COVID-19 UPDATED

Blair Cuneo, PA-C
While there are questions and uncertainties in our evolving understanding of COVID-19, its variants and vaccination options, there are many things we have learned. We continue to see reduced severity of COVID-19 illness in patients with less chronic inflammation and with healthy immune support.

The CDC website reviewing preventative recommendations for vaccinated and unvaccinated patients is below, including guidelines for mask wearing, social distancing and information on vaccinations.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

In addition to those guidelines, the providers at Carolina Total Wellness recommend the following lifestyle and supplement supports to optimize immune function, decrease viral transmission, reduce viral activity in the body and support the body’s immune response.

LIFESTYLE:
For adults and children, focus on eating foods that are organic and rich in antioxidants.  Try to eat 5 to 7 servings of vegetables and 2 to 3 servings of fruit every day.  Drink filtered water, avoiding plastics as much as possible. Improve ventilation, air flow and utilize quality air filters indoors, including home and work. Ensure adequate sleep for healthy immune and detox response.
Integrate mindfulness and stress lowering practices each and every day.
 
SUPPLEMENTS: (Bold items are available in online patient portal supplement store)

Adult Prevention Supplement Options:
1. Vitamin C: 500-1000mg daily to twice a day (Complete Vitamin C)
2. Vitamin D: 2000IU -5000 IU per day (Liquid D3, Vitamin D3, Ortho Force)
3. Zinc: 15-30mg daily (Zinc glycinate or Zinc Drink)
4. Quercetin 400 mg daily (Allergy Ease, BetaQ Immune, D-Hist Jr)
5. Melatonin 3-6 mg at bedtime (Melatonin CR or Quick Dissolve Melatonin)
6. Biocidin LSF mix 10 pumps into Xlear or a bottle of over the counter nasal saline spray: 2 sprays per nostril after possible exposures to virus.  
Additional options to discuss with your provider include curcumin, NAC, Andrographis, Vitamin A, Resveratrol and Immune Adaptogenic Mushrooms.
 
Pediatric Prevention Supplement Options:

1. Vitamin C (CTW Complete Vitamin C), Seeking Health Liposomal Vitamin C (liquid):3-5 years: 125-250 mg daily6-12 years: 250-500 mg daily 
2. Vitamin D (CTW Liquid D3 or CTW Vitamin D3):3-6 years: 1,000 IU daily7-12 years: 2,000-3,000 IU daily 
3. Zinc (Zinc Drink, Zinc Glycinate):3 years: 5-10 mg daily4-12 years 10-25 mg daily 
4. Quercetin (CTW Allergy Ease, D-Hist Jr chewables):3-4 years: 50-100 mg daily4-8 years: 100 mg daily8-12 years: 100-200 mg daily 
5. Xlear nasal spray: 1-2 sprays per nostril daily and after potential exposures. 
6. Elderberry:<7yo: 250mg daily>7yo: 500mg daily 
Additional options to discuss with your provider include curcumin and glutathione
 
The following therapeutic options are started at first signs of illness, positive exposure, and/or positive testing. Please notify your provider so that we can further personalize support.

Adult Therapeutic Supplement Options:

Vitamin C: increase to 1000mg four times a day. Reduce dosage to 500mg if loose bowels. (Complete Vitamin C)

Vitamin D: 2000-5000IU per day (Liquid D3, Vitamin D3, Ortho Force

Zinc liquid or lozenges: 15-20mg four times a day. Swish liquid before swallowing. If using lozenge, do not chew, instead suck on lozenge until done. (Zinc Drink)

Quercetin:  800 mg two times a day (Allergy Ease, BetaQ Immune, D-Hist Jr

Melatonin 3-6 mg at bedtime (Melatonin CR or Quick Dissolve Melatonin

Biocidin LSF mix 10 pumps into Xlear or a bottle of over the counter nasal saline spray: 2 sprays per nostril two times a day. 

Curcumin 500-1000 mg four times a day (Meriva or Turmero liquid) N-acetylcysteine: 600mg twice a day (CTW Liver Support or Trizomal glutathione

Andrographis: 375 mg twice daily (Viragraphis

Pediatric Therapeutic Supplement Options:

1. Vitamin C (CTW Complete Vitamin C), Seeking Health Liposomal Vitamin C (liquid)3-5 years: 125-250 mg four times a day, reduce dose if loose bowel movements.6-12 years: 250-500 mg four times a day, reduce dose if loose bowel movements. 
2. Vitamin D (CTW Liquid D3 or CTW Vitamin D3):3-6 years: 1,000 IU daily7-12 years: 2,000-3,000 IU daily 
3. Zinc liquid or lozenges (Zinc Drink or Zinc Glycinate)3 years: 5-10 mg four times a day4-12 years: 10-15 mg four times a day 
4. Quercetin (CTW Allergy Ease caps or D Hist Jr chewables):3-4 years: 50-100 mg two times a day4-8 years: 100 mg two times a day8-12 years: 100-200 mg two times a day 
5. Melatonin (Quick Dissolve Melatonin 3mg) or Source Naturals Melatonin lozenge, 1mg3-5 years: 1mg at bedtime6-12: 3mg at bedtime 
6. Biocidin LSF: 5 pumps into Xlear or nasal saline spray: 1-2 sprays per nostril two times a day.
 
7. Curcumin (Meriva or Turmero liquid)3-4 years: 125 mg three times a day4-8 years: three times a day8-12 years: 325 mg three times a day 
8. Glutathione (Trizomal Glutathione):3-5 years: 50mg two times a day6-12 years: 100mg twice a day


   
 

ADULT COVID-19 Vaccination prep: supporting resiliency
 
Start 2 weeks BEFORE and continue for 1 week AFTER vaccination:
 
1. Clean water: 8–10 glasses a day or ½ body weight in ounces
2. CTW Complete Vitamin C: 1 cap (500mg) two times a day
3. CTW Daily Multivitamin or MitoCore 2 caps two times a day
4. Daily Probiotic
5. Vitamin D3 4000IU daily
6. Zinc Glycinate 15mg daily
7. SPM Active 2 caps daily
 
In the days leading up to your vaccination, fuel your immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Rest when you need to rest and aim for quality sleep the two nights before the vaccination.
 
*Day of and day after vaccination, increase vitamin C:
CTW Vitamin C: 2 caps (1000mg) twice a day
 
After your vaccination, think muscle, immune and lymphatic system support:
 
Engage your deltoid, the shoulder muscle which received the vaccine. Movement and engagement of the muscle will reduce the tenderness and soreness which can start setting in a few hours later. Example exercises include arm circles, push-ups, resistance shoulder pressing exercises.
 
Go on a walk! Perform some light cardio and exercise after your vaccination to provide a healthy stimulus for your immune system for optimal response and reduce side effects.
 
Stimulate your lymphatic system! Right after the vaccine, begin gentle skin brushing of the vaccinated arm, encouraging lymphatic flow toward center of body. Whole body lymph support options: whole body dry skin brushing, gentle rebounding, deep breathing. 
 
   

PEDIATRIC COVID-19 Vaccination prep:
 supporting resiliency for children 12 years and older
 
Start 2 weeks BEFORE and continue for 1 week AFTER vaccination:
 
1. Clean water: ½ body weight in ounces
2. Vitamin C: 250-500mg two times a day (CTW Complete Vitamin C caps, Seeking Health Liposomal Vitamin C (liquid)
3. Daily Multivitamin (ActivNutrients chewables or CTW Daily Multivitamin caps)
4. Daily Probiotic (Ther-biotic complete chewables or CTW Daily Probiotic)
5. Vitamin D 2,000IU – 4,000IU daily (CTW Liquid D3 or CTW Vitamin D3)
6. Zinc 15mg daily (Zinc Drink liquid, Zinc Glycinate caps)
7. SPM Active 2 caps daily
 
In the days leading up to your vaccination, fuel your child’s immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Stick to sleep schedules/healthy sleep hygiene and aim for quality sleep the two nights before the vaccination.
 
*Day of and day after vaccination, add extra C to above protocol:
Vitamin C: 1000mg two times a day
 
After your vaccination, think muscle, immune and lymphatic system support, refer to instructions above.
  
Please contact our office for an appointment to further support and personalize your path to wellness.
 

Your Partner In Health!
Blair Cuneo, PA-C
 

References:
https://www.drkarafitzgerald.com/2020/03/16/covid19-traditional-chinese-medicine-and-western-options-for-the-non-tcm-trained-clinician/?mc_cid=1cd528a9bd&mc_eid=fb7826b1c3
https://healthykidshappykids.com/2020/02/27/coronavirus-covid-19/
https://www.drkarafitzgerald.com/2020/03/12/covid-19-preserving-your-familys-health-and-sanity-in-the-face-of-a-pandemic/?mc_cid=1cd528a9bd&mc_eid=fb7826b1c3
https://www.sciencedirect.com/science/article/pii/S1550830720301130?fbclid=IwAR0ZjInhMGulFrfnMHVL_uITY5EYuGNccwRII03as8NSVn_EeqRGvi8DgXY
https://healthykidshappykids.com/2020/04/04/pediatricians-pandemic-immune-support-plan/
https://info.ifm.org/covid-19?utm_campaign=covid-19&utm_source=website&utm_medium=popup&utm_content=resources_learn_more
https://covid19criticalcare.com/covid-19-protocols/i-mask-plus-protocol/
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/your-vaccination.html
 
 

 

PEDIATRIC COVID-19 Vaccination Prep

 Supporting Resiliency for Children 5 years – 11 years

The Centers for Disease Control (CDC) and American Academy of Pediatrics (AAP) have announced recommendations for COVID-19 vaccination in children 5 years and older, who do not have contraindications.

At Carolina Total Wellness (CTW), we seek to empower our patients and their families with up to date information and provide medical recommendations through our personalized approach.

If you have questions regarding vaccinations, please reach out to your established medical provider.
 
PEDIATRIC COVID-19 Vaccination prep:
Supporting resiliency for children 5 years – 11 years
 
Start 2 weeks BEFORE and continue for 1 week AFTER vaccination:
 
1. Clean water: ½ body weight in ounces
2. Vitamin C: 125-500mg two times a day
3. Daily Multivitamin (ActivNutrients chewables)
4. Daily Probiotic (Ther-biotic complete chewables)
5. Vitamin D: 1000IU per 25 lbs, daily (CTW Liquid D3)
6. Zinc 7.5mg daily (Zinc Drink liquid)
7. SPM Active 1 caps daily: cut/puncture the softgel and squeeze out contents onto spoon, ok to take/mix with food.
 
In the days leading up to your vaccination, fuel your child’s immune system with healthy, organic colorful foods that are nutrient dense. Avoid pro-inflammatory junk foods and sugary foods. Stick to sleep schedules/healthy sleep hygiene and aim for quality sleep the two nights before the vaccination.
 
*Day of and day after vaccination, add extra C to above protocol:
Vitamin C: 500mg two times a day
 
After your vaccination, think muscle, immune and lymphatic system support:
 
Engage your deltoid! This is the shoulder muscle which received the vaccine. Movement and engagement of the muscle will reduce the tenderness and soreness which can start setting in a few hours later. Example exercises include arm circles, push-ups, patty-cake!
 
Run around! Walk, run, play after the vaccination to provide a healthy stimulus for the immune system for optimal response and reduce side effects.
 
Stimulate lymphatic system! After the vaccine, you can begin gentle skin brushing of the vaccinated arm. When able, incorporate whole body lymph support with options like whole body dry skin brushing, gentle rebounding (jumping, hopping), or deep breathing (blowing bubbles, square breath). 
  
AAP statement:
https://www.aap.org/en/pages/covid-19-vaccines-in-children-and-adolescents-policy/
 
CDC statement:
https://www.cdc.gov/vaccines/covid-19/planning/children.html

  
Please contact our office for an appointment to further support and personalize your path to wellness.
 

Your Partner In Health!

Blair Cuneo, PA-C

Tips for Healthy Eating for Busy Families

Does the back-to-school season of busy weeknights filled with extracurricular activities have you relying on take out for dinners?  Here are some tips to keep meals at home that are healthy and easy. 

TIP #1
~ Keep freezer stocked with proteins to limit daily trips to the store.  Grass fed beef, organic ground turkey, organic chicken breasts, wild caught salmon, and Aidell’s chicken sausage.  Instacart has been a time saver for my family and Costco will deliver all of these protein options. 

TIP #2
~ Keep the pantry stocked with staples. Beans, GF Pasta (we love Jovial,) Tomato sauce (Rao’s,) Chicken and Bone broth, rice, quinoa, nut butter.

TIP #3
~ Use a crockpot or instant pot to cook meals and/or meat ahead of time.  One great way to cook chicken is to add a few chicken breasts, taco seasoning and a few scoops of your favorite salsa.  Cook for 3 hours in the crockpot.  This chicken can be used for many meals!

BONUS TIP
~ CHANGE YOUR MINDSET TO MAKE SIMPLE, HEALTHY DINNERS
This might be the most powerful secret of all. The best way to make simple, healthy dinners is to change your thinking on what dinner should look like. This means that not everything is gourmet, but the upside is now meals are much simpler while still being healthy.

TWO easy “on the go” meals:

1) Burrito Bowls or Taco salad in a Jar
~ Chopped up greens as the base
~optional rice, black beans, chicken, beef or turkey, guacamole, salsa, sour cream or Tessemae’s Avocado Ranch dressing. 
~ Prepare in a bowl or in jars to take in the car. 

2) Aidells Chicken Sausage & Roasted Vegetables

~ Aidells Chicken sausage – sliced
~ Broccoli, zucchini, mushrooms, potatoes or sweet potatoes, or whatever else you have on hand.
~Roast in the oven and enjoy!

For more tips on how to conquer healthy eating during the busy school season, contact our office at 919.999.0831 to schedule an appointment with one of our Health Coaches. 

Your Partner in Health!
Caroline Wilson, M.Ed., FMHC

5 Strategies For Stress Eating

Stress eating occurs when we eat in response to a stress signal instead of a hunger signal.  It is reaching for food to calm our nerves, soothe our sadness, chase away boredom or buffer against other emotions we are uncomfortable with.
 
When we stress eat we are usually reaching for sugary and/or salty foods.  It’s often food we eat with our hands.  Hand to mouth eating frequently occurs without much awareness or mindfulness.

 
Tips to Help Decrease Stress Eating:
 

1) Being Body Aware – This means getting in touch with your body.  Get back into your body, get grounded, get centered.    Are you truly hungry?  Pay attention to what sensations are going on in your body.  Has your heart rate increased?  Do you have butterflies in your stomach?  Are you feeling fragmented and disassociated in your body?  Feeling out of sync between body and mind?
 
You can bring yourself back to center by concentrating on your breath.  Put one hand on your chest and one on your belly and breathe in deeply.  Is the breath going to the upper chest area or the belly?  You want the breath to go into the low belly.  By doing this you engage the parasympathetic system (aka rest and digest) and reduce the sympathetic system (aka fight or flight).
 
2) Exercise your emotional muscle – Emotions are energy in motion.  Don’t be afraid to show your emotions.  We need to let emotions flow and we need to express them.  When we don’t do this we “eat our emotions” with food.  Emotional eaters tend to eat foods that are nutrient poor (junk food) instead of nutrient rich (veggies, fruits, healthy fats, lean proteins).
 
Keep a check on your feelings.  One way to do this is to check in with family and friends.  Be real about your emotions as this allows others to feel comfortable to open up with you as well.  Journaling is also a great tool for expressing your emotions. 
 
3) Developing alternatives – Rather than engaging in stress eating come up with alternatives.  Make a list of 5 things that you can do instead of eat when you are not really hungry but are craving food due to emotions.  Some ideas:  call a friend, physical movement, journaling, nap, read a good book, organize a drawer in your kitchen or bathroom.
 
4) Having healthy foods available – If you can’t fight the urge to eat, make the best choices with the cravings you have.  Ideas:  avocado for someone who craves fat, fruit for someone that craves sugar, cacao powder in water for someone who craves chocolate, olives for someone who craves salt. 
 
5) Fueling your body with real food – Be sure you are getting lots of nutrients so you are not vulnerable to the effects of stress.  Food modulates our mood and if we stick with whole unprocessed foods our mood will be better and we won’t feel as stressed.


Your Partner In Health!
Sara Yadlowsky, FMHC

A NEW take on an OLD favorite: a COLD soup for those last HOT days of summer!

Like so many of us with food sensitivities or allergies, the necessity of creativity in the kitchen has now become a joy. That said, I do not relish hours of prep time in the kitchen.  This new version of my old favorite gazpacho, has replaced the tomato I can no longer eat with cucumber! It is gluten, dairy, nightshade free, full of nutrients, yummy and so easy, done in 15 minutes in the blender.

Cucumber Gazpacho: serves 4
2 cucumbers (unwaxed/organic if possible to be able to use the peels; if waxed, peel first)
2 T shallots (or onion if you don’t have shallots)
2 small garlic cloves
1 cup cilantro leaves
4 T lime juice
2 cups coconut unsweetened yogurt
½ teaspoon salt

½ teaspoon black or white ground pepper
2 t coriander ground
2 T olive oil

1 handful arugula or baby kale or baby spinach
 
For garnish consider:
Lime zest (my favorite)
Diced avocado
Poached shrimp drizzled with lime, olive oil

Directions:

Put all ingredients in blender.
Chill in fridge.
Make sure it is REALLY cold so best to make ahead of time.
Enjoy!

Your Partner in Health!
 Frances Meredith, MD

Dry Needling with Dr. Kari Smith, PT, DPT

At Carolina Total Wellness we understand that our services and support are sometimes only part of the solution in optimizing our patients’ health.  We have worked over the years with various medical providers in our community to establish a base of high-quality clinicians who are able to meet the various health needs of our patients.  This is the first in a series of guest blogs from one of our community providers.  Dr. Kari Smith, PT, DPT, describes one of her approaches to treating pain – dry needling.

 
What is dry needling?
Dry Needling is a soft tissue manual therapy technique performed by a certified clinician with a professional degree in the medical field. The clinician safely guides a sterile monofilament needle into dysfunctional muscle tissue to aid in pain reduction and restoration of proper movement patterns. This technique involves identifying and treating a muscle trigger point (a collection of muscle fibers that lack healthy blood supply, have a higher resting electrical state and contain pain-generating chemicals). Left untreated, muscle trigger points can lead to altered joint movement, as well as increased stress on surrounding soft tissue.

A clinician may also use dry needling with electric stimulation to release overactive primary muscles, or to wake up dormant stabilizing muscles by improving their neural response. Primary muscle groups are comprised mostly of fast-twitch muscle fibers, so they fatigue quickly and require de-activation to recover. Stabilizing muscles contain more slow-twitch fibers and can withstand longer bouts of activation. Our bodies experience pain or movement dysfunction when the stabilizing muscles are inactive, and the larger muscle groups work over-time. Through dry needling with electric stimulation, the clinician activates these stabilizing muscles so that stress is taken off primary muscle groups, allowing these larger muscle groups to function optimally, but also have time for recovery.

Does it hurt?
The needles are much smaller than ones used for an injection, so often patients do not feel the insertion of the needle in the skin. There is also nothing injected (as the needle is solid), so patients do not experience the burning sensation that is commonly felt when a fluid is injected into the body. The most common sensation is a light cramping when the needle activates a deep twitch response in the trigger point. This is an effective response that is documented in the literature that indicates that the trigger point has been released and immediate changes in muscle length are observed. Some patients feel soreness after the treatment, similar to muscle fatigue after a strenuous workout. Your therapist will be in constant communication with you throughout the procedure to alter or cease treatment as needed.

How will I know the treatment is effective?
Your therapist will perform a series of pre-treatment tests to determine areas of pain, movement dysfunction, or loss in strength. Following treatment, these areas will be re-assessed for improvement, and often there are immediate results. Your therapist will then recommend corrective exercises to maintain the gains made during the manual therapy session.

If you are suffering from pain and feel that dry needling may be of benefit to you, feel free to discuss this with your functional medicine physician at Carolina Total Wellness or contact Dr. Smith at Prevail physical therapy.
 

 Dr. Kari Smith, PT, DPT
Founder, Owner, Physical Therapist, Prevail

919-482-9648 | f 919-589-4839 
kari@prevailphysio.comwww.prevailphysio.com
100 Keybridge Dr., Morrisville, NC 27560

 

   Supplement “TAKEOUT” Option

By: Ashley Beurer, Office Manager
 

In person supplement pick up includes a 10% discount on all supplements ordered. If you prefer shipping, we will continue to provide free direct shipping for online orders.
 
• Place your order for supplements through the “Online Store” on the home page of your patient portal.
• At check out, use the promo code TAKEOUT, Click APPLY and then complete your payment
• If you use the TAKEOUT promo code, we will NOT ship your supplements. We will ready them for office pick up.
• Supplements must be ordered by 5 pm the day BEFORE you would like to pick up. The order will be ready by 9 am the next day and you may pick up anytime Monday -Thursday from 9 am to 5 pm or Friday from 9 am to 12 pm.
• Please do NOT call the practice to place your order on the phone or request via messages.
• When you come to the office to pick up your supplements, they will be ready for you by the front office door on our pick-up shelf.

Please contact our office for an appointment to further support and personalize your path to wellness.
 

Your Partner In Health!

Ashley Beurer, Office Manager

Health Benefits of Napping

By: Susan D. Denny, M.D., MPH

With the hectic pace of day-to-day life, many people don’t get the recommended amount of sleep each night. According to the National Sleep Foundation, adults typically need between seven and nine hours of sleep per night in order to function at their best. Getting a few less hours for even a few nights in a row can have the same effect as staying awake for 24 hours straight. And, over time, chronic sleep debt can contribute to fatigue, increased stress levels, reduced attention span, and declined cognitive performance.

One way to combat the effects of sleep deprivation—and repay some sleep debt—is to incorporate daytime napping into your schedule. The length of the nap and type of sleep you get during that nap help determine its potential health benefits. The table below identifies these benefits.

Nap Duration  and  Potential Health Benefits

10-20 minutes:
 Reduces sleepiness; improves cognitive performance; increases alertness, attention, and energy levels; improves mood; improves motor performance; reduces stress levels

20-30 minutes:
Enhances creativity; sharpens memory

30-60 minutes:
Sharpens decision-making skills, including memorization and recall; improves memory preservation

60-90 minutes:
Rapid eye movement (REM) sleep, which is critical for problem solving; helps make new connections in the brain; enhances creativity; reduces negative reactivity; promotes happiness
 

The following is a list of tips and tricks to help you make the most of naptime:

  • Choose a dark, quiet, comfortable place where you can relax.
  •  Try to limit the amount of noise and light in the room, and make sure the temperature is comfortable.
  •  Choose a time that works for you, and aim to nap at that time each day to establish a routine. You may find that restricting your naps to early afternoon (between 1:00 pm and 3:00 pm, or an hour or two after lunch) is less likely to interfere with your nighttime sleep patterns.
  •  Set an alarm on your cell phone, watch, or computer so you don’t sleep for too long.
  •  If you’re napping at the office, try closing your door and hanging a sign that says, “will return in 20 minutes.” Alternatives to this are napping in your car or on an outdoor bench.
  • Wherever you nap, bring along something that you associate with sleep. Some ideas include a sleep mask, neck pillow, relaxing playlist and headphones, cozy blanket, warm socks, and lavender essential oil to dab on your pulse points.
  • Keep in mind that longer naps may be accompanied by sleep inertia, or a period of grogginess that sometimes follows sleep. Give yourself time to wake fully before returning to any activity that requires a quick or sharp response.

 Your Partner In Health!
Susan D. Denny, MD, MPH

Five Tips to Get Back on Track with Exercise

Sara Yadlowsky, FMHC

There are many reasons exercise may fall to the wayside:  injury, surgery, a major life event such as a divorce or death, demands of work or simply losing interest in an exercise routine can all disrupt your exercise schedule.  Life is full of ups and downs and sometimes things gets in the way of consistent exercise and movement.

Here are five tips to help you get back on track: 

Choose a Type of Movement
You don’t have to stick with the same type of exercise you have done in the past.  Perhaps it’s time to try something new – maybe something you’ve always wanted to try but haven’t.  Think about your current lifestyle and what exercise would suit you best.  There are so many different types of exercise.  You may want to sample a few before you decide on an exercise plan.

 Set Realistic Expectations
Don’t attempt to go from the couch to exercising 7 days a week overnight.  This will often end up in injury and put you BACK on the couch.  Instead come up with a plan that eases you back into consistent movement such as walking 2-3 days a week for 15-20 minutes.  This primes your muscles and joints more effectively.   It also gives you a “win” because it is manageable and you will succeed.  This is great for your mindset and will keep you moving forward with your goals.

Focus on Consistency
One of the most important aspects of forming a new habit is to be consistent.  So rather than working out once a week for 2 hours (and ending up sore and possibly injured) it is much better to exercise 5 days a week for 30 minutes.  Make a commitment to yourself to exercise a specific number of days a week and keep that commitment.  

Get Support from Family and Friends
Let your family know what your new fitness goals are so they can support you.  You may need others to take over some of the tasks around the house so you have time to exercise. Enlisting a friend to exercise with you can help keep you focused and can make exercise more fun.

 Fuel Your Body with Nutritious Foods
You’ll need to make sure you are fueling yourself well when adding exercise back into your routine.  Depending on what type of exercise you are doing you may need more protein than you are currently eating.  Focusing on whole foods with adequate protein, lots of veggies and healthy fats will give you the energy you need to get through your workouts. Exercise is hard sometimes but it should be fun!  Find something you enjoy doing and see how good it makes you feel to move.
 
 Your Partner In Health!
Sara Yadlowsky, FMHC

Gluten in Medication

Frances Meredith, MD
“What? There’s gluten in my Advil?” 

Those with food sensitivities are always on the lookout to avoid exposure to foods we know cause trouble for us. As someone with food sensitivities myself, I was horrified to discover that a migraine medication I was taking contained food proteins to which I knew I was sensitive. How could that be?

Medications, both over the counter (OTC) and prescription, need to have “fillers” to hold the tablets together. These often come from corn or potato starch, but can also have ingredients that contain gluten or soy as well.

Most prescription medications now are gluten free though not all are certified as such by the manufacturer. Several blood pressure medications contain gluten. Gluten containing OTC medications include Advil Liquid Gel and Advil Liquigel Migraine Caps.    
“Red flag” Ingredients in medications that can have gluten hidden within include:- modified starch, pregelatinized starch (can be derived from potato, corn, tapioca or wheat)
-dextrate and dextrin (can be derived from potato, corn, tapioca, or wheat)
– dextrimaltose (may be derived from barley malt)
-Maltodextrin (may be derived from potato, corn, tapioca, or wheat)
– sodium starch glycolate (usually derived from potato, but may come from corn, tapioca, or wheat)
-caramel coloring (when barley malt is used).
-All of above are suspect if the source is not specified
 
Now, let’s talk more about “inactive” ingredients.  Ingredients such as corn starch or potato starch may be labelled as “inactive”, however, for some of us they can certainly trigger some very “active” immune responses.

Corn starch is a frequent filler in many OTC meds as well as prescription meds. These include multiple forms of Advil, blood pressure medications such as amlodipine, birth control pills, cholesterol medicines, such as atorvastatin, and common antibiotics such as azithromycin.

Other inactive ingredients may be important, causing immune reactions in some people. For this reason, I always advise choosing the cleanest version of a medication possible when needed. An example of this is the difference between NP Thyroid and Armour. Armour contains inactive ingredients which may be reactive for some, including sodium starch glycolate (gluten free), a food coloring, and microcrystalline cellulose.  NP Thyroid contains maltodextrin (gluten free), mineral oil, calcium stearate, and dextrose monohydrate as inactive ingredients. These tend to provoke fewer immune reactions.
 
Often the “inactive” ingredients are not evident on the label.  For over the counter medications you will need to peel back the label and look underneath. If there is no information on ingredient sources, call the 1-800 number on the label to be certain.

A most helpful resource is  www.glutenfreedrugs.com  On this website, kept up to date by a pharmacist, you can look up most drugs to find whether gluten, potato, corn, or soy are within. Another helpful resource is  www.beyondceliac.org.

Your most valuable resource is your pharmacist. Speak to them personally to get them on your team, letting them know your particular food sensitivities. They will add this to your profile and double check any medication to make sure it is absent of your food triggers. They can also be helpful checking ingredients on any over the counter product you might consider using. Though they cannot do this on the spot, they can research the ingredients and get back to you. My pharmacist at Publix has been an immense help to me. I am so grateful to have her on my “team”.
 
Your Partner in Health!
 Frances Meredith, MD

Kids and Mindfulness

Caroline Wilson, M.Ed., FMHC
 You may be thinking that kids and mindfulness are not two things that naturally go together. But as anxiety continues to become an epidemic for our children and teens, we must find ways to help them make mindfulness a part of their lives.

So, what is mindfulness? 

A great definition by Jon Kabat-Zinn, the founder of Mindfulness-Based Stress Reduction describes it well:

 Mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally. 

Stopping, paying attention, and noticing what’s happening around you, and everything you’re feeling, thinking and doing in that particular moment with honesty and without judgment is being mindful.  Sounds easy enough, right?

Actually, this Harvard study found that we spend almost 50% of our time thinking about something else and NOT what we’re actually doing!

Here are just a few of the health benefits of mindfulness that have been researched:
Increased focus and attention
Improved memory and learning
Less anxiety and depression
Better emotional self-regulation
Stronger immune system
Reduced inflammation 

Here are a couple of my favorite mindfulness exercises that you can do with your kids:
 
STOP, LOOK, and LISTEN
 
You and your kids can practice mindfulness anywhere and anytime.  A great way for kids to learn how to be mindful is by using the STOP, LOOK, and LISTEN method.  This involves, STOPPING what you are doing, LOOKING around you and using all 5 senses (what are you seeing, hearing, feeling, smelling, and even tasting) and LISTENING (listen to your body and mind and how it feels in that moment).

THE FIVE SENSES EXERCISE

Another quick exercise that can be done anywhere is the 5 senses exercise.  Notice 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.  This exercise can bring you to a mindful state quickly.
These are just a couple of examples of how you can practice mindfulness with your kids.   

Your Partner in Health!
Caroline Wilson, M.Ed., FMHC