The Anti-inflammatory Diet

I guess this is a catchy phrase. In the last 3 lectures, whenever I open for Q & A afterward, people always ask for the info. I will always redirect to Healthy Aging by Andrew Weil. The concept is very healthy eating and once you read through I think the average person thinks ......ok, it's just a list of everything healthy.

http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet

The exerpt from the book is far more informative. Some people just need a list to post as a constant reminder. The food pyramid is a little more user friendly than it has been in the past but still doesn't have a wow factor. Some folks are probably looking for a new diet to follow also.

Most medical studies are centering on the role of inflammation in many diseases. Obviously in acute inflammation/injury but now in arthritis, heart disease, diabetes, bowel problems and even cancer. I have heard that people attending my conferences are trying to watch food intake but the economy is hitting hard. My beloved Whole Foods is a great store but leaving with half a bag full of stuff will usually run me the same price for a week of family eating at Jewel (a popular grocery chain in Illinois).

I am visioning a step wise approach to changing a diet will be with stuffing one's self with fruits and veggies. As is suggested by many a dietician, 5-7 f and v's per day is a basic. In my diet, getting 5 in daily will usually take up the volume in my stomach that would have been taken up by something else I would have been eating previously (fast food). Or the converse is true, the 5 would be filling up a stomach that would have been growling at 10-11am or 4-5pm for lack of anything being eaten. In 1999-2000, my medical practice was booming and my fund of knowledge was huge. My health was also the worst of my life. I remember often "powering" through lunch and dinner without eating and justifying that action as "at least I won't gain weight". I paid for those years with psychological scars I will never forget,(I still carry a wrist band from being admitted once to the hospital).

My wife made my daughters favorite spagetti dinner and I said, Oh No....I won't be able to stop so I shouldn't start. She said, why do I suffer so much. My reply was that I suffer more from the bloating, slowed bowel, and lethargy than I do from the act of starving. She often calls me OCD since I like to maintain eating small portions of fruits and veggies up to 4-5 times daily to keep the stomach full and stop the hunting for a dopamine rush with something carb loaded. I also rely on a small salad before eating a tasty dish just like the Italian restaurant does to postpone hunger.

So ultimately, the Saguil Approach is "stuffing down" 5-7 fruits or veggies per day will usually "push" out the space that would have been taken up by something else in the daily diet. The 5-7 "fillers" will also supply foods that are low glycemic index (keeping the stable and not crashing after food intake), high in fiber and easy on the bowel. A smooth working bowel will translate to proper absorption of nutrient, supplement and not to mention, secreation of serotonin, the hormone use to treat depression.....(another reason for carb hunting). Fluid plays a great role as well but thats for a later blog. Once a patient realized how good life is without bowel problems, and sleep is improved and workouts are more intense/rewarding, the process steamrolls and more aspects of the "Weil Antiinflammatory Diet" can be followed (without guilt)

Vitamin D3 (from the herbal411 library post)

It was a toss up betwen omega 3 fish oil and Vitamin D3. Because of some of the chronic pain flare ups I have seen in the clinic over the last few weeks, Vitamin D won. Well documented is the lack of ultraviolet stimulation to human skin to any state north of Georgia. Due to the angle the sun's rays hit during winter months, the amount of sun rays that get through is low. It takes 20-30 minutes during summer months from 10-2pm to create up to 10,000IU. That would be about 50 glasses of milk or 20 standard vitamins daily! I suggest taking a blood test first for 25 hydroxvitamin D, supplementing 5000IU daily and retesting in 3 months. With critically low levels less than 10, 50,000IU IV to load then 5000 daily. I frequently use 4000 daily of D3 in my "influenza cocktail" while working the ER. (astragalus, elderberry, mushroom extract throat spray and D3 twice a day for 3-4 days post exposure). There are very limited sources of data that show toxicity with vitamin d, and multiple new sources of literature with benefits of supplements. Many patients have felt improvement with supplementation in 4 weeks. Once levels are restored with pills, food and sunshine should be utlized to maintain a healthy state. Cod Liver Oil, Sockeye Salmon, Tuna, Sardines, Milk, Egg, Dairy Fortified, Mackerel, Yogurt, OJ are a few to consider. Use food as medicine!

A pulled hammy (torn hamstring muscle)

No one is bulletproof when it comes to injury or illness. As posted in my "Adventures", Thich Naht Hanh came up with The Five Rememberances:

1 I am of the nature to grow old. There is no way to escape growing old.
2 I am of the nature to have ill health. There is no way to escape having ill health.
3 I am of the nature to die. There is no way to escape death.
4 All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.
5 My actions are my only true belongings. I cannot escape the consequences of my actions. My actions are the ground on which I stand.

A near and dear yogi, was taking the time to teach students a difficult pose and "pop", an audible tear from about 40 feet occurred. Seemed to be the area of an old injury so hopefully it was just scar tissue. (If a long muscle is torn off its bony insertion, the long end may reattach close to where is came off but theres always a little piece of where it originated from that still remains tight and stuck on fibrous tissue-its useless and can pop but wont affect walking). So the reason for this discussion is to mention my "go to" supplements to aid in a speedy muscular injury repair.

First control the injured area from further damage. No further stretches, runs, jumps. I like ice to the area to decrease blood flow and halt the "seeping" of further lymph and blood to the area of inflammation. Black and blue marks will usually track down the back of leg with gravity in 2-3 days since it bleeds deep at the sit bones and works its way to the surface skin later. I have seen it go black and blue from the buttock to the back of the knee but without pain or discomfort to any place but the hamstring insert. We luckily had a massage therapist who also did Thai Massage and he helped with cutting the spasm back from the muscle. As a muscle tears, the body of the fiber will start to spasm, contract-like a rubber band that has been stretched then cut-the ends flail apart. So the idea is to try and gently relax the spasming muscle and more importantly for the first few nights-keeping the muscle lengthened so you dont wake up after 6-8 hours and the back of the thigh is 2 inches shorter. Ice is therapeutic for about 10-15 minutes only. After that time, the skin can get frostbite and the blood vessels you were trying to choke off will soon spasm and open up to cause more products of inflammation to enter the area. So keep the cold packs on for 10 minutes at the top of every hour for 48 hours. (as best as you can maintain). Lightly massage or gently stretch the muscle body-this would be the other end of the muscle that wasnt in the "tear zone". Alot of the pain comes from the muscle bulk spasming up and shortening. You can actually apply heat or warmth to this part in a hamstring since it is so long. Placing heat to the site of inflammation will cause the blood vessels to open and a flood of more swelling will result.

After the ice, wipe off and get the topicals on. I like essential oils like TEA TREE, HELICRYSIUM, MARJORAM (I used "PANAWAY" by Young Living to get me through the Chi-town Marathon every few miles), I also like TRAUMEEL by Heel- its a German homeopathic oinment that contains many things, one of the most active ingredients is ARNICA. At UCLA Acupuncture they teach us to apply this to the upper back before Gua Sha (skin scraping) to avoid black and blue formation. Great thing is you cant overdose on the topicals....traditional chinese medicine says you can also apply plant essence oils to the opposite extremity in the same approximate area as the injured leg to effect healing. (It has to do with unblocking the matching meridia/energy channel on the opposite extremity to get the body to heal it faster)

And this beings me to external modalities. Hands on-massage and the healing touch of MASSAGE THERAPY, CHIROPRACTIC or REIKI in some cases will help the body pay more attention to the area of inury. (more white blood cells, more proper nutrients, more organized repair/less inflammation). ACUPUNCTURE can help with cutting down muscle spasm to the injured muscle, help the energy meridia start flowing like prior to injury, also release endorphins to help with the sensation of pain. I have also read of MARMA therapy from ancient India (southern?) Finger or hand pressure to special areas on the body that move energy through "nadi's" or the Indian equivalent to meridias in China. (I have to get Vasant Lad to teach me this once I get some of my more immediate schooling out of the way). Modern day physical therapists can also help with deep tissue massage, transverse friction rubbing, ultrasound, infra red heat or ionotophoresis the application of steroid gel through the skin using elecricity. I like TENS units but seems when I write for these to be given by the therapist, always very difficult to attain. (Transcutaneous Electrical Nerve Stimulation-kinda what I do with needles and electricity but tens is just with sticky pads on the skin)-these are great because they can be applied through the whole night so the muscle doesnt shorten and make for a very difficult pogostick walk/hop to the bathroom in the dark. Physical therapy can also help to rehab 2-3 times a week in order to return to sports performance(and work) faster.

Then comes the oral supplements. First off all my athletes are told for 2 weeks. the "ANTIINFLMMATORY DIET" is a must. Andy Weil has this summarized on his website and he even had put together his own food pyramid to show how someone with chronic diease should be eating not just for 2 weeks but forever. (www.drweil.com) When the body is given foods that heal instead of foods that cause inflammation, white blood cells destroy damaged tissue faster, collagen gets placed by fibroblasts to form a matrix/scaffolding to heal the wound quicker, and muscle fibers reattach in an orderly fashion to make for stronger tissue patches instead of just fibrous/scar tissue. Fill up with water as often as possible. Low glycemic foods to treat the white blood cells better and not cause insulin spikes throughout the day- they essentially screw up healing not to mention that after meal sedation/sleepiness that comes on from eating. (www.glycemicindex.com) And my favorite: TURMERIC. This is a fantastic vegetable mostly used by India for food. I have also seen some older patients with sprains and strains coming in with orange powder around the injured joint as a paste. There are studies being performed on high dose turmeric for the ultimate inflammation-cancer. I am hoping to see these released soon. I have found and used NEW CHAPTER (www.newchapter.com/products/turmericforce) and GAIA (www.gaiaherbs.com/products/detail/83/Turmeric-Supreme) brands and usually I take 1 capsule 4 times a day for about 10-14 days with food. Recommended dose is 1 daily. (about 300 to 400 mg of extract) VITAMIN D3 at 2000IU twice a day (www.naturessunshine.com/us/product/vitamin-d3-60-tabs/sku-1155.aspx) for about 10-14 days is my other mandatory go to supplement with new injury. Even if it is summer and you are outside sunning, any city north of Georgia doesn't get enought sunlight (in my opinion) to convert a daily required amount of D. And finally OMEGA 3 FISH OIL at 2000mg daily (www.naturessunshine.com/us/product/super-omega-3-epa-60-softgel-caps/sku-1515.aspx)

So ultimately, we all will go through an injury, it is inevitable. The people who are already healthy when it happens will go through it faster! The folks arent healthy (and havent taken yoga) will go through the injury slower and probably develop another muscle injury from the over-compensation. My yoga instructor had already started to heal just with the THAI MASSAGE, so she is on her way to recovery in the next 10 days or sooner-(especially if we send healing INTENTIONS her way!)

This is not meant for medical advise so please seek out a primary care doctor who is trained in sports medicine, certified in medical acupuncture, studies with Andrew Weil and teaches yoga if you want to heal up fast.

Take this vitamin or you'll go blind

I love my daughter but boy is it challenging to get her to take a vitamin regularly. I started early with my son and introduced chewables early. Or it could be that formulations are better? I have found "Herbasaurs" by Natures Sunshine and "FloraBear" by Renew Life as a good or should I say "tolerable" daily. The former is the vitamin and the latter is the probiotic. Due to my son's asthma, I have had to retreat to antibiotics several times and his intestinal flora is probably shot. The great thing is that this guy loves fruit and veggies (thank you Lord!) My daughter on the other-hand is a typical teenager with an appetite for the poor carbs found in drive through windows. Have tried several types of multivits with little to no success until recently! New Chapter was the first herbal company I started buying at Whole Foods. I think I stumbled on Zyflammend for a trapezius muscle issue and it opened the herbal world to me. Of course my friendly herbalists Wendy and Jennifer in Clermont Florida taught me the "way of the Herb".

http://www.clermontherbshop.com/

Although I am a big supporter of Natures Sunshine for supplement products, I stumbled on a bottle from New Chapter called Tiny Tabs Multi. Six of these smaller than tictac size tablets is required daily. We are finding that due to the small size, when the palmed tabs are "thrown back", one usually escapes due to it's microscopic size. But at least she really likes them since they are so "cute". Big problem with both kids is the lack of calcium. I will tackle that battle at a later campaign.

Of course the old go to will be Flintstones, Bugs Bunny or someother generic chewable but I just don't trust these companies....maybe since I can't find any great information on them. I don't remember taking any vitamins when I was a kid. (But I also remember frying eggs and spam in a pan soaked with cooking LARD from a big nasty can under the sink....oh, just thinking of those days gives me chest pain!) I believe parents should set examples and teach ritual. Eating right and consuming 5-7 fruits and veggies daily outdoes any multivitamin routine but what child will do that when the parent is eating a donut, having coffee and taking pepsid for morning heartburn. I will never forget my college age nephew lookin his parents in the eye and very arogantly stating....."I am NOT, waking up early just to eat breakfast". I just shook my head and proceeded to "pants" him.

Fad diets

In preparing for the lectures on weight loss, I had to look into the use of fad diets. So many people have tried the Pritkin, Atkins and South Beach diets. The concepts are very novel but in the end, when the human body is presented with an extreme of conditions in environment or food intake, it will stabilize and adapt. If no other option is given to the body and it believes there is no good food to eat, it will slow down. (reset its own basal metabolic rate and make you gain weight or get frustrated by giving you a short temper) Remember that old commercial from the 70's..."you can't fool mother nature!"

I know the first few months of a new diet are great. The body hasnt figured how to adapt to the loss of food for hunting and it burns off all remaining calories from storage places like the love handles, the beer belly, the arm fat, the buttocks. Eventually though, no further fat to burn off or brain gets way to tired of not having any energy to function and it will make you "hunt" and there goes your diet! Most studies show that at 12-18 months, most people will blow the diet. There was a 4 pound weight loss for most people that participated but is this good for a year and a half of suffering? Not to mention that the cholesterol levels will usually shoot up during the diet phase. I recently was contacted by and old patient and he wondered if the Atkins was good and I told him what I thought. I said if he was going to try it, reevaluate at the 4 month mark and add an exercise program to it so he can loosen up on the strict carb cutting. He should make it until then. I did suggest omega 3 and a multivitamin. I will help him adjust the caloric intake in 4 months to make up the difference of his exercise. I would probably shift him to more of an antiiflammatory diet and try to bring down his cholesterol with red yeast rice and co q10. Then we reassess in the fall and prepare for the winter in Chicago. I always believe small portions and small goals are easier to achieve. But the applications that work for me might not work for others....this is why everyone has a different approach in my eyes. This is the "Saguil Approach".

Aspirin

Aspirin has been prescribed for those with heart disease for the last 3 decades. It is known to make plaques in the blood vessels break up. The massive heart attacks happen due to artery blockage. If the lumen or inner lining of a vessel is narrowed, one small plug that comes along with stop any further flow. The ER has protocols that start with 4 baby aspirins in the case of anyone coming in for chest pain (or stroke) before anything else is done. This basic and old drug is still useful for saving lives. There are more complex drugs and procedures that are used now but for the sake of this review, we will stick with the basics. Aspirin is known by its generic name of acetylsalicylic acid. It falls into the family of nonsteroidal antiinflammatory medicines. This family works on the cascade of inflammation that starts with a break in the lining of the blood vessel. A cascade develops to signal to platlets (small blood particles that rush to form a "glue plug") to accumulate in the area of damage and stop up the hole. Some times if there is no tear in the blood vessel wall but inflammation present from cholesterol plaques or tobacco damage, a plug will form anyway and block the lumen. There are herbs that are thought to do the same thing like ginko biloba. The theory is that by allowing blood to be "plug free" it gets to smaller sized blood vessels with easy. Think of the blood as being slippery so it gets to the smallest spaces. One of the known side effects of ginko is to have bleeding thus the contraindication to it's use when on a blood thinner.

I believe the use of this antiinflammatory has multiple benefits. Controlling inflammation should be considered a basic concept with anyone who suffers from any disease process. It has yet to be researched if antiinflammatory control will help to modify a disease manifestation but all my patients are told that in addition to controlling the specific disease, an antiinflammatory diet is encourage to gain further health benefits and possible reverse the disease at hand.

Try adding this to your daily diet :
http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet

Healing through sound

I have recently learned about the power of hard rock metal music when I go to push 430 pounds on the "smith machine" at Planet Fitness. Then it got me to thinking, how about I play soft music at the ER. I set up my music to play "Music for Brain Wave Vibration", bought some flowers, spread some lavender aromatherapy and tried to say hello to everyone no matter how hectic things were. So far, my shifts haven't sent me home wondering why I am working there, I have set the record for Yorkville Expresscare in highest number of patients seen and I am still blessed enough to save some lives. (I love this job!) Anyway, with the more than positive attitude I keep, I always see the cup half full. I feel the music is working for me and I believe a few others in the Emergency Department have picked up on a few things I do to make life rewarding.

Now there is more to music than just provoking imagery. There are technical hormonal chain reactions that occur when certain parts of the brain are stimulated (specifically with sound). The vibrational sounds of African drums, the flute of the Native American, Tibetan gongs.....all work along the same premise of healing by stimulating energy to move. In most parts of the world, the old theory is that every cell in the body has atoms and those small particles move. As those atomic size "things" move, so does energy that is generated through atoms, cells, human tissue, physiological organ functioning and finally human engineering. Injury works to block or slow energy, when the energy doesn't flow, something builds up but don't think of an electrical charge that is about to shock someone. The blocked energy usually show up in the form of back pain, headache, or more complex- heart disease or depression. I learned this through acupuncture that if needles can help "move" energy, patients will feel improvement. Can't explain this phenomenon though western research (and most insurance companies still don't agree with this form of healing) -but thats why people pay out of pocket when they get tired of playing the pill game.

Sound it just another part of healing that will help the mind body and spirit move together, may want to check out

http://www.brainwavevibration.com/

http://health.usnews.com/articles/health/brain-and-behavior/2008/07/17/music-as-medicine-for-the-brain.html?PageNr=1

http://www.rhapsody.com/tantric-music/kundalini-vibrations-2