Summer Health

 May 20th, 2019

Here are a few retread articles on summer health as you prepare for the wonderful fun that comes with trips to the beach and lake.

Summer Article #1
Summer Article #2

Love the beach,
Dr. M

Ticks and other Critters

May 27, 2019

 It is TICK time!

We have had a huge uptick in cases of tick exposure and potential infections over the past few weeks. Every spring and summer, many children present to our clinic with tick bites and other insect issues. While most bites are benign, some are not. We all should choose to be aware of the realities and risks of tick exposure to make good decisions regarding medical care needs.

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May 30, 2019

         After 20 years of private pediatric practice and 8 1/2 years of writing this newsletter, I want to take this moment to express my gratitude for all of you great parents and readers of this content. You take time out of your busy days to read and learn when you do not have to. I appreciate that!

I was at an important NC state medicaid meeting this weekend and was pleasantly surprised by the comments from folks around the state about this newsletter.

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June 3, 2019

A major problem in modern America is constipation. I have avoided this topic for far too long because I assumed that it was well understood. Alas, I am finding that it is not. So here goes the story of the gastrointestinal bowel movement in all its glory.

Unfortunately, more and more people are constipated than ever before as sedentary behavior, low fiber refined diets and food sensitivities drive colonic dysfunction, for example, irritable bowel syndrome. Never does a day pass by in clinic that this conversation is missed. For the purposes of this article,

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You Can Heal

 June 3, 2019

"I believe in your capacity to heal", says the fabulous educator Dr. David Rakel at a recent Institute for Functional Medicine conference on healing chronic pain and addiction. If we as a culture want to see our healthcare system change for the better, we need to start increasing the art and positive healing side of medicine. It cannot be a system that only supports the science of dysfunction and healing through pharmaceuticals without lifestyle and stress change. Rather it should be a system that looks to empower the human mind to aid the healing process. For years, I have been discussing the fact that

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June 17, 2019


The Environmental Working Group has released their annual sun screen analysis for toxicity. It could not come at a better time. We are living with a governmental industrial complex that does not take into account the risks of chemical exposure to the average human, nor the at risk child. Creams and lotions are a high risk vehicle as the absorptive capacity is high in humans and very high in infants and children.

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Being Uncomfortable

June 17th 2019

Being uncomfortable. While I was listening to lectures on stress and human vitality in San Antonio, I decided to put these thoughts in print.

To be uncomfortable in many ways has been a benefit to human longevity and vitality. For centuries, humans had to endure temperature change daily, food scarcity and seasonality, hard beds, animal and microbial exposure and much more. Fast forward to the last 50 years and we see many in our country enjoying euthermic environments in our cars (idling in parking lots for an hour at soccer practice - pet peeve) and homes, constant access to high calorie nutrient poor food, over clean environments and total home comfort where you can sit on a luxurious couch for 10 hours binge watching your favorite Netflix show.

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TBI and Fish Oil

June 24, 2019


Post-traumatic stress disorder and traumatic brain injury, TBI, are real problems in modern America. The driving force behind TBI is some physically traumatic event that rattles the brain producing a significant inflammatory response that does not resolve appropriately leaving the sufferer with subacute or chronic negative symptoms .

There is a significant body of research looking at the effects of omega three fatty acids on the brain in relation to inflammation.

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Choking Reboot

June 24th, 2019

Choking is a common and scary event that plays out in the homes of some parents of infants and toddlers. Counseling young parents on effective parenting around eating and play time can really help reduce the risk of such events.

"Choking can be prevented. Food accounts for over 50% of choking episodes. Be alert for small objects that can cause choking, such as coins, buttons, and small toys. Check under furniture and between cushions for small items that children could find and put in their mouths.

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Letting Go and Chores

July 1, 2019

One of the hardest things to do in life is to let go and let your children figure it out. I have been and am currently knee deep into experiencing this reality daily as my teenagers explore the modern world. After reading an excellent article in the New York Times Magazine by Heather Havrilesky, I decided to write about parenting, chores and letting go.

Where did it all go? The letting children learn and fail parenting style that is. The giving them chores because they are a part of the family team. The telling them that I love you and this is part of growing up.

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Devices and Neck Concerns

July 1, 2019

What has been a concern of mine since the beginning of the smart phone era may be coming true. In the past, we have focused on myopia/nearsightedness caused by the continual viewing of a device or a book close up (AOA link). That has been coming to fruition unfortunately for the past decade.

Now we see a report from Dr. Shahar and colleague regarding potential neck damage from the chronic user's downward gaze on a tablet or smart phone. Published in Nature Scientific Reports in 2018, the authors have noted an increase in "exostosis" developing on the base of studied patient's skulls.

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July 8, 2019

Every-time a new way of practicing comes to life in medicine, we have to question what is the reason behind the change. This is no different for telemedicine and urgent care. Both of these new modalities are springing up in increasing numbers in the medical world in order to meet the new driver of medical changes, convenience.

Medical consumers are now demanding convenience of time and location of their healthcare experience. On first blush, this is not a bad idea.

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Sleep Part IIII

 July 8th, 2019

Continuing the sleep education from a few weeks ago.

Sleep is a most special event that we all need to continue to focus heavily on in order to live a healthy and long life. It may be the single most important event that we do daily.

Here are a few more quick hits on sleep from the Matthew Walker/Peter Attia podcast AMA #6. The following is adapted or directly quoted from Dr. Attia's show notes.

1) Our bodies need to drop 3-4 degrees F before we can comfortably fall asleep. This can be induced by cooling the room down between 65-70 degrees.

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Fast Food Experiment

 July 8th, 2019

I was contemplating the reality that maggots and mold will not attack American processed burgers, but they loved the organic version. Are these rudimentary creatures truly smarter than humans? We eat these poisons willingly. Our FDA says that these chemicals are safe. What are we missing here?

If worms and mold are deterred by these chemicals, why are we not? Do they have sensory mechanisms in place that are capable of recognizing danger better than we can? The answer is that we don't know.

I fall back to the same simple explanations on life. If nature is against it, I think that I should be as well.

Dr. M

Science Time

July 15, 2019

Overeating and excessive glucose/sugar in your blood has always been known to be a negative event. What is really happening at the cell level? I am in the midst of a deep dive into the world of immunology and nutrition and decided it was time to share some cutting edge data. This will be science heavy. Skip to the end if you just want the take home point!

Science Time:

AMP-activated protein kinase (AMPK) is an enzyme that plays a key role as a master regulator of cellular energy balance. AMPK is turned on in response to stresses that deplete cellular ATP energy supplies such as:

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Substance Use

JUly 15th, 2019

Substance Use Disorder versus Substance Abuser

Why do we demonize people with addictions? Because we hate what they represent? Because we are afraid of them?

There are many reasons that we stigmatize substance users. What we need to do is look at the issue in modern terms.

At a conference in San Antonio on substance use and treatment, Dr. John Kelly discussed the reality that when people abuse food, we do not call them food abusers. They have an eating disorder of too much or too little. All abuse issues are problems of psychology and epigenetics based on life experiences that have occurred to shape one's psyche predisposing them to self-medication with drugs, alcohol or other substance to numb the psychological pain. We are very clear that substance abuse is not a choice for most people.

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Acute Flaccid Myelitis, AFM

July 22, 2019


AFM is a post viral disorder that presents with weakness and progresses to paralysis in ill patients. It became a distinct disease entity in 2014. Ill patients initially have a benign fever associated with a respiratory viral illness.

"Acute flaccid myelitis (AFM) was initially defined as a distinct entity in 2014 following reports of the occurrence of acute limb weakness in previously healthy children across the United States during an outbreak

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Couch Potatoes

 July 22, 2019

Sedentary behavior has been known to be a risk factor for diseases of the body and mind. A study from the Journal of Research in Personality by Dr. Yannick Stephan and colleagues looked at the chronicity of the couch potato phenotype over time. They wanted to see whether these sedentary behaviors had any lasting effects on personality and other patterned behavior.

The original data sets were from two large studies, the Wisconsin Longitudinal Study and the Midlife in the United States Study that began in the 1990's.

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The 90/10 Rule

July 29, 2019


When you have written as many articles as I have about health as it relates to nutrition and lifestyle, you start to get labeled as an all or nothing person. There is some mild truth to it, however, nothing is ever 100%. I cannot remember the last time that I discussed this topic so here we go.

When I show up in a grocery store and someone recognizes me, they always do two things:

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Sugary Beverages

July 29th, 2019

Dr. Chazelas and colleagues looked at the association between sugar laden beverage consumption and all cause cancer risk in a study published in the British Medical Journal this past May.

"101,257 participants aged 18 and over from the French NutriNet-Santé cohort (2009-2017) were included. Consumptions of sugary drinks and artificially sweetened beverages were assessed by using repeated 24 hour dietary records, which were designed to register participants' usual consumption for 3,300 different food and beverage items."

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