To watch a video on functional medicine click on this link: http://www.youtube.com/watch?v=IhkLcpJTV9M    If link is not working, copy link and place in address bar on top of internet browser.

Along with Dr. Carlson, we have a new Doctor coming on board that specializes in Functional/Integrative Medicine. Both Dr. Lynn Carlson and Dr. Ardis Fisch are excellent with chronic symptoms and diseases and also how to get your body back in balance. The idea behind functional medicine is that we search for the “Why you are hurting or experiencing the symptom”, not just the “What symptom are you experiencing”. For example, many people have feelings of sadness, apathy, lack of appetite and other things and many doctors might say “Ah hah! I know what you have, it’s depression!” and then they might give you a prescription for Prozac and other medications to help. We all know that the definition of depression isn’t that we have a “Prozac deficiency”. So what functional medicine does is say, yes, you have all these symptoms, but let’s focus on why and see if we can’t find the causes and imbalances that make you feel depressed, as people can all experience the same symptoms but have very different causes. Depression is just an easy example of the difference in practice of medicine, but the results are incredible!

What is Functional Medicine?

“Functional medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21^st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms. Functional medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, functional medicine supports the unique expression of health and vitality for each individual.” (functionalmedicine.org)

Vein Disease

What is vein disease? In contrast to arteries, which take blood from the heart to the extremities, veins – through a series of small valves that pump blood upwards – bring blood back to the heart from the extremities.

There are two main systems of veins in the legs:

• a deep system, which brings about 90 per cent of the blood back to the heart; and
• a more superficial system, which brings about 10 per cent back to this area.

Between these, is a third system – of perforating veins or perforators – which transports blood from the superficial to the deep system.

Varicose and spider veins occur solely in the superficial system, when the walls of the veins lose their elasticity and the pumping valves stop functioning properly. This causes the blood to flow back down, creating a reverse process called ebb or reflux, which can be heard with a Doppler machine, and heard and seen with Duplex ultrasound.

What causes varicose and spider veins?

• Heredity is the number one factor. They usually run in the family (“like mother, like daughter”)
• Hormones are also a factor: puberty, pregnancy, menopause, the birth control pill
• Obesity
• Aging
• Prolonged periods of standing (common to nurses, pharmacists, teachers, waitresses)

EVLT

Our treatment goal is to restore normal circulation in the leg. This is accomplished by closing the refluxing vein and eliminating locations where blood can pool (large varicose veins). EVLT (Endovenous Laser Therapy) is a technique in which a thin glass laser fiber is inserted into the refluxing vein. As the energy from the laser is delivered through the fiber and out the tip, the fiber is slowly withdrawn and the vein closes behind it. This is done in the office under local anesthetic. EVLT has emerged as the most popular technique in the country due to it’s high rate of success and excellent safety profile.

Micro-phlebectomy

Bulging varicose veins just under the skin are removed by a second procedure done at the same time as the EVLT called micro-phlebectomy or ambulatory phlebectomy. This procedure, like EVLT, is done in the office under local anesthetic. A series of tiny punctures are made over the affected area and a special hook is used to remove the loops of vein. Cosmetic results are usually excellent.

We make it our business to know everything there is to know about every patient’s insurance coverage. We have just been made aware that you again have preventive coverage for yourselves and your families at no cost to you! So, the solution is this simple: You schedule your preventive exam with us, and we do the additional testing and paperwork for your Teacher’s exam for free! We often can do medicine refills and take care of other things at your annual checkup as well so that you can save hundreds and even thousands of dollars each year!

We know that the best medicine is preventive medicine. In fact, we offer the best preventive screening on the Peninsula, oftentimes throwing extra tests that we feel necessary for you to have for free if not covered by your insurance. It continues to be the mission of the MediCenter to help every patient become more independent and healthier. We like to call it “Independently Healthy”. By scheduling you and your family for a yearly preventive exam, we save you money, and help you and your family avoid crippling and terminal diseases.

We all understand yearly maintenance on our vehicles and even our teeth. Isn’t it time to pay attention to one of the most important things in your life, like your physical and mental health?

Be smart…Prevent…with the MediCenter.

Call (907) 283-9118 to schedule your yearly exam for you and your family today!

Acknowledgments go to the many instructors I have learned from in the new specialty of Functional Medicine  and to Julia Ross, author of the book “Mood Cures” and “Diet Cures,’ as well as to the authors of so many other books about diet and nutrition who all seem to be humming closer to the same tunes now.  Thanks also to my patients who have taught me more than I have learned from the books and seminars.

Inflammation (characterized by redness, pain, swelling, warmth, and sometimes fluid build up) is part of the course of almost all diseases.

The immune system mounts this inflammatory response to help defend against infection and cancer, and to heal injured tissue.  Too often, however, our immune system “overdoes it” and causes too much inflammation with resultant excessive redness, swelling, pain, and warmth.

Whenever we are sick or injured, we should consider looking at our diet and lifestyle to see if there is something we can do to help our immune system function better, so as to limit the suffering from unnecessary inflammation.

The following is a list which I drafted over two evenings.  It certainly is not exhaustive, but I hope you find something interesting and helpful.

Things which decrease inflammation:

1.  Avoid trauma, infection, toxic exposures (Use common sense, be careful, use good hygiene, learn about and avoid potential toxins and triggers of the immune system).

2.  Keep skin, lung, and gut barriers healthy with healthy diet (see below).

3.  Essential fatty acid supplement, especially, take omega 3 fish oil (EPA and DHA).  Also consider flaxseed (which has ALA) and primrose oil (which has GLA).   The typical “Sad American Diet (SAD)”  has far too much omega 6 oils compared with omega 3 oils, and this leads to inflammation.  Omega 6 oils which should be avoided are found in margarine, Crisco, and store-bought red meat.  Cows fed corn in feed lots have more omega sixes in their meat.  Range-fed cows and wild game eat grass and “greens” and have more omega threes.  Alaskan wild salmon is full of the healthy omega 3’s.

People with depression, rheumatoid arthritis, heart disease and diabetes ought to know they are getting enough of the essential fatty acids.  Too little of these can lead to more arachidonic acid and prostaglandins and thus more inflammation.  If you are not sure of your diet, and you have some inflammatory condition, consider checking essential fatty acid levels.

4.  Take a quality multivitamin and mineral supplement.  This is a very short statement for a very big subject.  There will be more on this later in our web site and more in our clinic handouts.  Recognize that you can now measure vitamin and mineral levels, at a somewhat reasonable cost, but you need to know what tests to order.  Vitamin B12 levels, for instance, fluctuate so much that a serum B12 level is unreliable.  Consider measuring a urine methylmalonic acid level instead, as an indicator of B12 deficiency.

5.  Limit other unhealthy oils and fats, including all oils other than olive oil, and flaxseed oil, and all fats other than butter and coconut butter.

6.  A diet low in refined carbohydrates.  Refined carbs are the starches and sweets.  This includes flour, rice, noodles, bread, potatoes, corn, sugar, honey, fruit juice, soda pop, candy, cakes, cookies, and pastries;  Especially avoid high fructose corn syrup.  Also do not eat more than two cups of fruit in a day).

7.  A diet rich in nutrients (including protein, healthy fats (olive oil, butter, coconut oil), healthy carbohydrates, fiber, antioxidants, and other important vitamins and minerals).  Have all the different colors of vegetables every day.  Adults should eat 7-8 servings (4-5 cups) of vegetables every day.  Eat nuts, beans, and seeds.

One goal for adults, especially if they have depression or pain, or diabetes, is to have 25 grams of whole protein (meat, cottage cheese, eggs, etc) three times a day..  This is about the size of your palm, and the thickness of your palm.

You might notice that all of the successful diet programs (South Beach, Ultra-Wellness, Fit For Life, Weight Watchers, others) include a healthy serving of protein several times a day.

One reason for their success is that these proteins serve as precursors for serotonin, endorphins, GABA, adrenaline, thyroid hormone,  and glutamine which give us improved mood, decreases pain, helps us relax, gives us energy and suppresses our appetite (respectively).

One of the most exciting parts of my practice in the last 15 months has been replacing pain pills and addicting relaxants with amino acids / and more protein in patient’s diets.  Amino acid therapy is becoming more of a  “science” and certainly should  be considered in preference to the less-safe addicting meds whenever possible.  Before trying these on your own, you should consult with someone familiar with side effects and supplement-drug interactions.

The typical American diet has only 12 grams of fiber per day.  By increasing the intake of fiber (in vegetables, nuts, seeds, whole grain, fruits), to 50-60 grams, we decrease our risk of most chronic diseases including cancer, heart disease, diabetes.

A high fiber diet also helps the food that you eat with the fiber last longer so that your blood sugar is more stable and you stay full for longer periods of time.

The fiber also serves as healthy “food” or “prebiotics” for the healthy bacteria (probiotics) in your GI tract, and this has a definite effect on decreasing inflammation in the rest of your body.

Healthy fats are a very important part of our diet.  The brain, for instance is 60% fat (hence the term:  “fathead” may be more accurate that previously thought).  Every cell in the body is surrounded by a cell membrane that is mainly fat particles.

Some 20 to thirty years ago, fat was given a “bad rap” and all the agencies were advising “low fat diets.”  The problem was, they did not differentiate between good fats and bad fats.  I feel bad that I was part of the conventional medicine approach and I advised all my patients to eat a low fat diet, because that is what was advised by the agencies.  Despite these good intentions my patients all gained weight and moved towards diabetes.  We have all been frustrated.  Over the years I still asked all of my patients who lost weight and kept it off (a very small, independently-minded group, indeed), how they did it.

Inevitably, they said:  “I started grazing on vegetables, and I avoided the white stuff.”

There is enough information in the literature now to substantiate why this diet low in refined carbs works.

In the last 3-4 years I am excited about all the success of so many of my patients.  Many of my diabetic patients are exercising their independence from me and from prescribed meds and from the oppression of obesity by focusing on dropping refined carbs eating more vegetable and protein, and not worrying so much about the fats, except that they eat  healthy fats.

8.  If you have persistent allergies, reflux, depression, arthritis, ADHD, difficulty focusing, low energy, irritable bowel (among many other disorders),  then consider a very hypoallergenic diet by limiting the top 10 allergenic foods (we call this a “comprehensive elimination diet”) for six weeks, but be prepared to take fortified supplements if you are not real familiar with how to do this without creating nutritional deficiencies.

9.  Ensure healthy GI flora by taking probiotics, especially while taking antibiotics, or, if you are not allergic to dairy, take full-fat, non-sweetened yogurt.* Eat a diet high in fiber, both soluble, and insoluble, to feed the healthy bacteria in your GI tract.

Did you know that there are more bacteria in the GI tract than there are of your own cells in your body?  I think it must be a conspiracy – just kidding.

Some of the bacteria perform essential functions such as synthesis of vitamin B12 for optimal nerve health.  You can imagine what might happen if you change the types of organisms with (especially unnecessary) antibiotics or eat too many sweets (which can make fungus grow rampant where you don’t want fungus to grow).

There are now tests available which evaluate the stool and can show if your stool is friendly or foul (sorry, pun intended, but the tests actually exist).

9.  Exercise.  Exercise is important, except that you should avoid overuse of already-inflamed muscles, joints, and ligaments.  Exercise has been found to decrease inflammation in many different ways.  In order to bring healing nutrients and oxygen into an inflamed tissue, the muscles around it often need to be exercised.  Even people with degenerative arthritis have less symptoms if they exercise moderately.

10.  Drink lots of water.  Adults should drink 6-8 glasses of water every day.  By being well-hydrated, the inflammatory mediators can be carried away from the site of inflammation, and healing factors can move in as needed to calm the inflammation.

11.  Adequate sleep.  One dramatic example of this is the effect of sleep on migraine sufferers.  Migraines have been found to be another disease partially-mediated by inflammation, and almost all migraines subside when the patient takes a nap.  To limit inflammation, most adult patients should get 7-8 hours of sleep per night.

12.  Treat sleep apnea.  Any vitamin or mineral or fatty acid or protein deficiency can cause inflammation, but the worse stressor is a deficiency of oxygen.  Sleep apnea leaves a patient without oxygen for long periods at night, and has been found to be a cause of many chronic diseases because of the damage in it’s’ wake.  This includes diseases like obesity, diabetes, heart disease, depression, high blood pressure, and congestive heart failure.

One of my patients has “inoperable heart disease”, and had his first heart attack in his mid forties, and his only risk factor for heart disease was sleep apnea.  Consider doing an overnight pulse oximeter test (costs in the range of 200-300 dollars, but misses as much as 10-15% of actual sleep apneas) or a sleep study (may cost from $3,000 to $14,000).  One of the most disturbing things for my patient population is the cost of these sleep studies and someone should solve this problem –fast—please!!

13.  Avoid foods that cause inflammation (this varies among individuals, but can include gluten, milk, eggs, peanuts).  Consider doing IgE testing (for immediate sensitivity) and  –perhaps more important – IgG testing (for delayed sensitivity) to see what foods you are sensitive to.

I have seen many health problems cured by stopping foods that people are allergic to, such as:  allergic rhinitis, asthma, irritable bowel syndrome, unexplained abdominal pain, unexplained fatigue, rashes, depression, and psoriasis.  Many other diseases (for example, rheumatoid arthritis, ADHD, autism, Crohns) are ameliorated (lessened) when the patients eliminate foods they are reacting to.

14.  Avoid environmental toxins and optimize your body’s ability to remove toxins.  We are exposed to thousands of more chemicals than our ancestors were exposed to in the form of heavy metals, phthalates in plastics, pesticides and hormones in our foods, and many others.

Eating food grown close to home without pesticides, learning about heavy metals, and other toxic substances are all important things to do.   Although we appreciate the efforts the government agencies put forward to try to protect us, they are unable to do all the research necessary, and we the consumer must stay as “green and clean and close to home” with our food growing and purchasing as we can.

15.  Minimize emotional stressors, learn coping strategies to deal with stressors.  Every one (at least all whom I have asked) of my rheumatoid arthritis patients and Crohn’s patients and psoriasis patients can testify that emotional stressors worsen the severity of their illness.

Type A persons are also at higher risk of heart disease, and stress of any kind makes it more difficult to control blood sugar in diabetics.  Part of the reason for this is the cortisol and adrenaline that are released which hormones increase blood pressure and blood sugar.  This may help you deal with the stress over the short run, but it is unhealthy to have a chronically elevated cortisol and adrenaline level over the long run.

This does not have to be as much of a guessing game as it used to be.  Salivary cortisol levels correlate fairly well with serum cortisol, and a 4- or 5- panel cortisol salivary test can now be run for a fairly reasonable price.  There are health food supplements to take which seem to work for both high or low cortisol.

I have found the salivary cortisol levels to correlate well with the patients’ symptoms.  These levels may also help you adjust your lifestyle if your are “burning the candle at both ends” and think that there is no end to cortisol production (another common misconception not unlike the thought that the supply of insulin coming from the pancreas is infinite).

If you cannot bring yourself down from the frenzied pace, consider seeking professional help, pray more, let go and let God, learn some relaxation techniques—your life may depend on it more than you think.

16.  Good dental hygiene.  It could be easy to minimize the sore tooth, or think that it is “just another minor ailment.”  In actuality, the gums and teeth are the cardiologist’s most feared source of blood borne infection to infect the heart valves.  It is no surprise that one of the two most common causes of an elevated CRP ( “C-Reactive Protein”, a nonspecific indicator of inflammation in the body) is dental infections.  If you have any chronic inflammatory condition, and also have a tooth or gum infection, get the mouth taken care of and see what happens to the other inflammation.

Note:  The other common cause of “idiopathic” / unexplained elevated CRP is truncal obesity—which is one of the key factors in prediabetes / Syndrome X / Metabolic syndrome).  Speaking of C-reactive Protein, many years ago, I noticed that patient’s CRPs decreased when they ate a diet rich in vegetables.  I did not understand why at that time, but I understand it now.

17.  Check Vitamin D level and take vitamin D if it is low.  A low vitamin D causes inflammation.  Maybe this is one of the reasons low vitamin D is related to so many disorders including heart disease, cancer, osteoporosis, and depression.  Most Alaskans are low in Vitamin D.  I have tested hundreds of patients, and I have only had 2 patients whose level was in (what I call) the normal range (e.g., above 40), unless they were on vitamin D supplements.

The tough thing about vitamin D is that the test is kind of expensive.  Our clinic is actively lobbying for better prices with the available labs.

You should probably check a baseline level and then recheck levels about 2 months after supplementing your diet with extra vitamin D.  You should check your calcium level along with vitamin D level, because some people elevate their calcium level to dangerous ranges when they take vitamin D (although this is not common).  Vitamin D is a fat-soluble vitamin and should be taken with olive oil or butter or coconut oil or fish oil capsules or nuts.  It should also be taken with Vitamin A in your daily multivitamin.

18.  Consider taking natural antiinflammatories such as Bromelain, garlic, boswellia, or cat’s paw (my cat would not appreciate this) instead of ibuprophen, naproxyn or other nonsteroidal antiinflammatories (NSAID’s).   I recently took bromelain capsules (bromelain comes from pineapple) for a tendonitis in my left wrist.  It worked great.  I was pain free in 2 hours.

The natural antiinflammatories act “upstream” in blocking the inflammatory cascade, whereas the NSAID”s act “downstream” in blocking prostaglandins, which can have good and bad long term effects.  We will have more in our web site about the contraindications of the natural antiinflammatories later, so if you are on different medications, or have chronic or serious health problems, you may want to wait until we post more information about these or you talk to a health-care provider about them.

*This brings up the subject of whole vs non-fat milk.  I advise all of my diabetics and overweight patients to drink whole milk, along with eggs, and bacon from pigs fed things other than buckets of corn.  Each of them who do this brings their blood sugar and weight down easily as long as they eat these foods in moderation.  Skim, or 1% or 2% milk is  low in nutrients other than sugars (lactose and galactose), and should be classified as another “refined carbohydrate” – one of the “white foods” that you want to avoid.

• DOT Physicals are easy to schedule, inexpensive, and we try to make the process as painless as possible while giving you the care you deserve.
• Our Pre-employment Exams can be customized to whatever the company needs, although our capabilities and passion go way beyond what most ask for. We do our best to eliminate risk for both employers and employees at the start by doing quality functional capacity exams and other realistic job testing when needed.We not only test for capabilities, but train the client on proper body mechanics to help them stay healthy. We also educate them on how getting injured on the job doesn’t just affect their job, but everything they do or want to do in life. This enables companies to keep their employees healthy, allowing for happy workers and company savings.
• We do handle work. comp. but we believe that the best work. comp. strategy  is to prevent it from happening in the first place.

To schedule for any of our Physicals or Screenings please call (907) 283-9118 and we’ll be happy to serve you.

We want to give a special thanks to Gary from Gary’s Electric. Gary walked us through the whole process, first analyzing our wind and solar capabilities on site, and then recommending high quality renewable energy systems that have been shown to last. He properly sized the equipment to meet our needs and took care of the logistics and installation for us. He is currently in the process of preparing for our solar panel installation, which most likely will be mounted on our roof. Gary was reasonably priced and gave more to make this happen for us than we could have hoped for. If you want to learn more about opportunities in alternative energy, and learn how to take advantage of tax incentives while not being pushed into a sale that you might not want, Gary is the guy to talk to. He did an excellent job and I’d recommend him to anybody. You can contact him at 262-3993.

Here is a breakdown of costs, benefits, specifications, and energy produced from our windmill:

Total Cost including install before tax benefits:                                   $59,752.00

Minus 30% Tax Credit for alternative energy:                                      $17,925.60

Total Cost after Tax Credit:                                                                           $41,826.40

Apply Section 179 Tax Deduction on remaining balance

gives us further savings of this amount in taxes:                                $12,547.92

Net Total spent on 6KW windmill and tower:                        $27,278.48

KW hours used by average household each month:                            850kw hours

Average KW generated by windmill per month:                                     750kw hours

As with many businesses, the benefits of using tax incentives to be able to afford alternative energy greatly outweighed the cost. If you are thinking about the possibility of using alternative energy, it helps to consult with a professional who can measure and estimate with you your needs and resources available to you.

We love to help people to become independent, but we encourage you to use real calculations of the costs and the benefits before moving forward.  It has been a great investment for us and we hope to show you our daily production in the near future.

Remember, varicose veins won’t just go away. Let us help you take care of them. Call 283-9118 to schedule a free screening today. The procedure is less expensive than you think, and we do accept payment plans when needed. To find out more information go to our Varicose Vein Page on our website under services or go to Alaskaveincare.com.

Some Scary Facts on Diabetes

• Diabetes has a rate of amputations 10 times higher than average
• Significantly increases the risk for Sexual Dysfunction
• Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2005.
• Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.
• About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.
• Causes birth defects and complications in pregnancy Diabetes was the seventh leading cause of death listed on U.S. death certificates in 2006.
• Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
• The risk for stroke is 2 to 4 times higher among people with diabetes.
• $174 billion: Total costs of diagnosed diabetes in the United States in 2007
  • $116 billion for direct medical costs
  • $58 billion for indirect costs (disability, work loss, premature mortality)
  • After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes. So if you think Diabetes will only hurt your health, check your bank account once again.

For years, Diabetes has been known as the “Silent Epidemic”. Because of its “hidden” nature, Diabetes has infused itself into our society as the Plague of the 21^st Century. Just because you aren’t aware of any symptoms yet, doesn’t mean you are in the clear. The truth is, until you find out where you stand, no one is in the clear. 

Join the MediCenter in the “RACE AGAINST DIABETES” and get everyone you care about a free diabetes screening today…With diabetes, not knowing is the biggest danger.