Kussin Clarissa - Carolina Total Wellness

February 4, 2022March 28, 2022

Neurofeedback Therapy

Robert Baric, DC

We have invited several expert practitioners to educate our practice community on approaches to healing that are complementary to Functional Medicine. Our expert this week is Robert Baric, DC who will educate us on Neurofeedback. Neurofeedback is quite different from “biofeedback” with which you may be familiar. Dr. Baric is board certified in neurofeedback and has over 26 years of clinical experience. His passion for health and wellness has emerged throughout the years as he continues to deliver the most up to date knowledge to his patients, while providing them with impactful treatment in addition to neurofeedback, including nutrition, acupuncture, chiropractic techniques, and other applied therapies. I will hand off the microphone to Dr. Baric.

Neurofeedback Therapy: A Compliment to Traditional Medicine
Amidst 56 years of positive research and clinical trials in neuropsychology, neurofeedback has emerged as a modality of complementary therapy that is “evidence based”. Neurofeedback therapy has gained increasing popularity due to its non-invasive properties and the sizable body of research supporting its efficacy, along with it being an alternative to traditional pharmacological treatment. Essentially, neurofeedback is EEG-biofeedback, where a method of retraining brain waves through operant conditioning is utilized. Various conditions like ADHD, depression and anxiety, addiction, and insomnia are all cognitive disorders that can negatively impact an individual’s brain waves.

The first step to neurofeedback therapy is an initial brain scan that determines if a patient is a suitable candidate for neurofeedback therapy. A quantitative electroencephalogram (qEEG) shows brain activity and function allowing professionals to understand what ailments may be present and what can be done to mitigate symptoms at the root of the problem. The qEEG process takes just 45 minutes, recording brain waves with the eyes closed and opened. The results are then analyzed and a customized training protocol is created specifically tailored to the patient. Treatment includes monitoring the dysfunctional area while rewarding the preferred wave formation, with the reward being a TV show of the patient’s choice. Brain waves are monitored, and using operant conditioning, stimuli are adjusted to guide the brain waves back into a healthy pattern. If accepted as a patient, most individuals experience a marked improvement by sessions 10-15, most conditions requiring 40 sessions to finalize neuroplastic changes.

There are multiple conditions for which neurofeedback is impactful, with few being the most prominent throughout my years of experience.

Depression and Anxiety
The zeitgeist proves the need for complementary treatment options for individuals suffering with depression and anxiety. Approximately 33.7% of the population suffers with anxiety related disorders in their life, often comorbid with depression (1). The Journal of Clinical Psychopharmacology yielded results showing significant improvement in patients symptoms of depression with neurofeedback (2). Similar results were shown in patients with anxiety disorders, with the Journal of Industrial Psychology exhibiting results where neurofeedback therapy was deemed essentially as effective in reducing symptoms of anxiety as medication (3).

ADHD
Children and adults suffering with ADHD recognize notable improvements in their focus and attention after a series of neurofeedback treatment. When a group of students received either neurofeedback or pharmacological support, evidence showed those in the neurofeedback group improved in executive control to a greater extent than the pharmacological support group (4). A plethora of research supports the decrease of ADHD symptoms in both children and adults.

Insomnia
Brain waves play a significant role in the ability to sleep. If a patient is unable to enter into a restful and deeply restorative state, there could be a misalignment in brain waves causing a patient to feel unwell and never feel rested. Medications can be utilized to aid in sleep, but frequently result in a feeling of grogginess upon waking. Neurofeedback actually tackles the problem at hand at the root by retraining the brain waves in order to get quality sleep without the use of medications.

For issues involving the brain and cognition, it is essential to tackle the issue from multiple directions, utilizing multiple forms of treatment. As a pain-free and relaxing process, neurofeedback will maximize its growth throughout the coming years. Neurofeedback will continue to provide millions of individuals with a fully customized treatment plan to ensure optimal brain health, and alleviate years of morbid symptoms.

If there are any questions about neurofeedback please reach out through email or phone and MyBrainDr would be happy to discuss any inquiries.

Email: admin@mybraindr.com
Phone: 919-721-4800
Website: www.MyBrainDr.com

January 6, 2022January 6, 2022

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

January 6, 2022January 6, 2022

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.

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

January 6, 2022January 6, 2022

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

November 15, 2021November 28, 2022

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

November 15, 2021November 28, 2022

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

November 15, 2021November 28, 2022

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

November 15, 2021November 28, 2022

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

November 14, 2021November 15, 2021

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

November 14, 2021November 14, 2021

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

Author: Kussin Clarissa

Neurofeedback Therapy

Food and Mood

How Many “New Year Resolutions Have You Made?

Magnificent Magnesium

PEDIATRIC COVID-19 Vaccination Prep

Tips for Healthy Eating for Busy Families

5 Strategies For Stress Eating

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

Dry Needling with Dr. Kari Smith, PT, DPT

Supplement “TAKEOUT” Option

Functional Medicine

Allergy Testing & Drops

About Your Visit