Happy Happy New Year to you all!!!
I hope you spent meaningful time with family, friends and even your own self these holidays and that you are feeling refreshed and ready to take on 2017!
I'm starting the year off with some really fun projects, including these videos with my amazing integrative PA friend, Erica Benedicto Pa-C!
We aim to educate the world about the benefits of Integrative Medicine and thought video can more accurately capture our passion. So here goes...!
What are feeling passionate about???
As we enter the end of summer, some of you may be worried about the sun damage you accumulated the last few months. Hopefully you stayed out of the sun during the hottest times of the day and/or used UV protective gear or non-toxic sunscreen to prevent sunburns (I LOVE Beauty Counter's sunscreen, just for the record!).
But, even if you did accumulate a few extra wrinkles this summer, you may be interested in a study I just learned about. A study that found a DECREASE in facial wrinkles and an INCREASE in skin elasticity (the "stretchiness" or ability of the skin to go back to its original form) in healthy women who consumed 320 mg of cocoa bean flavanols.
Flavanols are the compounds found in cocoa and other superfoods like green tea, berries and apples, that help protect our cells from damage. They are one of the health promoting components found in cocoa beans that give dark chocolate and raw cocoa such great reputations for health.
And man, do I LOVE delicious food that LOVES us back!
The particular study I just read was just published in the Journal of Nutrition. The researchers randomized 64 participants in to 2 groups: the cocoa group and the placebo group (man, I'd be mad if I was in the placebo group on this one!).
The cocoa group received 4 grams of cocoa powder that was processed for flavanol preservation (320 mg) while the placebo group consumed a cocoa-flavored beverage without flavanols but containing the same nutrient profile.
After 12 weeks of drinking their respective beverages, participants in the cocoa group were found to have significantly increased skin elasticity than the placebo group. And after 24 weeks, the average and maximum roughness of the cocoa group was lower than the placebo group, which correlates to fewer wrinkles according to the authors.
There was even a subset of participants that underwent UV radiation on a different part of their body. The ones who did this and were randomized to the cocoa group, showed overall improvement in protective effects to the UV light when compared to placebo.
Although the best prevention of UV skin damage is staying out of the sun during intense UV times of the day (10 am to 3 pm) and/or using protective gear when outside for more than 10 minutes at a time, cocoa flavanols taken daily may be a tasty way to prevent skin damage.
For the best benefit, I recommend raw cocoa or cocoa powder in a daily smoothie or hot beverage.
I know chocoholics will love this post!
To your health,
Want to learn more tips and tricks to improve your health? Contact West Holistic Medicine to schedule a consultation with Dr. Maltz today! 512-814-0148
I'm so EXCITED to blend the best of what I've learned over the last 15 years in order to transform your health!
Please watch the video below to hear what the program involves and let me know if you have any questions about it.
Click here --> Video <--
To Your Health,
Irritable Bowel Syndrome (IBS) is a common motility disorder of the gastrointestinal (GI) system, affecting up to about 15% of the U.S. population, according to epidemiologic studies. The syndrome is characterized by abnormal stooling patterns consisting of chronic constipation, chronic diarrhea or alternating constipation and diarrhea.
Frequent complaints associated with the syndrome include, but are not limited to, abdominal bloating, abdominal pain that is relieved by having a bowel movement and a sense of urgency in getting to the bathroom in order to have a bowel movement. IBS typically affects females more commonly than males and is associated with acute and chronic stress as well as anxiety, depression and other psychological disorders.
It is a commonly seen condition in primary care clinics and there are some medications that can help along with many effective natural treatments for the condition. The purpose of this article is to highlight some of the natural treatments available for IBS.
Because IBS is a diagnosis of exclusion (meaning there is no definitive test for the syndrome and the diagnosis is made by ruling out other conditions), diagnosis is not made by any blood work or other tests. Diagnosis is instead made by taking a thorough history from a patient.
Based on the symptoms experienced, IBS is then characterized in to one of three categories: Constipation-Predominant IBS (IBS-C), Diarrhea-Predominant IBS (IBS-D), or Mixed-type IBS (IBS-A). If a physician suspects a more serious illness is occurring in the GI tract, other tests such as a colonoscopy, flexible sigmoidoscopy and/or upper GI endoscopy can be performed. These are not generally done to diagnose IBS.
Natural Cures for IBS include but are not limited to the following suggestions:
Stress management – Acute or chronic stress plays a major role in the pathophysiology of IBS. This likely occurs due to changes in neurotransmitters (specifically serotonin and adrenaline) and nerve firing in the gut. When we are stressed, our adrenaline levels increase and digestion shuts down. This is due to blood being shunted towards the brain, heart and large muscle groups and away from the digestive tract in order to allow our bodies to flee if in danger. When this occurs, we are in what is called the “fight or flight” response.
To improve gut function, one needs to activate the “rest and digest” parasympathetic nervous system. When this response is activated, our adrenaline levels decline and we feel a sense of calm take over us. It is then that our digestion can occur effectively and most efficiently.
Acupuncture – Because acupuncture works by decreasing the fight or flight response of the body, it can be a very useful tool for IBS. The medical studies done on it to date, have shown mixed reviews, however, in my personal practice, I find it to be extremely effective.
Probiotics - Probiotics, and the foods that support probiotic growth, know as pre-biotics, are also research-proven to help with IBS symptoms. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886445/
There are thousands of different types of bacteria in the gut and therefore it is difficult to know where to start with a probiotic. I recommend restoring the beneficial yeast, Sacchromyces Boulardii (aka S. boulardii) first and rotating with a different probiotic every few months.
Dietary Changes - Many patients find relief from IBS by removing dairy and gluten from their diets as proteins such as gluten and casein (found in cow’s milk) in these foods cause inflammation in the gut leading to IBS and inflammatory bowel disease.
Simply removing dairy and gluten from the diet can dramatically help many people with IBS.
When that doesn’t do the trick, the FODMAPs diet can be helpful.
FODMAPS Diet – This acronym for a diet is quite a mouthful when it is spelled out but can be very helpful for those with IBS.
The acronym FODMAPS stands for “Fermentable Oligo-, Di-, Monosaccharides And Polyols”. These compounds are found in many fruits and vegetables and in all beans and legumes. They are thought to worsen gut function by an unknown mechanism in some individuals suffering from IBS. Therefore, a low FODMAPS diet can be beneficial for those with IBS. For more information, please see: https://stanfordhealthcare.org/content/dam/SHC/for-patients-component/programs-services/clinical-nutrition-services/docs/pdf-lowfodmapdiet.pdf
Movement - Physical activity and movement is one of the most important things one can do to prevent and treat medical problems. Physical activity is particularly important in the treatment of IBS and has been clinically proven to improve symptoms of the illness. Anywhere from 20 to 60 minutes of physical activity a day can greatly improve IBS symptoms. http://www.medscape.com/viewarticle/737389.
Meditation – Meditation engages the Relaxation Response that is crucial in decreasing the sympathetic tone of the gut. The gastrointestinal tract consists of 100 million nerve endings and is overseen by the brain. One part of the nervous system, the parasympathetic nervous system, is mostly in charge of digestion, thus proper engagement of the parasympathetic function is necessary for optimal digestion.
One way to learn to meditate is by doing deep belly breathing. This type of breathing is a learned skill that occurs when you focus on allowing an inward breath to inflate your lungs and your abdomen. The increased amount of oxygen in your body automatically normalizes the stress response and can lead to your heart rate and blood pressure lowering. It’s a practical, portable and FREE modality that can be learned at any age!
A wonderful technique I learned in my Integrative Medicine Fellowship is Dr. Weil’s 4-7-8 breath. http://www.drweil.com/drw/u/VDR00112/The-4-7-8-Breath-Benefits-and-Demonstration.html
If you have a hard time learning how to do deep belly breathing on your own, you can learn from most psychotherapists and/or yoga teachers.
For constipation-predominant IBS:
Water – Most Americans don’t drink enough water. This inhibits gut function as the colon and kidneys are responsible for reabsorbing the precise amount of water from the intestinal lumen (where the food goes) in order to keep the delicate balance of hydration going in the body. I recommend at least eight tall glasses of water per day and more for those who are constipated or who work outside or live at high altitudes. In this case, water is your friend!
Aloe vera – We all know and love this plant for it’s external healing effects on skin. But many people are unaware that they can reap the same benefits by drinking the juice that comes from the inner fillet of the plant. In fact, aloe vera juice is one of my most favorite recommendations for constipation-dominant IBS. It can also be useful in diarrhea-predominant IBS.
The way aloe vera works in the gut is still unknown, however, it basically coats and soothes the digestive tract allowing for better transit of fecal matter. But, be forewarned, the whole leaf of the plant is a STRONG cathartic laxative – meaning you will clear out your bowels in a very dramatic way if you ingest it! Therefore, I recommend 1-2 oz. of the juice from INNER FILET ONLY! And make sure you get an unflavored or flavored bottle if you are sensitive to tastes as aloe vera juice can be very bitter if left untouched.
For diarrhea-predominant IBS:
Enteric-coated peppermint oil – Peppermint has long been known for it’s useful digestive properties. Fortunately, the medical scientific literature has found similar results in that patients with IBS generally find significant improvement in their symptoms when taking peppermint oil. The key to the remedy here, though, is the delivery system.
Enteric-coated peppermint oil is created for digestion in the small intestine and thus works it’s magical effects there and not in the stomach. In this formulation, the herb works just as well as many anti-spasmotic medications for IBS. It is extremely safe to use with the main adverse reaction being heartburn due to the menthol in the peppermint plant itself. Thus, it is not to be taken if you have GERD (gastroesophageal reflux disorder) or are prone to developing heartburn. I recommend taking one capsule of the enteric-coated oil it 30 minutes before a meal for best results.
As you can see, there are many effective, natural ways to manage Irritable Bowel Syndrome. It is best to work with a knowledgeable healthcare practitioner to figure out which techniques may work best for you.
It's the question I get most frequently about my practice and one of the most important! Why do I not take health insurance as payment? Find out in this blog post.
I'd love to hear your thoughts! Happy Wednesday!
Hello to everyone out there in Radio/Internet Land!
I had my very first real radio interview/show today and had a blast recording it! Here are the MP3 links so you can check it out at your leisure. And no, the political/religious beliefs of the radio station itself are not necessarily those of my own. I was strictly there to talk wellness and Integrative Medicine.
Happy Tuesday, everyone!
I admittedly have not been as diligent about writing a weekly blog post as I intended to be as, like many people, I find that when I HAVE to do something, it is not done with as much joy and passion as when I spontaneously decide to write. That being said, I found a study the other day that really lit me up and I wanted to share it with you all.
The study was done in an inpatient hospital setting by asking patients to take a survey about the care they received while hospitalized. For those unfamiliar, there are doctors who only work in hospital to admit, treat and eventually discharge patients. They are called "hospitalists" and many of my friends from residency are such physicians. They work grueling hours to ensure their patient care is tip-top and to get patients home safely and most efficiently.
Nowadays, when someone is discharged from a hospital, these doctors and the hospital itself are graded by the patient in what's called the Press Ganey score. Unfortunately, and somewhat unfairly (in my opinion), the Press Ganey score reflects how "patient-centered" the hospital seems to the patient and is not as much about the actual care received. Patients can complain about any and all issues with hospital staff, decor and even the FOOD, which is beyond control of the doctors and nurses! And some hospitals' compensation from Medicare may depend on these scores (this is very unfair to me as state, county and city hospitals are underfunded and need the money, yet are at risk of not receiving it due to poor infrastructure, inability to pay high salaries to retain staff, etc.). Needless to say, doctors and hospital staff, for the most part, do their best to try to impress their patients and treat them effectively and well. But, we are not perfect, and Press Ganey scores can reflect that.
So how does this study play a role in medicine? The study interviewed and surveyed patients about the empathy hospitalists showed them regarding what they encountered during their hospitalization. It then correlated the empathy scores with patients' anxiety scores (using a separate validated anxiety measure) and the patients' ratings of their doctors.
What did it find? It found that more empathic encounters (those doctors who could communicate their ability to relate to the patients' negative emotions) resulted in a significant decrease in patients' anxiety scores while hospitalized AND higher hospitalist ratings. Non-empathic physician encounters resulted in higher anxiety scores on the surveys partaken.
While this result does not in-and-of-itself surprise me, it does shed light on what is needed to allay patient fears while hospitalized and can possibly enable physicians to get higher scores on the important Press Ganey scores. Empathy can be learned, so It seems to be a win-win for everyone!
Now, what does being empathic mean and how can it reduce patients' anxiety? The word empathy comes from the greek root words em and pathos, which mean "in" and "feeling", respectively. Empathy is the idea of relating to or understanding someone else's feelings and being able to feel what they feel.
How does this simple gesture change another person's experience? Well, think about how you feel when others "get you". You feel heard, understood, appreciated even. Now turn it around and think about a difficult situation you have encountered when someone else was suffering and came to you for advice. Did you stop
What you were doing, sit down, listen to their worries/fears, and just hold space for them? Or did you dismiss their feelings and continue doing what you were already doing?
The key to helping someone through any suffering experience is not to dismiss their feelings nor is it necessarily to try to fix the situation. It is to sit down, offer a listening ear and truly try to understand what that person is going through. Only then can they feel heard, understood and appreciated. And only then, solutions can arise. You may instantaneously decrease someone else's suffering and the world can be a brighter place for you and them, whether in the hospital, at home or at work.
I know this may all seem very simple to many people, as empathy does come very naturally to some. However, in extremely busy, high pressure systems, such as medicine, learning empathy can go a long way. I hope you can feel me on this and somewhat agree! (it's ok if you don't)
Here's a link to the article synopsis which I credit the newsletter from Healio for making me aware of. Healio is a great resource I enjoy for current medical research. Enjoy and have a fantastic rest of the week!
Weiss R, et al. Hospitalist Empathy Is Associated with Decreased Patient Anxiety and Higher Ratings of Communication in Admission Encounters. Presented at: Society for Hospital Medicine Annual Meeting; March 6-9, 2016; San Diego.
Exercise in regular dosing has long been known to reduce the risk of developing various cancers. Here's an intriguing study on the complex interplay of adrenaline and the immune system and how it may contribute to cancer prevention.
In practical terms, I highly recommend at least 20 minutes of a physical activity in whatever form you're drawn to most days of the week (if not all). My preferred forms are walking in nature, yoga and dance.
What are yours??
I am absolutely THRILLED to announce that I am officially joining West Holistic Medicine to practice alongside Dr. Jennifer Pollard, Vanessa Huffman, L.Ac., Dr. Dane Mosher (functional medicine), Chef Priti Bhatt and Lis Riley, RYT (yoga therapist)!!!
I'll be seeing patients Monday mornings and Thursday evenings starting March 3rd, with expanded hours within the next 3-9 months!!
I am so excited to finally have a location to call home for Neshama Medicine. Would be honored to serve any of you as your Internist and/or Integrative Medicine consultant.
Contact the office to make an appointment today!
512 814 0148
It’s February 16th and Valentine’s Day has now come and gone. Millions of people around the globe honored their loved ones with cards, chocolates, flowers, etc., on this infamous day. Yet, how many truly honor themselves? How many stand up for what they want and speak their truth? How many have a negative self-view and constantly berate themselves for not being slim enough or pretty enough or for not owning a bigger house or fancier car?
These are the questions I am asking today. Questions that go deeper than a simple Hallmark greeting.
For me, a new version of The Golden Rule could be: Are you treating your self the way you would want to be treated by others? Are you being kind to yourself more often than not? Do you truly, deeply love yourself? Are you walking your talk of self love or are you making compromises in order to "not rock the boat"?
If your answer to these questions is mostly yes, great! Sounds like you are on a fulfilling path of self love. Keep up the transformational work!
If you answered no, consider what it might take to have you answer yes to all 3 questions. For some, it takes a horrible illness or disease to have the courage to live the life they want. For others, it takes financial ruin.
Ultimately, though, if a person is to move towards self love after a devastating illness or financial ruin, a chain reaction towards a person’s “Phoenix Process”, as renowned author and speaker Elizabeth Lesser calls it, must be catalyzed. The Phoenix Process is the process of breaking fully open after a catastrophic event or trauma and subsequently doing the painstaking work to rebuild oneself. It is thought to be a regeneration or rebirth of great proportion, as referenced through Greek mythology. https://en.wikipedia.org/wiki/Phoenix_(mythology).
Is it necessary to go through such a life-changing trauma in order to reinvent yourself? Of course not; however, major life events call in to question everything a person has known up to that date. People tend to live more intentionally during this transformation and typically only have energy for those people and things that truly excite them. It is a beautiful process to observe, however scary it may feel from the inside.
You may ask, "Why is a physician talking about transformation and self love?". Well, for one, as a physician, I’ve had the honor and privilege of guiding many of my patients through their Phoenix Process. Perhaps they are dying from cancer or are getting their life back from debilitating chronic pain through various lifestyle changes they have implemented (it does happen). Or maybe they are battling addiction and have been sober or cigarette-free for 21 days. Whatever the case may be, I feel honored to be there, on the front lines, with my patients through their transformation.
Secondly, I am also someone who has been through a few Phoenix processes and as such, I know how scary and liberating the experience can be. I am currently in such a process as we speak.
And thirdly, in most cases, self-love translates to health as it sets the tone for the way people live their lives. Whether or not you choose to eat well, abstain from smoking and drugs, exercise and treat yourself mostly stems from self love. And all of these factors influence your health. Of course, no-one can eat perfectly and choose only healthy behaviors 100% of the time, but we definitely ALL have room for improvement. And this doesn't mean that all physically healthy people are emotional healthy, nor is it vice versa. But, when you have a healthy self image, you tend to choose healthier behaviors that perpetuate your self love. Oh, and healthy behaviors make you FEEL good! :)
As the allegorical author, C.S Lewis once said, “It may be hard for an egg to turn into a bird: it would be a jolly sight harder for it to learn to fly while remaining an egg. We are like eggs at present. And you cannot go on indefinitely being just an ordinary, decent egg. We must be hatched or go bad.”
So, looking at your life...ask yourself: Have you hatched? Are you ready to fly? Or, conversely, are you okay with remaining an egg? (All answers are perfectly fine just something to think about).
Have a great week and happy belated Valentine’s Day (aka Self-Love Day),
DISCLAIMER: The content of this website does not serve as medical advice nor does it substitute for a thorough medical
evaluation by a qualified health care practitioner. It also does not represent the opinions of any of the medical institiutions or practitioners mentioned.
Consult a physician or local health care provider before changing any medications, diet or exercise regimen.