Category Archives: Uncategorized

What to do about aches and pains

Posted on August 2, 2024 | Leave a comment

I’m a physician. Naturally, I want to heal those aches and pains. But let me clarify, that doesn’t mean I want to bury the pain so that you don’t feel it. It doesn’t mean I want to rush you out the door with a quick solution that doesn’t get to the bottom of WHY you are experiencing aches and pains. Pills, patches, cutting or stimulating nerves are not what I am talking about.

Anybody who has experienced any ache or pain, understands that there are different kinds of discomfort and even more reasons for the aches and pains. Whether it’s a paper cut, a fall off the jungle gym, an unexpected fall due to uneven ground, being wounded by another intentionally or in an accident, having a disease that causes painful lesions, or a surgery for treatment, experiencing a breakup or loss of a loved one, or experiencing painful emotions elicited by social media or the news, pain is meant to stop someone in their tracks and to notice it. In other words, it’s meant to be a massive distraction.

Patients often tell me that they have a high or low pain tolerance. Some people describe pain with suffering and some describe pain as a matter of fact “thing” in their life. For many, emotional or spiritual pain is more “painful” than the physical pain of a wound or disease process. As a physician, my purpose is to help you heal, and that always begins with understanding.

First, know that pain is a signal that something is “off” and that you need to shift some focus and energy to whatever it is that’s “off.” Your body is screaming for attention and pain is intended to immediately get your attention and to get you to respond to reduce pain, presumably to protect you. Pain is necessary. People who don’t feel pain, are at risk of dangerous infections, unnecessary wounds and even otherwise preventable death.

Pain has a physiological part and a mental part. It’s how the mental part understands and frames the pain that it can lead to suffering, or it can “numb” the pain or make it more “bearable.” Some people can use self-hypnosis to not feel pain. Others are told their wounds have healed or they may be missing a limb, but they still feel pain. What’s that about?

I don’t have the answers, but I do remember a time when I was a small child feeling awful with a high fever, headache and aching all over. I was scared, felt like there was something terribly wrong, that it would be forever. While I was suffering, my dad talked to me while caressing my forehead. He calmly explained that my body was raising the temperature to kill of the bad bugs that were making me sick. He appealed to my logic that this passes faster if I rest, drink fluids and let my body fight the infection. He reframed my entire experience and reassured me that my body was working so well, and he used the Japanese word, “gaman.” This word means patience and in this case, in a “suck it up” sort of way.

That mental reframing and confidence that my body was doing what it was supposed to do, that it was working to protect me and getting stronger, removed the suffering so I could sit in the aches and pains and practice gaman (patience). I recovered and learned how amazing the human body truly is. I learned I can practice gaman and I felt more competent and more courageous in taking on the next challenge as I was on the journey to learning how to trust my body to take care of me.

I don’t have the answers about how to deal with aches and pains and I may not be able to eliminate all suffering. I do believe the human body is designed to heal, repair and thrive and aches and pains are the body’s way of signaling to us. I don’t believe we need to suffer as much as we do. I do believe that we can build practices like gaman and use reframing to reduce the unnecessarily high level of suffering that often accompanies aches and pains and even disappointments. Working with my patients and those who seek my help, I get to watch this confidence and freedom that emerges as these skills and the practice gets established. If more of us can learn these skills and pass them on to our children and grandchildren, we may reduce suffering and allow more space for peace and joy.

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How to use tracking to design your personal weight loss plan, based on 1000’s of successful patients’ experiences.

Posted on July 27, 2024 | Leave a comment
  1. Find a tracking method that you will use– that is most likely the simplest. You can use an app, your smartphone camera, a computer spreadsheet, a notebook or scrap paper. You can change it in the future, so don’t worry if you choose to just write it down on paper.
  2. What should you track? When starting out, track the times that you eat or drink anything, even if it is a sip or just a lick to taste something. Include the tic tacs too. This gives an idea about the signaling patterns your body is used to right now. Also, next to the times, you should track what it is that you eat or drink.
    • Including the date and day of the week is useful because it may help you identify patterns in the future.
    • Including location is also helpful if you travel or have some days eating at home and some at school or work because that clarifies where the biggest challenges will be.
    • Quantities are less important, you don’t need those just yet.
  3. What do you do with the information? Track for at least 3 days and then review your data. See how you did by answering the questions below. You can see the goals for each of these to compare where you are.
    • What is the longest time you go without eating or drinking anything other than water, black coffee or unsweet tea? That’s your fasting window.
      • Your goal: Fasting window of 12 or more hours on most days. If not, you may want to work up to 12 hours.
    • What time you first start eating or drinking any calories or sweetened beverages and when you last have any calories or sweetened beverages? That’s your eating window.
      • Your goal: Eating window of less than 12 hours out of 24 hours. Contain your eating in 12 or less hours per day.
    • Count the number of times you consume sugar in each day, even if it is only a small amount. Notice the first time in the day that you consume sugar on most days. The earlier in the day you have sugar, the less time you get to be in fat burning mode because the sugar turns off fat burning for most people, unless regularly working out or active.
      • Your goal: Get the sugar consumption frequency as close to zero as possible so your body can burn fat, create more energy and your liver is protected. Also, if you are going to have anything with sugar, postpone it so you get the longest time of fat burning before you turn it off.
    • Make sure you are getting enough* protein most days to maintain optimal health including muscle, hormones and immune system. There are many kinds of protein (eggs, yogurt, cottage cheese, soy products like tofu and tempeh, seafood, poultry like chicken and turkey, pork, beef, lamb, legumes like chick peas, lentils, and black beans, etc.). Everyone has their favorites. That’s fine.
      • Your goal: *Get 3-4 servings of proteins per day. If you are working out, older age, frail or vegan, aim for 4 servings of protein. Otherwise, you may be fine with 3 servings. You probably want to include protein every time you eat. Hint: One serving for you is about the size of your palm – think hands without fingers or thumb.
    • Look for the times you drink your calories. IF you are working to lose weight, it is best not to drink your calories unless it is a savory soup or broth. That includes sweet creamers in coffee, sweet tea, smoothies, juice, soda, alcohol.
      • Your goal: Limit the number of times in a week you drink your calories unless it is bone broth or other savory soup. Drink enough water so that your urine is mostly clear or a pale yellow and you have to go roughly every 3-4 hours while awake. Unsweet sparkling and flavored waters, unsweet tea and coffee are also fine. Try herbs, berries, lemon or lime or cucumbers in your water. A pinch of salt is fine too.
    • Make sure you get some fermented foods to feed your gut microbiome. Eating some of these foods daily may help your digestive system, your immune system and even your mental health.
      • Your goal: Consider adding fermented food like kefir, yogurt, pickles and fermented vegetables, kimchi, olives, miso, tempeh, sauerkraut, etc. to your diet on most days. You may find some favorites at your local grocery store or farmer’s market or find a subscription service like this one (I have no relationship with this company other than I order from them).
    • Check to confirm you have enough plant diversity in your diet so your gut is healthy and happy with soluble and insoluble fibers and so that you get all the vitamins and minerals you need.
      • Your goal: A minimum of 2 handfuls of leafy greens PLUS at least 1 handful of another vegetable daily. You can eat them any way.
    • Make sure your food log include omegas 3’s in your diet as a supplement or as food. There is evidence supporting their use for heart health, enhancing and improving mental health and cognition, helping wounds heal, reducing inflammation and supporting joints and even prenatal development.
      • Your goal: if you are eating fish like wild salmon (NOT farmed or Atlantic salmon), mackerel, sardines, herring, then you should be fine with 1-2 times weekly “doses.” If you are supplementing or getting a plant-based source like in chia, flax or hemp seeds and algae oil, best to take daily.
  4. Now you get to take make the tweaks necessary to optimize your nutrition to support your body’s best health and the weight follows as a side effect of getting metabolically healthier. With this new knowledge, continue to track and learn your patterns and where you have the greatest challenges. You can use your tracking data and work to achieve the goals listed for each item above. Rather than working on all of them at once, simplify it for easier and faster mastery by focusing on only one at a time starting at the top.
  5. Share your journey with a friend or group. When you have others to talk about your experiences, share recipes and favorite products and you cheer each other on, it’s super fun and a great way to bring people together around common goals no matter what else is going on in your life. Nutrition is one area you get to be in control most of the time and it directly impacts all the other things in life. Watch the weight respond over time, naturally. Watch the ripple effect. When your body feels great, you have the energy and confidence to live a fuller life! Enjoy and drop me a line.

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Posted in Habits & Behavior Change, Metabolism, nutrition, performance, Uncategorized

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Launching to have the best year yet – 5 Steps on How to Move Onward. What I learned from 10’s of thousands of amazing People.

Posted on December 9, 2023 | Leave a comment

As we prepare to close out this year and begin a new year, there are opportunities to level up as individuals and collectively as a community. In my experience as a physician, there are 5 steps to being the process of personal growth and leveling up and they can be accelerated by being deliberate in designing that process. If you have a coach or other person who can guide you, then you won’t need this. Otherwise, here are some tips from working with tens thousands of people from all walks of life and at different ages, and seeing the impact across generations of people.

Get Present, Reflect, Integrate & Let Go

  1. Prep for You-Time. Schedule protected (“uninterrupt-able”) time with yourself. Signal to yourself that you are present for you. Create a ritual to get present.
    • Belly Breath: Physiological signal to self (tell your cells it’s You-time): take a deep breath, letting your belly rise as you breath in through your nose. As you breathe out, let your stomach deflate and give yourself permission to protect time for you right now.
      • Use music, scents, lighting or movement if that helps.
      • Hint: Turn off notifications from digital devices so you can prioritize and focus on You.
    • Brain Dump: Mental signal to self (give your mind permission to relax and shift focus to now): Clear the mind clutter. Start with a Brain Dump of what’s on your mind now. Write down what’s on your mind. Mark the really important items that you definitely need to return to so they are easier to find again.
      • *Mark the really important items that you definitely need to return to so they are easier to find again.
      • Hint: Paper is more effective than a screen.
  2. Download and unload mind memories.
    • 2023 Year in Review: Make a list or a summary of your past year events and/or experiences, maybe even a list of people that impacted you. Label it with the year you are reviewing, “2023 Year In Review.”
      • Scan through your calendar, photos, emails, journal, or whatever helps you remember your last year and pull out key memories.
      • Next to each item, put a brief word, image, or one-liner if it helps you better connect with the significance of it.
  3. Organize the information.
    • Ongoing: Scan through your list and highlight or pull out the things that you have not processed, that are not complete, that you need to return to or add to.
      • Put those “incomplete” items on the current Brain Dump list (#1 from above) or start a new Ongoing list.
      • You might add the important items from the Brain Dump (#2 from above) to the Ongoing list that keeps those items in your forebrain so you will remember to think about them at the appropriate time in the future.
    • Pearls of Wisdom: Collect and Integrate. Review the remaining items and identify key learnings or things that you want to remember and integrate.
      • These items are your own personal Pearls of Wisdom, a part of your personal growth journey. Put them into a journal or place you can return to.
      • They are useful to collect over time. You can review these Pearls of Wisdom at any time and routinely every year!
  4. Release or reframe.
    • Release: Let go of whatever negative emotions, feelings, or thoughts that no longer serve you. If you have processed and learned what you need from a difficult experience, collect whatever Pearl of Wisdom you need from it and then Let The Rest Go.
    • Reframe: Or find a way to reframe the memory in order to see things from a perspective that helps you, empowers you, lets you learn and build.
      • It may help to have a mantra to repeat as you identify what no longer serves you and you work to let it go. Note: It gets easier with practice. Use the mantra.
      • A sample mantra or make your own. “I have a new Pearl of Wisdom as I have learned what I need from [this]. I can now let it go. Carrying [the negative emotions, feelings or thoughts] no longer services me. I am ready to move forward. I can do this. I am letting it go.” Note: Repetition works wonders.
  5. Let it rest. Read over what you have written and then allow your subconscious mind to percolate on it. Over the next weeks, add to it, replace it, doodle on it, decorate it, look at it this week. Let your subconscious mind work on it. You will be ready for what comes next.

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For All the Parents with School Aged Children (in September of 2020)…

Posted on September 6, 2020 | Leave a comment

As a previous at-home Mom of 2 boys, who then matriculated into medical school and residency with children, and found it was easier than being at home full time, I am beyond impressed with all of the parents who work full or part time and are an at-home parent and teacher, simultaneously. At least super hero’s don’t have to do laundry, housekeeping, grocery shopping, cooking, or feeding other people. They usually get some extra superpowers to support their activities and they often have cool ways to get around and they can travel freely. So if you are working from home with school aged children, you can be awed by how absolutely amazing you are and remind yourself constantly, that you are even more incredible than a super hero.

Let me share with you some tips and tricks that may be helpful in these times.

  1. Structured routines help everyone. Routines will be different depending on the developmental age of the child(ren) at home. The younger the child, the more structured routines are better. For example,a regular wake up time, followed by a morning routine that may include looking at the calendar and seeing what everyone will be doing, what can be expected and when all the “break” or “recess” or “free” times will be. Some physical activities or play time like a 15 minute walk/run, jumping jacks, dancing and singing along to a favorite song, or youtube kids yoga session followed by 5 minutes of meditation can help set the mindset for a focused day. For an older child or adolescent, it may be easier to sit together and help understand the goals for the day and find ways to check in with lots of smiles and eye contact intermittently throughout the day with some regularity, whatever that is.
  2. Integrate physical activity spurts throughout the day to burn off energy and stress and also, to optimize brain function. Studies have shown that exercise or gym class scheduled before the most challenging classes or for students who struggle in school, result in less suspension, better academic achievement and improved overall function. Help your child of any age, integrate physical activity throughout their day. When a young child is losing interest or focus, create a safe physical activity option and have them log it (ie. put a sticker in a calendar for each activity or add a check mark). Using gaming theory, consider “leveling up” after a pre-determined number of successes. For some children and adolescents, setting a plan to walk together daily and decompress together by sharing the day’s events, is a wonderful way to establish healthy routines of staying connected despite trying times.
  3. Create the environment to allow the best chance for the outcome you want. It’s no mistake that there is a Lego corner, an art corner and an eating space, a library and a science room. The expectations are different in each space, and at various times, they get changed out to create novelty. If you can be creative about setting up your space to promote the behaviors you want and make it clear to your child(ren) what their options are in those spaces, then they can use location as a way to choose to shift their mindset and get “in the zone.” These skills are useful for all of us. One thought, establish that the space you are working in, when the computer is on, it’s like the library and that means it’s quiet in this space. Then every break you get, a quick hug, smile or appreciation or expression of love, will refill your child’s tank, and they will get really good at being mindful and your best work buddy.
  4. End of day celebration, recap, and reflections. When the school or workday is complete, mark the transition with a celebration. This may be as simple as jumping up with arms in the air and shouting, “I DID IT!” and even add in some fist pumps. At some point of each day, take time to reflect back on the day and openly talk about the experiences and feelings during the day. Help your child learn how to share their experiences and feelings, to learn from their experiences and also how to have self compassion when things didn’t turn out the way they had wanted or they had a rough day. Be open to hearing the strong negative feelings and help them learn safe and health promoting ways to cope. Rather than isolation, being destructive or lashing out to others, how about journaling, drawing, meditating, singing, making music, listening to music, dancing, throwing, hitting or kicking a ball, swimming, working in the yard or going for a run or bike ride.
  5. While establishing routines and creating structured environments are helpful, remember to include as much opportunity for fun. By maximizing choices and/or novelty wherever possible, children can have fun. By setting clear expectations and an environment for success, children get to experience both fun, a sense of belonging and the pride of accomplishment. Again, think of what makes games popular. They have do-overs, restarts as well as rewards and leveling up. While nobody is perfect, humans can learn quickly. It helps to practice reflecting and being compassionate with yourself. Let children be children. We all make mistakes and we can all learn from them. Let your child level up their skills and be rewarded with the most important thing – your smile, your genuine love, approval and acceptance of them exactly as the wonderful person that they are.

It may be messy, it is not easy and it is also part of this time in our lives. Do the best that you can. Appreciate and celebrate any and all the positives. Stay connected. We evolve together.

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Healthier Together Series: 7B. Physical Activity – Stimulus to Change

Posted on August 3, 2019 | Leave a comment

robert-collins-tvc5imO5pXk-unsplashWe are always changing. This can be a good thing or a bad thing, depending on many factors, some of which are in our control and some of which are not in our control. The best part — We Are Designed to Thrive! Provide your body the right environment, and your body can heal, regenerate, and thrive. This is reassuring.

Throughout the Healthier Together Series, we continue to share the ways in which we can help create the right environment for your body to thrive.

Nutrition provides your body with the “supplies” to create new cells and to do what it needs to do. Depending on the nutrition you provide, you will have healthier or less healthy cells and you will have better or worse function of those cells in your body. So we can make choices about our nutrition.

Physical activity, is the way we signal to the body that we need to be alive and that we need to “change” or adapt to be able to thrive. It is actually the stimulus for change. In fact, if you decrease your physical activity enough, your body starts to decay. This leads to rapid aging and decline in function. The good news – it doesn’t have to be that way and you can turn it around. Even if your body is not in its best state right now, or you feel unwell, or you have chronic health concerns, or if you are in good shape and want to continue to be well and maintain your independence and freedom as long as possible, over the long term, by moving your body, you stimulate your body to continue to “change” to stay functionally “young.”

When you make choices to power your body with the essential nutrients – like water, proteins, fats, minerals and vitamins (vegetables), you provide it with everything it needs to repair itself the best it can. Then, when you make the choice to move your body, regularly, in health-promoting ways, you stimulate your body to heal, regenerate and thrive. Your body can and does the work to “get better.” Physical activity is one of the areas that is in your control and can be a powerful stimulus for your body to heal, regenerate and thrive. The choice is yours. For me, I’m heading out with family for the evening walk around the neighborhood to connect and provide that stimulus for change. =)

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5 Exercises to Maintain Fitness While Traveling

Posted on July 9, 2019 | Leave a comment

Side View Photo of Woman Doing Lunges Against Black BackgroundIf you travel frequently and your workout schedule gets thrown off, let me share with you 5 moves you can focus on to help you stay fit while traveling. Of course, there are great apps that you can use, and the famous 7 minute workout, but if you like another option to keep it simple, here’s the 5 main moves.

To increase resistance, if there is no gym, pack some resistance bands or use your body weight. Do these movements slowly to really engage the maximum muscle fibers.

  1. Sun Salutations: 90 seconds for each sequence. You can download a sequence online.
  2. 2 x PUSH: Push up, Push forward (90 seconds each, learn the proper position of your hands and wrists first. A personal trainer can show you how.)
  3. 2 x PULL: Pull down, Pull in (90 seconds each, learn the proper position of your hands and wrists first. A personal trainer can show you how.)
  4. LEGS: Squats and/or Lunges (90 seconds each, learn the proper form first. A personal trainer can show you how.)
  5. Photo of Woman Doing YogaCORE: crunches and/or plank pose (90 seconds each)

To really keep your body in a good place, avoid sitting as much as possible. If you have to sit for long periods of time, plan to get up at least every hour to help circulate your blood and stimulate your muscles. If possible, stand instead of sitting, and make sure you walk as much as possible. Every time you move your body, you signal to your body that you have to heal and recover. This is much better than the alternative, signalling that it is ok to decay. Keep moving as much as possible.

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How Can I just “DO IT”? (Part 2)

Posted on October 3, 2013 | Leave a comment

Earlier, we reviewed BRAIN ENERGY. Today, we move onto the next concept.

Concept #2. Resilience.

Brain energy is directly linked to resilience. Resilience is your defense against things that derail you. It protects your supply of brain energy, it’s your reserve. It can be more specific to events and can include behavioral patterns you develop in response to negative influences. Resilience protects you from giving up your plans, your goals. It helps keep you moving forward.

If brain energy is the gas in your car, resilience is the size of the gas tank. The larger the tank, the more gas it holds, or the more driving possible between fill ups. Even if you end up getting lost, you will have enough gas until you reach your destination. The more resilience you have, the more you can accomplish in a period of time even when you have detours.

Good news! You can learn to increase your resilience so that you are more resilient to change and transitions…which will be topic of the next blog.

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Welcome!

Posted on June 16, 2013 | Leave a comment

This blog brings together the most ancient medical and health concepts with the most recent research and knowledge. I am excited to share ways in which we can be healthy. While I am trained, licensed and practice in Western Medicine, I believe that health is more than the absence of illness. In fact, your body is designed to thrive. We can add the perspectives of traditional Chinese Medicine and more recent research in fitness and nutrition to help our patients pursue their healthiest lifestyles.

While there is a place for standard Western protocols in medical treatment, we can also incorporate more organic, natural healing techniques to address physical, mental and emotional dysfunction. As a physician, when I evaluate a person as an integrated whole human being, I have at hand a broad variety of interventions to address that individual person’s imbalance. In Western Medicine, we re-actively respond mostly to symptoms and focus on decreasing or eliminating the immediate complaint(s); in traditional Chinese Medicine, we focus mostly on the causes, facilitating balance and harmony within the body to allow healing to happen. We can benefit from integrating both modern knowledge and traditional wisdom.

Currently, in my practice, I am finding that my more than 30 years of experience studying weight management, fitness and nutrition gives me an additional perspective that has proven to be very helpful to my patients. A significant portion of my practice is made up of people who have been referred to me specifically for performance and weight management. I am seeing that through education and helping thousands of people understand and manage their health, many other areas of their lives improve. Sharing this journey together, my patients continue to teach and inspire me. I am hoping that with this blog, I can share some of what I am learning in my ongoing studies and in my practice.

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