Oura Ring experience

Since I am often trying new products, supplements, self experimentation type things, I thought it would be fun to write some reviews of my experience. None of this is medical advice, just sharing information for your education.

My first topic is the Oura ring. I was a fairly early adopter on this one. I either read about it or listened to a podcast about it before it was available to buy and got on the preorder list. I think that was back in 2018?  It appealed to me because I have had chronic sleep issues and I wanted to gather more data about what my body was doing to maybe make some changes that would improve my sleep quality and quantity. I liked the idea of the ring rather than a watch or other device because it is comfortable to wear 24/7, except for the time it has to charge. It is waterproof so I never take it off when I wash my hands. It can be worn in the shower, but I choose not to. And it is sturdy but light weight and attractive. 

The sensors are seen on the inside of the ring and should be on the palm side of your finger

From the ouraring.com website: “Oura combines advanced sensor technology and a minimal design with an easy-to-use mobile app to deliver precise, personalized health insights straight from the most reliable source: your body.”  The sensors on the inside of the ring measure your pulse from the arteries in your finger. The infrared sensors use photoplethysmography to reach deeper into your tissues than green light LEDs in other wearables. It also measures your temperature directly from your skin. 

The ring gives three scores: readiness, sleep and activity. During the day, it captures activity and movement. During sleep it captures body temperature, sleep stages, respiratory rate and resting heart rate as well as heart rate variability. I don’t always wear it during the day, but it is recommended to wear it 24/7 to monitor daytime activity. I find I am mostly looking for my sleep data. I charge it in the morning but not everyday. It can usually last 2-3 days before needing a charge and charges pretty quickly once it is placed on the charger. The website says battery life is 7 days, so maybe that’s for the newer version. I didn’t realize that the sensors should be on the palm side of my finger! So much for reading the directions! 

Because the ring measures your body temperature, it can alert you to early signs of illness, possibly before you start feeling bad symptomatically. You can create “tags” to help you evaluate which habits contribute to poor sleep or which ones add quality to your sleep. For example, say you want to see if drinking a glass of wine after dinner changes the quality or quantity of your sleep. Then you create a tag each night you drink wine and compare it to the nights your don’t drink. Or you can tag taking a hot bath before bed or drinking coffee late in the day, etc. It’s hard to notice trends if you don’t keep track of those behaviors.

I tend to fall asleep fairly easily, mostly, but then wake up at 3 or 4 am and struggle to get back to sleep. When I look at my sleep stages, I cycle in and out of deep sleep early in the night and I generally get a good amount of deep sleep. That is a good thing because it helps my brain clear out toxic stuff while I sleep. But if I wake too early, then I miss out on REM sleep, which is also important for brain health. I’ve included a few pictures of the data from the app to show the kind of data that is collected and reported. I don’t understand all the details of the report, but I still find it helpful. 

This was a good night- both REM and deep sleep were in optimal range.

Not as good sleep. REM not optimal, total sleep was only 5 hours

What if I wake up refreshed and subjectively feel like I slept well, but the app disagrees? I go with how I feel. There is a tendency to allow yourself to feel sleep anxiety when your app says your deep sleep or REM sleep was not optimal. And sometimes it is hard to know what will help increase the quantity of those stages. I’ve tried multiple interventions like dark room, eye mask, cool room, hot bath, no late in the day caffeine, CBD, herbs, trazodone, benedryl and on and on. Benedryl is not on the healthy brain list, but neither is lack of sleep. It can be a real dilemma. I need to use those tags more often to try and identify trends to see what may be helping or hurting. Since everyone is different, some things affect one person more than another. Some people can drink caffeine late in the day and still sleep well. I’m not one of those people! Generally alcohol is a sleep disrupter, but some people don’t experience that.

If you decide to try out the ring, I recommend getting the sizing kit (if they still offer that) so you make sure you get a good fit. If I were to do it again, I would wear it on my left middle finger. I don’t have a wedding ring, so if you do, the left middle finger might not be your preference. I wear mine on my right ring finger but find it more comfortable to take it off when I’m playing pickleball because I hold the paddle with my right hand. It is all just personal preference. The current price on the Oura website is $299 with a choice of 4 different colors. I am not an affiliate. I have used it consistently since I purchased it, so for me it has become a habit and I still feel like I gain useful information.

For more information check out their website and blog posts at :www.ouraring.com

Is there something you have wanted to try but wish someone you knew had tried it first? Let me know, and maybe I have already checked it out!

Stay well!

The End of my Camper Van Travels

So where have I been? My last travel post was back in November! Time sure flies by. After my time in Margaritaville, I drove back to Columbia, TN to celebrate Christmas with my daughter, her husband and my grandson. Christmas is always more fun with a 5yo to share it with! I spent some time in the Porch House Retreat which was so comfortable and relaxing. After Christmas I decided to head to FL in search of warmer temperatures and sunshine! 

I camped in a real campground for the first time in Dothan, AL. My impressions: very friendly people at the campground, many didn’t wear masks, don’t believe COVID is serious, home of the international peanut festival, red lobster nearby that I took advantage of, lots of fireworks being shot off past midnight even though it was New Years Day, not Eve, cold temps, plugging into power for the first time- not scary.  

Next stop- Ocala National Forest where one of my childhood friends comes for the winter to provide maintenance and clean up in the park. It was a beautiful peaceful location and they prepared a delicious meal for me. Thanks Lylie and Jay!

I then visited Winter Garden where Tom, Melinda, Jonathan and Shelia live. I camped in their driveway and had another difficult nights sleep thanks to someone driving through the neighborhood at 2am with their music blaring!  Visiting Disney Springs for dinner was interesting- they really enforce mask wearing and won’t let you enter if you don’t have a mask! 

I have friends in Deland,FL that I visited and had a fun time catching up with Lynne. Then I was determined to get to the beach at least one day even if it was chilly. I drove over to New Smyrna beach and found a campground nearby. Still too cold for my wimpiness and I appreciated my heater. In the morning I checked out, drove to the beach, got coffee and walked in the sunshine along the beach! It was even nice enough to sit in the sun for a bit and I thoroughly enjoyed my time there. And I found a super cute flip flop necklace to commemorate my new street address!

One more friend visit in Deland. Ann and I met when our kids attended the Montessori school back in 1994 (about). It was great catching up and meeting her friend John, an extremely talented artist and potter. 

As I was heading back to Orlando, all I could think was “I need a real bed to sleep on to have a decent night sleep!”  So I found a nearby hotel and paid a ridiculous dog fee for Charlotte to be with me. Not all hotels allow dogs, but when they do, there is sometimes a large fee! Several of the Holiday Inns I stayed in only charged $25/night. But most other hotels were quite a bit more. I was waiting for my two cousins to arrive from Michigan, so I also stayed in the Margaritaville Resort Hotel in Orlando. I loved the fun decor and the happy vibe of the whole place! 

Waiting for Covid testing- All negative!

The best stone crabs ever from Lombardi’s in Orlando

My cousins Mary and Barb were in Barb’s community in Davenport and since we had all been traveling, there was a requirement for COVID testing before being able to participate in activities In the community. We went to Disney main gate area where the health department was offering rapid COVID testing. We stood in line for almost 2 hours, had our noses swabbed, and had a result in 20 minutes. All three of us were negative! Woohoo! It’s hard for me to be in FL without treating myself to fresh stone crab claws. We went to Lombardi’s in Winter Park and bought stone crab claws, key lime pie and the mustard sauce for the crabs. Sooo good! 

Key Lime pie from Lombardi’s

The last leg of my trip was driving back to SC. I enjoyed being in Latitude Margaritaville Hilton Head so much, I decided to buy a house there!  Yikes! I was not expecting that, but I decided I was ready to have a home. I thoroughly enjoyed my van, especially the driving across the country and seeing special people. But the hard part for me was lack of sleep and being cold. So I made the decision that I would rather have a house than a van, and didn’t think it was financially wise for me to have both. So, I sold it and am in the building process with my house. (on Flip Flop Ct 😂) Another new experience for me! There are so many decisions to make and things to pick out, but I am enjoying the process. I have met so many kind, friendly, fun people here in my new community, I am looking forward to being here full time.  I may be able to close on my house as early as April! Time will tell. 

On my way back to Redmond by plane, I stopped over in Page, AZ to spend some time with my grandson while my daughter and son-in-law were leading a retreat for several women in my daughter’s coaching group. Another beautiful location! Then on to Redmond where I tested negative for Covid again and then packed up all my belongings and loaded them in a U-Pack Cube! It was snowing the day I left. I’m back in South Carolina, waiting for the rain to stop and warmer temperatures soon!

So this is probably my final van travel post. If I explore South Carolina by car, I may write about that. Otherwise I will get back to focusing on medical topics again. Let me know if there is a topic you would like to see me cover in the future! And thanks for reading!

Stay well out there!

My Experience with Continuous Glucose Monitor

It has been 11 days since I started using the continuous glucose monitor (CGM). Just to review- I signed up for the monitor through the Levels Health app. It is still in Beta testing so it takes a few weeks to receive the sensors. I also had to use a link from a podcast I listen to that supposedly helped jump the wait list. The box contains 2 sensors with included applicators made by Abbott called FreeStyle Libre. You can also obtain these same sensors with a prescription from your health care provider. If you get one that way, you still are able to monitor your glucose, but you won’t have the benefit of the Levels software app to assess your food choices. 

Levels package with 2 sensors and 2 patches

Once I received my box from Levels, I went to the email they had sent me with step by step links and instructions for getting started. I really like their videos. The young woman who explains it all is fun and upbeat and explains it all very clearly! So there is an app from Abbott called FreeStyle Libre Link that I downloaded and set up then there is the Levels app that gets set up as well. The sensor is a small disc with a tiny filament that penetrates your skin when applied with the applicator. It is best to apply it on the back of your arm where it is fairly flat and out of the way. You load the sensor into the applicator and then apply pressure to the applicator against your arm until it clicks. I know all the videos I watched online say “I didn’t feel a thing!”  I DID feel something! Like a very brief pinch that wasn’t bad at all, but I felt it! Just saying...  

Position of sensor

It takes a little while for it to start reading and they explain all this in the videos. There are also numerous very helpful blog posts on the Levels Health website about metabolic health and glucose control. 

https://www.levelshealth.com 

I received 2 sensors in the box, each one is good for 14 days. There are also 2 patches that are applied over the sensor to protect it from catching on something. Once In place, I pretty much forgot it was there. I use my phone to scan the sensor and I can do it as many times as I want during the day. I was happy to discover that it reads the result through my clothes! (A long sleeve tee shirt and a sweatshirt) I took a reading with and without clothing and they were the same. Every time I ate something, I opened the Levels app, took a picture of the food and a description so that I could see the correlation with my glucose response later.

I saw some comments online that the finger stick reading didn’t match the scan reading. So I tested that out. There is a small difference, but the sensor is reading interstitial glucose and the finger stick is measuring glucose in your blood. So they don’t correspond exactly at the same moment. 

What have I learned? My metabolic score on the Levels app was the best when I fasted😬. Not really a surprise. There were a couple nights when my glucose dropped below 50- both times just before I woke up in the morning. I had no awareness or symptoms on waking. Eating refined sugar such as candy canes or chocolate caused a significant spike in my glucose level. There was one time that it didn’t and I’m not sure why- it didn’t seem like I had eaten fat or protein that would have modulated the effect. I experimented with Chick Fil A waffle fries and grilled nuggets and had a spike of my glucose to 150!  Would it have been better if I ate the protein first before the fries? I don’t really know. And by the way, I am not recommending candy canes and fries as a healthy food choice- just doing some self experimenting!  I found it a bit discouraging that one bad choice seemed to throw off my metabolic score for the whole day! It is a learning process for sure. I seem to be especially sensitive to carbs, especially refined carbs which I shouldn’t be eating anyway( but it’s Christmas!) and high glycemic carbs like potatoes and grains. 

Here are 6 things Nat Eliason learned from using the CGM and Levels app, posted on the Levels Health website. nateliason.com

1. Ingredient quality matters-unprocessed and organic is usually better

2. Meal composition and order matters-before eating carbs eat fat or protein first

3. Eating late is bad for sleep-it disrupts your glucose levels and interferes with quality sleep

4. Every body is different-it helps to learn how your body responds

5. Meal pace matters- slow eating =better glucose curve

6. Exercise helps digestion- walk after eating to lower impact of glucose

So there you have it! I have learned that I really should avoid refined carbs, even though some people are not as sensitive as I am. I also learned that it is helpful to know how different foods and combinations can affect my glucose differently and that exercise after eating can modify my glucose levels. All of those things ultimately are motivation to make healthy choices during the day because it really does make a difference.

Why does all this matter? Does it really make a difference if I am metabolically fit or not? More on this next time!

Insulin resistance, Insulin sensitivity, metabolic fitness...

Insulin resistance, insulin sensitivity, metabolic fitness, time restricted feeding, continuous glucose monitoring.. what does it all mean?

Insulin resistance is the body’s response to too much insulin. When insulin levels are high, the body develops a resistance to it. Excessive insulin causes obesity because insulin is a fat storage hormone. And excess insulin causes insulin resistance, also called type 2 diabetes. So why would we treat a disease of excess insulin with more insulin? Good question. To be clear, I am not talking about Type 1 diabetes, which is marked by a lack of the ability to produce insulin and those patients have to have externally administered insulin. Type 1 is a totally different disease process.   

Insulin is produced by the pancreas in response to ingested food. Different food stimulates a higher or lower insulin response. Insulin’s job is to take glucose from your bloodstream, (aka sugar from carbohydrates that you ingest) and move it into your cells for energy. Insulin resistance keeps your cells from responding to insulin so the glucose in your blood can’t enter your cells and it builds up in your bloodstream causing high blood sugar readings. Then the body produces more insulin to try to push more glucose into the cells. So insulin levels in your blood are high, and blood sugar is high and this keeps you from burning fat for fuel, because insulin is a fat storage hormone. The answer then is to reduce insulin levels to restore the insulin sensitivity in your cells. So how do you do that? That is where fasting can be helpful. Dr. Jason Fung wrote a book called “The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day and Extended Fasting.” He discusses the different ways of using fasting and the metabolic benefits to restore insulin sensitivity.

Does all food affect insulin production in the same way or to the same degree? The three macronutrient categories are protein, carbohydrates and fat. Insulin production is most stimulated by carbohydrates, especially refined carbs like sugar. Protein and fat can stimulate insulin as well but to a lesser degree. It is also interesting that different people respond differently to different foods. I’m not sure we really know why, but most likely a combination of genetics, metabolic and hormonal differences and level of physical activity.  

So to decrease insulin production, you need to stop stimulating it with food, which is where the fasting comes into play. As mentioned before, there are many forms of fasting, from a 5 day water only fast to alternate day fasting or time restricted feeding. I am most familiar with time restricted feeding, also sometimes called intermittent fasting, because that is what I have practiced most often. One common method is called 16:8 time restricted feeding. That means you fast for 16 hours and eat during an 8 hour window. One way to do this is to not eat your first food until 10am, eat your last food at 6pm (8 hour feeding window) then fast from 6pm until 10am the next morning. (16 hour fast) You can also eat earlier if breakfast is important to you so you could eat from 8am to 4pm for example, then fast again overnight.There is some evidence that eating earlier in the day has metabolic benefits. There is obviously controversy about what types of food are best- ketogenic, carnivore, vegan, pegan, etc, but that is a whole other discussion! All those plans still agree on cutting out sugar and refined carbohydrates if you are trying to improve insulin sensitivity and metabolic fitness.

Many of us may resist the idea of going without food for 16 hours since we are a culture of abundant food that is always available. Do I get hungry? Yes I do! I am a chronic snacker, so it takes effort to resist that and not have tempting foods available. My fasting blood sugars have been in the pre-diabetic range for a while and I have seen improvement with a lower carb, higher protein approach with time restricted feeding. I am not perfectly compliant, especially while traveling and staying with friends and family along the road. But I am making progress! And I also found that I can learn to be comfortable with mild hunger and not feel like I have to feed it constantly.

One of the challenges with monitoring your blood sugar is that it has required a finger stick to check your glucose levels. Typically people check first thing in the morning while fasting to measure fasting blood sugar levels. The optimal level is between 72-85mg/dl. But what does that really mean if you are only checking your blood sugar occasionally and you aren’t measuring blood sugar after eating to see how your body responds to different foods? Now we have something called a continuous glucose monitor (CGM) that is applied to your skin on the back of your arm with a tiny hair like filament that enters your skin and measures your glucose continuously! There is then an app on your phone that can scan the monitor and give you a readout of what your blood sugar is doing. People using this device have found that certain food spikes their blood sugar more than they would have expected and it is different for different people. Like so much in medicine, there are individual difference. 

From Abbott Freestyle Libre website

From Abbott Freestyle Libre website

The ultimate goal is to develop metabolic fitness. What does that mean?  From the blog on the Levels Health web site: “We take “metabolic fitness” to mean our ability to keep average and fasting glucose levels in an optimal range, minimize post-meal glucose spikes, optimize insulin sensitivity, and to exhibit flexibility in utilizing different energy sources — including stored fat and glucose — for fuel.” https://www.levelshealth.com

It is how well we process energy in the body. 

From the Levels Health website- the position of the CGM on back of arm

The good news is that we can make changes in our diet and lifestyle that will improve insulin sensitivity and metabolic fitness. You want to choose food that does not cause large spikes in glucose, exercise consistently, get quality restorative sleep, manage stress and avoid environmental toxins.I know, easier said than done! But when your metabolic fitness is poor, you are more prone to diminished brain function, low energy levels, poor memory, depressed mood, and risk for multiple chronic diseases. Having a continuous glucose monitor gives you information about how your particular body and metabolism responds to the foods you eat and the exercise you do. It is hard to change a behavior if you don’t know what is contributing to the problem. 

Levels Health is a company that has developed an app and software that pairs with a continuous glucose monitor made by Abbott called FreeStyle Libre. The app gives you a direct view how your food and lifestyle affect your blood sugar so you can make changes that are specific to your metabolism. The FreeStyle Libre is available by prescription through your medical provider, but is typically used for people with a diabetes diagnosis. It may or may not be covered by Medicare, but last time I checked my plan it was not covered. The advantage of Levels is that it is available to a broader group of patients, including those who want to optimize their metabolic fitness even if they do not have a diabetes diagnosis. I went to their website, entered my information as requested and then it was reviewed by a physician in the state where I live to provide approval. The monitor is on it’s way so I have not yet used it, but I will post about my experiences in my next blog. 

The cost from Levels was $399. This may be an introductory offer, so I’m not sure how long it will be offered at this price. It includes 28 days worth of monitoring and then you would need to purchase more monitors. A 14 day Freestyle Libre kit from Abbott costs $85-$100 depending on where it is purchased and does not include the Levels Health software analysis.

I realize that I am just scratching the surface of this topic. There is much more that could be said and for a more in depth discussion I highly recommend the blog posts on the Levels Health website as well as books by Jason Fung, MD about fasting and obesity. Our metabolic health is super important as we realize that the severity of Covid 19 has been correlated with poor metabolic fitness in many cases. Stay tuned for my next blog when I have had a chance to experiment with my CGM! Stay well!

Resources:

https://www.levelshealth.com

The Complete Guide to Fasting by Jason Fung, MD

The Obesity Code by Jason Fung, MD

Margaritaville! Plus Sheree's home hacks

In my last blog I was on the way to South Carolina to visit friends in Latitude Margaritaville. Well, I’m still here! I ended up not staying in a camp ground on the way down because it was colder than I preferred so I wimped out! I stayed at the Stay and Play at Latitude Margaritaville for 2 nights. The accommodations were super comfortable. It was one of their villas and they provided a large snack basket, two complimentary towels, a golf cart to use and a margarita maker and mix. (alcohol not provided). It was great!

Charlotte is ready for a ride

She insisted on driving

Complimentary towels!

Then I stayed with Sheree and Scott-thank you for such generous hospitality!! We had Thanksgiving dinner at a restaurant on Hilton Head Island with outside seating. We went to the beach the next day and it was beautiful!

Hilton Head Island beach

There is so much to do here! Live music on Friday and Saturday night-everyone drives up in their carts and stays mostly socially distant. There is bingo on Tuesdays and trivia on Thursdays. And they have lighted tennis courts and lighted pickleball courts!

Six lighted pickleball courts and an onsite pro giving lessons

The dog park is called Barkaritaville 😊. I love that they have a large outdoor tub to give baths and a section for small dogs separate from the larger dogs.

Charlotte enjoyed this!

My friends Sheree and Scott were my neighbors when I lived in Midlothian. I learned a ton of useful home hacks from Sheree that I will share below. You may know some of this stuff but it was new to me so I’m sharing it for your reading pleasure and lots of pictures!

A cover to keep people from turning the switch on and off

felt sliders for chair legs- kind of like condoms for chairs to prevent scratching of floors

no streaks and no ammonia!

cute little containers for snacks- avoid all those zip lock bags

vegetable chopper- not so good for lettuce

magnetic measuring spoons

Lint free towels-how did I not know about these!

a meat separator chopper thingy- for when you cook ground meat

So there you have it! Hope this was fun and that you learned something new.

Stay well and take your vitamin D.

Columbia, TN and Beyond

In my last blog I promised to give you more information about Columbia, TN. My daughter moved here from Nashville about 3 years ago because Nashville was getting super busy and real estate prices were climbing. She bought a cool historic home in Columbia, within walking distance of the downtown square, at much less money per square foot than what was available in Nashville. (That house is now a “Porch House Retreat” available for rent @porchhouseretreat on instagram for pictures!)

Columbia is a small town about 45 miles south of Nashville. It is a nationally accredited Main Street community. The downtown square has lots of fun restaurants and shops. It is also a ‘Top 10 Best Small Town’ by Southern Living. The population is approximately 37,000. I like to look up demographics of different areas and find those numbers interesting around the country. In 2020, the median age of the population is 38.9. Average home value is $222,526. (data from https://www.columbiatn.com) Average household income $57,942. Some of my favorite shops are Muletown Coffee, Tin Cottage, Columbia Health Foods, Southern Exposure… and too many others to name. I have had amazing meals at Vahn Dy’s Asian Cuisine, Buck and Board and Puckett’s Grocery and Restaurant. When I read the Columbia, TN brochure for the first time on this last visit, I realized that there are so many things to do and see that I was not even aware of. Now I have a bigger to do list for my next visit!

Thanks to Andrew for all the expert fire building and to Kristin and Hudson for all the fun times and places to eat and sleep.

I have left TN for more travels. Next stop was seeing my cousin in Ohio. Thank you to Alice and Mike for your hospitality! On the way there I discovered something I didn’t know. Where do you think Center of The World is? It is in Ohio! I have a photo to prove it! And have you ever eaten at Quaker Steak and Lube? Yes, it really is a restaurant and no they don’t put motor oil on your steak. (www.thelube.com) There are lots of them in the mid west- never tried one though. And while I was in Ohio it snowed! First snow of the season for me. It was beautiful, but time to head further south!

There it is, Center of The World, OH

You can tell you are in Ohio because of the shape of the state route sign! Hadn’t noticed that before. If you don’t know where you are when driving ask Siri “hey siri, what state am I in?’ She knows!

Yes, a restaurant in Ohio and other states!

Now I am in Virginia to visit my son for his birthday and other friends and family. I lived here for 20 years, so there are still a few people who remember me! It’s fun to be back in a familiar neighborhood and see how some things have changed. My in person visits here are unfortunately limited because of Covid. I apologize to anyone reading this who I did not get to see personally. I have not been aware of any exposure myself, but I want to be cautious and respect other people’s needs to be distanced. It has been beautiful here with sunshine every day and milder temperatures. The love the sunshine for body, mind and soul! Thanks to Kelly, Brenna and Eddie Ann for a place to rest my head.

Sunset over the farm in VA

Next on my travel plans is heading to Hilton Head, SC. I have friends who recently bought a home in Latitude Margaritaville and I am curious to see them and how they like their new place. It looks like it will be sunny there too. And it has such a fun vibe! They have street names like Flip Flop Lane and Landshark Blvd. How fun is that? I am planning to stay in my first RV park on my way down there, so wish me luck! Hopefully the nighttime temps will be milder in South Carolina. 

Audio Books I have been listening to on the road:

1. No Time Like the Future-by Michael J Fox and narrated by him

2. Caste by Isabel Wilkerson- “the author examines the unspoken caste system that has shaped America and shows how our lives today are still defined by a hierarchy of human divisions” Listening to this opened my eyes and hurt my heart.

3. David and Goliath by Malcolm Gladwell

4. Talking to Strangers by Malcolm Gladwell

Thanks for traveling with me! I will add more as I wander south. I continue to wear my mask in public places and eat outside when at a restaurant or with distance when inside. Stay well my friends!

Road Trip 2020 More Adventures!

In my last blog, I had not yet reached my daughter’s house in TN. I thought I might stop in or near the little town of Bonnie, Illinois, but it was only 4 pm when I drove through there and I wasn’t ready to check into a hotel. There was not a hotel in Bonnie but there were some not too far away. So I made the decision to keep driving! I had about 4 or 5 more hours to go and I thought I could push through. In retrospect, not the wisest choice. I arrived in Columbia, TN by 9:30pm and was beyond tired. The last leg of the trip was plagued by rain, darkness and construction on route 24 into Nashville that felt very precarious with all the truck traffic and single lane roads! Yikes! I was grateful that there were no accidents or delays and super relieved to arrive safely!

One aspect of camper van travel that I am still figuring out is the bathroom choices. My friend Leisa suggested that I write about my bathroom accessibility observations on my trip. I find it difficult to stay well hydrated when I travel because I never know when I will encounter a safe, clean rest stop along the way. Fortunately, I seemed to find a rest stop that was open most of the time I needed one. Most rest stops were open and clean, but most did not allow dogs, so I was leaving Charlotte in the van briefly. It wasn’t hot, to temperature was not an issue. The first rest stop in Idaho though only had a long line of porta potties that were not especially pleasant. That is when you need a “female urination device” that allows you to stand to urinate when you are in that “I don’t want to sit on that toilet seat” situation. I had one with me but forgot where I packed it! Darn.

Look at all the fun colors!

The most remote rest stop was somewhere in Utah on a long stretch of road in the middle of nowhere. There was a small building with a non-flushing toilet- basically a toilet seat over a large hole.  Grateful for the availability. 

Remote rest stop in Utah

Another handy purchase is something called “Travel John! disposable urinal”, or pee bags as my grandson and I call them. They are a small plastic bag with a conveniently shaped opening that allows collection of urine without spillage and the bag contains a powder that instantly turns into a gel when the liquid comes into contact with it. No spill no mess! You just throw it in the trash can like you would a baby diaper. It took me a while to use one for the first time, I guess I was not being an early adopter on this one, but once I tried it for the first time, I never want to travel without them! Why didn’t I know about this sooner in my life!  On my trip through Missouri, I had stopped at a gas station to fill up with fuel, use the rest room and then drove a bit further to find a Chick-fil-A. Then I realized I needed another bathroom break and I didn’t know where I would find the next available stop. So I found an area of the parking lot that was empty, got into the back seat area of the van, and gave the pee bag a try. My windows are very tinted and it felt comfortably private. Truly amazing!

Not an affiliate of any of these products

The pee bags have also been a life saver when I have been staying in my van on family’s property. Who wants to wake everyone up by traipsing into the house at 2am to use the bathroom, when you can use a pee bag instead? It’s the thoughtful thing to do and so convenient!

When I was looking at camper vans over the years, it seemed to me that the presence or absence of bathroom facilities in the vehicle was never very clear. It just wasn’t talked about. So I was left with the thought “so what do people do when they need to go to the bathroom”? There are some campers that have a flush toilet of sorts and then that requires a holding tank, or black water tank. this has to be emptied at designated areas in certain campgrounds. I haven’t had this experience so I’m not speaking as an expert here. My van does not have a toilet or a shower. It is up to each owner to decide what sort of portable toilet they prefer to add. I wasn’t sure what I wanted and I did some online research to try to figure it out. I like simple and small, something that doesn’t take up too much space, and that isn’t complicated to take care of. At home we had purchased a luggable loo, which is a 5 gallon bucket with an attachable toilet seat, for our earthquake prep supplies. You then use “double doodie” bags inside the bucket when you need to go, one bucket for pee and another one for poop. Then you can add some coconut husk to help with the odor and seal the bag and dispose of it after use. So I considered that kind of set up for my van, but it seemed like it would take up too much space. 

Portable Toilet Camping Toilet

Then I happened to find this collapsible potty that folds up into a small round disc shaped package and it can also be used as a stool. I love stuff that has more than one purpose! So that is what I decided to do. It also requires disposable bags. And it is not complicated to use. I have not had the opportunity to try it out yet, but I can already see that it will come in handy at the park with grandkids when the public restrooms are closed! (Thanks Covid)

It collapses so flat!

And a handy stool!

Now I am in Columbia, TN. It is a super cute, small town, about 45 miles south of Nashville. My daughter moved here 3 years ago because Nashville was getting more and more crowded and busy and real estate prices were getting higher and less affordable there. 

Next time I will fill you in on small town Columbia!

Hope you found this fun and helpful for your future travels.

Road Trip 2020!

This was supposed to be my year for adventure and travel! I had all sorts of trips and conferences booked. I did manage to travel to Costa Rica, Florida and Tennessee before the pandemic shut everything down, so I am grateful for that. But I was really looking forward to medical conferences in New Orleans, Austin and Minneapolis. And a trip with a friend to Europe. And then the pandemic happened and all the trips were cancelled. 

Back in May of this year I started seriously considering buying a camper van. If flying was going to be limited, why not plan a road trip and camping? I had been thinking about a camper van for a while. I like the looks of the Sprinter, but when I checked one out in person, it just seemed too big for me, and expensive. I didn’t want to have to pay to store it somewhere because it was too big for the driveway. I liked the idea of the VW Eurovans or Westfalia vans. There are plenty of those out there, but they don’t make them anymore so the older ones can be a bit problematic as far as repairs and maintenance, and I am not a mechanic. 

Then I came across the Metris camper van. The Metris is made by Mercedes and has been a work van or passenger van. Then various up-fitting  companies started making them into camper vans, kind of modeled after the VW vans as far as the layout. I found Peace Vans in Seattle who is one of the companies that have been up-fitting the Metris into a camper van or a weekender,  and I decided that was what I had been looking for. It is 17 feet long, so about the size of a Honda Odyssey. They install a pop top that allows you to stand inside when the top is up. There is also a lofted bed in the pop top as well as the main bed that fills the back of the van when the seat is folded down. The full camper build has a 2 burner propane gas stove and a small sink, a refrigerator and several storage cabinets. It does not have a built in toilet or shower, and so you buy the porta potty of your choice. 

I placed my order for a Metris camper van with Peace Vans and Mercedes of Seattle at the end of May. Since the pandemic, they have been swamped with orders, because apparently I’m not the only one who thought camping and road trips might be the way to go!  The whole process took about 5 months, most of which was waiting in line and then waiting for it to be shipped across the country after the camper build was finished in South Carolina. I picked it up 10/23 and headed out on my first road trip on 10/25! It is super comfortable to drive and I was able to pack a lot of stuff in all the storage spaces since I don’t know how long I will be gone. I have not slept in it yet, but will soon. I added a gasoline heater as an extra feature option and I am glad I did. It will heat the van when it is parked, even if not hooked up to power and uses minimal gasoline. 

She looks excited, right?

I put my dog Charlotte in her bed behind the passenger seat and attached her harness to a large D ring by the sliding side door- very convenient!  We left Sunday morning from Redmond and headed towards Boise. I had heard that the Snoqualmie pass can be treacherous if it is snowy, so I was prepared with snow chains just in case. It was so clear and dry that I never even saw where the pass was! There was some snow on the mountains, but the roads were perfect. 

Somewhere along I-90

Once I crossed the mountains, it was blue skies and sunshine! The traffic was light and most of highway 90 allowed a speed of 70mph. Then when I hit Idaho, the speed limit was 80 mph. Woohoo! The first night I stayed in a Holiday Inn in the Boise area. When I woke up it was 18 degrees outside! I made a point of filling up my gas tank when it got below half a tank because sometimes gas stations are not readily available! The part of Idaho that I drove through was super flat. You can see mountains in the distance but the road was mostly straight and flat as I drove toward Salt Lake City on route 84. I stayed with my sister and her husband in Lehi the second night. It was still in the teens in the morning in Utah. 

Utah or Colorado?

On Tuesday I headed out toward Denver. I was a bit apprehensive about traveling on Route 70 since there had been recent snow and the mountain roads were closed down on Sunday and part of Monday. But it was going to be sunny, so I decided to go for it. There were still areas of snow and ice on some areas of the roads and several cars still stuck in the median from the previous days. But my travel went smoothly without any issues. Very grateful! My car is a mess though from all the dirty residual snow and slush that splashed on me. I need a car wash! I had a great visit with friends in Littleton and had the best homemade chicken and vegetable soup ever! And homegrown veggies too! 

Wednesday I headed east on Route 70 again toward Kansas. Another very flat straight road, but no mountains in the distance this time. There is lots of farm land and wide open spaces and wind farms. I spent the night in Abilene, KS at a Holiday Inn. Certain of the Holiday Inns are pet friendly, so I look for those. It’s in the 40’s-50’s here! Feels like a heat wave!

Tomorrow I head towards St Louis. I might try to stay in Bonnie, Illinois! wouldn’t that be fun?

What I have learned from traveling solo so far:

1. I listened to a wonderful mix of music without anyone objecting or changing the channel- Beatles, Willie Nelson, Jesse Cook, Stevie Wonder, Yolanda Adams, Stephen Curtis Chapman, All Sons and Daughters, Adele, and more.

2. I sang along as loud as I wanted and didn’t care if I was off key. Charlotte didn’t howl one time!

3. I stopped whenever I needed or wanted to

4. Pharmaceutical help from the vet allowed a more relaxed trip for Charlotte- no visible anxiety

5. Audible books help pass the time- I finished listening to Malcolm Gladwell’s book “Talking To Strangers” and I am in the middle of another one of his books called “David and Goliath”. He is quite the storyteller! I have enjoyed both of these books. Any of you have other suggestions?

6. Traveling alone is not as scary as I thought it might be! Facing my fears😊

So there you have it! My first 4 road trip days. 

I will still be doing medical blog posts as well, but since some of you wanted to hear about my trip, I decided to do some travel blog posts too.  Be careful out there! Stay well.

Biohacking

What in the world is biohacking? Have you heard this term? I have been familiar with it for a few years now since I have been following Dave Asprey’s blogs and podcast called Bulletproof Radio. It’s always difficult to know where the word originated, but Dave Asprey has been called the father of biohacking. According to Dr. Axe, the definition for biohacking is “the process of making changes to your lifestyle in order to “hack” your body’s biology and feel your best. 

I just learned while doing research for my blog that there are different types of biohacking. The categories as described by Dr. Axe are: nutrigenomics, do-it-yourself biology and grinder biohacking. 

Nutrigenomics: nutritionally manipulating the activity of your body. This can include sleep manipulation, exercise, attention hacking, changing environmental triggers like sound and light and stress management. This is the type I have been most aware of.

Do-it-yourself: this is a subculture of people who conduct biological experiments and study life sciences outside of conventional means. 

Grinder biohacking: a subset of DIYBio. They attempt to push the limits of technology and the human body. (sometimes risky techniques) 

Definitions are from Dr. Axe:   https://draxe.com

The reason I decided to write about biohacking this time, taking a break from Alzheimer’s disease, is that last weekend I attended the Virtual Biohacking Conference organized by Dave Asprey and his team. It is usually an in person conference but because of the pandemic, this year it was virtual. There were many great speakers, break out sessions and a super interesting vendor hall. I am a sucker for new gadgets so this is always a fun part for me. 

Here are some take aways:

Dave Asprey has a new book coming out called “Fast This Way”- discusses the latest thinking on fasting so you can make the most of your fasts.

Jay Shetty: “ Service is the ultimate hack.” 

Wim Hof- cold exposure and breathing guru- he has an app and a book out soon. I personally have not tried this, mostly because I am not a fan of cold, but I know done right it has real benefits!

Panel discussion about boosting immunity with Dr. Harry Adelson, Dr. Frank Schallenberger, Mansoor Mohammed, PhD, and Ally Perlina.  Fifty percent of humans are Vitamin D deficient. Doing interval training increases mitochondrial function. Most common cause of mitochondrial dysfunction is stress.

Patrick K. Porter,Ph.D. presented information about the Brain Tap device. This device is a headset that uses light and sound to create a relaxation response and “helps restore your brain’s natural balance so you can feel relaxed, rebooted and revitalized.”  https://braintap.com  Some people have found it is especially helpful for better quality sleep.

Maria Shriver spoke about resilience. She is the founder of the Women’s Alzheimer’s Movement. She also has a newsletter called The Sunday Paper that is a digital newspaper that informs and inspires Hearts and Minds. Words of wisdom from her talk: “check your intentions, calm down, and listen.”

There were so many speakers, I have not had a chance to listen to them all, but fortunately I purchased the upgraded ticket so I can listen to the recordings on my own time.

There were a least 77 companies represented in the vendor hall or as sponsors! I still haven’t explored all that they offer but they are all super interesting. I purchased something called Hypoair, that is a high performance air purifier that is plugged into an electric outlet in whichever room you want to clean the air. https://hypoair.com.  Who doesn’t need clean air with all the smoke, viruses and mold many of us are exposed to.

Another company called Levels, https://app.levelshealth.com offers a device that continuously measures your blood glucose. They have a patch that is applied to your arm and the patch has tiny sensors that penetrate your skin in order to measure your blood glucose. I haven’t seen one in person so it is hard to describe accurately. It allows you to monitor in real time how different food affects your personal biology. One person may be able to eat a banana for example and only see a small rise in their blood sugar, while someone else may have a huge  glucose swing after eating the same banana. I have been dealing with borderline fasting blood sugar for a while now and it seems like it would be really helpful to know which foods are contributing to my glucose intolerance and insulin resistance. I’ll let you know if I try one out!

One thing I have learned from my own limited amount of biohacking is that what works for one person, doesn’t always work for everyone else. Sleep is a good example. I have more supplements in my supplement graveyard than I can even list! I read about a sleep aid, non-pharmaceutical, and either nutritional or herbal, so I buy it and try it only to stop taking it in a couple weeks because it didn’t help. Sometimes I probably don’t give it enough time. Then I try different gadgets that calm my brain waves, or meditation or breath work, and sometimes it helps, sometimes it doesn’t. What I have concluded is, we are each one big biologic experiment. And our biology can be complicated! There are definitely times that you need an expert to monitor and guide you in the process, especially if you are dealing with a more chronic issue. 

So there you have it. This was a very limited view of the conference and hopefully it sparks an interest in biohacking areas in your life that could use an upgrade. (diet, sleep, exercise?) 

Wouldn’t it be fun to have a vendor hall that was always available? That has always been one of the best things about any conference I have been to. Sounds like a good idea to me!

As always, this blog is only intended to be for educational purposes and is not intended to be medical advice. Please consult with your medical provider for any specific medical questions.

Alzheimer's Prevention?

What if Alzheimer’s disease and cognitive impairment could be reversed or prevented? In my last few blogs I have been writing about Dr. Dale Bredesen’s new book “The End of Alzheimer’s Program”. He discusses the many lifestyle factors that contribute to the progression of dementia and ways to address them. There have been hundreds of patients who have seen reversal of their symptoms by following the ReCODE protocol that Dr. Bredesen developed. But despite this, there is still a predominant message and belief that there is no treatment or hope for Alzheimer’s disease. 

What I am reading:

I read an article recently that supported Dr. Bredesen’s findings that there are ways to prevent and reverse this disease. The article was published in The Lancet volume 396, issue 10248, p413-446, August 08, 2020. The article title is “Dementia prevention, intervention, and care: 2020 report of the Lancet Commission”. In 2017, the Lancet Commission identified 9 risk factors for dementia that could potentially be changed to modify risk of developing dementia. They are: lower level of education, high blood pressure, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes and low social contact. Three more have now been added: excessive alcohol intake, traumatic brain injury and air pollution. The conclusion from this article is that these 12 risk factors account for about 40% of worldwide dementias. Therefore, it is possible to prevent some of these dementias with lifestyle modification. 

Lifestyle changes are sometimes difficult and results are not typically immediate. As of today there are no medications that have shown significant benefit in reversing Alzheimer’s disease. As Dr Bredesen explains, since there are at least 36 factors that influence the development of Alzheimer’s, there will most likely never be one drug that will be effective. A roof with 36 holes will not be fixed by a single patch. 

And here is another study from Australia that looked at an eight week program of dementia education and lifestyle changes including diet, exercise and cognitive engagement. They found that these interventions significantly improved cognitive performance and reduced the risk of Alzheimer’s disease in seniors with pre-dementia conditions. The BrainHQ app (Posit Science) was used for the brain exercise component.  This study was published in the Journal of the American Geriatric Society. ( 09 September 2020) https://doi.org/10.1111/jags.16762

The interventions in this study included four educational modules about dementia and lifestyle risk factors, Mediterranean diet, physical activity and cognitive engagement using online brain training (BrainHQ). The Australian National University-Alzheimer’s Disease Risk Index ( ANU-ADRI) was used to evaluate lifestyle risk factors. You can take this test yourself at https://anuadri.anu.edu.au.  Other assessment tests were also used for cognition. (listed in the article) They concluded that improvements in lifestyle risk factors for dementia can lead to improvements in cognitive function in a short time frame in a population who were experiencing cognitive decline.

So what do you do with all this information? Where do you start? If you are in your twenties or thirties, look at your lifestyle habits and see if there are things that you could improve to help support a healthy brain and body. As we get into our forties and beyond, it is possible that our brain function has started to show some decline, even if we are not aware of it. We are all exposed to toxins on a daily basis, the incidence of chronic illness has been on the rise, even in younger people, and the amount of processed food that we are surrounded by is incredible. Dr. Bredesen also has a program called PreCODE designed for those of us in middle age(or later) who are not currently symptomatic but may have the early biochemical and physiologic changes that put us at more risk for dementia. PreCODE is for optimizing our brain function and preventing dementia. PreCODE includes labs, a comprehensive report, a BrainHQ account, access to cognitive assessment tools, access to the list of trained practitioners including physicians, nurse practitioners  and health coaches, an online community and more. The cost is an annual subscription model that is detailed on the website: https://www.apollohealthco.com   ($39.95 monthly plus cost of blood draw)  

I have not yet subscribed to PreCODE but I am definitely curious about where I stand with regard to my brain function! I did take the online test mentioned above from the Australian National University and learned about lifestyle risks. I did start a strength training program so looking forward to a stronger body!

What I am excited about:

I recently enrolled in the ReCODE training that Dr. Bredesen offers for health care practitioners! There is so much helpful information and I look forward to passing along what I learn!

Podcasts I am listening to:  some medical and some other

Health related

Bulletproof Radio-Dave Asprey

Broken Brain-Dhru Purohit

Ben Greenfield Fitness Feel Better Live More- Dr. Chaterjee, MD

The Energy Blueprint- Ari Whitten

The Drive- Peter Attia, MD

Revolution Health Radio- Chris Kresser

Wild Health

Doctor’s Farmacy-Mark Hyman, MD

Inspiring:

Unlocking Us- Brene Brown

The Porchcast- Kristin Sweeting 

I hope you found this helpful and feel free to share with anyone who may be interested. Thanks for reading!

Toxic Alzheimer's Part 2

In my last blog I discussed Dr. Bredesen’s Type 3 Alzheimer’s, or the Toxic Type. I listed the different toxins that we are all potentially exposed to in our air, water, food and skin care products and ways to avoid them. Today I want to address how to support your body in it’s efforts to detoxify what you are exposed to after you avoid known toxins as much as possible. 

From Dr. Bredesen: “In today’s world, it is impossible to avoid dementogens completely, so a combination of minimizing exposure and optimizing detoxification is the best approach.”

One source of food toxins that I didn’t cover in my last blog is related to how you cook your food. When we cook our food at high temperatures we can produce advanced glycation end products(AGEs), polycyclic aromatic hydrocarbons and acrylamide (think-french fries and blackened or charred meat) The oil you cook with is also important. Olive oil is best for low temperature cooking and avocado oil or ghee for higher temperature cooking. 

Now that you know where toxins come from and ways to avoid them when possible, the next step is to optimize your ability to detoxify. 

Drinking filtered water, in adequate amounts such as 1 to 4 liters per day, can help flush out toxins into your urine. It’s hard to drink adequate amounts of water, since that requires easy access to a bathroom! Staying at home certainly helps that but when travel is necessary it is harder! Your water goal depends on your weight and activity level. There is an app called WaterMinder that can help you keep track.

Fiber in your diet helps absorb and eliminate toxins in your gut. Fiber is categorized as soluble or insoluble. A few examples of soluble fiber are broccoli, black beans, brussel sprouts, sweet potatoes and apples and many more. Some examples of insoluble fiber are wheat bran, oat bran, whole grains, beans, flaxseeds, certain fruits and vegetables. As you can see, some foods have both types of fiber. It is recommended that we eat more than 30 grams of fiber each day, which most of us do not accomplish!

Sweat can remove toxins through your skin. Exercise or taking a sauna are two methods to stimulate sweat and eliminate toxins. It is a good idea to shower after sweating to remove any accumulated toxins so they are not reabsorbed back through your skin. 

Time outside, especially in forests, helps you avoid any indoor toxins that may be present in your home. As I write this, the west coast is on fire and the air quality in some places is super hazardous, so being outside is more dangerous than being indoors in those locations. 

Some people have what is called leaky gut that basically means that stuff is being absorbed through your intestinal lining that is not supposed to be in your blood stream. It is important to try to heal your gut if this is you, which means eating prebiotic foods such as jicama and Jerusalem artichokes as well as ingesting probiotics as a supplement or as fermented food. Healing your gut is not always a simple task, so seek out help from a knowledgeable medical practitioner to get some guidance in this area. 

We all produce our own detox chemicals in our bodies but some people have genetic mutations that limit the production of these chemicals. Glutathione is an antioxidant that helps the body in the detoxification process. If your glutathione is not optimal, you may need to supplement with liposomal glutathione or N-acetylcysteine to support the detoxification systems in your body.

Support your liver, the most important organ for detoxification. Avoid liver toxins such as tylenol and alcohol. Supplements that may help are milk thistle or curcumin. Foods such as cruciferous vegetables, salad greens, artichokes and fish oil can be anti-inflammatory. 

Support your kidneys since they are another organ that helps you eliminate toxins from your body. Dr. Bredesen mentions drinking beet juice as a method to increase blood flow to your kidneys as well as blueberries, ginko, gotu kola and magnesium citrate. 

Other methods to support detox are having a massage that can increase lymphatic flow, and managing your stress levels through mediation or prayer. 

Many of the above recommendations are preventive and geared more for those of us who have not yet been diagnosed with cognitive decline or dementia. If you or a loved one is dealing with more symptoms of cognitive decline, then more aggressive treatment may be indicated. If you have done testing and found that you have mold toxicity or heavy metal levels that are not healthy, then it is important to find a medical practitioner who can help you heal from those toxins. Dr. Bredesen has a program called ReCODE that looks at all possible exposures and then develops a plan for dealing with your individual issues. He also has a program called PreCODE to find potential issues before you have symptoms. 

Here are Dr. Bredesen’s websites for further information:  www.mycognoscopy.com or https://www.apollohealthco.com

The above information is for educational purposes only and is not medical advice. Seek out guidance from a medical practitioner if you have concerns about your cognitive health.

Toxic Alzheimer's

In my last blog I talked about Dr. Dale Bredesen’s first book “The End of Alzheimer’s “. Now his new book has been released, “The End of Alzheimer’s Program”. It is full of useful, practical information for all of us, whether you are dealing with cognitive decline in yourself or a loved one. And especially if you want to know how to prevent cognitive decline. There is no one size fits all plan for dementia and in fact Dr Bredesen describes several types of Alzheimer’s, each with different causative factors and different therapeutic approaches. In my last blog I described types 1-3. Today I will update the list and describe the other types that Dr. Bredesen details in his new book.

Type 1- Inflammatory or hot: evidence of systemic inflammation 

Type 1.5- Glycotoxic or sweet: high blood sugar, high fasting insulin

Type 2- Atrophic or cold: suboptimal levels of nutrients and hormones

Type 3- Toxic or vile: exposure to mercury, toluene, mycotoxins( such as molds)

Type 4- Vascular or pale: associated with cardiovascular disease and strokes

Type 5- Traumatic or dazed: history of head trauma in the past

There are also mixed types that show characteristics of more than one of the types listed.

Today I am focusing on type 3 or toxic Alzheimer’s.  Toxic exposures are all around us. The air we breathe, the water we drink, the food we eat, the products we apply to our skin can all contain toxins that can harm us on a cellular level. Some of us have a genetic makeup that allows for strong detoxification activity. When we are exposed to toxins, our body cleans it up and eliminates it. But some of us have genetic SNPs (single nucleotide polymorphisms) that don’t allow the clean up process to be as effective. 

The strategy is to eliminate exposure as much as possible and then support the body’s ability to clean up what we are exposed to. I think we are all familiar with the word carcinogen- toxins that are thought to cause cancer. A new word to me is dementogen- toxins related to the cause of dementia. Not surprisingly both lists have many toxins in common. 

Three groups of dementogen toxins (poisons) are: metals and inorganic chemicals, organic chemicals like toluene and pesticides (glycophosphate or Roundup), and biotoxins which are toxins produced by living organisms like black mold.

So where are these toxins coming from and how do they get into your brain? What is your individual exposure? If you don’t know how you are being exposed, you won’t know how to eliminate those toxins.

Mercury is a heavy metal and can come from dental amalgams (inorganic mercury) and seafood especially large long-lived fish such as tuna, swordfish, and shark (organic mercury). Arsenic can also be found in seafood. People who were exposed to the World Trade Center cloud had multiple toxic exposures. To check your metal exposure requires a test like the one offered by Quicksilver or Doctor’s Data to measure the presence of heavy metals in your system. Some test hair, or blood and urine. 

Organic toxins can include glycophosphate, toluene, and many others. Glycophosphate is a very common herbicide used to kill weeds. The World Health Organization has designated it as a probable carcinogen. It is suspected that it is also a neurotoxin but it has not been officially designated as one. Food that is genetically modified like corn, soybeans, canola and sugar beets have significant glycophosphate levels. Apparently even food that is non GMO and labeled organic can have glycophosphate sprayed on it as a desiccant before harvest. It helps to know your farmer! The large majority of us have been exposed to glycophosphate in the air we breathe and the food we eat. A lab called Great Plains Laboratories is able to test you for toxin exposure including glycophosphate.

I learned something new about the source of toluene! It is released when you burn paraffin candles! Paraffin wax comes from petroleum, coal or shale oil. It’s hard to know if a significant amount of toluene is released,  but since there are alternatives, like beeswax candles, that may be a better way to go if you are someone who is chemically sensitive. A great source to research toxins in food or products is the Environmental Working Group. www.ewg.org. They evaluate ingredients in skin care products and recommend nontoxic choices. 

Biotoxins include mold exposure. A large percentage of the population has mold exposure because of water damage in our homes from floods and hurricanes and because of mold in schools and workplaces. I clearly remember my daughter’s dorm room at college where the heating/ air conditioning vents were all gunked up with black fuzzy stuff that looked like mold and who knows when they were cleaned last. Or even major hospital systems who had to close down operating rooms recently because of the presence of aspergillus mold in the ventilation system that sickened vulnerable patients including some who died. Mycotoxins are everywhere! Some of us are more sensitive to the harmful effects of living in a moldy environment, but it is not healthy for anyone. Tests for biotoxin exposure can be performed by way of a urine sample. Two tests are GPL urinary mycotoxins and RealTime Labs urinary mycotoxin test. There is also a test online called visual contrast sensitivity (VCS) that tests how well you can distinguish fine shades of gray. https://www.vcstest.com. This test is not diagnostic but if positive it may indicate the need for further investigation. 

So what can you do if you are living in this toxic soup? How can you minimize exposure to dementogens?

Air: HEPA air filter, avoid smoking and second hand smoke, avoid air pollution as much as possible, check your ERMI score in your house- it should be less than 2. An ERMI score is the Environmental Relative Moldiness Index. An average home should have a score of 0, and it is considered high if over 2, possibly needing remediation. The ERMI panel includes 26 mold species that thrive in water damaged homes and 10 species found in all homes. The samples are taken from dust in your living room and bedroom. 

Water: Use a water filter or have your tap water evaluated for the presence of chemicals and biotoxins. I recently used a company called National Testing Laboratories, LTD that offers a variety of tests for your tap water. The results were ok, not perfect, but not dangerous. There are many choices for filters- both below the sink, above the sink, counter top and whole house systems and many opinions about which is best! I liked having a filter under the sink so it was out of the way and I had a spigot for clean drinking water. The filter only had to be changed once per year. The brand I used was by Multipure. (I have no financial interest). Drink out of stainless steel or glass bottles rather than plastic to avoid BPA and BPS.

Food: Eat organic fruits and vegetables. Avoid the Dirty Dozen listed on the EWG site which are more heavily sprayed with pesticides and herbicides. (2020 list: strawberries, spinach, kale, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery, potatoes)  So if you eat these, aim for organic. They also list the clean 15 that are safer to eat in the nonorganic variety. 

Skin: Avoid toxins in soaps, topical lotions, shampoo, toothpaste, sunscreen, lipstick, scented laundry detergent etc. There is an app called Think Dirty that helps you evaluate ingredients and of course the environmental working group has an extensive data base.

Whew! That is a lot to think about, especially if thinking about the toxins around you is new territory for you. In my next blog, I will discuss ways to support your body to detoxify what you are exposed to. It is impossible to totally avoid all the above mentioned toxins, so finding things you can do to help make your body’s detoxification systems stronger is super helpful.

If you want to learn more detail about toxins, there are two books that Dr. Bredesen recommends, that I have not yet read.

1. “The Toxin Solution: How Hidden Poisons in the Air, Water, Food and Products We Use Are Destroying Our Health-And What We Can Do To Fix It” by Dr. Joseph Pizzorno

2. “Toxic: Heal Your Body from Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness” by Neil Nathan, MD

Thanks for reading and stay well!

This blog is meant for educational purposes only and does not constitute medical advice.

The End of Alzheimer's?

Cognoscopy? Have you heard this term before? Fortunately it does not involve having your brain invasively examined with a scope through your ear or nose, not that that is even possible. It is a term Dr. Dale Bredesen uses to describe a comprehensive evaluation of your brain function starting after the age of 45. It involves blood tests and genomic testing as well as physician evaluation to determine your current level of brain function and is a way to find any early signs of cognitive decline so that you can make lifestyle changes to reverse those areas of difficulty. www.mycognoscopy.com

Dr. Bredesen wrote a research based book called “The End of Alzheimer’s” in 2017. In this book he describes the different types of Alzheimer’s based on the causative factors and then describes the individual approach to treatment depending on the type. He has written a new book called “The End of Alzheimer’s Program” that is being released today, 8/18/2020. This book goes into more of the “how to” of implementing a program to reverse cognitive decline and Alzheimer’s. I’m excited to read it and looking forward to sharing more information with you on this blog!

So what is dementia anyway and why are there so many different names and types?

Dementia is a general term that describes a group of symptoms affecting memory, thinking and social abilities significantly enough that it interferes with your daily life. There are many causes of dementia and several different categories based on the underlying cause and presentation.

It used to be thought that the amyloid plaques and tau tangles are what caused Alzheimer’s disease, and so the treatment was focused on removing the tau and amyloid with a drug. This has not worked in multiple drug trials. The current thinking is that the amyloid and tau are a protective response of the brain to injury and inflammation. Which means that we need to look upstream at what is causing the inflammation and toxicity. Alzheimer’s results when the brain’s synapse making signals are outweighed by the synapse remodeling/destroying ones. 

The Alzheimer’s Association, https://Alzheimers.org, lists the most common types of dementia:

Alzheimer’s Disease- the most common type, distinguished by amyloid plaques and tau tangles on PET scans

Vascular dementia- also called multi-infarct dementia, or post stroke dementia, the second most common type

Lewy body dementia- the third most common, marked by protein deposits, called Lewy bodies, seen in nerve cells in the brain. ( This is the type of dementia that Robin Williams was diagnosed with. I heard there is a documentary coming out next month called Robin’s Wish, set to release on September 1 about his struggle with Lewy body dementia.) 

Frontotemporal dementia- less common, marked by more behavioral and emotional changes, memory can be preserved, also called Pick’s Disease

Mixed Dementia- features of more than one of the above

Parkinson’s dementia- associated with Parkinson’s disease. Not all those with Parkinson’s develop dementia

Huntington’s Disease

Creutzfeldt-Jacob disease-also called Mad Cow disease

I will be focusing on the types of Alzheimer’s disease described by Dr Bredesen in his first book. 

Type 1: Inflammatory or “hot”- more often these patients carry the gene ApoE4. If you have a single copy of ApoE4 your risk of Alzheimer’s is increased by 30%, and if you have two copies of ApoE4 your risk increases to 50%. ApoE3/3 people have a 9% risk. This type is marked by high crp (c reactive protein, an inflammatory marker), decreased albumin/globulin ratio, increased interleukin 6, increased tumor necrosis factor and insulin resistance. 

Type 1.5: Glycotoxic or “sweet”- marked by high blood glucose and insulin resistance

Type 2: Atrophic or “cold” more frequently seen in people who carry 1 or 2 copies of ApoE4, no evidence of inflammatory markers, the overall support for brain synapses has dried up; they may have suboptimal levels of thyroid, adrenal, estrogen, progesterone, testosterone and pregnenolone, and reduced levels of Vitamin D, they may also have insulin resistance or elevated homocysteine 

Type 3: Toxic or “vile”- people who carry ApoE3, tends to occur at a younger age, may follow time of great stress, generalized brain atrophy on brain scan, low vitamin D, low zinc, high copper levels, may have mercury toxicity or mycotoxins

Dr. Bredesen developed the ReCODE program to help people reverse cognitive decline. His book coming out 8/18/2020,  will have updated and detailed information about how to make brain healthy choices and reverse degenerative changes that you may already be experiencing. There is no one magic fix for Alzheimer’s disease. It will take multiple therapeutic approaches and an individualized approach to start seeing a difference. As Dr. Bredesen says, patching one hole in a roof that has 36 holes is not going to stop the rood leak.

I hope you find this overview helpful! The information in this blog is meant for educational purposes only and is not medical advice. Stay well everyone! Check out “The End of Alzheimer’s Program” Available today!

Dr. Bredesen’s website: https://www.apollohealthco.com

To Mask or not to Mask?

I decided to write a blog about the hot topic of masks to look logically at the issue. 

Q.- Why are masks being recommended or mandated? 

A- The SARSCoV2 virus is thought to be transmitted by respiratory droplets and aerosols. Droplets are small liquid particles produced by breathing, coughing, sneezing, laughing, singing or talking. If you are alive you are producing droplets with your saliva and mucous from your lungs, nose  and throat. Respiratory aerosols are a suspension of fine solid particles or liquid droplets in air. (It has a broader definition but I’m focusing on respiratory sources of aerosols) Aerosols are smaller in size than droplets and so can stay suspended in air for a longer distance and longer time. Both droplets and aerosols can contain viruses and bacteria. SARSCoV2 appears to be transmitted via both droplets and aerosols. A mask acts as a barrier to limit the ability of the droplets and aerosols (henceforth called spit for simplicity)  from leaving you and flying towards someone else. Masks aren’t perfect, but helpful. Here’s an article from the New England Journal of Medicine  called: Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering  N Engl J Med. 2020 May 21;382(21):2061-2063. They had someone speak the words “stay healthy” with and without a mask and showed that masks significantly decreased the droplets that were measured by their laser device. Watch the video- impressive!

Q- But I don’t have any symptoms! Why do I have to wear a mask? It’s annoying and hot!

A- There is some evidence that people who are asymptomatic or presymptomatic can still spread the virus. Some people have virus in their throat but have not gotten sick from it. We aren’t sure why. As long as you are in your own home, or outside at a distance from others, a mask is not required. But if you are in breathing or spitting distance from other people, then you could potentially infect each other. 

Q- The government can’t tell me what to do! I have my constitutional rights! Doesn’t a mandate violate that?

A- The government is not mandating that you wear a mask in your own home. That would be infringing on your rights. Masks are an effort to protect public health. There are people out there who are more vulnerable to this virus than you might be and they don’t realize it. Only 12% of the population is metabolically healthy which means that 88% of us have obesity, hypertension, diabetes and autoimmune diseases that put us at risk for COVID-19. So even if you are young and think the virus can’t possibly harm you, you could be wrong. Young people have gotten sick and died. And there are young people who have gotten a milder version of COVID-19 and were left with chronic, longer lasting symptoms and lung damage. Doctors who are taking care of COVID-19 patients share that it is a very unusual virus. People who know they are at risk have a responsibility to protect themselves from possible exposure by staying home, ordering grocery delivery if possible and avoiding indoor gatherings. Those of us who are “healthy” have a responsibility to do what we can to protect ourselves and those at risk. 

Q- I read on Facebook that masks cause your carbon dioxide (CO2) to go up and your Oxygen to go down and damage your lungs. Or even cause pleurisy! They say you breath your own bacteria and viruses and make yourself  sick. What about that?

A- I spent 5 years in a surgical residency and 5 years in surgical practice wearing a mask every day for many hours per day. I never passed out from low oxygen levels or high carbon dioxide levels. I never got pneumonia or pleurisy. The health care workers who are on the front lines now wear masks and shields all day long. If they pass out it is from not having time to eat or drink water because of the thousands of sick people rolling in their door for weeks and months.  The most common cause of pleurisy is viral, not mask wearing. If you have an oximeter, that gadget you put on your finger to measure oxygen levels, put on a mask and check your levels for an hour or 2 and see what it shows. If you already have compromised lungs, like from chronic bronchitis or chronic obstructive pulmonary disease, then maybe it’s more of an issue. Then you could try a face shield instead.  

Here’s my results from my mask experiment: baseline without a mask: 96%

One hour later with continuous mask wearing and measuring on the same finger: 98%

The initial reading of 96% could have been from my finger being cooler, but my oxygen obviously did not decrease after 1 hour. I had no symptoms from mask wearing.

Q- Why did the whole country have to shut down? There are some states that had very few cases but they had to close too with all the negative economic impact. 

A- That is a tough call. It seems like the countries who have been more careful about social distancing and masks have controlled the spread of the virus better. The numbers have been a challenge to interpret because at first, there wasn’t enough testing. Then the accuracy of the testing was questioned. When there were delays in restricting access to nursing homes by visitors, that seemed to allow the virus to run rampant in some places. The larger cities needed to limit the number of people who were getting sick and requiring hospitalization because they have a limited number of beds and health care workers and ventilators. This virus acts differently than the influenza virus. It is easier to catch (infectivity) and in some people is deadlier than the flu. 

Q- Why can’t we all just catch the virus, become immune and move on? Like we used to do with chicken pox?

A- The SARSCoV2 virus is very different from other viruses. In order to be protected from catching a virus again, you have to have made neutralizing antibodies to the virus. That means the type of antibodies that prevent the virus from being able to enter your cells and make more of themselves and make you sick.. Not everyone is able to respond to the virus by making the right kind of antibodies. If you do form neutralizing antibodies, we still don’t know how long they will be effective. So if you intentionally expose yourself, you may be one of the ones who become critically ill and dies instead of having a mild case and forming neutralizing antibodies. Kind of Russian Roulette, right?

Q- Why does SARSCoV2 seem to effect the African American and Latinx communities more than other communities?

A- There are probably many reasons. One important one is access to care. I don’t have statistics here, but people who are uninsured or live in an area that has limited choices for health care are going to have different outcomes. This is an area that I am learning more about, so not pretending to have any expertise. I have not seen evidence that there is a genetic difference.

Q- When are we going to have a vaccine so we can be done with this?

A- Multiple labs and pharmaceutical companies are working hard to develop a vaccine. Some viruses are more difficult to work with than others. The HIV ( human immunodeficiency virus) still does not have an effective vaccine. But there are preventive pharmaceuticals and multi drug treatments that have been effective. In order to have an effective vaccine for SARSCoV2, the vaccine needs to prevent infection when the person is exposed to the virus. No vaccine is 100% effective, including the influenza vaccine which is often only 40% effective. And some viruses are able to mutate and change their genetic make up requiring the vaccine to be adjusted for the new mutation. So a vaccine is not going to be the magic wand that makes SARSCoV2 go away. It will take a long term effort of vigilance, scientific studies, preventive measures and lifestyle health changes, socially distancing and masks to turn things around. A lot of what we were used to doing in our day to day lives will probably be different for a long time. 

I know masks are inconvenient, but if they help protect you and people you care about, isn’t it worth it?

Functional Medicine Part 2

My last blog on June 17 reviewed talks from the Institute for Functional Medicine AIC conference held virtually. Today I am sharing from the talks that were presented on day 2. 

From my last blog: What the heck is functional medicine anyway? Is that the same as integrative medicine, or complementary medicine or even alternative medicine? They all have their own focus and also have things in common. Here is the explanation from the Institute for Functional Medicine website: (www.ifm.org ). “Functional Medicine determines how and why illness occurs and restores health by addressing the root causes of disease for each individual.” 

I like this quote from Mark Hyman, MD: “We need to understand how the whole body operates as a system, not just how different pieces of the body operate independently from one another. We need to treat people, not body parts; we want to treat the causes of disease, not symptoms.”

Here are some snippets from day 2:

Francesco Di Pierro, PhD. “New Discoveries in the Microbiome”

The large majority of the bacteria in our gut, 95%, belong to the bacteroides and firmicutes group of organisms. The other 5% is made up of several other bacterial species. Streptococcus salivarius is a prominent organism in the mouth. Hormones, diet and lifestyle all contribute to the make up of our microbiome. There was so much information in this talk it was hard to pick a snippet to share!

Panel discussion: Georgia Tetlow, MD, Mylene Huynh, MD; Joel Evans, MD; Kara Parker, MD; Facilitated by Patrick Hanaway, MD “ COVID-19, Clinical Practice and the New Normal: A Panel Discussion

It’s important to explain why risk factors make the disease worse. Inflammation and mitochondrial health need to be addressed. For prevention it is important to support the strength of the person’s immune system with vitamins A,D, K, C, as well as zinc, NAC and glutathione. (Contact your health care provider for specific recommendations). Shift conversation to health, cultivate mindset, self care, emotional health and community. Integrative Medicine for the Underserved (https://im4us.org) is a nonprofit organization believing that integrative health care should be accessible to all, not just the wealthy. They have a yearly conference in August, this year virtually.

Here is a fun recipe from Kalia Wattles, ND: Flax muffins in a cup-

1 egg.   2 TBS flax meal.  Coconut oil to grease cup.  1/4 tsp cinnamon

1/4 c blueberries. 1/2 tsp baking powder. Monk fruit to sweeten if desired 1 TBS chopped pecans

Mix 1 egg well, add flax meal, baking powder, cinnamon, pinch of salt, add monk fruit if using (1/4-1/2 tsp)  add blueberries and pecans,  grease ramekin(10 oz size) with coconut oil. Add mixture to ramekin. Oven: 350 degrees, 10-15 minutes.  10gm protein 12gm carbs 6gm fiber  (not sure how much fat)

A Unified Theory of Disease: Joe Pizzorno, ND: “Community is the Guru of the future” Thich Nhat Hahn”

Nutrient density in our food supply is diminished and toxic chemicals are abundant. Arsenic contributes to several cancers and can be found in public water supplies. Toxins and nutrient deficiencies damage synergistically. Toxins impair our detoxification systems. If you want to test your own water for toxins you can purchase a test from National Testing Laboratories  https://watercheck.com.    Environmental Working Group www.ewg.org is a great resource for learning about environmental toxins in food, skin products and cleaning products.

What Timing Matters: Circadian Rhythms and Chronobiology. Satchidananda Panda, PhD

One in 3 adults in the US have a chronic disease, and many of those diseases are related to lifestyle choices. Lifestyle is what, when and how much we eat, sleep and move on a daily basis. A robust circadian rhythm leads to health and vitality. Circadian rhythm is closely tied to our light exposure. Daytime exposure should be 10,000 lux for 15-60 minutes in morning. Before bedtime- less than 20 lux.  App mentioned: my lux recorder.  There is a research project that uses an app to help understand your body’s rhythms. Go to https://mycircadianclock.org to learn more.

Try to be in bed for 8 hours. If you are practicing time restricted feeding, eat during a 10 hour window, nothing before or after. (For example 8am-6pm)

Dysbiotic Drift and the Modern Health Crisis: Susan Prescott, MD, PhD

(Dr Prescott is also an artist! www.drsusanprescott.com) Her slides were amazing!). Dysbiotic systems are life in distress. Dysbiosis is an unhealthy change in the normal bacterial ecology of a part of the body. Inflammation is the most significant threat to our health. Autoimmune diseases, allergies, eczema and mental health crises are all on the rise. Contact with soil and plants increases our immune resilience. Grass root strategies: local food, green spaces, community. For change to happen we must believe that our actions will make a difference. We all need to take responsibility for our choices.

Food Fix: The True Cost of Food: Mark Hyman, MD

Only 12.2% of people in the US are metabolically healthy. The majority of Covid-19 deaths, 94-97%, had obesity or chronic disease- diabetes, hypertension, cancer. In the US, 6 in 10 have a chronic disease, 4 in 10 have two chronic illnesses and 1/3 of the federal budget is for Medicare. 

Violent crime in prisons was shown to decrease when prisoners were fed whole food. Policies do not serve public health. Dr. Hyman’s latest book: www.foodfix.org.  Dr. Hyman’s podcast: Doctor’s Farmacy. Movie: Kiss The Ground. An organization that works to promote a healthy, sustainable food system through public education, issue advocacy and publication of the National Food Policy Scorecard. https://foodpolicyaction.org 

Systems Biology and the Journey in Uncertainty: Patrick Hanaway, MD

Dr Hanaway shared his personal and moving experience with his own cancer diagnosis. Normal cells slow down and are protected from chemotherapy, while cancer cells can’t slow down and are more susceptible to chemotherapy. Water only fasting 24hrs before chemo and 24hrs after chemo has been shown to decrease side effects. Ketogenic diets are sometimes prescribed because cancer cells cannot use ketones for fuel. Cancer cells thrive on sugar!  These cancers respond best to a ketogenic approach: breast, colon, endometrial, pancreas, glioblastoma and head and neck cancer. High carb enteral feedings have an increased mortality. Ketogenic enteral formulas are better but hard to find. A balanced microbiome decreases the adverse effects of immunotherapy.

The Radical Redesign of Healthcare: What Now?  Tracy Gaudet, MD

I was especially encouraged by Dr Gaudet’s talk! Great information and hope for the future. She is now working for a new nonprofit called The Whole Health Institute in Bentonville, Arkansas. It is still new and does not yet have a website. Whole health empowers and equips people to take charge of their physical and mental wellbeing, and live their life to the fullest. Me + self care + professional care + community = whole health. Being mindful and aware is critical. Focus is on purpose driven care. The personal health plan is in the center. Explore what matters most to the individual. Future: well being instructors, peers, coaches. 

Me: led by peers, empower, finding your purpose “What is your purpose in life?” 

Self care: equip- led by instructors and coaches

Professional Care: led by clinicians, shared medical appointments, co-create personal health plan, people start wherever they feel drawn

Community- led by all, rooted in and sustained by ones community

This was longer than I expected! If you made it this far, I hope you learned lots of helpful information!

And as a reminder- this blog is intended for educational purposes only and is not medical advice. 

Stay well out there! Keep your immune system strong. Wear masks when you are around other people-you never know who might be more vulnerable than you. Be kind.

Functional Medicine Part 1

Last weekend I attended the Institute for Functional Medicine Annual International Conference. This was the first time it was held entirely online! It was unprecedented! ( I think that is the most used word for 2020 so far! ) There were so many excellent speakers and an abundance of helpful information shared. The goal of this blog is to share snippets of what I learned and was inspired by.

What the heck is Functional Medicine anyway? Is that the same as integrative Medicine, or complementary medicine or even alternative medicine? They all have their own focus and also have things in common. Here is the explanation from the Institute for Functional Medicine website: (www.ifm.org ). “Functional Medicine determines how and why illness occurs and restores health by addressing the root causes of disease for each individual.”  The importance of this model is that it is individualized and science based. The patient is involved in their own care. It focuses on the root cause rather than just symptoms. This model looks at the systems of the body and how they are interconnected instead of looking at the body as separate parts with limited connection to each other.

Here are some brief snippets from the conference:

Jeffrey Bland, PhD: COVID-19 challenge: Resilience is an important factor in infectious disease. All disease is a result of disordered function. The immune system is dynamic, making millions of new white cells, red cells and platelets every 10 seconds. As we age, our immune function declines. Future of public health should be focused on precision individual health. We need to help our bodies be more resilient.

Nathan Price, PhD: Predictive Biomarkers: Most disease worldwide now is chronic rather than infectious. (other than the current pandemic of course) Our focus should be more on prevention earlier in the disease progression. A healthy gut microbiome is hard to define. What goes on in our gut can influence every other system in our body. In people with a high genetic risk for ALS, Omega 3 fats increase the risk of degeneration. In the majority of people omega 3 fats are anti-inflammatory and protective, but not in this group for unclear reasons. www.isbscience.org   Institute for Systems Biology, Seattle. This site also has STEM resources for your kids!

Lara Mangravite, PhD: Smart devices, tracking health: https://sagebionetworks.org. One interesting device for remote monitoring is called Propeller. https://www.propellerhealth.com. It is a way to help you manage your asthma or COPD with your doctor by monitoring when you have flare ups and what might be causing them. With the Unified Parkinson’s Disease Rating Scale the patient can self monitor with their cell phone. The app is called UPDRS and is in the apple App Store.

Christopher Gardner, PhD: What to Eat?  Haven’t we all asked this question? Carnivore, keto, vegan, vegetarian, pescatarian, paleo, ancestral and many more! Yikes! As Dr. Gardner said “Uniquely Complex”. Michael Pollan writes: “Eat food, not too much, mostly plants.”  The foundation of our eating plan: more vegetables, more whole food, less added sugar, less refined grains and less processed food. If you eat grains, they should be whole intact grains. If you eat meat, eat organic pasture raised, not feed lot meat. The goal is to eat the foundational diet plus personalization. And let’s all get along if we eat differently! So helpful!

Jason Fung, MD: New Paradigm of Insulin Resistance: The old paradigm would say that our cells become resistant to insulin at the receptor, so glucose can’t move into the cell even with enough insulin in the blood, resulting in too much glucose in our blood stream. Dr. Fung shared the overflow paradigm. There is too much glucose in the cell. The receptor is normal and insulin is normal but the cell is too full with glucose so by giving more insulin you just make the diabetes worse. More insulin cannot shove move glucose into a cell that is too full. Insulin is a fat storing hormone. The answer is to get glucose out of the cell. Diabetics on a 600cal/day diet for 8 weeks had a decrease in fasting blood sugar, decrease in fatty liver, and improved insulin resistance. An increase in ALT in the blood is an indication that the liver is full of fat. Low carb eating and intermittent fasting helps burn off fat in cells. 

Books:” The Obesity Code: Unlocking the Secrets of Weight Loss” Jason Fung, MD

“The Complete Guide to Fasting” Jason Fung, MD

Kurt Hong, MD, PhD: Fasting and Fasting Mimicking: Definitions- chronic calorie restriction is 1200cal for women, 1500cal for men. Prolonged fasting- water only for 2 days to weeks. Intermittent fasting can be alternate day feeding, or 5:2 meaning you fast with 500cal or less on 2 days out of the week and eat a healthy meal plan 5 days of the week. Time restricted eating- avoid any intake for 14-20 hours 4-5 days of the week. Fasting mimicking diet- 5 days of plant based food/month with each day eating 800-1000cal/day. Prolon is a commercially available plan that supports this way of eating. https://prolonfmd.com Fasting slows down the aging process. Ketosis improves neurogenesis.

Stephen Phinney, MD: Effects of Nutritional Ketosis on Inflammation and Type 2 Diabetes. Remote continuous care that is app based has been helpful in managing diabetic patients. Continuous glucose monitors (CGM)  are more readily available and give great feedback to patients so they see how specific foods affect their blood glucose. A low carb diet is generally less than 30% of total calories in a day. Typical ketogenic diet is: protein 15-20% of calories, carbs 5-10% and fat 70-75%. This translates to 30grams of carbs, 1.2-2gms/kg of protein and fat to satiety. A ketone called beta-hydroxybutyrate is a superior energy supply and inhibits inflammatory gene expression. Diabetes is an inflammatory disease.

Whew! That was just Day 1! I learned so much. Look for Part 2 soon when I share snippets from Day 2 of the conference.

Additional Resource:

Functional Medicine Coaching Academy- https://functionalmedicinecoaching.org an excellent online certified health coach program

Disclaimer: This blog is intended for educational purposes only and is not medical advice. Consult your health care provider if you have specific questions regarding your own circumstances. 

Xploration Centre Parenting and Education Tips

I decided to take a break from my usual medical blog to share information I learned watching a virtual retreat recently.

I started watching the Xploration Centre  Virtual Retreat last week and have learned so many new things! I am a grandma now, but I enjoyed my time homeschooling my kids years ago. This retreat made me realize how much life has changed in the last 30 years. Our kids now need to be prepared for a world that has an exponential increase in technology. In this blog I am sharing a few helpful tips and resources that I have learned so far. They have included so much content, I have only gotten through 2 of the 5 days of speakers.

From Xploration website:

“This is why we created a new model that actually prepares children for the world that is emerging, and connects them to nature, themselves, and community.

A place where children feel safe and encouraged to be themselves and are supported to foster their passions and purpose.“

The emerging world needs a new kind of human, one that is deeply loving, always learning and strongly connected to the natural world.

www.xplorationcentre.com.       Located in Victoria, BC

Speaker: Jim Kwik-world expert in speed reading, memory improvement and optimal brain performance. His life story is super inspiring! His new book is called  “Limitless”, and I can’t wait to read it!

How to retain information using the mnemonic FASTER:

Forget what you know about learning, empty your mind

Active- brain learns through creativity, ask questions

State- you never learn in a bored state, increase the emotions when learning

Teach- learn with the intention of teaching someone else

Enter- schedule your learning on your calendar-make time for learning

Review- spaced repetition-review what you learned

Jim spoke again during the retreat so I can share more of his wisdom in future blogs.

Speaker: Kathy Kolbe. Conative traits, cultivating genius

Website: www.kolbe.com

Ask your kids questions you don’t know the answers to. 

Student aptitude quiz- the truth about your natural abilities, available on the website

Other assessment tools are also available on the website

Kathy talks about knowing your strengths in 3 areas- cognitive or thinking, affective or feeling and conative or doing. How do you as a unique individual think, feel and do in your life? Cognitive strengths include your intelligence, skills, knowledge, experience and learned behavior. It’s what we can do. Affective strengths are our motivation, preferences, emotional intelligence, values and your personality. It is what you want to do or what you value.  This was the first time I had heard the word conative. The definition is: “The aspect of mental processes or behavior directed toward action or change and including impulse, desire, volition, and striving”. Conative strengths are your doing, striving instincts. It is how you will take action. Knowing what your conative strengths are helps you understand how you approach getting things done in your day to day life. It describes our striving instincts. At kolbe.com you can take a test to learn about your conative strengths and learn more about yourself and how to support your innate strengths. (there is a cost but the report is super complete and helpful) I took the test and I’m a 9722. Fact Finder was 9, Follow Through 7, Quick start 2, and implementor 2. And there is no bad score! Each strength profile is about who you are and how you get things done. You can read more on the kolbe.com website.

Speaker: Patty Wipfler, talking about why kids act out. She is author of the book titled “Listen: Five Simple Tools to Meet Your Everyday Parenting Challenges”. https://www.handinhandparenting.org

It is important to reassure kids that you are there with them when they are upset. Their behavior is language and we need to read their behavior to connect with them. 

Five tools to promote connection:

1. Listening partnership- a self care resource for parents to talk to another parent who listens without offering solutions

2. Special time- 5-10 minutes to do what your child wants to do with you, they get to chose, you give undivided attention

3. Play listening- using the power of laughter, releasing tension, tickling not recommended for this activity

4. Setting limits- allows emotional release

5. Stay listening- listen empathetically to their emotions and stay with it while they unload

Rough housing with your kids is healthy- studies show it increases leadership skills.  Book mentioned:

“ Playful Parenting: An Exciting New Approach to Raising Children That Will Help You Nurture Close Connections, Solve Behavior Problems and Encourage Confidence” by Lawrence J Cohen, Ph.D.  I have always known that play is important for kids (thanks to my Early Childhood Education Mom specialist). But I didn’t realize the benefit of rough housing. I was too afraid that someone would get hurt! I guess I never learned the fun side of rough housing, or the rules of the game.

I have so much more to share, but that will be for another time. Here is the summarized list of resources plus some others I didn’t talk about yet.

Resources:

1. www.Xplorationcentre.com    A school is soon to open in Victoria, BC

2. www.kolbe.com  so many great resources on their website

3. https://jimkwik.com   book “Limitless”  and online classes

4. https://www.handinhandparenting.org   many resources for parents; book mentioned “Listen: Five Simple Tools to Meet Your Everyday Parenting Challenges”  

5. Book about play: “Playful Parenting: An Exciting New Approach to Raising Children That Will Help You Nurture Close Connections, Solve Behavior Problems and Encourage Confidence” by Lawrence J Cohen, Ph.D. 

6. Exercise recommended by Ray Kurzweil- teach kids about exponential growth vs linear growth. Example: 1;2;4;16;256;65,536…..and so on as exponential growth

7. Nate Ball, mechanical engineer, entrepreneur - has a PBS show called Design Squad where he shows you how to make cool stuff with your kids-super fun! and he does beatboxing!

I will share more information from the retreat next time. For now, keep learning!

Mystery Illness

You have probably been hearing or reading about a “mystery illness” in children lately. It seems to have some similarities to Kawasaki disease or toxic shock syndrome and is possibly connected to Covid-19 infections. 

What is going on? I thought kids were pretty much spared from Covid-19? Doctors have been seeing kids coming into the ER with fever, skin rashes, lymph node enlargement and abdominal pain. It resembles Kawasaki disease because of these presenting symptoms. Some of these kids have tested positive for COVID-19 using the nasal swab test. Some have tested positive for antibodies to COVID-19 which is why they think there is a possible connection. New York has had the most cases so far, but it has been seen in other states and other countries as well. It may be a post-infectious syndrome, meaning it appears in someone who had the virus infection days or weeks earlier and then they present with fever and other signs of inflammation in multiple systems of the body. One of the key messages to parents is to get your kids to the doctor early if they develop fever, rash, bloodshot eyes, abdominal pain, enlarged lymph nodes and irritation inside the mouth. It is treatable if diagnosed early before the inflammation affects the heart. Kawasaki disease has been known to affect the arteries of the heart with inflammation and possible long term injury. This is still considered a rare occurrence but one to be aware of in case you see it in your kids or grandkids.

In other COVID-19 news: Have you struggled to understand why this virus has been so difficult to understand? And so weird in how many ways it presents? First it was thought to be mostly affecting the lungs with pneumonia and respiratory distress syndrome. Then we started seeing other organ system failure and neurologic symptoms. Then there was an increased incidence of blood clots in large and small blood vessels. One reason is that it is a “novel” virus. We humans have never been exposed to anything like this. Yes, we have been exposed to coronaviruses like the common cold, or SARS1 or MERS, but COVID-19 has a unique genetic make up and we have no previous exposure or immunity to it. And because it is so new, health care professionals are still learning about what this virus does and how it attacks the cells and causes symptoms. It is amazing to me how much the scientists in the world have learned about this virus in such a short period of time. And it is encouraging that there is global cooperation in research to find treatment options that are effective. It is not clear whether there will ever be an effective, safe vaccine for COVID-19. We still do not have one for HIV and some other viruses. But there is also the more likely scenario of finding drugs that may work in combination to treat the virus and studies like this are underway. I doubt that there is going to be one miracle drug, but more likely a combination of two or three agents.

I read an article by F. Perry Wilson, MD on Medscape that helped my understanding of why this virus is so scary for health care professionals (HCPs). He also writes a blog at www.methodsman.com. One of his article talked about variance when it comes to looking at disease and risk of death. For example, when someone has severe cardiovascular disease and advanced age, there is low variance. Those who die would probably die soon anyway. But when young people who have no health issues die, that is high variance. A JAMA Network Open letter reported on 168 patients who died from COVID-19 in China-30% had no co-morbidities at all. It feels like Russian Roulette. It is extremely hard to predict which patients will get hit hard with COVID-19. Is there a genetic predisposition of some sort? Obviously the older population and those with obesity, diabetes, hypertension and respiratory illnesses are at much higher risk. But it is not just this group. And that is what makes the virus so scary to HCPs who are taking care of those critically ill from COVID-19. There are so many questions that we do not have answers for yet. 

I will leave you with a quote from Claude Bernard (1813-1878) He was a French physiologist and one of the founders of experimental medicine. He said this: “ The terrain is everything; the germ is nothing.” Maybe focusing on the health of our immune system and our body will make a difference in how we individually deal with COVID-19 exposure.

Disclaimer: This blog is meant for educational purposes only and is not medical advice.

Covid 19 decisions

There is something I’ve been reading about that I feel compelled to share. There is so much information available about the pandemic and after a while, I get tired of reading! But this is important to think about. This is not meant to be medical advice and is for educational purposes only. It is also not meant to create fear. The large majority of people who become infected with Covid 19 have mild to moderate symptoms that do not require hospitalization. 

The information I have read about how rapidly Covid can progress in people who become acutely ill, makes me realize how important it is to make sure your loved ones know what treatment you would want or not want if you suddenly became critically ill. Most likely you would be in the ER or ICU alone since family are not allowed to be with you. Having your advance directive with you or on file in the hospital records will save the medical professionals and your family a lot of time and confusion.

Remember, from my previous blog, an advance directive designates someone as your decision maker if you are unable to communicate for yourself. In that document you spell out in as much detail as possible, how aggressive you would want the medical interventions to be. I will share several possible scenarios below. 

But first, I want to share information from a very helpful webinar I listened to last week. It was hosted by the Wild Health Podcast doctors and included multiple speakers. The recordings are available on their podcast.

The doctor I was particularly interested in was Dr Scott Weingart. (podcast #104) He is chief of the Division Emergency Critical Care at Stony Brook Hospital in New York. He shared that death rates are higher in those patients who wait to come in until their symptoms are more serious and also in older age groups especially those with other chronic illnesses. Those with heart disease, hypertension, diabetes and obesity are all at higher risk. But there are also younger patients without any apparent health issues who have bad outcomes and the reasons for this are not clear. Maybe there is a genetic predisposition? Maybe they had health conditions they weren’t aware of? I have not seen answers yet.

Doctors have been observing that patient outcomes may be better if intubation (which means putting someone on a ventilator) is delayed and instead use techniques such as prone ventilation or cpap or higher flow oxygen. The issue may be that hemoglobin can’t carry oxygen to the tissues because the Covid virus has blocked oxygen’s ability to attach to the hemoglobin molecule in our red blood cells. The lungs of a Covid patient are sometimes not as stiff as the lungs of someone with acute respiratory distress syndrome (ARDS). So the protocols used for ARDS are not always  working for Covid. All this is still just observation, not proven physiology. 

Dr. Weingart has described 4 categories of patients he has observed:

1. Mild symptoms, some fatigue, cough, fever but minimal shortness of breath and these people generally do fine at home with supportive treatment like rest and fluids

2. The happy hypoxic patients come into the ER and are found on testing with an oximeter to have low oxygen saturation. Normally the saturation on a pulse oximeter, the device they put on your finger to check pulse and oxygen levels, is around 97-98% if you have healthy lungs. This group has oxygen saturations less than 90% and sometimes in the 70’s or 80’s which would typically result in respiratory distress and urgent intubation. But for some reason this group is not as uncomfortable as expected. They respond to oxygen by nasal cannula but do not generally need a ventilator.

3. Indolent presentation- they may look ok at first but then explode with cytokine storm and have to be intubated rapidly or they die, and even after intubation they still may not be able to come off the ventilator and may die after two weeks of intensive effort

4. Hyperacute- a very rapid course that may only last 4 hours from admission to sepsis and death. Even young patients can present this way.

I am not aware of anyone who has figured out who presents with each of these patterns. There are some lab tests that are potential indicators of who is deteriorating, and that can be predictive later in the course. 

So getting back to the advance directive discussion. Say you are a pretty healthy person, maybe in your 50’s for example, and you start getting sick with a fever and cough. You get tested (hopefully tests are available), and you test positive for Covid. You stay home and rest and drink fluids like you are told but then you get worse and go to the ER. Your family cannot go with you because of the quarantine and you do not have an advance directive. You kept meaning to have that conversation and prepare the papers but just hadn’t gotten around to it. Your family doesn’t know if you would want to go on a ventilator or not since you didn’t talk about it. Now you are in respiratory distress, you can’t breathe, you can’t talk, the doctors don’t have time to call family because they have multiple people needing emergency care.  So now you are on a ventilator with a tube down your trachea and probably sedated so you don’t fight the machine.

Did you want to be on a ventilator?

What if after 2 weeks you are no better, will you want a tracheostomy? That is a direct hole in your trachea to continue to allow the ventilator to breathe for you. 

Will your family be able to make the decision to stop the ventilator if there is no hope of improvement?

Do you want CPR to be performed if your heart stops?

This can be so confusing and upsetting for all involved! At this point in the pandemic, the data that I have seen is that once people are intubated and on a ventilator, the chance of surviving, coming off the ventilator and having restored lung function is not very good. In some age groups the rate of death is greater than 90%! Obviously younger, healthier groups have better statistics. And also remember that the large majority of Covid infections are mild. I am only talking about the patients with severe symptoms and those who experience the cytokine storm where  the body over reacts with a massive inflammatory response. 

I read an NY Times article today about the 44 year old physician who was critically ill in Washington state and survived after experiencing near death, thanks to aggressive and experimental treatments. He had his age and health on his side. And he still has a long recovery ahead of him but he is out of the hospital! Encouraging news!

If you knew ahead of time that you would not want to be on a ventilator, then you can have your advance directive with you and be able to communicate your wishes more clearly. This should mean that you can then be treated by a palliative care team and kept comfortable, rather than being put on a ventilator when your chance of survival is so slim. To be clear, there are definitely indications for being on a ventilator! And there are definitely people who have survived Covid and successfully come off the ventilator. Some will have better function than others, depending on what their lungs were like before getting sick. But having an advance directive and having these tough discussions with your family ahead of a sudden illness is super helpful.

Advance directive decisions are different depending on the individual. If I were a healthy 30 year old, I would want more life saving measures performed than I would as a healthy 66 year old or an unhealthy 70 year old. Having a conversation about choices and having them written down will hopefully  make decision making easier for all involved.

Resources:

1. Wild Heart Podcast #104

2. A Beginner’s Guide to the End by B.J. Miller, MD and Shoshone Berger includes many resources for creating a will and advance directive 

3. https://emcrit.org/ibcc/COVID19/  A great resource for more medical information about Covid 

Resources for Sleep, headaches and Covid

So much has happened since my last post! I find myself reading and reading and learning and then not taking the time to share nuggets of what I have learned. There is so much to read out there! And no end to new information. So here goes-what I have been reading and listening to. Not all is related to the Covid pandemic, so if you are tired of Covid news, keep reading for other information. 

I seem to be on the list for all the new Summits. I have listened to some of the following:

Pain Solution Summit

Holistic Sleep Summit

Migraine World Summit

Your Best Sleep Ever Summit

Pandemic Recovery Summit

CBD Health Revolution

Genius of Your Genes

Our Health Talks with Dr. David Perlmutter- available on Youtube

I also listen to Podcasts:

Dr. Peter Attia- The Drive

Wild Health-lately with almost daily Covid updates

Broken Brain

The Doctor’s Farmacy with Dr. Mark Hyman

Bulletproof Radio with Dave Asprey

Revolution Health Radio with Chris Kresser

Other smart people:

David Sinclair, PhD- author of Lifespan, and researcher from Harvard. He has been publishing research based newsletters that are super informative.  www.lifespanbook.com

Yikes! Can you tell I am a lifelong learner?

My goal is to share a few things that I have learned from some of these summits that might be of help to you.

SLEEP:

One helpful resource I learned listening to the Holistic Sleep Summit was the app called BrainTap. The creator is Patrick K Porter, PhD. www.braintap.com   The app uses brainwave entrainment technology with a library of more than 400 guided audio programs and creative visualizations. They offer a free trial to check it out. I found that using the sleep visualizations to be very helpful in initiating sleep and sometimes I use it again if I wake during the night. The science is fascinating and if this interests you, check out the web site for more details. They also sell a headset that includes visual stimulation too, but I have not tried that, yet. I love trying new things! Hahaha…

HEADACHES:

There were some really interesting talks on the Migraine World Summit.(thanks Leisa!) One thing I learned was that Stanford University has a web site to help you evaluate your headaches in more detail and to be able to share a report with your physician. I have had chronic headaches for years and have gotten relief from imitrex, even though I do not have typical migraine headaches. So I took the survey on the website :

https://www.bontriage.com    What I learned is that I probably do not have migraines, but my symptoms fit more into the diagnosis of Chronic Tension Headaches and Medication Overuse Headaches. It was eye opening! Since then, I have had fewer headaches and have not had to use imitrex! I think it helped for me to recognize that it was related to stress and tension so I can deal with that and try to avoid medication. Braintap helps with relaxation too!

COVID: (Also called Rona somewhere on the internet Hahaha)

So much information here that it is hard to know what to share. To me when I read stuff it feels like blah, blah, blah… until something jumps out and grabs your attention. Here are some brief nuggets:

The virus may start out in the back of the nose (nasopharynx) which is where the testing swabs try to reach. But maybe it moves down to your bronchi later in the illness which may explain the false negatives if testing isn’t done early. Then the bronchial secretions would test positive-but that is not done in drive-by testing. I haven’t seen research on this so just a theory.

t is likely that we all will “get” the virus at some point and most will have milder symptoms. But there are obviously some people, young and old, who are critically ill from Covid and who don’t survive. I have not read anything about how to predict which people will become critically ill ahead of time, other than the obvious risk factors of advanced age, chronic diseases such as diabetes, hypertension, obesity, asthma and immune compromise. But what about the younger people who have no known health issues? We don’t seem to know yet. Healthcare workers are at more risk because of the viral load that are exposed to.

Covid spreads by respiratory droplets-such as when we cough or sneeze, as well as aerosols- which can be in the air around us just from breathing and talking or singing. That is why the choir practice in early March in Washington state that included 60 asymptomatic adults resulted in 45 becoming ill with Covid and 2 of those dying. That is also why it makes sense to wear a mask if you have to be out in public, such as a quick trip to the grocery store. I’m still not sure why the CDC recommended against masks early on. 

The Lifespan newsletter that was published today (4/2/2020) by David Sinclair, PhD, discussed how quickly the virus is mutating. It is interesting and a bit disturbing. It is behaving differently than most other viruses and very unpredictable. Mutations make it harder to develop an effective vaccine. I highly recommend his newsletter. He also has a facebook page at David A Sinclair.

One last thought. I was trying to figure out what the mortality is for people who become so sick with Covid that they require a ventilator to breath. This means having a tube placed into your trachea and then being on a machine that breathes for you. Obviously it is different depending on the person’s age and health. But, thinking about myself and others in the over 65 age range, if one of us requires intubation and support with a ventilator because of pneumonia and respiratory distress, how many of us would be able to come off the ventilator at some point and have functioning lungs? My google search and Pubmed search is not very encouraging. Once you get to that point in the disease, the mortality is very high. This is one more reason to be sure that you have an advanced directive and that it is up to date! If I learn more in this area, I will post an update. 

Stay well out there! Social isolation seems to be helping the spread so far. Take care of yourself too! (Healthy food, fresh air, movement)