Validated

Back in the 90's, I used to acquire titles to be someone. Can't be a good sports medicine doc it you don't work with a team, can't be a good family doc if you don't see 30 patients a day, can't be a successful physician without driving a Porsche. Did it all to validate me as being a good doc amongst my colleagues. Patients were praising me but administration said I still was not competitive with how the average doctor in the US bills in a day (MGMA standards). So when I didn't agree with the direction the hospital was going (insurance business model) I left private practice and worked for emergency room/immediate care centers. I didn't have to worry about finding a true cause of suffering, I just treated acute symptoms, gave medicines and told everyone to follow-up with your doctor ("Treat and Street"). Just have to follow acute care "cook books"" and not worry about bonding with humans-(takes too much time). Ha!, but little did I know, when I started to show compassion and listen, my "numbers" went down compared to how many patients were seen per hour by other docs. Then when I followed orders and moved through charts like a Jewel Grocery cashier scanning cans, then patients complained they felt rushed. I just can't win in this insurance reimbursed model. I had to figure, how do I empower patients to help themselves while at the same time, be profitable as a small business owner. I needed to find an answer and was always taught the answer is in the wisdom of other docs who have the biggest buildings, fastest cars and biggest staff. But.....I found there was a message inside, a knowledge within each cell of me that knew the exact way to problem solve and come up with the correct choice in every decision. My epiphany came when Deepak Chopra came to Chicago and I thought maybe if I heal the inner turmoil between compassion to serve and the hollywood picture of success I can be better at applying my textbook knowledge and problem solve. I listened, learned, met other non-health professionals that were healing (also met some docs that were going through the same thing as me but they seemed very angry.....complaining about the medical system and missing the event of something beautiful morphing during the lectures that allowed for an inner message to be heard.) I began to interpret feelings my heart generated and allowed these to effect my decision-making/problem solving. I didn't recklessly abandon medical protocols but I allowed for feeling comfortable with using "feeling" to help guide patients to better health. Something called me to learn acupuncture, something called me to observe an herbalist using aroma therapy, something called me to give more "free lectures" to the community, something called me to start following Andrew Weil, something called me to start teaching yoga. I would have never done any of this in the eyes of my doctor friends because it would seem "quackery practice" and I can't get reimbursed for it. Fast forward to earlier today, I am supposed to be preparing a lecture for Cancer patients but the new Hospital Wellness Center that just hired me for yoga instruction, still had to have me go through the painful administrative paperwork of credentialing, verification of training, drug testing.....I dont have time for this! In my mind, the question of why am I even teaching yoga? as my first class was filled with 20 people who had no training, and I probably will be paid just enough to take care of gas....I should just stick at filling my office hours and promoting myself using the "usual marketing companies". Well as I was being told I needed another picture ID (I live 25 miles away!) and about to stick it to the manager of HR saying, this paper-chase is sooooo frustrating and worthless and just get some "minimum wage non-MD" to teach it! A lady walked up and excused herself but had to interrupt and say; she attended the meditative yoga class I gave yesterday and in the 10 years of suffering from Fibromyalgia, had an entire day of feeling no pain: she told me it was "transforming and has been telling everyone she can't wait for next week and wanted to see me as a patient". Like a switch, all the anger left, I suddenly was speaking to an HR manager that appeared to look different and this calm was injected into my blood stream. To imagine I was seconds away from allowing self doubt to control my heart/mind, ruin another human's day and probably get on the highway at dangerous speeds taking frustration out on innocent motorists. Although it was reassuring to be validated, I feel more empowered to follow the innate wisdom that was always there but sequestered by the ego. As Deepak's Law of Karma says; My Actions are Aligned with the Universe

Extremes of Age

A great Marine Corps motto (popularized in Heart Break Ridge) is applicable to daily life. Most would speak of this as being used in physical situations like those seen on Dual Survival or Man vs Wild. My belief is one can apply this to milestones of life. Our first day at school, first public speech, first kiss, first house, first funeral, first bully, first job loss, first financial setback....the list goes on. In psychology it can be referred to as coping skills. We accumulate coping skill from small life challenges and hopefully rely on previous experience to deal with larger ones we take on in later years. That's if we are lucky enough to have the big challenges saved until the very end. With the current financial climate, the existing health status of the US, and the 24/7 internet tsunami of yellow journalism media related stress.....our tweens and "millennial's" are being tested before standard defenses are learned. I think of the ending scene in Platoon where Charlie Sheen is coming back from a slaughter, exhausted about to fly home and he looks over the line of young soldiers coming off the plane with uniforms freshly ironed, rifles unfired, clean-shaven with "deer in the headlights" looks of bewilderment. It is my hope that has young people learn their coping skills, the wing of a parent will be around to secure a soft landing from the experience and add insight to why an outcome occurred.

How can we expect this with 50% of all families end in separation, the new parents of today have more psychological diagnoses and reliance on prescription medicine than ever before and our elderly are separated from the nucleus of the dinner table. In fact, those "banks of wisdom" (before they turn senile) held as a big focus in American Indian society are so de-valued today. Even if the information is considered ancient by our tweens, the interaction of story telling and experience passed from grandparent to grandchild (without having to be interrupted with -"I have to get this phone call; I must have a drink; I can't take you since my work starts early tomorrow") plays such a valuable role in the young adult experiencing events that lead to grandpa's own coping skill. Whether or not the grandchild adapts that particular coping skill is not important, it is the experience that is being lived in the story.

Richard Davidson in his new book The Emotional Life of you Brain, speaks of his studies where a person watching a sport being practiced will stimulate the same brain pathway as actually playing the sport. The best athletes in the world have long known if you visualize the "basketball free throw" enough, you will increase the chance of sinking the ball in the real life situation.

So....do we abruptly throw our chicks out of the nest and hope they fly right after hatching.....no! Nature allows animals to provide parental shelter, teach life lessons then teach not to need sheltering. Wayne Dyer in his book The Shift spoke of parents making "leaning" unnecessary. It seems irresponsible to allow children to experience the world "on their own"....but in the true family nucleus; they will never be alone. The challenge I see is how to impart these values to our kids in problem solving life if the family nucleus is devolving. Probably goes back to respecting wisdom, tradition and our heritage.

The legacy of humanity is not only in the young generation but also in our elders.

Ecotherapy

Usually when I ask a patient about exposure to nature, they say I live near a wooded area. When I ask further how often they venture into the wooded area, most just pass by. Even with people who have a backyard facing trees, the idea about experiencing nature is to be in it. Usually means at least 10-30 minutes of no technology, little to no mechanical noise and the intention to not react, just be. This last part usually is the deal breaker with people I speak to. In fact, most of my lectures are preceded by a slide showing a doctor's prescription pad where instead of writing a drug, I write orders for 1- nutrition; 2-movement; 3-grounding. I can usually make people feel better with the power of temporary drugs AND a plan for lifestyle change. Both are equally important but in my former life of 15 minute visits (please see The Fatal Fifteen blog), I didn't have time for teaching lifestyle change (or come up with an individualized, intricate plan). I have found if I stick to the 1,2,3 way of formulating a plan, makes it easy for me and my patients. Experiencing (witnessing) nature can easily take care of # 2 and #3. Takes physical movement to get into the forest or wooded area and once you are in, if you let go of technology and are willing to "slow down to the speed of nature", nature's speed will consume you. Example; going to the beach, (even if you are not a beach person), will usually capture you just with the powerful sound of the waves hitting the shoreline. Hypnotic, mesmerizing, relaxing if you stay long enough. There is usually an inherent "need" to check internet, email or text but when you start to realize the web will still be there later, the emails can wait, the texts aren't important information anyway.....then you allow nature to take over. That is when you realize, the breeze is cooling, the shade is refreshing, the surf is inviting. In fact, the surf is continuous, powerful and you don't have to power it on to access joy. Eva Selhub in her book Your Brain in Nature, speaks of Japanese Forest Bathing. Around the late 80's to 90's, there was research started about the effects of nature on city dwellers. For the medical community to make recommendations, doctors have to see studies. (Randomized Control Trials) Good for making drug companies spend on research and development (really just marketing); not good when simple suggestions like diet and exercise that have to be studied and tested before being recommended. Who is going to pay for expensive studies on the Mediterranean Diet being heart protective or a regular walk in nature being a treatment for high blood pressure. Truthfully, since the American public keeps on asking, your tax dollars are being used to pay for fancy double blind studies on diet and exercise. As I mentioned, Japan did precede us by testing whether health is effected by hanging out in the forest. They found that the blood and urine hormones for stress were less in those who spent regular time in the forest. They also found hormones for relaxation were higher in the forest group. Imagine if I wrote a script for high blood pressure that said go to a forest preserve 5 times a week and just sit there for 10-30 minutes 3-5 days a week. (or imagine if medical insurance paid for it!!!!) Well they will never do that, in fact, most medical insurance won't pay for anything preventive: exercise, weight loss, good nutrition, good sleep. What they will pay for is your disease-management after you have been diagnosed with the illness. My suggestion is don't wait for the disease to pop up in one of the annual physicals, start listening to your inner voice, start acting on what you see in the mirror, start taking extra time to sleep or wind down at bedtime. Spend on "Healthy". Even if it costs more in the short run, it will save you so much in copays, sick leave, prescription deductibles (and I am sure you won't miss the side-effects to the one or two pills used to "control" the disease you are labelled with). Eva's book is due out 13th of June 2012-well worth it if you want to make a pre-emptive strike on health and personal healing.

JUNE 2012 Schedule




We're on! Been a while since last post. To get up to speed, last posting was fall 2011. Went "dark" for 1/2 a year re-emphasizing local community advertising. Now that I have established some good footholds in the the community, back to blogging. I will keep posting adventures with patients on my Wordpress blog and use this to post local appearances.

Summer break brings vacation time so I have limited engagements.

1. June 9th (Saturday) Whole Foods Market Schaumburg at 3:00pm Detoxing Deconstructed
Please call (847) 585-5800 to reserve a place.
http://wholefoodsmarket.com/stores/schaumburg/store-calendar/

2. June 14th (Thursday) REI Oak Brook Terrace at 7:00pm Knee Pain in the Outdoor Athlete
Please call (630) 574-7700 to reserve a place.

3. June 23rd (Saturday) Northwest Community Hospital Wellness Center at 11:00am Healthy Community Project: Yoga?
Please call (847) 618-3500 to reserve a place for program #05-4104 (small fee/lunch included)

Have a great summer, see you in the classroom!

Moving Meditation and Gene Expression

A few years ago I listened to Herb Benson lecture about how he discovered the Relaxation Response in the 70's-

http://abcnews.go.com/video/playerIndex?id=7392433

and Jeff Dusek at Harvard is now finding a coorelation in the DNA of meditators. If I was to develop a pill that promised to turn on genes that fight cancer, heart disease and depression, and then advertise on TV, everyone would be coming into the office asking to try the "new medicine". What if the label said no side effects, and what if insurance paid 100% with no copay. What if the therapeutic effects would extend to all body systems and not just help the heart, or improve mood or give and erection for more than 4 hours. This is what I feel yoga does to people. Its more than just bending over and wrapping your leg around into a pretzel. We sell it to the public as a way to get flexible just because marketing says the majority are hesitant to listen or do things that involve spirituality but they will click and read on things that improve physical fitness. Its ashame but life long practitioners usually are the ones that started with taking a class out of curiosity then became engulfed by the positive effects on every aspect of daily life.....who cares if I can touch my toes when I now feel better and more aware of existence and happiness than any other time in my life!!! Everyone I teach knows my story, I used to add a few poses to my "pre-workout routine" to get warm and wake up muscle. Now my old work out routine is used as a "pre-yoga warm up".



Truth in practice is that yoga, a moving meditation has the ability to lower the blood pressure, improve core strength, take the mind out of the onslaught of ideas and thoughts that bombard it every second, change metabolism, maximize digestion, and enhance killer attack white blood cells that fight cancer. Its like a smart bomb that can be set off in a crowd but only kill select badguys, leaving women and children unharmed. One of the most profound effects I have experienced with this is that if applied at the beginning of the day....after class I feel a great sense of wellbeing (I can get that with a workout-endorphine rush for an hour) but then its effects are pervasive. I think clearer so traffic is not a bother. I am more productive at work so efficiency is maximized and projects are finished in a shorter time span. Lunchtime comes without a rabid hunt for carbs/ meat/ salt/ volume so I dont get saturated in post gastric sleepiness. Since satiety is there without being drowsy, no need for the big starbucks venti. Without caffeine, sex is magnificent and sleep is immediate and continuous. Then the next morning, wake up bright and alive looking for more yoga and meditation. You can see this pervasive improvement from one aspect of life to the next. Its like a logirithmic improvement in feeling and functioning at a true maximum without a drug. Just think of anabolic steroids, ritalin, viagra, prozac, marijuana, HCG, and vicodin without any side effects! (Aahh....now you understand!!) There was a recent movie "Limitless" that was about a drug that opened mental awareness, but it didnt stop there, every system in the body functioned at a level that was superhuman, all because the mind was unlocked.



So when a yogi exclaims "I feel better at 50 than I did in my twenties" its not just that the mind has been dupped into thinking pleasant thoughts....its because cholesterol is lower than ever, sleep is without a pill or a beer, food is digested without heartburn or bloating, muscle repair is faster than varsity highschool years, the morning is fine without coffee......and oh yeah...... I can also touch my toes.

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.