What is good for the goose is NOT good for the gander.....

The diet and lifestyle for Sean (a 26 year old professional football player) wont work for me (a 49 year old physician/yoga practitioner)------------------------>


"You have to start exercising!" I caught myself saying to a patient. Then I asked, have you ever exercised before? No....well, there was badminton in high school. Now if I didnt ask, I would assume she would just go back to her "Bally's" membership and start her old routine again. I imagine some people leaving with suggestions I made and getting home but not knowing how to begin. Maybe going out and starting to jog with 2 year old pair of tennis shoes with no arch support. (That would eventually lead to shin splints, pain for days with walking down the stairs and having to indulge in a few advils, get reflux symptoms then curse me for having made the darn suggestion to begin with.) Or the 40 year old that buys a treadmill again only to use it for hanging laundry after 3 months because its boring to run in the house. The word "exercise" can actually connotate fear and embarassment in some that didnt like gym class in highschool. In 2005-6, only 53% of students in the US participated in athletics. That can be translated to 47% didnt like gym or have great experience with finding a sport or just arent aware of healthy forms of exercise short of running and calisthenics (-Arnold Schartzneggars attempt at the presidential physical fitness awards). Zooming to the CDC's statistics, if 2/3rds of the population is overweight, then dare I say more than 1/2 of that group may not have any experience/knowledge of activity that could save their lives short of running that will probably hurt their knees. Oh.... "pre-habilitiation exercise education" is not covered by insurance but a below the knee amputation for diabetes pays "good money" to the surgeon and hospital.

I have coined the phrase "Heart Healthy Activity" to be spoken instead of "exercise". It doesnt conger up experiences from highschool for some and it opens ideas up for the ex-athletes that are stuck on one kind of routine. Andy Weil professes in his book "Optimum Health"....act your age. To prevent injury in activity not designed for the decade of life you are in. Heart Healthy Activity for a 20 year old differs from that for a 40 year old. The HHA for an obese 20 year old differs from that for a lean 20 y/o. A 40 year old on high blood pressure medications cant measure heart rate like a diabetic on sugar medicine. A 49 year old ex-bodybuilding, high school sprinter (booya) usually will be against starting yoga with the typical preconceived notion that "I'm not flexible so don't think its right for me". Bottom line is just like some medicines cause back side effects in one person but lifesaving results in another, HHA has to be "tailor-made" to the persons age, loves, goals, economic status, physical disability, sex, family responsibility and free time. I believe if this basic lifestyle change is to be sustainable, then thought, design, and a good intention to make the patient successful in changing has to be invested. This is why I work with chiropractors, a physical therapist, a registered dietician/personal trainer, exercise physiologists and counselors. A well rounded team can provide several different "in-roads" to attempt with each patient in order to design a HHA that they will be able to embrace to initiate a change. The more you change with HHA, the more you improve the chronic medical disease: the more you improve the chronic medical disease, the better you feel: the better you feel, the more empowered you are to make the next change.......

As a patient, you have to be willing to try new things outside normal comfort zone....essentially trust that the person designing the program has the best intentions and desires for your success. As a provider of healthcare (doctor trainer, yoga teacher...), we have to keep in mind, not every prescription for lifestyle change is the same for a given patient.

The New Wellness Culture

Went to the "2011 Veggie Fest" in Naperville because a trip to downtown was cancelled by a "Half-Marathon" occuring at the same time. I remember reading about it and wondering if it would be like a glorified sunday farmers market or smaller. As we approached from the highway, I could see major road barricades and a mass of people being controlled with police direction across a major off ramp. First I thought, must be an accident or concert....then a realized they were all headed to the "Veggie Fest". According to one of the vendors, (a cosmetic dentist and previous patient of mine) 10,000 people were expected for this 4th annual get together. I was amazed to see a cross generations, not just the tail end of the baby boomer generation (booyaaa!!) but young college kids, young families, a few retirement age folks; Indian, Asian, African Americans and "other" all walking around really taking advantage and interest in open tent lectures, vendor stands, food sampling tents, yoga (booyaa again!) Chiropractor tents......there was one MD tent. The Md/doc had a sign over this table reading "Ask the Expert" ....no other pamphlets, give aways, hand outs....pretty drab compared to the flashy and informative tables of alternative medicine counterparts at the next tables. And he wasnt busy...kinda looked bored.

All this is a statement that the call for better health is being asked by the community and answered by the community (at least a small percentage). In my opinion, healthcare reform will not be able to move anything faster than snails pace. I appreciate that "Obama Care" has made some initial steps to change the paradigm. But with the polarity of the government, it will take a heathcare catastrophy to make a significant inroad to change. (Just like the automotive industry bailout!...rescue at the last minute and socialize it). Nothing wrong with socialized medicine: it is working for Europe while our way is failing-along with our health) People have placed too much reliance on govenment to "get them healthy" .....like the guy who comes in after 40 years and says "fix me doc...just dont make me change my hours, diet or free time.....and by the way, I am not a pill taker and dont believe in psychiatry".

What prompted me to discuss?... Chicago Mayor Rahm Emanuel announced this morning new plans to "Incentivise" (......actually-Penalize) city workers to lose weight, lower cholesterol and lower blood pressure. An article in the Sun-Times called it -"Carrot and Stick approach".

http://www.suntimes.com/news/metro/7105643-418/city-workers-might-have-to-shape-up-under-new-wellness-plan.html

Just so happens my partners at First Health Associates and I have been working on a sustainable plan for lifestyle change just because of the way our weight loss graduates over the last 3 years are still maintaining a hunger to seek out more change even with the great gains they have made. All have been able to lose weight, most have been able to get off medicines, some have been able to change their family members and friends......every single one has been empowered to understand the concept that the power for successful change was inside all this time, just took education/guidance to plan a way to bring it out. The "incentive" we give people in the current program is/are the graduates from the previous programs. We have a growing "wall" of success stories to our program "The Largest Losers". I believe in what Dean Ornish said at my AZCIM fellowships conference......"Fear based medicine that uses the threat of future heart attack or cancer is not a sustainable motivator for change......its about the Joy of Living"....when our team is able to help in making a single change....our patients feel better, it empowers them to embrace the next opportunity to make another change. Small, high value, "daisy-chained" steps to lifestyle change are more sustainable than the "all in" decision to change everything at once. (although some of my Vata patients need this)....either way, we are ready to support all with conventional, alternative and ancillary healthcare.

A small percentage of Chicago's city employees drive 2/3rds the total healthcare costs around 5 chronic illnesses that could be managed with lifestyle change. The US population is the same way, an average of 6000 dollars spent per citizen per year and we are ranked close to the bottom of the list of world countries for being healthy. The good news is that with what I witnessed at The Naperville Veggie Fest, a small percentage of the population is taking their health into their own hands and showing great success at initiating a lifestyle change that is sustainable. I believe in the next decade, we will incentivize the rest of the community to break free of the status quo and instead of Dying Longer-experience the true Joy of Living. I feel in my heart we can grow this from a club, to a culture to a Wellness Generation....just takes the one step at a time.

Collective Thinking

We have incorporated summer vacation into our family ritual. Its so easy to say, lets just stay in Chicago....theres so much to do here and its a hassle to plan an outing. Many more excuses can be created in the depth of my mind but its so fulfilling when the vacation is over and the memories of time spent away from the normal ritual are permanently burning into the temporal lobe of my brain. I have to praise collective thinking as to how great ideas are creatively morphed and then carried out. If it wasnt for the sharing of the initial intention and desire between me and my beloved, then her and her siblings, I dont think the idea of "where should we take the kids before school starts" would have blossomed just because- I'm to busy with promoting my clinic, giving lectures and growing my practice. I love the way a small spark of an idea can be shared with like-minded people and especially with the speed of communication now-a-days, a well planned concept can be effortlessly developed. People all have dormant talents that sometimes go unrecognized until a spark ignites that center in the heart chakra. Once ignition happens, its like this inborn desire continues to drive the individual to creatively expound on what they feel is the right way to "celebrate" the idea that was initiated. Usually in giving group, this inspires others to contribute to the growing idea in their own way. ( ie...one person is great at shouting out the idea to the group, one person is great at searching for flights and houses, one person is great at cooking meals, one person is great for planning events, one person is great at packing the whole kitchen to make sure we dont forget anything.....) When everyone contributes their individual talents, no matter how small, the "universal idea" that was started with a thought...takes off with all details being covered and in the end....almost no effort being recalled as to how did we launch this massive plan into reality.

I feel this speaks to the concept of surrounding yourself with like minded individuals. Equally important is to "shed" the relationships that seem to foster alot of energy just to end up with a feeling of I didnt feel good about spending time with that person. Some people have not matured to the point of realizing the universe isnt here for YOU; you are created to contribute to IT. Those people who pollute, eat without guilt, cheat taxes, cut in line, disturb the peace, spread rumors, insult others....all have an agenda to be self serving. When your intentions and desires are geared to just bring energy to you and not to grow or contribute to the good of all, you become an "enery drain" to your family, your friends, your coworkers, your community, your race.....and yeah, even the planet.

In the end, something that started as an idea and blossomed into an experience that my kids, neices and nephews will remember as "I remember feeling good about myself when we all participated in that trip way back in 2011", makes it worthwhile to share ideas with other likeminded individuals.

You cant fight and cant fix what you cant face

I had a young guy come in for a rash today and when I asked how often he sees a doctor, his reply was “I don’t really need one-I am healthy”. I would always like to think me and my collegues from around the world are worth visiting if you are interested in saving your life. Unfortunately, statistics in 2000 showed Iatrogenic deaths (caused usually while in a hospital) were number 3 in the US right after heart disease and cerebrovascular death. So…..maybe its good that this young guy stays away? Naaaa, this is why I love Integrative Medicine- the judicious use of scientific western medicine and the intelligent use of natural medicine.

One of the most common issues that accumulate to great degrees are feelings of anxiousness, anger and doubt in my 30+ year olds. One would think “these are psychological symptoms that arent that common or lifethreatening” but we see high blood pressure, or insomnia, or reflux, or impotence in essentially 8 of 10 patients that come in for "routine physicals" -and these are usually based on anxiety and stress. So how does the average American take care of such a problem? Most usually wait until the issue causes physical problems and MD's usually treat only the physical ailements with medicines. Patients and doctors ignore the psychological and spiritual aspect rooted in disease and miss the whole picture.

Taking smaller steps at an earlier time in the evolution of a disease process usually results in postponing when the symptoms show up (and health conscious folks sometimes the disease never shows up) I believe you have to acknowledge your problem before you can start working to solve it. How can someone self-assess when judgement is already impaired? Or perhaps there is no prior knowledge of how normal should feel? Ahaa!! This is where a well trained doctor-team can be useful; to search for and point out an issue that should be adressed. Oh, its not the same when someone says, “I had an aunt with anxiety, I know what the treatment is!” If there was one treatment for everyone then there would be no further outbreak of disease since all would be cured. In fact, people get put on the “standard” treatment and still, dysfunction exists. Truth is that everyones personality is “a little different’; everyones family dynamic is “a little different”; everyones outlook on their neighbors is “a little different”….so treatment has to be personalized every time. Aint just one pigeon hole that works for everyone. Friends, doctors, counselors, psychologists, naturopaths, "intervention groups", dieticians, coaches are all very powerful ways to realize things about yourself that you wouldnt have seen. So it all starts with self revelation and realization.

Unconditional Love

Melissa's mom came into my office wondering if I could provide a different option for her daughter to get healthy. Mellisa has cerebral palsy, psychological imbalance that results in difficulty controlling anger and an intestinal absorption problem (called leaky gut syndrome in alternative and complementary circles). Mom is bringing her daughter (with electronic wheelchair, computer talker/voice, and handicap car) to Rush GI department, Rehab Institute of Chicago and mostly a visiting counselor for Behavioral Health. She has handpicked the best of the best. I liken this to the FBI, CIA, National Guard, TSA; all powerful individually but difficult to get in the same room. Melissa has been maintained on specific protocol medicines well established for each diagnosis. The problem I see is that as she ages, the dynamics of her role as a patient change. Interpersonal self esteem, mom daughterrelationship, handicapped/caregiver status all will change no matter how solid and stable the physical home and care situation is.


Think of the typical guy that comes into my office at 40 years of age; hasnt seen a doc for 20 years aside from coughs and colds, then says "fix me doc". High cholesterol, high blood pressure, overweight, erectile dysfunction.....suddenly the small tolerable problems that were previously stable, all become problematic. I quickly stabilize the problems with prescription meds, highly suggest lifestyle changes and dont hear back until a refill is needed. Few years go by and no lifestyle has been changed, same bad habits fall out of control as more weight is gained, more family dysfunction is accumulated and more bad habits are continued. I give more medicines, stabilize and make more suggestions on seeing specialists. Then the specialists use a host of medicines for severe disease with individual suggestions for lifestyle change and diet modification. [I firmly believe it takes less effort to take a powerful pill than to submit to saying, I will switch to mostly vegitarian food, exercise 3-5 times a week, meditate daily or find another job with less stress.] The problem is that coping skills and pills will make things better until the next crisis occurs (and this is bound to happen because human interaction and interpersonal relationships are dynamic and always changing.)

I will see people after several crisis have been dealt with, and controlled. With each intervention, a bigger more poweful medicine is used or another specialist is called in. When the episodes occur with more frequency or regular medicines dont help and only harm (or make the other problems flare up); then hospitalization is attempted and intense polypharmacy, poly-specialist control, poly-therapy is thrown into the mix to stabilize and discharge. I used to just blame this cresendo-like occurance to total-body-failure on aging but I really believe this is just over medicating and not allowing the body to heal. Of course there are disease states that do not have a way out, when the spirit is really challenged .....but.... there are more disease states that have a way out (better living) but those doors are not opened.


Back to Melissa's case, it was mom who, even with every well known specialist in Chicago, listened to her instincts and went outside the box and looked for help. (In Bruce Liptons Biology of Belief-every cell in your body has an energy to it and every cell can create a message, the idea that about having a "gut feeling" takes the power of decision making away from the brain and more into your cellular DNA) I looked at her mom and saw someone that that was reaching out for answers not being given by conventional medicine. Melissa was in the hospital with a decompensating gut that didnt work and caused pain (I had a fear that she wouldnt leave the hospital at that point). The only nutrition was with an IV bag. (called TPN) There was a tube that went from her stomach straight out to her abdominal wall for feeding but her gut was too inflammed to even put water in the g-tube. I listened to moms story and it sounded like all the specialists were circling the wagons for the last fight. I didnt think I could add much more. AAhh!!! Then I turned on the part of my brain Deepak and Herb Benson trained and I thought......lets try to create a relaxing environment for Melissa. Soothing music, aroma therapy, a relaxed mom with hope (suggested she take a short vacation). Then I thought about sending out an SOS to 2 gurus-Dr Dave Rakel a fellow grad from the AZCIM and Jennifer Hoschel my herbalist from Clermont FL. We put together a few suggestions that the specialist were ok with and some the specialist didnt approve for lack of US studies. (these were mostly nutritional implementations) I didnt hear from mom for a while then 2 months later....here is Melissa- out of the hospital, out of her house for the first time in a year, in my office with mom and her caregiver Mindy, smiling dressed up and with more weight than the initial videos mom played for me during our first meet (since back then Mel was too weak to get out of the house). She talked to me via her computer board and I had a great meeting with everyone. After we finished and I said my goodbyes, I stepped out of the room feeling great then suddenly ......this unusual feeling came over me.....as if I just watched an episode of Oprah-the tears started flowing- I had to duck into an empty exam room to protect my testosterone. There are more challenges ahead, (and my gut is telling exactly what we have to do next) but Melissa and her mom have captured my heart. To see the dedication and instinctual bond they share even in the face of great challenge, makes me thankful I am able to experience their energy. (check out the smiles in the pic, that is a true dedicated family!)

Month 1, Training for Everest

Got back into my Deepak Chopra Audiobooks and I forgot the beauty of his wisdom. As I did my first hike for 2011 coming out of Chicago winter hibernation, I noticed during the portions of my hike that were on stone path, I was with some runners, the majority of which seem to have facial grimace. I do remember the feeling while running my marathons, I had to put myself into the "zone" to fight the urge to quit and turn in my electronic chip for a ride back to the finish line. So I tried to support these guys as I passed by but not much eye contact either. I mentioned my hike experience with Cristina and she said maybe they were just trying to push themselves for the health aspects of getting out. Then that got me thinking.....we probably train ourselves routinely with calling out the Hans Selye "stress response" but aside from getting our heart rate to tick at a lower rate than a non-exercising person, does a low heart rate and bp give us peace? I run into this in the office with big, muscular 20-30 year olds that come in for physicals and say "I'm healthy doc, I get enough exercise every day with the work I do", then I look at their blood pressure and find, pre-stroke levels. It's true they could lift more than I for 8 hours at a time but thats not the exercise that results in long living. Then there is the athlete type that comes in and although playing league basket ball or pushing weights and body building, cholesterol is high and liver a little fatty from alcohol use. I remember seeing a group of college guys hanging around the power rack at the gym taking turns in round robin full squats (not recommended for people who like to avoid cortisone shots in the knees) and one of the guys had a bite plate/mouth guard he was gnashing his teeth on when his turn to push the weight.
I only bring up the scenarios of anger associated exercise bursts to call for regular practice of calm and peace as well. I always go back to my first experience of relaxation and yoga with a patient of mine in his 40's with hypertension. I was giving him 2 daily medicines and leaving it at that as long as he was ok with taking the pills. One year he came in and stated he was going to try a new yoga place for exercise. (Back in the mid 90's, not too many yoga studios to choose from) I was skeptical but when I saw him the next season, his blood pressure was lower. Ok, I weaned him off the pills and the next time I saw him, he actually gained weight, not to the point of obese but little handles here and there, and his BP was still low!!! So to summarize, I controlled his BP with 2 different blood pressure pills, he started yoga, got pressure controlled and got heavier with continued control all with yoga and nothing more. No supplements, no surgical procedure, no job change....lin fact he was still running his business 40-50 hours a week. I started watching this "yoga cult" and their ideas of moving meditation and cultivating the "relaxation response".
Western medicine always pushes aerobic activity, cardio, exercise to bring the heart rate to 80% of your age maximum; all in efforts to postpone the onset of diseases of stress. (heart attack, stroke, diabesity) Its all scientific, proven with randomized control trials and pushed as an adjunct to eating healthy and controlling symptoms with prescription meds. But then cultivating the relaxation response, sitting in stillness and quiet, mindful living and spending time in nature; I feel is just as powerful, more rewarding and cost saving. For cultural reasons, the practice of spiritual grounding is looked at like the profession of psychiatry, its there and works but not embraced like the others profesions in healthcare. I thought is was just the baby boomer generation that thought of psychiatric illness as "nuts", but when a young guy came in for a school bus driver physical, the entire office sensed the very "bipolar-like" personality and demeanor so I told him respectfully that I cant approve his department of transportation card until fully evaluated by his primary care doctor for some underlying psychological tendancies I see coming out in the interview. The 30 year old said "so you think I'm crazy?" and started going into uncontrolled manic bursts (reinforcing my diagnosis of bipolar disorder).
I think most people are missing the boat with very beneficial techniques that work to allow the body to think better, heal faster and perform at maximum even without expensive gyms, equipment, or foods. I wouldnt substitute yoga and meditation for the whole exercise healthy living kick, but I would inter-twine the practice of cultivating Herb Bensons "Relaxation Response" amongst all the grunting, grimacing, panting, shouting, power movements everyone seems to try and turn a new leaf with.

The argument for; "Removing yourself from an Argument"

Most people have heard about the food that you crave is probably the food your body finds most harmful. (ie....people with hypertension crave salt, diabetics crave sugar) Not to say this is set in stone, but most comfort foods are the ones that have "turned on us". How dare a food become bad for my body! Lets talk about "the how". Food when it is broken down by the gut goes through some fancy chemical reactions and then introduction into the blood stream is made. Once in the blood stream, the different food types (protein, carb, fat) can induce a hormone wave to be released. The blood stream has delicate sensors that essentially tell the brain/body life is good so rejoice, relax and procreate or life is bad, fight, flee or scavenge. The take home point is that the body/mind can be coersed into creating an altered environment "inside" just by manipulation of hormones.

At a conference we presented saturday on Depression, it was cool to see some dynamics of communications with strangers. Most people have been taught to not open up too much to new aquaintances as part of a ritual in society of "getting to know others". Others will have some idiosyncratic habits of jumping into a conversation with very intense and saddening or argumentative personal revelation. And this would be in a first meeting! Most people would usually start to move away from the conversation, some will stay and engage. Aaahhaaaa! When the boistrous or codependant person gets an audience, the emotional stories begin... (both extrememly saddening or annoyingly involving-like the joke teller who laughs so loud one would be expected to also join in on the laugh for fear that you "don't get it")

Some people feel so comfortable in their diagnosis of depression or bipolar disorder that life seems stable when in tears or in argument with others. There will seem to be comfort in going back an environment that may be bad for health and socializing but it is what they are used to. There will be a talent of creating a tornado of emotion around the individual that you either get pushed away or get sucked into the conversation. The feeling or emotion thats evoked in a listener or innocent bystander to the tornado is called counter-transference. Those folks that can change the emotional feeling of a conversation to "depressing" or "defensive engaging arguments".....are creating a local climate change all around them- the saddened person will have everyon weeping with them or the argumentative person will always through out a new debate to keep one constantly defending another point. Either way, they feel comfortable having that type of "feel" within their mind/body and it is more empowering when others around them are involved with the feeling. It may not be your way of thinking/being but if allowed to engage, the force will be strong not to get involved emotionally. If not well grounded, the chance meeting with someone like this can subconsciously impact your actions the rest of the day.


Although my religious upbringing tells me I have to reach out to these folks, my actions has a healer are to help others first; engaging a tornado of emotion will hinder my ability to do this, so I confidently will respond with a simple answer and move on without guilt. If anything, I would reach out to the person supporting this tornado epicenter because they are exposed to this type of engagement every day.

......“If someone comes to give you a gift and you do not receive it,” the master replied, “to whom does the gift belong?”