specifically for the region of the body involved. (ie.....one of my favorite shoulder guys is Tony Romeo from Rush/White Sox, most young grads have gone through enough knee scopes that they all know about ACL/meniscus repairs-so for the knee guy I go for the best bedside manner, hand injuries still go preferentially to hand surgeons.) A must for any of my "Pods" is good bedside manner. There used to be a magnificent hand surgeon that worked down the street when I was with CDH. His talent in the OR was famous.....so was his anger. Dude used to throw sterile instruments to the ground and have a tantrum if everything wasnt perfect. I guess thats ok if he is looking out for you but I dont use healers that hurt inside or outside the office.<br />
3-Chiropractic physicians have excellent training around Illinois so I like the ones that listen in and get the true dynamics of the patients pain. The chiros I use have turned pain/function around faster than patients going through conventional methods. Dr Joe Musolino in my office does great work, graduate from National University in Lombard. Great communicator with me and physical therapy and this is what gets people better fast-coordinated efforts between all providers. You have to research training and experience and see how they are active in the community. Just like medical schools, if the chiro school has been around for years and continues to expand curiculum, probably a good school. On the flipside, I spoke with a DC that took care profighters in MMA, he just wanted to refer patients to me for writing scripts of anabolic steroids, saying alot of docs he refers to do it for him. (obviously fell into the dark side of healing for the glory of rubbing shoulders with the rich and famous.....doesnt have to be that way-see my pics!)<br />
4-Medical Acupuncturists are powerful in their own world of healing (and have been for the last 2500 years) When combined with conventional healing, I consider bringing them in like calling a left handed pitcher to a tie game. For any injury that has plateaued or if an athlete needs to get better fast for a fight, game or match in 2 weeks-call in the needle doc! I originally studied medical acupuncture at UCLA to see if I could speed up healing while waiting for the physical therapy HMO referal to be approved. When I used it, it worked like a charm, sometime the patients would get better and not need therapy or surgery second opinion any more. Ahh...unfortunately, insurance caught on and discontinued covering acupuncture as a benefit so I had to retire my skill. (Only bring them out for special cases like in getting my pro MMA fighters to relax before a fight....see my pics!)<br />
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So if you are injured at work, in a league event, or during training; dont be embarassed to ask your provider what kind of training s/he went through. If it seems like the injury is taking longer than expected, seek out one of us (see above) and get better faster!!!! A "sprain is not just a sprain". <br />
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<img border="0" height="229" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEik8CiOPk4-Ux_hXyc6zLlCw8LOelZrAeHeqvtIPOGK5_UC4enOPzEAUwcabqPJMYvx1QvGyaWq553LCH5DKv4v1z7eAno5yjqxByJBjcH5uscH7ukw05mpuiFOOCLEWAqcRjy9iR6fwFAW/s320/sportsmed20001.jpg" width="320" /><br />
Colorado Springs Olympic Training Center<br />
<img border="0" height="229" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZ2Fr9KNBeGRMjrshZTeAmukG1RbSYf0AArfnRnU9X2rYNYmuw5ic5I7mQ2lPnEQdTOPI3nYjyMOr_W45bxO8PUGLvcpDkMt0TMIktP-uXH1IMy_-J-bDwRURia48mfj9mR8OdSo9SFkuo/s320/sportsmed60001.jpg" width="320" /><br />
Illinois Gynmastics Association Bravo Meet<br />
<img border="0" height="243" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSSkW1OK2cbHEwjAgw5Cn-Hril-LFVHtyXHzni1-evbpePbNIVUPczg5HMu9ZmjMY0inKVyZdWp6qF8KtwSEH7753wV37gDjJUefbMl-bym9UW9tuMby6bXAK0F4xRAx-ARvGDBXIIuyzv/s320/sportsmed50001.jpg" width="320" /><br />
Chris Chelios ex-Chicago Blackhawks<br />
<img border="0" height="228" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZFngLPAGw3JT7HBpoQKaQmBthrjgWijVeaSIefl5p_XW5JpQ7OAi9Arzufan5ZYyaga823N4dqueN0VoRsh-wHaRlkE-VIGwSB3QNaLCwI31LHe9JUO4xYF6VSxn8kSBPtr98SQ_ftuya/s320/sportsmed40001.jpg" width="320" /><br />
David Reid Gold Medalist 1996<br />
<img border="0" height="227" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0ElaKqOSg8rt3WySpGGywb9jskvHwIo0WWo9IhLzuvUaaifaElS5S4GmvI_O1ZUXcA2CcaepIXIBV-k2P1V9_9aj2M5-D4iZdT4saX6Qkcd1eC9sCW2ZWxxYyJ2nwzicubaFdhJkNsGjU/s320/sportsmed80001.jpg" width="320" /><br />
DonWilson martial arts 1990's<br />
<img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKtPheN9xphp31nxPVeMzyIpqiKNY0pzTLLHMF2zfUqTI1MtVp51Cv9gK7l5AT8htpRZFF4-ajB1D4rTxcg3ocP0EJCZvHYOwZSvDRL3UbYgmnc8m_T88MFwww5olNVAL-Y032kSWTV3vH/s1600/me+and+sean.PNG" /><br />
Sean Murnane Chicago Bears<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjldxvw1DN_ZqLLuWlmoyOujIvDhHMgETQvMdYTzv3zZPBCgJul8xHE-IuARu2_HVjPhyphenhyphenMxCw5IcG2UxIEcYlOfT6ZkGH6FF8B3dJmTQYOUB_uQT3CwPqZL28PkXqNU_G2zKnjeykWRzGOX/s1600/felice+and+julian.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjldxvw1DN_ZqLLuWlmoyOujIvDhHMgETQvMdYTzv3zZPBCgJul8xHE-IuARu2_HVjPhyphenhyphenMxCw5IcG2UxIEcYlOfT6ZkGH6FF8B3dJmTQYOUB_uQT3CwPqZL28PkXqNU_G2zKnjeykWRzGOX/s320/felice+and+julian.jpg" width="320" /></a><br />
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Felice Herrig Bellatore Fighter (the non athlete is Julian from B96 morning radio show jumped into the pic as he was leaving my office)</div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-5324071695562803589.post-17855236490043928302012-10-08T20:48:00.000-07:002012-10-09T18:23:48.646-07:00Yoga....ain't just for Girls!<div style="clear: both; text-align: center;">
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(<a href="http://www.chopra.com/teacher/oct11/spotlights" target="_blank">DrRic the Teacher</a>) <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR3vMQPYl8VZZ70o4uwgp7bM7_NKTAawXRewEA7SWXFC0grWeTeSedP-D-4pvSvQEIy2YuKwdNNJU70xluAoS16va2ZJd6I0OCEla7YhLIb6rW8erF_QHSEHl9bvtwjzz7OIVPdTWCVzHe/s1600/IMG_0620.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjR3vMQPYl8VZZ70o4uwgp7bM7_NKTAawXRewEA7SWXFC0grWeTeSedP-D-4pvSvQEIy2YuKwdNNJU70xluAoS16va2ZJd6I0OCEla7YhLIb6rW8erF_QHSEHl9bvtwjzz7OIVPdTWCVzHe/s200/IMG_0620.jpg" width="198" /></a></div>
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Why is it that when I advise "you should try yoga", the immediate response is, "I'm not flexible"! I did mention "consider yoga" to one of my patients drafted by the Chicago Bears and he comment, "I want to be able to do some of the things you do" ........................"when I get older" (eeyowch!...this turning 50 business sucks) Truthfully, yoga as a form of movement/exercise is one of the oldest forms of healing. The true beginning of all martial arts stems from humans trying to stretch and move "energy channels" on the body that would maximize their health. (This was before medicine and surgery....before Einstein, Newton and Aristotle) Tai Chi involves stretching things called meridia's. There's 12 that go up and down the front and back of the body that correspond to the positions you see in classic pictures of Tai Chi or Qi Gong. Although time periods apart and a continent away, yoga as well uses Indian based energy channels and moves chakras with poses you see in classic pictures ....the same ones that are now the rage with most wellness centers, healing clinics, sports teams even churches and businesses. I see practitioners trying it once and immediately professing great feelings of health and release from stress. After my first Meditative Yoga class at Northwest Community Hospital Wellness, I had been over to get my ID picture taken and a lady approached me and said she attended the class and she felt the most positive response in pain relief from her fibromyalgia in years. </div>
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So the reason I bring this up is unfortunately if you attend any yoga class, the majority of participants will be women. Some haters would say women choose yoga because they are naturally flexible so opting for an "easy" sport they can excel in is natural. Or it's a nice way to get an hour work out if you don't want to sweat. Or it's a good way for someone that isnt athletic to start learning about flexibility before they begin a real sport. ( I have actually heard these excuses from men) I politely say "you'd be surprise at what it entails. Yoga is a combination of balance, flexibility and strength. My ex-olympians from Cirque Du Soleil-La Nouba knew the value of having all three; imagine a male body builder pushing an object over head equal to his own body weight. Seems easy right? Now how about if he uses one hand; and is upside down! Regarding the sweat, well there are some students who sweat during practice, then there are some that don't push too hard-both can be in the same class, not to mention Bikram Yoga this multimillion dollar world wide chain of studios all designed to keep you focused on the instruction in a room heated to 105 (anyone remember wrestling practice?) Finally, professional athletes usually go to yoga after maximizing on their individual sport in hopes of getting an edge ahead of the competition. </div>
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From the mountain tops I say...... at 50 I have competed in body building, run marathons, climbed mountains, finished triathalons but the most rewarding (just like that lady who approached me) has been yoga. I learned the concepts and essentials of yoga from Total Body Yoga in Illinois and was taught the deeper concepts and health benefits from Deepak Chopra/The Chopra Center in Cali. Yoga grounded me to understand that practicing medicine wasnt about getting rich, it was about service to others. It helped me with all my years of practice and study get through the helplessness of not being able to do anything while my mom slowly died from a terrible cancer. As my mentor/classmate Davidji points out to me, when you feel you dont have time for yoga, it is probably the one thing you should be doing before healing the world. So as a species I say, those that are the most inflexible, the most "relaxation response-lacking", the most muscle bound, top heavy (chicken legged), the most testosterone based/adrenaline addicted individuals that think grounding has to do with electricity are the ones who need the practice of yoga the most. All a neophyte has to do is find a local studio, contact the teacher, explain your curiosity and try it. 9 times out of 10, you will feel the same benefit that a fibromyalgia sufferer had after countless years of no help and taking one class; the same benefit I experienced after seeking multiple adrenaline sports to satisfy my "man-liness" (from competitive shooting to rock climbing to racecar driving.....all pale in comparison to the lasting effects I get when I finish the last pose of the class-svasana!) The effects of yoga are truly like a drug, and when you get addicted to it, you lose addictions to food, alcohol, caffeine, TV......without taking one prescription or attending one counseling session!</div>
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I used to warm up my powerlifting routine with a few yoga poses, now I use a few powerlifting movements to warm up for a fulfilling class of yoga. I can still sharp shoot, drift a car, dyno a rock ledge and break boards............but then again, yoga tells me I dont have to. It ain't just for girls.<br />
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<em>.....how to start? Usually once a month, studios offer "community class"- to give back to the locals and entice others to come and socialize. Most places offer your first class for free as well. Call and ask about which class/instructor would be good for beginners. Ask about shower facilities if you decide to check out a lunchtime class. Be prepared to pay for renting a mat/towel (or just buy your own at walmart or target). IMHO the hottest of hot yoga is not for beginners (I began with Bikram and loved it but the intense heat scares off some of my patients that are on the fence) , especially if you take medicine for blood pressure. There are so many "classic" practices and modern hybrids that it would take forever to list. I teach a </em><a href="http://www.chopra.com/teacher/oct11/spotlights" target="_blank"><em>meditative yoga practice</em></a><em> at Northwest Community Hospital Wellness Center and I often teach meditation classes/topics at Bodhi Prem Yoga. My goal with guiding people to make lifestyle changes is always embrace sustainability. Weekly yoga practice in a studio (open class or private) is wise until you are comfortable to practice on your own. Once you get hooked, you can usually purchase memberships or a block of studio visits to cut back on price. Average "drop in fee" is 14-19$, cut that down by 3$ if you buy in bulk. Enjoy-Namaste!</em> </div>
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