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Dining Out With Kids

 

It’s tricky enough to find restaurants with healthy options for grown-ups. Here are a few suggestions for dining out with the whole family.  

Cowfish Sushi Burger Bar- With locations in Raleigh, Charlotte and Orlando, Cowfish melds the deliciousness of sushi and burgers to make sure there is something for everyone on the menu. Cowfish makes special occasions fun with their playful ambiance and noisy gong birthday song!  

With most kids’ meals priced at $8, it’s affordable for a regular dinner out, too. Their kitchen takes care to accommodate a variety of allergies. The kids’ menu is made up of Bento Boxes with main dishes including California rolls, grilled nuggets, PB&J Sushi Roll and more. Each one comes with two sides and a rice crispy dessert. Healthy side options include oranges, carrots, edamame, apples and sweet potato fries. For the grown-ups, gluten sensitive and vegetarian options are clearly marked. Try the Double Salmon Roll and the Tuna & Avocado-Tini.  

Firebirds – Okay, confession time. I am guilty of ordering from the kids’ menu at Firebirds. It’s tough to beat grilled salmon with two sides and a drink for less than $11. In my defense, I do tip generously when I go this route.  

Firebirds is a chain with locations around the country – including Raleigh, Durham, Morrisville, Winston-Salem and Charlotte. The dining room is nice enough for a special occasion dinner. 

For healthy kids’ options, try the grilled chicken breast, salmon or steak with broccoli, fresh veggies and/or fresh fruit and 1% milk or an Honest Juice Box to drink. They also have mocktails for fun, non-alcoholic drink options for the whole crew. Food allergies? Ask to see a manager to ensure your food is prepared in a way that is safe for you and your family.   

Chipotle- For a quicker meal on the go, Chipotle offers vegetarian, vegan, paleo, Whole30, gluten-free, dairy-free, soy-free and even sulphite-free options. They do not use eggs, mustard, peanuts, tree nuts, sesame, shellfish or fish as ingredients. Kids meals are less than $6 and include a fruit side and organic milk as healthy side/drink options – and I admit to ordering the kids’ meals here, too. I still tip like a grown-up, though. This is a fantastic option for tired grown-ups in the middle of a Whole30. 

Your partner in health,

Erica Nelson, MSPH, NBC-HWC

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Back To School Checklist

Blair Cuneo, PA-C

While the family is enjoying the downtime from school break, the upcoming school year is in the back of my mind. I’m slowly starting to make lists for updating lunch boxes, checking clothing sizes, gathering school supply items, all the while wondering what the next grade level will be like for my kids. 

“Preparation clears a pathway for success.”  ~ Ron Kaufman

As a pediatric functional medicine provider, I recognize that each child has unique needs to optimize their mental and physical wellness. However, there are several general recommendations from which many children and families can benefit.

Specific to academic performance, here are some fundamentals for your “Back to School” checklist:

– Honor the importance of sleep for body and brain.

Lack of sleep impacts production of neurotransmitters like dopamine, crucial for its role in attention and focus. School aged children should be getting 10-12 hours of restorative sleep. Restless sleep, teeth grinding, snoring, and waking up tired after adequate hours, are all signs that the sleeping hours are not “quality”. Without quality sleep, the body has not had the restorative opportunity to repair, heal and learn.

– Check in on screen time.

Prolonged screen time is associated with increased difficulty in attention, focus, emotional regulation and anxiety. Take into account screen time needed for school and set boundaries for when and what type of screen time is allowed in the home.

– Clean up the pantry, stock the fridge.

Artificial foods and dyes have a direct, negative relationship to behavioral health and cognitive performance. When hungry, go the fridge first, aim for rainbow whole foods, read labels and avoid eating what you can’t pronounce.

Many patients and families notice improvement in mood, energy, digestion, pain and school performance by integrating the above considerations.  If needed, there are more areas to investigate with a pediatric functional medicine provider.

In the functional medicine approach, we evaluate metabolic, nutritional, environmental and genetic contributors to your child’s symptoms or medical conditions. We want to understand “root cause” and not rely solely on band-aids to suppress or mitigate symptoms. We want to support the body and mind in need, while also shifting towards fundamental healing and prevention.

Some major contributors to impaired school performance include nutrient needs, like zinc and magnesium. If nutritional needs are found, we can directly support, but let’s also consider why the needs are there! Is the diet lacking? Does the digestive system have trouble absorbing nutrients adequately?

Speaking of the digestive system, the gut-brain axis is a recognized, bidirectional communication mechanism between the gut and brain. The gut microbiota affect the production and breakdown of neurotransmitters like dopamine, serotonin and GABA. These neurotransmitters are responsible for mood and academic performance. Dopamine is a key neurotransmitter for attention and focus.

When the body is under stress, dopamine production is hindered. Areas of stress include poor sleep, inflammatory foods/chemicals, food sensitivities, nutritional needs, yeast overgrowth, inflammatory bacteria.

Objective testing can be helpful in creating a personalized plan for our young patients. Less guessing, with more targeted interventions and support, can help you and your child experience enjoyment and success in their academic programs.

Call Carolina Total Wellness to schedule with our pediatric functional medicine provider.

Your Partner In Health!

Blair Cuneo, PA-C

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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

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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

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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
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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
 
 

 
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Tips for Picky Eaters

By: Caroline Wilson, M.Ed., FMHC       

Do you have a picky eater?

Picky eating often begins early in life for our kids and is often one of the top concerns reported in our practice.  It’s not about perfection, it’s about creating a love of food and how it fuels our mental and physical health. 

Healthy eating habits start at home. With a few changes and persistence, we help patients go from eating chicken nuggets and white pasta meals to filling their plates with more colorful fruits and vegetables.

Here are a few of my favorite tips for picky eaters:

#1 Lead by example.  If you want your children to add more colorful and healthy foods to their plate, then you must eat them too.  Help them understand why it’s important to eat healthy.  “Because we want to feel good and have energy.”

#2 Make food FUN and Accessible.  We eat with our eyes so access and presentation are key.  For example, put healthy food at eye level in the refrigerator or create a vegetable tray and set it out on the counter.  Cut food into fun shapes or arrange the snacks in a mini muffin tin for something different. 

#3 Timed Snacking. Endless snacking does not allow time for kids to get hungry and eat what is prepared for meals.  One idea to help guide snack choices is to set out the veggie/fruit tray at designated snack times and “close” the kitchen soon after.  If you prefer them to choose their snacks, a great rule is to pick something from the fridge before the pantry. 

These are just a few tips to help you get started with creating more colorful plates that your kids will want to eat.  Our pediatric team has experience and more ideas to handle the pickiest eaters.  Every child is different and learns to eat new foods and make healthy changes at a different pace.  With a little persistence, patience, and fun, positive changes can happen.  

Contact our office for an appointment to get started with our Pediatric Team

919-999-8031

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Pediatric Guidelines for “Colds”

Blair Cuneo

By: Blair Cuneo, PA-C

Pediatric Supplement Prevention Options:

1. Annual Vitamin A “flu” shot (Seeking Health liquid vitamin A, CTW Vitamin A caps): • 150,000 IU vitamin A once

2. Vitamin C (CTW Complete Vitamin C):

• 3-5 years: 125-250 mg daily

• 6-12 years: 250-500 mg daily

3. Vitamin D (CTW Liquid D3 or CTW Vitamin D3):

• 3-6 years: 1,000 IU daily

• 7-12 years: 2,000-3,000 IU daily

• 13-18 years: 3,000-4,000 IU daily

4. Zinc (Zinc Drink, Zinc Glycinate):

• 3 years: 5-10 mg daily

• 4-12 years 10-25 mg daily

5. Probiotics (Ther-biotic Chewables, CTW Daily Probiotic, CTW S. boulardii):

• All ages: 1 a day

6. Omega 3 (Nordic Naturals DHA (strawberry), Nordic Naturals CLO (orange), CTW Omega 3s):

• 4-12 years: 2000 mg daily

7. Elderberry: • <7yo: 250mg daily • >7yo: 500mg daily

8. Boiron Oscillococcinum (homeopathy):

• 1 vial once a week

Pediatric Supplement Therapeutic options: Start at first signs of upper respiratory illness.

1. Vitamin C (CTW Complete Vitamin C)

• 3-5 years: 125-250 mg dosed every hour, reducing if loose bowel movements

• 6-12 years: 250-500 mg dosed every hour, reducing if loose bowel movements

2. Zinc liquid or lozenges (Zinc Drink or Zinc Glycinate)

• 3 years: 5-10 mg every 6 hours

• 4-12 years: 10-15 mg every 6 hours

3. Elderberry:

• Kids: 1-2 tsp 3-4 times a day

• Teens and Adults: 1 TBL 3-4 times a day

Homeopathy options begun at symptom onset:

1. Boiron Oscillococcinum

• One vial 3xday for 24 hours

2. Boiron ColdCalm

• Ages 3+: 2 tabs under tongue every 15 min for 1 hour; then 3xday until symptoms resolve.

3. Umcka ColdCare/Cough/Cold+Flu (ages 12 and older) and Umcka ColdCare Kids (ages 6 and older)

• Use as directed

Carolina Total Wellness also carries “Viracid” and “Viragraphis”, combination formulas to combat viral illness, in capsule form. Ask your provider for more information on dosing.

Healthy foods and restorative sleep are fundamental, especially when sick. Bone broth daily, minimum 5 servings of fruits and vegetables daily.

Restorative Sleep guidelines from AAP:

Children 3-5 years old: 10-13 hours of sleep every 24 hours (including naps)

Children 6-12 years old: 9-12 hours of sleep every 24 hours

Children 13-18 years old: 8-10 hours of sleep every 24 hours.

Blair Cuneo
Pediatric Team Lead

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A Note From Blair Cuneo PA-C Lead Pediatric Team Care Provider

Blair Cuneo
Pediatric Team Lead

Thinking back to my childhood, it was difficult to list many friends or classmates with multiple medical conditions that decreased their quality of life. Fast forward to working as a family practice PA-C, I saw not only the list of medical conditions and medications increasing for my adult patients, but also those of my pediatric ones. These included severe food or environmental allergies, difficult to treat eczema or asthma, overwhelming anxiety, sleep difficulties, chronic or recurrent pain with migraines, menstrual cycles, joints. I did as I was well trained to do, prescribe, and refer; prescribe and refer. I felt confident in suppressing their symptoms but not genuinely appreciating the cycle we were all in.
Traditional visits to family care or pediatric providers do not allow the time to truly sit down with a family and understand where their child is, how and why they got there, and where they want to be. Pediatric functional medicine appreciates this thorough discussion, as it will powerfully impact the creation of an individualized plan of action. Pediatric functional medicine works to understand root cause of symptoms and diagnoses. We implement medical and lifestyle therapies that will change the momentum of chronic illness and improve quality of life.

Your pediatric functional medicine team includes a medical provider and health coach certified through the Institute of Functional medicine. We work with families to target nutrient needs, understand inflammatory triggers inside and outside of the body, diversify and increase colorful, anti-inflammatory whole foods and address lifestyle balance. We work to increase the resiliency of these young bodies who are under increasing pressure to detox from stressors on their systems.

Every BODY can benefit from a functional medicine approach to wellness. Lists of medicines and medical concerns have become normalized in our society, but it is not normal and it’s definitely not optimal.
Call or go online to learn more how Carolina Total Wellness pediatric functional medicine team can optimize health for the special children in your life.

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Covid 19 Recommendations

COVID19 Recommendations
Updated March 23, 2020

Your best defense against a viral infection is a healthy immune system which you can support with clean air, clean water and clean food. Focus on eating foods that are organic and rich in antioxidants (fruits and vegetables). Make sure that the water you drink is adequately filtered and do not drink out of plastic bottles. Use good quality HEPA filters in your home, especially your bedroom. Practice good hygiene with frequent hand washing with warm water and soap. Keep stress levels as low as possible and make adequate sleep a priority.
In addition to social distancing, frequent/adequate handwashing and sanitizing guidelines from CDC (https://www.cdc.gov/coronavirus/2019-ncov/index.html), here are Cov19 recommendations. Please keep in mind, information is changing daily. Covid-19, also known as SARS-CoV-2, is too new for us to have a body of literature on how specific nutrients or herbal remedies affect clinical outcomes. We therefore predict the risk/benefit based on understanding mechanisms involved and similarities between this virus and its most closely related viruses. Based on new concerns regarding this specific virus, we have amended our prior recommendations on high dose vitamin A and D.

These supplement regimens are not intended to cure Covid-19 but to help boost your body’s own immune response to the virus. If you suspect symptoms of Covid-19, we recommend that you call your primary care physician’s office or seek evaluation and testing through an Urgent Care center. A list of resources is available at the end of this document.

Adult Prevention Options: (supplements available through your online patient portal)
1. Vitamin C: 500-1000mg daily (CTW Complete Vitamin C)
2. Vitamin D: 2000IU -5000IU per day (CTW Liquid D3 or CTW Vitamin D3)
3. Omega 3 (EPA/DHA): 2500mg daily (CTW Omega 3 or Arctic Cod Liver oil) or (Metagenics SPM) 2 caps twice daily
4. Zinc glycinate: 15-30mg daily (Reacted Zinc or Zinc Drink)
5. N-acetylcysteine: 600mg daily (CTW Liver Support) or (Trizomal glutathione) 5mL once daily
6. (Biocidin LSF) mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray twice into each nostril upon returning home from outside exposure like your office or the grocery store.
7. PEA: 2 caps daily. Recommend Vitalitus PEA or Metagenics Hemp Advantage Plus {PEA with CBD}.
8. Real Mushrooms 5 Defenders, providing >20% beta-D-glucans: 1 cap daily**
9. Real Mushrooms Reishi 415**: 1 cap daily**
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

Pediatric Prevention Options: (supplements available on your online patient portal)
1. Vitamin C: 250mg daily (1/2 capsule of CTW Complete Vitamin C)
2. Vitamin D: 600IU-1000IU per day (CTW Liquid D3)
3. Omega 3: 500-1000mg daily (DHA Junior Liquid or Arctic Cod Liver oil) or (Metagenics SPM) 1 cap twice daily
4. Zinc glycinate: 15mg daily (Zinc Drink)
5. N-acetylcysteine: 300mg daily (CTW Liver Support) or (Trizomal glutathione) 2.5mL once daily
6. (Biocidin LSF) mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray once into each nostril upon returning home from outside exposure that couldn’t be avoided….stay strong parents! No friend visits!
7. PEA: ages 5-14: 1 cap daily. Recommend Vitalitus PEA or Metagenics Hemp Advantage Plus {PEA with CBD}.
8. Real Mushrooms 5 Defenders, providing >20% beta-D-glucans: 1 cap daily**
9. Real Mushrooms Reishi 415**: 1 cap daily**
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

See next page for graphic to review signs of illness and therapeutic options:

*** New data, obtained after this chart was generated, indicates that diarrhea occurs in up to half of all patients presenting the Covid-19***

At first sign of illness, adult therapeutic options:
1. Vitamin C: increase to 1 gram per hour x 6 hours per day. Reduce dose slightly if you develop loose bowel movements
2. Zinc liquid or lozenges: Swish liquid or allow lozenge to dissolve slowly, bathing the throat in zinc. Total zinc should be 60mg per day x 1 week. Recommended to divide this up with 1 teaspoon Zinc Drink 4 x day only to avoid copper depletion.
3. Biocidin LSF mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray twice into each nostril two times a day.
4. Metagenics SPMs: Increase to 2 caps 3 times per day with first symptoms, continue x 6 weeks.
5. N-acetylcysteine: Increase to 600mg twice a day or Trizomal glutathione 5mL twice a day
6. PEA: increase to 2 caps three times per day with first symptoms. Continue for six weeks
7. Real Mushrooms 5 Defenders**: increase to 2 caps twice a day with symptoms
8. Real Mushrooms Reishi 415**: increase to 2 caps once to twice per day with symptoms.
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

At first sign of illness, pediatric therapeutic options:
1. Vitamin C: increase to 500mg per hour x 6 hours per day. Reduce dose slightly if you develop loose bowel movements
2. Zinc liquid or lozenges: Swish liquid or allow lozenge to dissolve slowly, bathing the throat in zinc. Total zinc should be 60mg per day x 1 week. Recommended to divide this up with 1 teaspoon Zinc Drink 4 x day only to avoid copper depletion.
3. Biocidin LSF mix 10 pumps with a bottle of over the counter nasal saline spray or Xlear and then spray twice into each nostril two times a day.
4. Metagenics SPMs: Increase to 1 cap 3 times per day with first symptoms, continue x 6 weeks.
5. N-acetylcysteine: Increase to 300mg twice a day or Trizomal glutathione 2.5mL twice a day
6. PEA: increase to 1 cap three times per day with first symptoms. Continue for six weeks
7. Real Mushrooms 5 Defenders**: increase to 1 cap twice a day with symptoms
8. Real Mushrooms Reishi 415**: increase to 1 cap once to twice per day with symptoms.
**Mushrooms are highly complex. Certain compounds are immunostimulating. Is this a problem in COVID19, or a benefit? We don’t know the answer. There is also concern using immune stimulants in autoimmune patients**
Herbs such as elderberry, echinacea, astragalus, andrographis and beta glucans can help to boost immune function. However, we do not recommend taking these supplements if you have an existing autoimmune condition as these may flare your condition.

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

Coronavirus (COVID-19): What a Pediatrician Wants You to Know


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

From the NC Health Department:
If you have questions about COVID-19 (coronavirus), dial 2-1-1 or 888-892-1162. Sign up for updates by texting COVIDNC to 898211.
For all other questions, the DHHS Customer Service Center can assist in finding programs and people to help you. Call 1-800-662-7030.

3708 Forestview Rd., #202 office@carolinatotalwellness.com T: 919-999-0831
Raleigh, NC 27612 www.carolinatotalwellness.com F: 888-394-6442