I can't breath!

Tonight, took care of a 15 y/o who was running in the school hallway and fell backward. I thought he was screwing around but turns out another team had the gym so the indoor track team had to run in the hallways! I used to do this in the 70's during winter track and this was before technology was developed for sneaker soles. I remember seeing the "waffle" sole for the first time and wondering how in the world can anyone get good traction with these soft rubber nipples sticking out from under the shoes. Well, now in this high tech time of protein supplements, 200-300 dollar running shoes, internet running clubs, high tech water......there are still schools that have their runners train in the hallway! I shared this memory with the student and his parents and of course gave some free advise about running and performance enhancement with his running and football training.

What is more online for tonight's problem is about an asthmatic that came in after being seen 2-3 days ago for asthma. Given an albuterol inhaler to help breath temporarily (4hours) and a steroid called prednisone to speed up the lungs fixing the inflammation that was causing the wheezing. She worked for a nursing home as an assistant and made a little money. Unfortunately, this was enough of a paycheck to not qualify for a medical card. She was now responsible for paying for an emergency room visit last time that came out to 400-500 dollars. And now again since she was slowing getting better but still having problems breathing, has to come in again to get reevaluated to make sure nothing was wrong. I was wondering why the previous doctor didn't maximize on her medicines and give her everything possible to "cool" down the asthma so she would turn around fast. Well, I did what the other doc did and after evaluation, gave her a nebulizer treatment with medicine steamed through a small hand held machine with a liquid medicine going straight to the deepest portions of her lung tissues. This makes a faster difference than the 10 dollar inhaler she is using every 4 hours. Inhaled steroids would be good...yeah so I wrote a script for something but called the pharmacy and found out one little inhaler costs 200 bucks! Asked about a few different older ones and all were 100-200 each! Tried to get her a long acting albuterol inhaler so she wouldnt have to hit the rescue inhaler so often but that also was 100-200 dollars! I couldn't find anyone even walmart or kmart discount drugs to cover anything. I felt so bad for this lady but exhausted all I knew to help her get better medicines. I even tried to give her a nebulizer which I did find medicines for that walmart had for 4$ only but the nebulizer machine itself was 100-200$.

How do people trying to make a living support not only their health but the lives of their kids? In Illinois we have an All Kids Program. Even before that, how can a medicine that lasts a month and saves lives cost 100-200dollars? Really I know the answer but it sounds powerful to throw a rhetorical question out in anger. In business weekly I read of how hospitals are joining with finance companies to collect from people who visit and get care without health insurance. Not that hospitals shouldn't charge for services rendered but when will the escalating prices ever plateau? Drug companies arent helping either. Listening to Suze Orman in the background she is touting not to discount yourself to others. When you undervalue yourself to the world, the world with undervalue you! So I also should not give out care at a discount and learn to charge top dollar since not too many doctors do what I do.

Bull! I always tell my daughter hatred is infectious, mob mentality is infectious, the less you know, the more you can be influenced. This countrywide problem of healthcare is too big to stop. But you know what, I will not play the same game, that lady will be spending alot to turn off her asthma in the next 1-2 weeks but I will get her to make some changes with diet and exercise so next winter she hopefully wont get sick and if she does, she will have the knowledge to calm down the lungs before they flare up to the point of having to come to the ER which is probably the most expensive way to see a doctor quickly. I also tell my daughter smiling is infectious so is a good deed. I see she always goes out of her way to protect her friends and as long has she doesn't make naive choices, I will continue to support her for being giving. Hopefully my teaching has already paid off and she can make a bigger difference in society than me.

The Saguil Approach to asthma-

avoid smoke
improve on omega 3 fishoil intake
decrease alleric response with stinging nettles
improve bowel function the entrance point to many of the triggers for asthma (probiotics)
the antiinflammatory diet....whole grain, decrease animal protein, decrease dairy
increaseing lung volume, deep breathing exercises breath holding (swimming, yoga, meditation)
biofeedback, emotional freedom technique for psychotherapy
change the environment; pets, flowers, molds, cold, dirt, dust, food.

Head in the clouds

It was a chilly day in Chicago and my family was in post turkey slumbering. We had a birthday to attend and it was a pool party! (Indoor of course) I haven't swam since august and the anticipation of doing "laps" got me excited but at the same time, I didn't want to injure myself with overusing muscles I haven't used in a while. I had done the usual work out the 2-3 days prior of aggressive weight training (heart rates into the 160-170 range) for 30 min followed by 40 min of cardio (bike and run with heart rates in the 130 range). I pride myself on being able to mix up the weight training with a little crew team type station to station exercise with the "300" type work out. This is where muscle hurts with lactic acid build up but the dry bronchial tube pain reminds me of the feeling from school track practice with repetitive sprints of 100, 200 yard for what seemed to be hours. Gives you a kind of razor in the trachea type feel while breathing in cold air. I feel a 45 if I can do this without injury and still notice muscle bulk increases, a 20-30 something should be able to kick my butt. Watching my wrestlers at UCF go through a workout just puts me to shame and collegiate athletes are not only muscular but ripped to shreds. (low body fat for you non-athletes) If they can do it then there's no reason I have to see guys talking and joking around waiting between sets and staring at themselves in the mirror. One of my pet peeves is when I see guys walking from machine to machine in between sets... staring at themselves as if something is going to change! After watching the extras part from the movie "300" and seeing how the personal trainers got the actors in shape for the movie.....the principal character stated many times he would work out to the point of barfing. That's the good old days measurement of exhaustion....not pulse rate taking but vomiting. You know you had a good work out if you threw up.....and only the best athletes vomited after a lift or a sprint! As a warning, there is the theory of overuse when it comes to exercise but come on....in this day of ultramarathoners, triathletes, iron men and olympians....is there is a new standard by which we can push ourselves in a gym or at home. I just think we get too delicate once we hit 30 for fear that a heart attack may emerge from nowhere so we take it easy. I plan on encouraging my older patients that have been cleared by me to push the envelope with heart rate and exercise and set a new standard.
As I was saying, I was looking forward to doing some laps and after my boy swam a little and my wife had time to socialize, got my goggles and swim fins and hit the 25 meter pool. Did some slow laps and had my cousin join me for a few....by the time I was done, 30 minutes went by and I covered about a half to 3/4 of a mile. The adrenaline wasn't spectacular but just being able to tackle the distance after being out of water so long put me on a high.....then I went on to the dinner table and saw a few pork dishes and ended up going with a little roasted pork (no skin) with a plate full of peanuts and grapes.....no guilt! The rest of the night was all the same, I actually was amazed I didn't feel sore at all. This is the kind of feeling with yoga, not the adrenaline rush of weight training but a more euphoric feeling with a feeling of being impervious to outside insult or trauma.

I am a big proponent of tai chi and yoga with stress reduction, hypertension, arthritis and depression. It is always a difficult sale to someone from a society built around getting self reward for breaking a sweat in front of a mirror over 60-90 minutes and feeling a "pump". With most of the baby boomers hitting 50-60, they will probably have a basic knowledge of the 2 forms of exercise with a picture of an short old chinese guy or a man in a turbin exercising. Truth of the matter is is you look in any local YMCA or health club, they will usually have a female instructor in yoga and a male instructor in tai chi. (Yoga seems to be the big craze now). When done properly and continued for 30 days or more, one will usually see the benefits of the gentle movement sports over the hard hitting exercises for heart health. Just takes a little encouragement to make it to the point of gaining the benefits.

Fear of Flying

I was flying back from a lecture in Clermont today and sat next to a wonderful young lady. She had been trying to flag down the steward before take off and the urgency in her voice made me think she was a little worried. It was headphones she was looking for to relax. I know the feeling. Several years ago about the time of the 911 tragedy, I used to have a fear of flying. I would take a xanax (fast acting valium) to relax. I think it came from years of flying back and forth to the Philippines during winter when the storms over Japan were harsh. Imagine, 2 hours after take off from a tropical island and then snow storm in Narita Japan....then only 16 more hours to fly before getting home! Needless to say it was either alcohol or drugs and drugs were cheaper. When I learned acupuncture, my instructor said he would take needles with him to France to start treating jet lag before he would even step off the plane. (The needles are so small they don't even set off security alarms) I tried this once and placed in 3 needles to relaxation points and landing didnt even phase me. From that point I was encouraged by my daughter to not stick needles in my self on a plane cause it looked "weird". I went onto acupressure techniques and breathing with meditation. (More recently I added aromatherapy-lavender- and piece of cake.

I quickly offered my seat mate a whiff of my lavender bottle and explained how it is used. Before I knew it we were up at 30 thousand feet and talking about all kinds of things. She had so much energy and life, it was inspiring to me. Usually the sick I see are worn down with a medical issue and chronic stress. Here is the perfect picture of someone with gobs of energy and life with some medical issues from not controlling or harnessing the power she wields. Stressed, on a medicine from the OB for anxiety/depression, never suggested to see a therapist, no experience of biofeedback. I forgot to ask if she ever was tested for thyroid disease of vitamin imbalance. Got a little diet hisorty from her but not enough. She also leads the typical life of a twenty something living single in "wrigley-ville". Alot of freinds and going to bars and parties. (ahhhh the good old days) What was a red flag for me was she had indicated a doctor placed her on Wellbutrin which she states helped her tremendously without gaining weight. But the doc never sent her to behavioral health. Here she is far from her initial stressor but still on the same dose.

I stressed to her that although she is feeling great with the low dose of the medicine and she uses it every day, more stressors are coming. Theres's always going to be stressors during christmas holiday, tax day, birthday and new years. God forbid she develops a sickness from Chicago winters in addition to late night partying on weekends. If she is being maintained on a level dose and a larger stressor comes up..doc is going to increase the dose or add another med. May I add that a rather large stressor for single women in the US is coming up.....30th birthday! So I gave her my advice for breathing exercises, yoga (although she sounds like an adrenaline junkie) aromatherapy and possibly acupuncture/tui na. Luckily Dr Leon Chen of East West Healing Center in Lombard also goes to Chicago and may be able to help her. Turns out there is also couple other problems typical for a person of her level and she would benefit from kidney clensing with probiotic.

I am a walking example of what I preach, The Saguil Approach-

-plan to wean off meds 2-3 weeks, have a substitute in place to help control the original issue, add a few more interventions with alternative medicine that will help control the flare up that always happens when stopping potent perscription medicines.
( although I dont think the alcohol is one thing she will give up)

Moral of this story is not to just accept a medicine as a cure. Always work to get off what you are on...whether it is a script or an herbal medicine. Nutrition and exercise are always the basis to treatment even if the doctors dont remember. I will keep an update as to how she tolerates acupuncture, anxiety sufferers dont do well and usually go to alcohol for its depresant properties. No coffee, caffeine, guarana, tobacco. She should also try carb rich diets. I usually suggest protein for breakfast and lunch then carb for dinner. In the anxious case, carbs for dinner with an evenly distributed prot/carb breakfst and lunch is good to go. Suggested breathing technique and reading into drweil.com for some pointers.

Alway insist the doc treats the mind, body and soul. In eastern medicine its all in the same package. Only in america does the body get treated without consideration of the mind. (and visa versa) serotonin that acts on the mind also is big in the colon so docs have no choice but to make it work with a multi faceted aproach.


valerian
respir-eze
kava kava
lavender aromatherapy
emotional freedom technique with psychology
diet and multivit changes.

Da Bears!

I saw one of the staff of the Chicago Bears Organization today. Funny, I met him a the Naperville Mercedes dealership in the parts department. So this huge guy that reminded me of a professional wrestler, had a 3-4 week problem with his nondominant hand. The guy exercised regularly till the injury and it showed with the size of his deltoid alone. (All during the time I was talking to him, I was thinking to myself, if I had to use and acupunture needle to his shoulder, I would have to order a special long one just to get through that muscle.) Well, it wasn't in his training he was injured but in a 20 second move of a firepit. (Again my mind wandered....was it a firepit or an entire chimmney he moved?) Problem was that since it was a small muscle in the forearm, it prohibited grip, pinch, and wrist rotation. A "dud" left arm ment he couldn't do symmetrical lifts in any of his exercise movements. Not good to be off a lifting program if job performance depends on size whether to use force or just intimidate. (Alas my mind wandered on to think... if I didn't come up with a diagnosis, he could pick me up and throw me to the otherside of the Mercedes dealership!)

I always tell my lecture audiences that 80% of the diagnosis to a problem will be in the history of the ailment. Thus a good reason to seek a doctor that listens and isn't pushed to be out of the room in the "magic 10"-(the 10 minutes it takes to listen, feel and write out a prescription with most of the talking being on the side effects of the medicines being given). Well, same here with this BEAR of a man; the sudden pull, the degree of twist the fist was in while he reproduced the motion he went through while pretend pulling the firepit and the lack of anyother defects in mechanics for this "athlete" pointed me to a common ailment in the forearm......tennis elbow. It is acutally a misnomer, you don't have to play tennis to get it. It so happens that tennis players often get this from trying power backhands. The front hand on the racket gets alot of vibratory stress suddenly with impact and the muscles don't like it. Stress leads to microscopic tears in muscle and blood acumuluates to start healing but the forearm can never be truly rested so we continue to tear it in everyday activities. In summary, it's the initial sports shock that usually causes the injury but its everyday actions that keep it going. Here we have a single pull in a very muscular arm (that is used to lifting enough iron to make a little mercedes c class) being used the wrong way. Now that little muscle is shutting down the motion of the entire beefy extremity. He's rested it for 3-4 weeks already so now its time for me to step in.

Here The Saguil Approach is to actually, leave him in the hands of a capable therapist with further suggestions of continuing his multivitamin, taking an antiiflammatory medicine, cross training for now to keep cardio up and substitute the endorphin rush he is used to, adding herbs like turmeric, boswellia, white willow bark to the diet, and stretching the forearm in positions Steven Segal would be pround of. If all else fails, I bring out the acupuncture needles but I may have to order to extra extra long needles from china.

Something for me to stress to those interested, just going which ever physical therapist is covered by insurance isnt an option. In my experience with college level, olympian or just average joe athletes, a therapist can make or brake a musculoskeletal problem. Just like doctors, there are ok therapist and there are great ones. For something easy like an ankle or a knee, standard PT is ok. For something complex like a neck or a shoulder(-my favorite), if the therapist isn't used to measuring scapular slide or can't do manual therapy to a trigger pointed trapezius, the 2-4 weeks in therapy may just result in a failure and it's one step closer to pod cutting, (orthopedic surgery)

GO BEARS!

What really happens in Concussions:

Here's me, Sherrie Payton(Mrs Walter Payton), Gabrielle(my daughter) and Brandon(my son) at the talk.

I was at Healthplex in Aurora giving a talk on concussions. I met a great person that had old fashioned parents. The good kind of parent that was down to earth and followed a proper diet and got to bed on time. She seemed to have very good balancing skills with multitasking and most of all, very good at choosing and sticking to a healthy diet. Seems like her kids respect her and are following her ways of watching what goes on her plate and in her arteries. She unfortunately has some stressors typical for a high profile woman in the millenium but also has plans to deal with the stress. (I wanted to suggest more immunesupport, and antioxidants while in stress in addition to yoga and breathing classes-that defensive postion, in tolerating stress places most humans into a two fist forward, shoulders forward, back flexed chin down postion. This is the usual set up for neck stiffness and pounding headache, chest pain that comes with stress easily fixed with deep breathing and chest opening!)

The reason I bring this chance encounter up is that we are seeing a few of the baby boomers now getting in great shape. Seems like the 50's age group now is getting a taste of health with the advent of 5k's, healthclubs associated with physical therapy, numerous supplement companies, (some of them very good while many others crappy, with poor bioavailability). In the populations I have come in contact with from the Wheaton-ites of Dupage, to the newyorkers transposed to Florida, to the developing cities of Aurora and Oswego Illinois, 50% of all I see are with a BMI of 25(overweight). 40% are normal or close to overweight and 10% are in good shape. Most of the answers for the 10% club say they are doing good because they want to stay off medicines, most of the 50% say they dont know what a BMI is or that they dont have insurance so they havent seen a doc in a "long time". Bottom line is we are a very unhealthy nation leaving our health essentially in the hands of the fast food people hoping these companies and restaurants are doing a good job at declaring "fatfree" or "caffeine free" or "no transfat". Well, guess what, all that great tasting stuff is taken out with the addition of something else synthetic sugar substitutes...places still need to sell and "hook" buyers so they will pay and return to pay again. Doctors have great intentions to watch our risk factors and reverse them once found.....but that is usually it. ONCE risks are found, medicines can be used but you are now taking a pill every day for the rest of your life. It should always be a temporary bandaid while we make changes in life and diet. I have had the worst risk factor laiden patients get off most meds with a major reversal of diet and health habits. It's hard to keep up but once used to the diet schedule, and more over, once you get a taste of "this is how I felt when I was 20 years younger" now that is addicting and it is worth suffering through not eating that crispy cream donut and instead going for a fresh crispy fruit or colorful veggie. As I have said before about the millenium doctor office, time is money and the average visit with all medical algorithms in place only lasts for about 10-15 minutes. Not much time to figure a dietary diary over the last two weeks then come up with changes to work into the weekly grocery list. Again I say that insurance should pay for nutrition visits but seems only covered nowadays is you already are manifesting diabetes or refractory cholesterol control. (I remember once when high blood pressure was used to pay for a visit a dietician).

The "Saguil Approach" would be to find a nutritionist or napropath who knows food and pay out of pocket, visits would be finite, eventually the learning curve will plateau and one should be able to continue on alone. Patient should be able to apply the charges to a health savings account for tax free benefits. On the doctor side, billing for face to face time and counseling is LEGAL but one would have to document topic and time spent. Front desk would also have to be creative in scheduling the up coming patient for counseling dietary habits and using more time than 15 minute slots. (Certainly seems like an extra 15 minutes doesnt amount to much but if 75% of the medical problems need nutrition counsel, 75%of the schedule has to be lengthened and that translates to a 12 hour day of just patient contact. Add on 2 more hours of paper work and 1-2 hours of rounding at a hospital or volunteer work and you have broken the 15 hour work day!..hoooray!) I can only tackle one problem at a time and now it is "intellectual marketing" as Paul Pilzner refers to teaching. If enough people get taught nutrition, enough can write a letter to their insurance companies and maybe an insurance company may change what is allowed for dietary visits. I'm dreaming .....but me and Martin Luther are allowed to.

Turn your head and Look Away

I was told to not write scripts for physical therapy while working as a doctor in the emergency room because therapist will call to discuss cases and we arent built to answer primary care issues with patients we see for one visit in a year. The general idea of and ER is to "treat and street", take care of immediate issues and if not life threatening, send them back to primary care. Problem is that many people who cant afford insurance use the ER for their office doc. Even people with public aid will have ER visits paid for but primary care may be paid for but will be difficult to get into.....thus they also see the ER for primary care. Then there are the well established doctors who have very full schedules and cant pack in patients for same day appointments so send them onto the ER for what "sounds like it needs an ER visit symptom". Since I have been working in the ER I have noted that the average patient may wait 2-4 hours. This is a wait that will range from sore throat to chest pain.

One of the reasons I write is to kinda of gripe about the need for efficiency but the resitance for change. I have training in sports medicine and medical acupuncture more than most of my counterpart family practice breathren. This doesnt win me a bigger paycheck or a higher position in a hospital. Ney, I get paid the same paycheck at everyone else but I may get patients cleared of their disease state faster. More due to the fact that I combine physical medicine with conventional medicine. A regular primary care doc would probably be able to come up with the same diagnosis but an extra step or two is saved due to the fact I dont have to get another consult to help with ongoing care or treatment. (example: if ortho is needed, it will usually take about a week to get one to see a patient and that is after the right test is ordered)...that could translate to a week of lost wages or a week of a mom staying home to care for a kid that could have started physical therapy sooner.

I digress, in the ER I see alot of sprains and strains. I know how to send off and I even write specific plans and orders on the script to physical therapy. The option is always to start it and just have them follow up with primary care if they still need something after a few weeks or if the patient suffers a set back while in PT. So I save the patient, save the primary care docs office the hassel of seeing the patient after the accident or trauma and then prescribing the same script they would have written in less detail, saved the patient time at home doing nothing waiting for a call back from the primary care doc or ortho docs office, saved the work from paying for a temp to come in and do the work of the individual for his or her time off. But ....if it goes off the grain of standard procedure I shouldnt do it. Dont get me wrong, The administrator is doing the right thing by saying to hold it cause the system isnt set up to follow these people I am helping (an I am doing it at a discount since I am not getting paid for giving my expert opinion on the topic of how to care for a specific injury).

To expound on the topic, I have alot of nurse freinds who have been trained to be managers but it is just too much hassel and political red tape that even with training they step down to routine "grunt" work because the excessive frustration isnt worth the extra few dollars on the paycheck. Also a higher liability, since one that is higher on the food chain is also accountable. (more of a scapegoat when needed)

Patients know this and they will pay extra just to be in the care of a doc that knows their particulars. This concept is growing of "concierge medicine" which used to be called boutique medicine since it seemed to cater to those who needed foofoo care and hand holding. Truth now is that patients know faster care and more efficient care can be managed if the doc knows you and is willing to cut corner in caring for you, whether it is in time to see him, time to get to talk to consult or time to get out into a procedure. The catch is a family usually has to pay a "retainer fee" to be in the docs small circle. Doc usually takes 500 patients only to devote more time to each one. (this compared to the 2500-3500 patients needed per year to break even with the expenses of a 1-2 man office) Imagine a family paying an extra 1000 -1500 dollars a year on top of medical insurance bills.

I believe this is also the reason people are shying away from docs and conventional medicine due to the doc doesnt spend time to listen since he or she is so busy that they only spend the bare minimum to hear a select symptom or two and make a great diagnosis to prescribe the standard prescription medicine and have them follow up. Patients are never one medical problem now a days. With all the pressure today and 50-60 hour work weeks, dual income families, poor eating and poor health, even if they only complain about one thing, there are two more to address that have to be postponed until 1-2 weeks when the next opening is available. The proverbial 15 minute slot has to be followed or a practice with go belly up paying for all the extra people needed to take care of the paper chase that the insurance companies create to keep money in check. Well, I do what I am told and dont write scripts for PT anymore....tonight was painful because a patient whom I was treating could have used physical therapy quickly but now I had to send her back to the clinic that couldnt fit her in tonight for a simple sprain. And she will probably spend 3 days getting an appointment, then another 3 days to see a specialist, then another 3 days to get to PT. At least the nursing manager said the idea was good but it has to be approved by all primary care docs before I could do it and the other ER docs had to agree. I'll submit it to the house to be approved by the senate just to be veto'd by the higher ups......oh well! Just do your job and turn away is what my wallet says.....but my heart says help the sick! Where is Hippocrates when you need him!

Sweeeet!

Whats the deal? Tonight I had two patients,one in for an infection and the other with chest pain. Both had difficulty with controlling their individual problems. No other complaints told to the triage nurse and I attempted to take care of the two separate issues, but upon discussing what to do next with each of them, something told me to check a sugar level and....both of them were in the 300+ range and both were obese. Both were admitted diabetics for at least 10 years each. It turns out both were on insulin. The gentleman had insurance and wasnt checking sugars daily but stated he was last in his doctors office about 6 months ago. The ADA states to get a hemoglobin A1c every 3 months, so thats at least a visit for a blood test. I asked what is daily calorie intake was and he said about 3000. After I picked my jaw off the ground, I mentioned that a normal person is 3000- 3500 cal per day. He says it's "hard". I gave him the reality scenario of having silent ischemia from heart disease and diabetes and that dont count on doctors missing his heart, he will live and doctors will have him on machines and medicines. He will live a lousy life if it gets to that point and it will unless he changes his goals. He was more worried about getting a pain shot for his low grade back pain than the bronchitis in his chest or the chest pain. I explained that the muscles in the back and the bones in the back wont heal if sugar is constantly floating around in the blood stream and not getting into any cells the heal.

The young lady was in for a new absess to her neck and was a very nice person, she had a different story. Alot of stress lately with death of her dad, no insurance since then, no job. Had last vial of insulin but couldnt pay for new vial. Had been losing weight and was at about 100 lbs. off since 1 year. Told her that infection is the begining, with the sugar being so high and not being able to get one drop of glucose into the little white blood cells that fight infection, I could virtually give her all the big gun antibiotics in the world but we wont win since the white blood cells cant finish the job. She broke down and cried and obviously was in alot of stress. Last lecture I gave had a topic of stress and I explained how stress brings on more free radicals that produce damage to cell membranes. This leads to poor gland functions, poor organ functions, poor thinking. also opens to infection, worsening diabetes, and cancer. I explained how if sugars arent stabilized and given to the body in regular increments, all organs fail (but they do it very slowly).

Many of the problems with diabetes, blindness, kidney failure, heart attack, stroke, amputation happen due to free radical formation. When diabetics get sugars under control, great but this subset of the population does exceptionally well with antioxidants. Magnesium seems to be depleated due to the high influx of insulin stimulating the membrane cells to change permeability from the failing pancreas so this supplement also help curb wide sugar variations. Finally Chromium and cinnamon seem to make the cells more sensitive to the circulating insulin. The basics always hold true and those would be decreasing total calorie intake in addition to not hitting the body with massive amounts of food followed by times of famine. The presence of food/glucose in the blood stream will start the usual chain of hormones to be released, serotonin, insulin, growth hormone.....when the levels of glucose vary at the extremes of the scale, the hormone response will be in extremes. Think of being in a fight or flight panic, several times a day. Not healthy and would eventually depleat all the hormone supplies causing poor sleep, poor concentration, anxiety, diarrhea, hallucinations. Remember vietnam vets and post tramatic stress disorder. Not just the mind but also led to poor health, poor social skills and poor tolerance for change.

Diabetes is a growing epidemic, almost one in three are overweight in the US. Usually the big three always come together; diabetes, high blood pressure, high cholesterol. And guess what....all related to diet. And guess what else, doctors usually dont have time for nutrition counsel but have just enough time to discuss medication side effects and new prescription use. We werent trained properly in school and residency. And the good nutritionists arent covered by insurance. Thank god for diabetes.org and all the info on the website. Whether on insulin injections or pills or nothing at all, food and diet are always supposed to be the basic building blocks. With all the medicines in the world, if diet isnt changed disease will continue to deteriorate. I am really worried for both of them.