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
 
 

 

Food and Mood

Blair Cuneo, PA-C

I think about many things this time of the year with seasons changing and holidays approaching. As a functional medicine provider, I consider how changing landscapes not only affect my patient’s physical health, but also their emotional health. This landscape or “environment” of less direct sunlight, more time indoors, increased celebratory food and drink and increased holiday stress has a major impact on mental health for many of us.

Our relationship with food is complex, as is our body’s response to our culinary selections. We hope that our bodies can effectively digest food and absorb its nutritious content, but how do we know if it doesn’t? We hope the foods we are eating are contributing to healthy neurotransmitter production, healthy immune system messaging, but what does it feel like if that’s not the case?

You’d think that your stomach would definitely let you know if any of the above was amiss, but consider this: approximately 30% of us will have a gastrointestinal/gut symptom if there are imbalances in digestion or immune activation, while the majority of us will have a “beyond the gut” symptom first, such as headaches, mood changes, sleep disruptions, fatigue and pain. Thus, the majority of people may not be thinking of a direct relationship between green bean casserole and their anxious or sad days.

Several things need to happen when we eat a meal. First, we need to be in a “rest and digest” state. This signals to the body it’s time to produce digestive acids, enzymes and bile to sterilize the food, break it down and absorb it well. Next, we need healthy proteins that can be broken down by these digestive supports to become the basic amino acids that our body will use as the building blocks to create neurotransmitters like dopamine and serotonin. Neurotransmitters are signaling molecules, providing communication between nerves. The balance of neurotransmitter production, absorption and clearance, affects mental and physical health. Further, this building of neurotransmitters requires cofactors of several micronutrients like zinc, vitamin B6, magnesium and vitamin D.

To cap things off, there can be immune system reactions to foods, allergies and/or sensitivities that are contributing to inflammatory messaging that starts in the gut, but travels “beyond the gut”, affecting our emotional state.

In my practice, I regularly see low levels these cofactors, low levels of digestive enzymes and gastric acid, high stress and of course, the daily challenge in regularly making healthy eating and drinking choices.

In order for a body and mind to be healthy, each of these areas needs to be considered, evaluated and addressed.

While there are objective tests available for providers to check your nutrient and digestive status, there are also excellent lifestyle supports to begin making a shift in your wellness today.

-Eat at regular intervals. It is less stressful for the body when it knows it can count on you to feed it. This also helps the timing of the digestive acids/enzymes release where there are patterns in meal timing.

-Whole foods. Limit processed foods. Head to the refrigerator, before you head to the pantry. Each meal should contain a protein, small amount of fat, and colorful fruits and vegetables.

-Mindful eating, not distracted eating. Try to avoid multitasking while eating. As often as you can, eat at a table, focused on your food and the company that you share. Look, smell, taste and chew well! Even the process of chewing is signaling release of enzymes.

-Connect with your healthcare provider to review your micronutrient and vitamin status. You might discuss multivitamin, magnesium and/or zinc supports and also test your vitamin D to help assign dosing recommendations.

Remember, Food can be medicine! Make sure you use it wisely!

Your Partner in Health!

Blair Cuneo, PA-C

How Many “New Year Resolutions Have You Made?

Erica Nelson, MSPH, NBC-HWC

How many ‘New Year resolutions’ have you made over the years? Do you ever wonder why so many promises made with the best of intentions fade away into chocolates and flowers by the time Valentine’s Day rolls around? With the popularity of books like The Power of Habit by James Duhig and Atomic Habits by James Clear, the inevitable social pressures to make resolutions, and the loss of so much routine and normalcy over the last 2 years, the time seems ripe for some intentionality around building or replacing habits with behaviors that will serve us well.

The dramatic and unexpected shifts to working from home, changing jobs, and reduced social interaction have forced many of the routines that once worked for us to be eliminated or drastically changed. Maybe you miss the drive to and from work that you once thought was stressful. Maybe you are exposed to significantly more trauma and environmental stress than you were accustomed to. Maybe you are grieving the loss of a family member you depended on. No matter what has changed for you, you have the power to decide how you want to spend your time and energy going forward. January 1 is not the only opportunity to make a change – if you look around, you just might find there are chances around you every single day to make a new choice.

 As we delve into another year of uncertainty, I invite you to consider a few thoughts and strategies to support you on your path. Cheers to drawing nearer to YOUR vision of the healthiest version of you.

  1. You are the expert on you.

Take some time to yourself to get clear on what matters most to you – not  to your family or friends or employer. What does ‘healthy’ mean to you? Health may be physical, emotional, financial, relational, spiritual… any aspect of your life that affects your ability to have your desired experience most days.

  • Self compassion is not selfish.

If 2020 & 2021 taught us anything it’s that some days just won’t happen the way we desire or expect them to. Many of your circumstances and situations are beyond your control. The way you respond, however, is under your sole control. This is why it is called responsibility or ‘response-ability.’ When you choose to let go of thoughts about mistakes made by yourself or others, you are free to return that energy to doing the next right thing for you. Name that negative voice in your head and tell it to go away. I like to say ‘Shut up, Sharon!’ (No offense to anyone named Sharon out there.) If you fall short some days, simply begin again.

  • Replace – don’t restrict.

Once you identify a behavior that is no longer serving you, consider changing or replacing it instead of trying to quit ‘cold turkey.’ Your brain likes the predictability of your responses to certain things (triggers) in the environment. It is a much smaller effort to alter your response than to just stop responding. If, for example, you want to stop drinking alcohol or sodas the first step would be to notice what comes before you drink the undesirable beverage. Next, choose a more desirable beverage to have when you are presented with those triggers.

  • Willpower doesn’t work and motivation is a myth. Mindset matters.

To increase your odds of success in replacing one behavior with another, make the desirable replacement beverage (or other behavior) very convenient and the undesirable ones very inconvenient (not in your house.) Finally, notice and appreciate yourself each time you choose the behavior you were aiming for. For some, a habit tracker – paper or electronic – serves as a useful reward. Making the choice on your own terms makes the ‘stress’ of change into a positive stress. Try to think of it in positive terms like ‘I GET to do this’ instead of ‘I HAVE TO do this.’ Eventually we all have a day when our resolve is not as strong and putting these supports in place will make it easier to endure, or begin again.

  • Set yourself up for success.

Do not try to quit drinking alcohol, caffeine and sugar all at once! At most, take on one or two changes at a time. Start with the things that matter most to you and celebrate as you notice the promises you are keeping to yourself. See if you don’t feel so great when you make one change that you want to make another!  

Your Partner in Health!

Erica Nelson, MSPH, NBC-HWC

Magnificent Magnesium

Frances Meredith, MD

In the times of COVID, so many nutrients seem to be in the news these days from quercetin to Zinc, to Vitamin D.  Overlooked I believe is the nutrient essential for every cell and every process in our body including immune readiness: Magnesium!

Magnesium is a cofactor for over 300 enzymatic reactions, supporting DNA and RNA synthesis, cell growth and reproduction. Magnesium enters the energy cycle as a cofactor in at least 12 different steps in the process, and is essential for the little batteries in every cell, our mitochondria, to transport electrons and create energy. It is necessary for bone growth and strength, stabilizing the cell membrane, and maintaining normal nerve and muscle function.

Magnesium sits within the cell, balancing all of our cells, keeping calcium outside the cell from overstimulating cellular activity in all parts of the body. For example, Mag balances Calcium in the NMDA glutamate receptor, controlling its opening, avoiding “neuroexcitation”.  Thus, lack of Magnesium sets the stage for nerve overactivation, hyperexcitability (think chronic anxiety, chronic pain, chronic states of inflammation created by lack of Magnesium). When we are Mag deficient this NMDA glutamate receptor activates. This is good for survival when we are under intense stress, but not something we want to live with on a day in and day out basis.

Low Magnesium can express itself in so many ways including fatigue, muscle cramping/tension, PMS, headaches, especially migraines, constipation, insomnia, tinnitus, brain fog, heart arrhythmias, anxiety and depression, TMJ, ADHD, and blood sugar issues. Sound familiar?  If that’s not enough, Magnesium deficiency is implicated in diabetes, osteoporosis, and hypertension. It is a natural “calcium channel blocker” (think drugs that do this such as amlodipine used for hypertension). The lower the Magnesium levels the greater the progression of Alzheimer’s. Fibromyalgia improves with Magnesium treatment. Increasing Magnesium intake is correlated with a decrease in stroke, diabetes, heart failure, fracture risk and all-cause mortality. Sounds like we all need more, yes?

Why are we so deficient? The answer lies both in the disruption of our food chain and the breakdown of our food choices. The soil is now deficient in Magnesium due to lack of crop rotation, pesticide use and overproduction; in addition, the use of fertilizer heavy in nitrogen and phosphate blocks the plants’ ability to absorb Magnesium.  Further, as foods are processed, Magnesium is leached out. The end product: less for us.

Testing for Magnesium is easy, with red blood cell levels being the most accurate form of testing. Body signals, however, are much more important than a test result. Symptoms such as myofascial and muscular tightness/tension/cramping, sluggish bowels, and low energy point to low Magnesium and a trial of Magnesium is warranted even without checking a blood level.

So how can we optimize Magnesium for all of the cells in our body to “sing”? It is clear that plant-based Magnesium is much more effective than the mineral in supplement form. This is due to the fact that Magnesium is at the heart of chlorophyll, responsible for the green pigment in our green foods. Plant based Magnesium is very absorbable and is already charged, essential for its function. The big winners for high magnesium are pumpkin seeds, spinach, almonds and cashews. This great link from Cleveland Clinic lists the magnesium content of many foods.

https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food

 Magnesium in supplement form can be very helpful, and must be attached to a “chelator” to get across the intestinal border. They are best taken with food to improve stability. Magnesium comes in forms including glycinate, citrate, theonate, asparate, orotate, and oxide, with different benefits associated with the specific chelators.

For example, the Mag oxide form is only minimally absorbed and very unstable, drawing water into the intestinal tract, helpful for severe constipation or impaction but not helpful to get Magnesium into cells elsewhere in the body. In contrast the Magnesium glycinate is more stable, better absorbed and better for anxiety or insomnia. Mag citrate is helpful for intestinal motility/constipation as well as energy as it plugs directly into our “Krebs cycle” to create energy.

In addition, optimal intestinal absorption is necessary, with Magnesium absorbed mostly in the ileum of our small intestines. Therefore, if things go awry in the ileum, our ability to absorb Magnesium (as well as other nutrients) will be impacted (think leaky gut, small intestinal bacterial or fungal overgrowth).

Sounds like most everyone would be better off with a little more Magnesium! If any of the above-mentioned symptoms or conditions apply to you, your functional medicine provider at Carolina Total Wellness would be most happy to discuss this with you.

Your Partner In Health

Frances T. Meredith, MD

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