You Are What You Eat (Part 1)

brain food

Is the body just a composition of all the food that you eat?  YES! To convince you, let’s talk!

I will walk you through your brain and show you how what you eat makes up every intricate part of your cells affecting how you act, sleep, feel and move. Making the connection between food and the body will allow you to take back control of your mental health. Here is how it works!

What is the Brain?

Your brain is made up of food – 80% water, mostly fat, some protein, amino acids, micro-nutrients and glucose. So when you feel sluggish, tired, foggy brain, irritable, moody, sleepy, angry, anxious, forgetful, it is all related to food! Food can be healing or can be toxic leading to cellular breakdown, malfunction and harmful disease. What you feel is just a symptom of an injured brain, signaling you to find out what substances you need to REMOVE or what you need to ADD.

  1. Water- Believe it or not, water makes up 80% of the brain. Every single chemical reaction needs water. Dehydration causes neurological dysfunction and causes the brain to physically contract and shrink. Even mild dehydration affects memory, cognition and focus. Drinking a warm glass of water before a test has been shown to increase reaction time dramatically. The next time you feel fatigued and need a boost, reach for a full glass of spring or filtered water and aim for 2 liters or 8 glasses of water a day. What not to drink? Soda, water in plastic bottles, sugary drinks, juice, sports drinks with artificial dyes, colors and sweeteners, because they poison the brain cells causing glycation end products corrupting your neurons leading to neuropathy, damaging cellular signaling and causing brain inflammation. How does this translate to how you feel? Your brain function declines, memory fails, mood swings, sleep is disrupted and you feel sick and tired. Bottom Line: Water = Energy Production
  2. Good Fats– The cell membrane is like the walls of your home. It keeps the outside from coming in. Just as your front door stays closed, until you invite someone in, receptors on the surface of the cell membrane decides what gets in and what stays out. As long as your walls and doors are in good condition, you and your family are safe inside from bad elements. Right? Your cell membrane also protects your precious belongings (DNA, Mitochondria, organelles) from bad toxins and influences outside the cell. It screens and allows only approved items into the cell. This cell membrane is entirely made up of fat. On nerve cells, there is a special insulation, called a myelin sheath, also made out of fat to help the nerve cell conduct electricity. Breakdown of the myelin sheath causes poor nerve conduction and conditions like Multiple Sclerosis.  The cell membrane and myelin sheath need good fats like Omega 3 from fresh sources of wild caught fatty fish (SMASH) Salmon, Mackerel, Anchovies, Sardines, Herring, grass fed animals and fats from plant sources, olives, avocados, hemp, chia, flax seeds, almonds, walnuts and other tree nuts. These fats make up a robust cell membrane that can seal the inside and send the right signals for proper brain function. Like in the story of the three little pigs, if you build your cell membrane with straw or sticks, your home will not last long and will break down quickly when taxed by bad influences. What not to eat? Transfats, hydrogenated oils, fried goods, processed vegetable oils, fats from industrial animals, pastries, french fries, potato chips, processed meats like cold cuts, sausage, bacon, hot dogs, icing, fast food, cookies, donuts, crackers, muffins, pies, corn chips, tortillas, movie or microwave popcorn, ready to use dough and margarine. These fats, when incorporated into the nerve cell membrane, causes the membrane to send inflammatory and distress signals to the interior of the cell. This signaling leads to abnormal protein production, demylenization, glial cell activation, cellular and mitochondrial destruction and poor cell to cell communication. How does this affect you? Memory loss, movement disorders, behavioral disorders like ADHD, neuropathy, weakness and dementia. Bottom Line: Good Fats = Cellular Integrity & Anti-inflammation
  3. Amino Acids & Protein– What makes up your emotions? They are made of amino acids from protein. When you are happy, calm, satisfied, relaxed, you are releasing serotonin, dopamine, norepinephrine, GABA, all produced from amino acids like tryptophan, tyrosine and glutamine. In addition to neurotransmitter production, proteins also conduct intra-cellular communication and DNA translation to produce essential enzymes, messenger, structure and transport proteins. So, good sources of protein from plant sources like beans, lentils, legumes, vegetables, seeds, nuts and grass fed animal and fish sources support good brain function. What not to eat? A high refined sugar, processed carbohydrate diet. Diets rich in crackers, cereal, rice, bread, pasta, cookies, cakes, pretzels, chips, donuts, muffins, candy, soda, factory animal proteins and pre-packaged processed foods rich in preservatives, dyes, chemicals, pesticides and additives poison the brain’s physical and chemical functions. This destruction in nerve cell function and communication leads to mood disorders like depression, anxiety, insomnia, anger, irritability and fatigue. Bottom Line: Good Proteins = Good Mood
  4. Vitamins, Minerals & Phytonutrients-  What makes up memory?  When you remember your childhood sweetheart or where you left your car keys, it is all due to the magic of vitamins and minerals. Acetylcholine, made from choline from the B Vitamin family, is the major neurotransmitter involved in memory, movement and cognition. Other B vitamins like B1, B6, folate and B12 also play an essential role in the production and protection of neurotransmitters for memory and mood. Deficiencies in B vitamins has been long associated with neurocognitive decline, brain atrophy, dementia and memory loss. In addition to vitamins, minerals like magnesium, iron, calcium and zinc are an integral part in making the magic of memory happen. Replacing these vitamins and minerals through leafy greens, vegetables, lentils, oats, grass fed liver and meats, wild caught fish, organic eggs, nuts, seeds, whole grains can help restore brain function. Phytonutrients found in colorful vegetables and fruit like blue berries and spices like tumeric have powerful antioxidants that act like superheros to protect the nerve cells from oxidative stress from pollution, toxins, infections and chemicals in our soil, air, water and food. What not to eat? Foods like fish and shellfish contaminated with mercury, nitrates from processed meats (cold cuts, hot dogs, bacon, sausages), artificial sweeteners like aspartame in diet soda, sugar-free ice cream, jams, cookies, pudding, ketchup, jello, gum, pies, candy and yogurt, and high sugar foods listed above including alcohol. Bottom Line: Vitamins, Minerals, Phytonutrients = Memory

So, wellness seekers if what you are looking for is better cognition, mood and memory, look no further than your plate. You are what you eat. Your daily choices have a direct impact on the health of your organs. Using nutrition to improve function, longevity and resiliency is the path to restoring vitality and living a healthy life.

 

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained and board certified in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Natural Remedies for Stress

stress

A young lady struggling with daily worry, feelings of being overwhelmed, insomnia and chronic fatigue comes to the clinic to find solutions. She quit her job as her ability to focus and complete tasks had become exhausting. Her food choices have been poor, extreme fatigue keeps her from working out and her sleep is disrupted. She has been to multiple specialists and has tried a number of different mood medications to help her feel better. Her stress level has been high for a while, stemming from being a single parent, financial crisis, weight issues, diffuse pain, recurrent infections and irritable bowel syndrome. She is on a downward spiral and this has affected her daily life and relationships.

’21st Century stress’ can force us into a life of multi-tasking, chronic stress, technology, lack of time, information overload accompanied with poor nutrition, sedentary lifestyle and over-indulgence of other substances like coffee, sugar, salt, trans fats, hydrogenated oils, processed foods, drugs and alcohol. This chronic toxic stress and poor lifestyle leads to inflammation spreading like wildfire, setting the entire body ablaze, leading to eventual destruction and disease.

How Do We Regain Control of Our Health?

The ESSENTIAL pillars of health include a plant based, whole food, nutrient-dense diet, regular exercise, good sleep, spirituality, cultivating gratitude and resiliency through mind-body exercises, social connection and self-care.
Slowing down, finding balance and learning the nutrition hacks to creating resiliency is the key. 
A well-balanced diet is one that includes all the colors of the rainbow. Your cells need A, B, C, D, E, K Vitamins, minerals like Chromium, Zinc, Selenium, Magnesium, Iron, amino acids, good fats, fiber, fermented foods, herbs and spices. Think of nutrients as powerful weapons against stress, each color with its own unique super powers. They help your cells function normally and protect the cells from toxins, pollution, infections that cause oxidative damage. These nutrient-rich foods act as chemical signals which help optimize the cell’s anti-oxidant function, energy production and health.
The Standard American Diet provides empty calories, refined and processed chemicals, salt, bad fats and high sugar foods. They are lacking all the nutrients a cell needs to prevent aging, disease, damage and death. Instead, unhealthy food sends the wrong signals to cells, breaking down the cell’s mitochondria, cell membrane, DNA, protein and energy synthesis, cellular function, and eventually makes the whole body sick.
Food also has a tremendous power to heal. There are herbs, roots and mushrooms that can be added to support the adrenals and help us through a stressful event. The best way to receive benefits from these foods is through dried herbs or teas. Some clinical studies have looked at how adaptogens support vitality, immunity and longevity.
WIRED?
  1. Ashwagandha,Withania somnifera- (Indian Ginseng) ‘Fried’ or ‘reaching your limit’?  This herb has shown to help balance stress. It can lower inflammation (CRP), dampen anxiety (noradrenaline and cortisol ),  support memory and sleep. It helps down regulate the fight or flight, upregulate the parasympathetic system (acts like GABA and increases acetylcholine). It comes from the nightshade vegetable family (tomatoes, potatoes, eggplant, okra). Helpful with sleep.
  2. Holy Basil– (Tulsi) – acts as a mild relaxant, it’s leaves can be used to help people who are nervous and have frequent colds. It can support the liver and immune system. Easy to grow in your backyard, leaves can be used as tea.
TIRED?
  1. Asian Ginseng (Panax)- used for vitality, stamina, mental & physical performance.
  2. Siberian Ginseng(Eleutherococcus senticosus)- supports longevity, fatigue, muscle pain and immunity. Studies show increased endurance and mental performance in patients with mild fatigue and weakness.
BRAIN FOG?
  1. Bacopa- cognitive enhancer that preserves acetylcholine (supported by Vitamin B1, B5) that helps with memory, focus, recent recall by reducing the stress response.
  2. Rhodiola– helps with fatigue, exhaustion & inflammation. Studies show improved attention, cognitive function and mental performance in fatigue and in chronic fatigue syndrome.
SICK?
  1. Astralagus– “Qi” tonic supporting stamina and resistance to disease. Boost immune function and decrease inflammation. Has a role in the mitochondrial function in muscle cells.
The best way to receive nutrition is through the food choices you make. If you choose to take a supplement, always consult with your doctor to verify any drug interactions or harmful effects from the product. Just as you would not take a prescription that has not been clinically tested and evaluated by regulatory agencies for safety and efficacy, similarly you would not want to take a vitamin or supplement that is based on testimonials, uncertain ingredients, marketing promises or false labeling.
Food is Medicine, Energy, Information, Connection.  Making the right decisions with food may seem like a difficult path to follow. Start where you are, make small changes, announce your decision to others, remind yourself of ‘why’ you need to take back control of your health. Let us guide you on your journey to wellness!
‘A journey of a thousand miles, begins with a single step’- Lao Tzu.
  • Panossian A1, Wikman G.: Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity. Curr Clin Pharmacol. 2009 Sep;4(3):198-219. Epub 2009 Sep 1.
  • Alexander Panossian* and Georg Wikman: Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity.Pharmaceuticals (Basel). 2010 Jan; 3(1): 188-224.
  • Pooja, A. S. Bawa and Farhath Khanum, Anti-inflammatory activity of Rhodiola rosea – “a second-generation adaptogen”, Phytotherapy Research, 23, 8, (1099-1102), (2009).
  • S.K. Kulkarni and Ashish Dhir, Withania somnifera: An Indian ginseng, Progress in Neuro-Psychopharmacology and Biological Psychiatry, 32, 5, (1093)
  • V. Gupta, S. Saggu, R.K. Tulsawani, R.C. Sawhney and R. Kumar, A dose dependent adaptogenic and safety evaluation of Rhodiola imbricata Edgew, a high altitude rhizome, Food and Chemical Toxicology, 46, 5, (1645)
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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained and board certified in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

The Road to Relaxation

old man

Last week in clinic, I sat with a man in his ’80’s who I have been treating for anxiety and depression for the past year. He shared with me that he was once a high functioning executive and his life changed dramatically after his wife suffered a stroke. It led him on a downward spiral to insomnia, panic, grief, loss, hopelessness and loneliness. It triggered an intense fear of death and dying and he has trouble leaving the house or engaging in social activities.

It is natural to have feelings of loss, grief and sadness. A stressful event may cause feelings of panic or anxiety with rumination and worry. It is easy to get stuck in this place of worry, perseveration, re-living past events, leading to a path of months or years of depression and anxiety. As part of a holistic approach, I often recommend evidence-based relaxation techniques to help restore balance in the system. I hope they can be helpful to those who suffer from anxiety and depression.

  1. Breathing Exercises – There are many techniques that work to bring attention to our breath. It creates an awareness of our bodies and tethers our minds to our physical beings for the moment. When we focus on our breathing, slow our breath with intention, we down regulate the stress chemicals that make us anxious or depressed. Find a quiet spot, start by sitting in a relaxed position, observe your breath without trying to control it. You may place one hand on your chest and the other on the abdomen to appreciate the rise and fall. You can remind yourself with something as simple as “breath-in, breath-out”. I often teach children finger breathing, trace the fingers of one hand with the index finger of the other hand as you breath in and out. And I also teach a technique called 4-7-8 where you breath in through your nose for a count of 4, hold for a count of 7 and exhale through your mouth for a count of 8 to induce relaxation. When your exhalation is longer than your inhalation, you are activating the relaxation pathways that message your body to rest and digest. This changes the conversation in your body and decreases cortisol and adrenaline levels and infuses your system with happy, calm signals.
  2. Meditation – There are many misconceptions about this word as some incorrectly associate it with ritual or religious beliefs. Think of it as a technique to clear the stress from your mind. Meditation is simply the act of inward concentration. Taking the wandering mind and redirecting it to the inner workings of your body. Whether you concentrate on your breath, your heart beat, relaxing your muscles, or you repeat a phrase that brings you peace or calms your mind, they all work and are considered meditation. It is difficult for most people to sit still and keep their mind from wandering to the past or future events. Guided meditation websites, CDs and apps can help lead those seeking assistance with their practice. Apps like Calm, Headspace, Insight Timer, and Stop Breath Think are very easy to follow and have become immensely popular. My recommendation is to work up to a 20 minute twice daily meditation practice to help reverse the inflammation caused by the toxicity of stress on our systems. Think of it as a mind re-boot. In addition to lowering anxiety and depression, studies show that meditation helps lower blood pressure, risk of heart disease and stroke.
  3. Progressive Muscle Relaxation- A wonderful technique to use at night to settle the restless mind. As you lay in bed, find a relaxed position, and close your eyes if you feel comfortable. Now, feel your toes. Appreciate the sensations, whether they feel tingly, numb or cold. Now curl your toes and tighten your muscles, take a deep breath, relax your toes and breath out. Next move up to your calves, then your thighs, abdomen, shoulders, hands, face, taking one part at a time, tightening the muscles, breathing in and then relaxing the muscles and breathing out. This exercise is excellent when the mind needs to quiet down and the body needs to relax and sleep.
  4. Guided Imagery Exercise- Redirection of the mind to a happier place can help decrease our stress response. Children and artistic people with an active imagination find this technique to be easy and beneficial. Taking your mind to a pleasant experience, like a visit to the beach. Find a quiet spot, close your eyes and then transport yourself to this place. Experiencing it with all your senses; feel of the hot sand, sound of the breezy ocean, taste of the salty air, seeing the waves crash across the shore with the cool, blue water washing over your toes. Allowing for the mind to enter a quieter level without the busy chatter that drives tension and stress. This is a beneficial technique for those who have trouble resting at night.

Relaxation techniques such as the ones mentioned above are only a few suggestions. Any other methods whether it is music, dance, massage, pet therapy, spirituality, exercise, art therapy, social connections, nature walks can all work to restore balance in the brain. Start treating any imbalance with nutrition, exercise, sleep, and mind-body work. It is also important to seek proper mental health and medical professional care in treating serious conditions. It is my belief that true health is obtained by taking the middle road, bridging Eastern and Western medicine.

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained and board certified in Integrative Medicine. 
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Coughs & Colds: Your Natural Guide

cold

It’s cough and flu season again. Missing school and days of work can be difficult during this time of year. Scavenging the pharmacy aisles for the perfect remedy to get you through the night can be frustrating and confusing especially when you are sick. So, here a few quick tips on how to stay healthy in the winter and what to stock up on.

Prevention is Key!

Studies show that our immune systems flourish at higher body temperatures and our immunity is reduced at cooler body temperatures. Unfortunately, cold and flu viruses thrive in cooler environments where our immune systems are not optimal. Some suggest it may be one of the reasons we are more likely to get sick in the winter.

To make yourself more resilient, increase your core temperature. Consume foods that are nourishing and warming during the winter months. Enjoy soups, stews, hot drinks and teas with immune boosting herbs and foods.  Use warming spices like cinnamon, cloves, ginger, fennel, black pepper, cayenne and cardamom. Minimize your time with large crowds to limit your exposure to potential viruses during the cooler months like cruise ships and shopping malls.

Manage your stress level, slow down, balance your commitments and breathe. Wash your hands frequently. Consider hot yoga, steam, warm baths, and saunas during these months. As it gets darker earlier in the winter months, plan to go to bed earlier. Resting, celebrating, and being merry in the winter months may have some added health benefits for mood and boosting your immunity.

Nature knows Best!

Eat seasonally. Nature provides us with the right foods to help us stay healthy. In the fall and winter, eat seasonal yellow, orange and red vegetables which are loaded with Vitamin C and A. These vitamins are essential for a strong immune system. Winter fruits and vegetables like clementines, oranges, lemons, grapefruit, tangerines, pomegranate, pumpkin, squash, yams, sweet potatoes, bell peppers (yellow, orange, red), onions, garlic, beets, turnips and carrots provide essential vitamins to boost your immunity. It is amazing how Food Is Medicine!

Plant Based Remedies!

Here are some simple, safe plant-based remedies for cough and cold symptoms.

  1. Menthol, Eucalyptus, Frankincense, Cinnamon, Cloves, Oil of oregano and Camphor – essential oils help as decongestants for cold symptoms. Add nasal massage for added benefit.  Use as nasal ointments or drops, chest rubs, or added to bath water, a cup of hot water as an inhalant, or even an aromatherapy infuser.
  2. Infusions with Thyme, Peppermint, Eucalyptus and Horehound- loosen secretions as an expectorant.  Other expectorants are garlic, cinnamon, cayenne pepper and ginger. Hot and spicy foods will do the trick!
  3. Teas for ant-viral properties, sore throats and cough: Ginger-Honey-Lemon Tea, Sage Tea, Echinacea Tea, Elderberry Tea. Sip on these for prevention and to shorten the duration of the common cold.
  4. Warm salt water gargles, nasal saline rinses and warm sinus compresses
  5. Fermented Foods- yogurt, sauerkraut, kimchi, kefir, kambucha, miso
  6. Supplements like Zinc, Vit D3 , astralagus, panax ginseng, andrographis can be added to boost your immune system during the cold & flu season.(always consult with your doctor first!)

With all natural remedies, it is important to partner with your healthcare provider to make sure they are safe with your prescription medications and medical conditions. Any condition that progresses to respiratory distress, dehydration, high fever or symptoms in high risk patients should lead to immediate medical attention. Medical advice should be taken particularly with infants under the age of one, pregnant women, elderly or sick with any over-the-counter remedies.

As with everything, my first recommendation is balance. Proper nutrition, sleep, exercise, stress reduction and self-care are the corner stones to good health. Nourish your body with healthy habits and reap the benefits of a healthy mind, body and soul!

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained and board certified in Integrative Medicine. 
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Love: A Path Through Grief

love-heart-cloudbig-300x227

Last week, I was sitting in the exam room with a young woman undergoing chemotherapy for cancer. ‘How are you?’ The existential question which has no real answer. How IS one after facing one’s mortality? Grieving the loss of a healthy body sends one through a whirlwind of emotions, changing daily from denial, bargaining, anger to sadness. Well-intended friends and family unknowingly try to bolster support by encouraging a fighting attitude or offer unsolicited advice on nutrition and lifestyle changes.

If your loved one is dealing with an illness, it is my intention to help shed light on the process of grief and how you can help them through this journey. Every person’s experience is unique and we start by honoring the person as an individual. Be present without judgment, and refrain from offering unsolicited advice that may incite resentment or guilt. Let’s start with offering our love.

Love

Unconditional love. The center of what we all seek. Put energy behind your intention to love someone. In order to do this well, you will need to know how your loved one likes to be loved. A wonderful book, ‘The five love languages’ by Dr. Chapman suggests we all like to be loved in the same manner we treat others. There will be dark days, times where being happy and upbeat is difficult. Be patient. Put your ego aside and allow for them to process their feelings. Be a good listener. Allow your loved one to feel heard, remember it is about them. Try not to interject with your own experiences and needs. Laughter is the best medicine. Not all conversations need to start and finish with their disease. Pay attention to what they value, every person may appreciate different acts of kindness.

  1. Words of affirmation like ‘I love you’ and compliments may carry a lot of weight for some people. They feel validated with words. Use them daily to show them that they are loved. Leave them love notes and handwritten messages that will bring them up. Also, hateful words or disparaging remarks cuts them more than anything you can do. Avoid unnecessary arguments, remember the most important thing is their well being and not winning an argument.
  2. Quality time and your undivided attention may be what your loved one likes to receive.  Being there for them is crucial. The worst thing that hurts your loved one may be excuses with postponed events, the failure to listen or distractions. When you make a commitment, be present. With technology today, we passively communicate online through social media, texting or emails. Even when together, we find ourselves on our phones, engaged in a virtual world instead of the real one. The loss of face-to-face interactions erodes the fabric of connectivity, blunting real love and compassion. Make the time to look into their eyes, sit and really listen to them.
  3. Receiving gifts, mementos, thoughtful presents may make a person feel loved. This does not have to be expensive gifts or trips. A thoughtful remembrance of their likes and dislikes and taking the time to provide them with an item can be a treasure for your loved one. These gifts can be hand-made or something you own and have no other value than the love you put into it.
  4. Acts of service shows your loved one that they are valued. You recognize how hard it has been for them. You show them you really care by lending a hand because actions speak louder than words. This may be preparing a meal, watching their kids or pets, taking them to doctor’s appointments or running their errands. They may be givers themselves and have a low tolerance for ‘takers’ -people who make more work for them and unwilling to help them or let them down with broken promises. Fulfilling their daily needs and making their life a little easier will ease their stress and make you shine in their eyes.
  5. Physical touch like a hug or touching their hand can make them feel safe and loved. This may also be a gift of giving a massage, pedicure or a facial. Creating a physical connection maybe how you can validate their importance in your life. During a time of physical illness, intimacy may not be desired and remembering to maintain boundaries and respecting their wishes without guilt or judgment is also a show of love.

Grief from illness is a journey that one cannot go around, ignore or evade. It is necessary to walk through it, one day at a time with the support of the people around us. Sometimes, one may be surprised at the lack of response from our closest relatives and friends. But other times, support is received from the most unlikeliest sources. To best serve your relative, friend, neighbor, co-worker or acquaintance who may be suffering in silence, find a way to reach out in a meaningful way to show them love. We all belong to the same fabric of energy and love is how we weave our connection.

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained and Board Certified in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

 

 

 

 

 

Sleep Apnea: Getting Enough Air?

float

So, imagine instead of going to bed every night, you decide to sleep in your swimming pool. You tread water in your pool, waiting to fall asleep. As you drift off to sleep, you start sinking to the bottom of the pool. You stop breathing for a few seconds. Your brain signals you to wake yourself up by gasping for air. A few minutes later, you drift again, gradually find yourself under water, unable to breathe, waking yourself up for another breathe… You do this for eight hours every night, maybe even 30-50 times every hour. The next day, you are exhausted, tired, sleepy, foggy-brained and irritable.

This is called Sleep Apnea, a serious sleep disorder where a person stops breathing during sleep. Spouses may complain of loud snoring, forgetfulness, daytime sleepiness but most people are in denial or are unaware they have it. Roughly 18 million Americans suffer from sleep apnea and as many as 90 percent are not diagnosed.

“I am so upset – he won’t do anything about his sleeping problems! When he wouldn’t even bring it up with the doctor — and I know this is because he doesn’t want to use the machine — he came home and started saying I was the one who has the problem sleeping. He said he sleeps just fine.”

Are you AT RISK for Obstructive Sleep Apnea?

Okay, so men are more likely than women, being over 40 years, being overweight with a neck size greater than 17 inches in men and 16 inches in women, large tonsils, large tongue, chronic sinus issues, acid reflux and family history puts you at risk!

What are the signs and symptoms?

  • Wake up with a very sore or dry throat
  • Snore loudly
  • Occasionally wake up with a choking or gasping sensation
  • Sleepy during the day with lack of energy
  • Feel sleepy while driving
  • Have morning headaches
  • Feel restless during sleep
  • Forget things easily, memory issues
  • Moody, irritable, depressed
  • Decreased libido
  • Wake up frequently in the night

Why is it IMPORTANT to Treat Sleep Apnea?

UNTREATED sleep apnea can lead to serious conditions like high blood pressure, atrial fibrillation, diabetes, heart attacks, stroke and heart failure.

UNDIAGNOSED sleep apnea in children with sinus issues, allergy issues, large tonsils, deviated septums is frequently misdiagnosed as ADHD.

UNDERLYING sleep apnea is linked to major depression, chronic headaches, memory loss, impotence and obesity.

Take an excessive sleepiness quiz! (Epworth Sleepiness Scale)

Choose 0 for never dozing; 1 slight chance; 2 moderate chance; 3 high chance of dozing

  1. Sitting and Reading [ 0   1    2     3 ]
  2. Watching TV [ 0   1    2     3 ]
  3. Sitting inactive like a theater or meeting [ 0   1    2     3 ]
  4. Passenger in a car for more than an hour without a break [ 0   1    2     3 ]
  5. Lying down to rest in the afternoon if circumstances permit [ 0   1    2     3 ]
  6. Sitting and talking to someone [ 0   1    2     3 ]
  7. Sitting quietly after lunch without alcohol [ 0   1    2     3 ]
  8. In a car, while stopped for a few minutes in traffic [ 0   1    2     3 ]

RESULTS: 0-5 Lower Normal ; 6-10 Higher Normal; 11-12 Mild Excessive; 13-15 Moderate Excessive; 16-24 Severe Excessive Daytime Sleepiness

(Talk to Your Doctor If You Score High to Severe Excessive Daytime Sleepiness!)

Did you know there are different Types of Sleep Apnea?

Obstructive sleep apnea (OSA): The back of the throat gets blocked when the soft tissue in the back of the throat collapses during sleep.

Central sleep apnea: The brain fails to signal the muscles to breathe, due to injury to the brain’s center that controls breathing.

 

So your Sleep Study (polysomnogram) says you have Obstructive Sleep Apnea?

Treating obstructive sleep apnea may involve lifestyle, weight loss, medications, equipment, surgery, or appliances.

  1. Weight Loss. Your risk for obstructive sleep apnea is higher if you are overweight with a body mass index (BMI) of 25 or more or obese with a BMI of 30 or higher. Neck Circumference in males >17 inches and women >16 inches.
  2. Avoid alcohol and sleeping pills. It relaxes the muscles in the throat leading to apnea and may prevent the person from protecting his/her airway from waking up.
  3. Sleep on your side. 
  4. Stop Smoking. It causes swelling the upper airway making both apnea and snoring worse.
  5. CPAP (continous positive airway pressure) and BiPAP devices.
  6. Dental appliances
  7. Surgery- Nasal surgery for septum correction, Uvulopalatopharyngoplasty (UPPP) for removal of the soft palate and Mandibular maxillar advancement surgery.
  8. INSPIRE- an implantable pacemaker-like device (small pulse generator) placed under the skin in the upper chest. One wire detects breathing from the lung, another wire sends an impluse to the hypoglossal nerve stimulating airway muscles in the neck keeping them open. It can be remotely programmable to turn it on before bed and turn off after waking up.
  9. Expiratory Positive Airway Pressure (EPAP)– it uses disposable adhesive valves that are placed over the nose when you sleep and have a high compliant rate. Upon inhalation, the valve opens and helps the airway remain unobstructed. Then with exhalation, the airflow is directed into small channels, which creates pressure and, again, keeps the airways open. 

Your Sleep Apnea Effect Others too

People with sleep apnea are up to ten times more likely to have a motor vehicle accident as a result of sleepiness, sometimes with fatal results. Focus and memory issues can affect your work and may impact lives if you work with children, in the health field or drive a vehicle. Obstructive sleep apnea also affects relationships, family and friends. Being chronically tired makes it hard to socially engage and being depressed leads to failed relationships.  Because of the loud, bothersome snoring, spouses or bed partners might choose to sleep in separate bedrooms. For men, untreated sleep apnea can also lead to problems with impotence also affecting sexual intimacy.

Better sleep quality can help reverse and repair your brain, heart, mood, weight issues, invigorating your mind-body-spirit. Imagine a life full of energy, bounding happiness, sharp memory and the best of health. It is my hope that reading this blog and understanding the importance of sleep will encourage you to get the medical help that you need. Wishing you a restful night and sweet dreams!

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.

Diabetes: Are You the 1 in 4?

one in four

Last week, a high school student shadowed me in clinic and we saw several patients with diabetes and so we chatted about the epidemic that affects One in Four Adults in the U.S. and is a leading cause of death in the United States.

What is Diabetes?

Diabetes is a disease in which blood glucose levels are above normal. The food that we eat is turned into glucose, or sugar, which enters our blood stream, flooding the blood vessels and rushing through our body. The brain signals the pancreas to release insulin and the insulin unlocks the doors allowing sugar into the cells. If the insulin is not produced by the pancreas or the insulin produced doesn’t work properly to allow the sugar into the cells, the sugar cause havoc in the body. Medical doctors define diabetes as a fasting sugar over 125 (at least twice) or a three month sugar test called a hemoglobin a1c greater than 6.5.

How Sugar Damages Your Body

When the insulin is lacking or it doesn’t work effectively to drive the sugar into the cells, the sugar acts like shards of glass coursing through your blood stream, injuring and inflaming the lining of the arteries as it flows to the eyes, kidneys, heart, brain, feet causing damage to the little and big blood vessels. Diabetes is a major cause of blindness, kidney failure and lower limb amputation. This sugar when not driven into cells can cause progressive damage to the arteries, leading to plaque accumulation, inflammation and blockage, becoming the leading cause of heart attacks and strokes. Other bad influences like cigarette smoking, fried foods, processed meats, artificial sweeteners, preservatives, salt add cumulative effects to the destruction of the body.  Adults with diabetes have a 2-3-fold increased risk of heart attacks and strokes. Diabetes is also a major cause of memory loss and Alzheimer’s disease.

Causes of Diabetes

There are genetic factors that can predispose one’s risk for diabetes. African Americans, Mexican Americans, American Indians, Native Hawaiians, Pacific Islanders and Asian Americans have a higher risk for diabetesAlso diabetes risk increases with age, family history, other conditions like pancreatic injury through trauma, infection or surgery and autoimmune diseases can cause diabetes. But by far in our Western society, rising rates of obesity contribute greatly to this epidemic. Our current food sources, desire for prepared convenient foods and sugary drinks, larger food portions, hidden sugars in our food, weight gain, sedentary Western lifestyles are major contributors to diabetes, especially in children. An average American consumes approximately 66 pounds of sugar a year, that is equal to the weight of an average 7 year old child. Most children in the U.S. consume their weight in sugar annually and have rising rates of diabetes and pre-diabetes.

Sugar Addiction

Sugar is an addiction. Research also shows that, for some people, eating sugar causes chemical changes in the pleasure centers of the brain leading to of craving and withdrawal, just like a drug.

There is scientific evidence, using brain-scanning technology by the U.S. National Institute on Drug Abuse to show that sugar causes changes in peoples’ brains similar to those in people addicted to drugs such as cocaine and alcohol. These changes are linked to a heightened craving for more sugar. This increased sugar consumption causes insulin levels to rise.  Unfortunately, high insulin levels cause the body to store more calories as fat leading to weight gain.

Another hormone besides insulin leads to weight gain, Leptin. Leptin’s main role is to curb appetite, it tells the brain to stop eating.  But with increased sugar intake, high fructose consumption and elevated insulin levels, we shut down the effects of Leptin and the brain becomes “Leptin-Resistant” and no longer hears the message to stop eating leading to weight gain.

How to Treat Diabetes?

Healthy diet, regular physical activity, lowering stress levels, proper sleep, reading labels, logging food, maintaining a normal body weight, cutting back alcohol and avoiding tobacco use are ways to prevent or delay the onset of non-insulin dependent diabetes and complications. Healthy lifestyle habits are a drug-free, cost-saving option to control or prevent diabetes. To effectively treat diabetes, the patient has to take 100% ownership of their daily decisions and take back the power to drive their own healing.  They can enlist the support of their family and friends, diabetic educator, exercise instructor/trainer, counselor, primary care physician and/or endocrinologist. Often, there are diabetes education classes offered at local libraries (free) and hospitals that are a valuable resource. Pharmaceutical companies have online and phone support with a diabetic educator or nutritionist that can help motivate the patient.

Arm Yourself With Technology 

There are several smart phone Apps that help track sugar, diet, exercise, allow you to sync stats like blood sugar levels, hba1c, lipids, offer data sharing with your doctor, provide motivational feedback, recipes, restaurant diabetic information and goal setting. My favorite diabetic apps are:

  1. Diabetes In Check
  2. Diabetes Companion
  3. icookbook diabetic
  4. healthyout
  5. mySugr (and mySugrkids)

Finding your Own Path

There are so many mixed messages with diet plans, documentaries, online gurus, latest fads and supplements promising the one path to health and wellness. They latch on to one food group whether it is carbs, fats or proteins and demonize the rest. False promises of one savior or one villain is based on anecdotal testimonials and opinions based on biased and selective studies.

Keep it simple and find your balance based on your system. Incorporate whole foods, vegetables, fruits, beans, lentils, nuts, seeds, whole grains, water and if desired little meat. Work towards cutting out processed meats and grains, high sugar foods, preservatives, dyes, artificial ingredients, pesticides, antibiotics and chemicals in your food. Keep moving in your day, laugh, breathe, sleep restfully. Its not one good thing, its all good, natural things in balance that should make up most of your meal plan. Variety is the spice of life.

References:
sugarscience.ucsf.edu, diabetes.org, cdc.gov/diabetes

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The light in me, bows to the light in you~ Namaste
Dr. Patel was named one of the TOP DOCS in Phoenix Magazine 2009, 2016, Healthcare Provider of the Year 2017 by the Fountain Hills Chamber of Commerce and Internist of the Year 2011 by the American College of Physicians Arizona Chapter. She is uniquely trained, board-certified and practices both Pediatrics and Internal Medicine in Fountain Hills, Arizona. She is additionally fellowship trained in Integrative Medicine.
She has a passion for teaching medicine and acts as a preceptor for both medical residents and providers in training. Dr. Patel has a special interest in Integrative Medicine, Women’s health, Pediatric & Adolescent care, Nutrition and Medical Cosmetics.