Saturday, February 10, 2018

Puppy Love

So my goal with medical practice is to help patients define a goal.  In creating my annual DrRic's Hiking started as a goal for me to keep activity as top priority.  Modern lifestyle keeps activity and exercise on the bottom of the "totem pole" regarding multitasking.  When we keep shoveling other tasks atop the required daily move count, before you know it January first rolls around and your 5-10lb heavier, still tired, and planning a check up with doc to most likely get started another medicine since nothing changed from the previous visit.  That is why I find it easier to daisy change small tasks and have mini successes so life isn't overwhelmed with ONE BIG GOAL OF LOSING 50 POUNDS BY SPRING.  (...individual goals may vary but you get the picture about procrastinating on health) 

During the dreaded annual wellness exam (15-20 minutes max as allowed by medical insurance reimbursement)...when I hear "I know what to do I just have to do it"....I immediately retort "please don't rely on failed routines as if your technique failed to give long term success then if will fail you again" and we don' want to have the same conversation next year. 

A common benchmark for success or failure is levels of glucose, cholesterol, and vitamins.  If your deductible is too high to invest in getting blood tests or fancy imaging studies ...then we go old school. 
-new school = test blood levels and get xrays or ct scans and determine if change has occurred.
-old school  = measure waist line, weight, level of fitness, blood pressure, diet or number of meds (the more medicine prescriptions you have accumulated / the more health has "left the building")
So the inherent problem with doctors of functional medicine is they follow numbers not the person.
If you feel good now after fixing the lab values....okay but you have just accumulated more vitamins and herbs instead of medicine prescriptions!!!  If there was a way to add old school guidance to new school measuring....that would be perfect.  Using old school ways will change the basic ways of eating sleeping activity and stress should be recognized as a 360 degree change but that takes motivation (in your face accountability every day during the weakest times of the day.)   A coach for keeping eyes on your activity and making you aware of goals short and long term, a nutrition expert to remind you BEFORE the crave kicks in on what is expected by end of day and a mindful coach to design and redesign do-able routines to keep a stress neutralizing routine on your daily accomplishments.  If I act as head-coach one to twice a year during your visits....I need these coaches in your back pocket with day to day/week to week motivation. 

Either way, if you are headed to and early coffin or worse, a label of "disabled" due to stent, numerous medications, physical pain or emotional imbalance has been adopted...someone has to design a template for lifestyle change.  In taking care of lowering blood sugar, I usually like to add psyllium (fiber), timing of meals, volume of meals, ingredients of meals and level of satiety (satisfying feeling of fullness).  In Toms story of lowering sugar, the odd thing is he gained weight since his last visit which doesn't make sense as his sugar level dropped down?!...  In the Q&A that ensued, I found out his sleep was being interrupted!!!  AH HA!!! but poor sleep would cause sugar to go up?  Then he revealed the answer.  Tom got a puppy and he has been the one caring for the new family member.  The little guy wakes Tom at 3 am to pee but even with this seemingly frustrating info...Tom was smiling while talking about his new best friend.  To me this is the typical result found when people participate in laughter yoga.  Small studies have been used to check pain tolerance during duchenne type laughter and it was speculated that there may be an endorphine mediated response that changed the way damage to the body was handled.  Being in love can cause the heart and mind to be bulletproof to damage / the opposite is true too.  Maximum stress can cause a normal heart to undergo anatomic changes resulting in the heart attack.

This is where my hypothesis on love and inflammation.  Tom gains weight=sugar goes higher.  Tom loses weight=sugar goes lower.  Tom finds happiness=metabolism changes.  Tom finds puppy=sugar lowers JUST LIKE HE LOST WEIGHT!!! and the test for my theory is his weight gain should have increased sugar but actually reversed it.  Now there is alot more to test, control for variables, check the lab reliability, scale accuracy...but who cares.  Tom found a friend, puppy found a home, doctor got a reason to blog, one less medicine the insurance has to pay for. 

LOL -click here to check you how laughing changes the world