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
CONSTIPATION OR FUNCTIONAL MEGACOLON
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,
Gratitude
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.
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.
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
Breakfast and Heart Disease
May 20th, 2019
If you have read any recent reporting on breakfast skipping and heart disease risk, please read on. The silliness of the modern news media latching on to a published scientific study without thinking through the reality of the published result or reading the entire study is exemplified in the recently published study linking heart disease to those people that skip breakfast.
Dr. Rong and colleagues looked at the large NHANES3 data set and looked for a link between breakfast consumption and heart disease. This is like asking, did the NHANES study population stub their toe on days when the sky was blue.
Wearables and Tracking
May 20, 2019
I am officially a fan of wearables as the tech has finally achieved a level of sophistication worthy of tracking health data. I have played with many different devices over the years and the vast majority are garbage providing bad or meaningless data. After a very short time, these devices are shown for what they are, gimmicks.
The Oura Ring, on the other hand, is a device that I am in love with. (Full disclosure - I have no financial interest in this company) The Oura Ring gives the wearer the ability to look at a level of readiness for the upcoming day based on sleep, heart rate variability and activity level the previous day. The accuracy appears to be spot on or at least the best that I have seen to date.
Flossing
May 13th 2019
Flossing has been a cornerstone of Dentistry for years, yet very few Americans floss on a daily basis. Do we really need to???
The American Dental Association recommends it primarily for cavity and gum disease prevention. The recommendation is to floss daily. Some dentists actually think that flossing is more important than brushing because it gets to the hard to reach places in between the teeth and gums that a tooth brush is ineffective at reaching. This mechanical disruption prevents plaques from building up on the tooth. These plaques are biofilms made up of bacterial colonies
Movement
May 13th 2019
I often struggle with finding the sweet spot between preaching and teaching. I don't like preaching, yet at times I feel as if these newsletters can feel preachy, especially when pointing out society's failings for health. Leading by example is important, but it is not the only way. Verbal explanation of "the why" and "the outcome" coupled with motivational interviewing works well in a face to face clinic environment. How to translate that method to the written word is a bit of a different animal. How do you ask a reader to name what they will do for health without a dialogue? How do you hold someone accountable? The answer is that we cannot. The written word can and will always only be a starting point to learn from. The rest is up to you to make and continue a change behavior.
Sleep
May 06, 2019
I have thought long and hard about the past three newsletter pieces on sleep. They really could be 20 weeks in length based on the totality of the data available. The problem with these long multi week newsletters is that they crowd out acute bites of new information. So I am trying to limit them, failing a little I suspect. Here is an alternative at least as it relates to sleep. Listen to it with the brilliant Dr. Peter Attia.
I do not think that I am overstating how powerful this sleep information is. That being said, I am HIGHLY HIGHLY HIGHLY encouraging everyone to listen to the three part series with Dr. Peter Attia and Dr. Matthew Walker on sleep.
Teenage Female Issues
May 06, 2019
When it comes to teenagers, we are often so busy messing around with behavioral issues and preparing for them to fly the coop that we forget some of the basics of aging.
For young girls, they begin to transition to womanhood through puberty and can struggle with issues related to menstruation. A few things to pay attention to at this time are related to natural physiology. Regardless of age, teenage girls starting puberty are physiologically preparing for the ability to become pregnant. This means many things to all of us with young daughters. It means that they need extra special attention paid to their macro
Sleep - Why is it so important? PART III
April 28th, 2019
Finally, the other elephant in the room related to sleep is STRESS. Stress alters the function of the hormone cortisol and can significantly alter night sleep function. There are three major chemicals that affect sleep: cortisol, adenosine and melatonin.
In normal conditions, adenosine rises during the day making you sleepy, cortisol hits its low point at night and melatonin rises as the sun goes down. This combination puts pressure on you to feel sleepy and want to go to bed. Unfortunately, modern life has made many of us feel stressed and sympathetically fired up which affects cortisol function.
Asthma, Allergies and Nutrition - The Story Part XI
April 29th, 2019
LAST THOUGHTS
Now that we have thoroughly explored nutrition and asthma in humans, what other adjunctive therapies can be leveraged for better outcomes?
Simply put, think of asthma or allergies symptoms as a glass of water overflowing. If the cup overflows, then you have disease symptoms like sneeze, congestion, itchy eyes, wheeze, shortness of breath, cough and so on. Therefore, it would make sense that we reduce the volume of water in the cup to reduce the disease burden. This helps to rebalance the immune response.
Perfect High School Experience
April 22, 2019
After thinking long and hard about the above data and other high school ponderings, what would the ideal high school experience look like.
Teenagers would attend a school that starts at 9:30 am after they have presumably had a nice long night of memory consolidating sleep. They would learn the classics of art, literature, math and science with a wide open and skeptical pedagogy. Teaching to the test would be abolished. Thank God. Thinking outside of the box is praised.
Lunch and snacks would be provided and be wholly nutritious including fresh fruits and vegetables, locally sourced meats and no sugary beverages would be seen.
The air would be circulated twice daily with fresh air to enhance learning.
Sleep - Why is it so important? PART II
April 22, 2019
Let us pause here! So far we now know that humans at all ages will suffer from memory dysfunction and brain sewage cleanup problems leading to inflammation and damage long term. What ages are most at risk? They are likely mirrored by other physiologic events that are at risk based on age. Teenagers, infants and toddlers are rapidly growing creatures requiring more macro/micronutrients, water, and toxin avoidance for success. It is likely that sleep follows these same principles.
Going to a simple google scholar search for "sleep deprivation age risk" brings up countless articles on the effects of sleep deprivation
Asthma, Allergies and Nutrition - The Story Part X
April 22, 2019
THE NUTRITIONAL STUDIES
THE CASE
Case presentation: DM is a 12 yo caucasian male who presented to integrative pediatric clinic for the first time at age 8 years with the chief complaint of moderate persistent asthma and allergic rhinitis. His past medical history relates one to three severe asthmatic flairs per winter requiring steroids and overnight hospital stays over the past few years.
Sleep - Why is it so important? PART I
April 15th, 2019
Sleep has always been a necessary function of everyday life for all mammals. From an evolutionary perspective this cannot be a mistake as during the period of sleep you are vulnerable to predation. Therefore, there has to be a really good reason for mammals to sleep for extended hours. What is that reason? Why are toddlers and frankly all of us more cranky when we do not sleep enough?
Dr. Peter Attia and Dr. Matthew Walker's recent podcast on Drive was the impetus for this newsletter. They deeply dove into the deep end of the sleep pool and answered a host of questions
Asthma, Allergies and Nutrition - The Story Part IX
April 15th, 2019
THE NUTRITIONAL STUDIESTHE DO Omega 3 and 6 Fatty Acids
Fish oil, flax oil, wild caught fish, kelp, grass fed meats are all the rage now for health conscious consumers. There is good reason for this shift in consumerism. These foods are all loaded with health promoting omega three fats. On the other hand, seed and vegetable oils are the major source of omega six fatty acids. Omega three and six fatty acids are a type of fat called polyunsaturated fatty acid(PUFA)
Center for the Environment Lecture
April 8th, 2019
Physicist Amory Lovins, who is called one of the Western world's most influential energy thinkers, will speak at Keppel Auditorium on the Catawba College campus on Wednesday, April 17, at 6:30 p.m.
Lovins, chief scientist and chairman emeritus of the Rocky Mountain Institute, will speak on "Transforming the Energy named him one of the 100 top global thinkers.
According to Lovins "most of the energy we use is wasted. Smarter technologies and designs that use energy more efficiently could provide the same or better services with far less energy, money, and risk.
2000 Days for Mom and Baby ITS TIME TO EAT!
April 8th, 2019
We now know that immune tolerance is critical to developing a balanced immune response to food proteins and thus maintaining a non allergic phenotype. Knowing this to be true, what is the ideal time to start eating real food as an adjunct to breastfeeding?
For years, pediatricians told parents to wait until after 1 year to start with the major allergenic proteins like eggs, peanut or shellfish. We also, wrongly, told parents to start with pure sugar as rice cereal at 4 months of age! Boy were we wrong!