What a Doctor Learned from his Patients

Dr. Garrett Smith, MD, had a unique vision for an oncology practice here in San Francisco.  He explains, “The dream for our practice was to be more than just a doctor’s office where patients come to get their chemotherapy.  We also wanted to be a community center based on an integrative approach to healing, evolving over time to reflect what patients tell us they need.”  For example, he found Natalie Ledesma, a dietician, through one of his patients, who told him, “You’ve got to meet Natalie.  She saved my life.”  He also learned from patients that when they come in to talk about nutrition, they often bring a buddy or partner.  These lessons that he learned from patients informed his decision to set up a clinic that had enough space for complementary practitioners (including a nutritionist, a massage therapist, a psychotherapist, an exercise physiologist, and an acupuncturist) and for meeting spaces that allowed patients to bring friends and support to their appointments.

You can read more about Smith Integrative Oncology, including how Dr. Smith came to administer chemotherapy treatments himself and why Natalie believes nutrition counseling must be highly individualized, in the “Featured Practitioner” article of Koshland Pharm’s Spring 2013 Prescriptions for Health newsletter.  We were inspired by their approach to health and healing, and hope you are, too.

~Krista, Outreach Director at Koshland Pharm, and Peter

www.koshlandpharm.com

Thyroid Health

I get a lot of questions as a  pharmacist about thyroid medications.  This is not surprising, considering that an estimated 11 million people worldwide are affected by hypothyroidism.  Common symptoms include low energy, fatigue, cold in the extremities, and constipation.  Hypothyroidism means that the body’s thyroid gland is producing too little thyroid hormone.

The body’s thyroid gland produces two types of peptide hormones.  Liothyronine (T3) is the active thyroid molecule, the form that exerts its effects on the body’s cells. The body also produces levothyroxine (T4) and converts it to T3 in the blood vessels.

The conventional treatment of hypothyroidism starts a patient off on T4 alone (i.e. Synthroid, Levoxyl). For many patients, this is an effective treatment, but it assumes that they efficiently convert T4 to T3.  For patients who do not respond well to T4, desiccated porcine thyroid (i.e. Armour Thyroid, Nature-throid), which contains T3 and T4 in roughly physiological doses, can be a viable option.

Another option is a compounded, or customized, thyroid capsule that has T3 and T4 in a sustained-release form. This product is similar to the off-the-shelf products like Synthroid (T4) and Cytomel (T3) with two distinct advantages. First, T3 and T4 can be combined into a single dose and customized to a strength that perfectly suites a patient’s profile. Secondly, by making these capsules sustained-release, it prolongs the activity of the T3, which has a short half-life.  This allows the T3/T4 capsule to be taken once daily for most patients.

For patients taking any thyroid medication, it is important to know that this type of medication interacts with most foods, drugs, and supplements.  Therefore, it is important to take the capsule one hour before any food or drug, and four hours before any supplement containing minerals like iron, calcium, or zinc.

To see a thyroid symptom rating form that helps to screen for thyroid imbalance, see Koshland Pharm’s new webpage about thyroid treatments.  The webpage also addresses quality considerations for compounded thyroid medications.

~Peter

www.koshlandpharm.com

Upcoming Conference in San Francisco about Environmental Risk Factors for Our Health

The California Naturopathic Doctor’s Association will be hosting a conference March 23-24, 2013 in San Francisco called “Environmental Medicine and Oncology in Primary Practice.”  Its target audience is naturopathic physicians and integrative medical practitioners.  Participants will learn about ways to limit exposure to environmental toxins and factors to consider when integrating natural therapies with conventional treatments for cancer. The staff of Koshland Pharm is looking forward to attending this conference as an exhibitor.  More information about the conference can be found on CNDA’s website at www.calnd.org/mm14.    Wondering what a naturopathic doctor is?  See this great article in the Huffington Post (10-9-12) for more about naturopathic medicine:  “You’re What Kind of Doctor?”

~Krista (Outreach Director at Koshland Pharm)

4 Mindful Eating Tips from Bay Area Holistic Pediatrician

Peter and I recently came across these succinct tips for eating mindfully as a family on Getzwell Pediatrics’ website:

Mindful Eating: Fostering a Healthy Fondness for Food

Children form associations with food very early in life. You can help your kids develop positive eating preferences by teaching them to experience and relate to food in mindful ways.

What is “Mindful Eating”?

In a nutshell, to eat mindfully is to build a positive relationship with food that allows for better control of eating habits. According to The Center of Mindful Eating, this is achieved by approaching food with appreciation, awareness, and enjoyment. For faithful followers, meals become sensory experiences where smells, tastes, and textures are savored.

A recent New York Times article reveals that a growing number of psychologists, pediatricians, and nutritionists claim that paying attention to how and why you eat can combat unsavory habits and conditions like binging, emotional eating, obesity, food addictions, to name a few.

How can you raise a mindful eater?

1. Pencil in regular family meals.

Children are commonly fed before parents to accommodate busy schedules and daily routines. However, sharing meals as a family shapes your child’s development and attitudes toward food. Sitting down for at least one family meal a week (preferably more) is a natural way to bring the topic of nutrition to the table.

2. Turn cooking into child’s play.

Inviting your kids into the kitchen is a great way to engage their senses and expand their knowledge of food. Let them knead the dough, taste the sauce, smell the cilantro. As meals are prepared, talk to them about where the food comes from and why it’s good to eat.

3. Make trying new foods the norm.

Exposing children to different foods from the get-go can open them up to a well-balanced and diverse diet. Introducing new dishes on a regular basis will pique their young taste buds and help minimize food fixations.

4. Broaden your baby’s palate BEFORE birth.

Studies show that babies develop preferences for foods they encounter in utero. Eat an eclectic array of cuisines and spices (i.e. garlic, vanilla, carrot, mint, etc.) during pregnancy and give your baby’s palate a sophisticated head start. Learn more about these fascinating findings in our post A World of Flavor within the Womb.

It’s never too late to start eating mindfully.

Thanks to Dr. Julia Getzelman and Nurse Practitioner Emily Waight for the helpful tips and links!

~Krista (Outreach Director at Koshland Pharm)

The Role of Our Thoughts in Healing

Check out this great article by naturopathic doctor Connie Hernandez, who writes about the importance of our thoughts as part of the healing process: Of Words and Woes  I’ve often told the story of my perimenopausal struggles with insomnia. At a certain point in the menopausal transition, I became unable to sleep. Remedy after remedy proved successful with my patients, but failed to transform my own sleepless situation. Any one of you who has suffered prolonged periods of sleeplessness knows the length to which a person might go to find a remedy…. My story was that I never slept and that I felt horrible all of the time because of it. One day, a certain wise shaman asked me to explain my problem. My response was that I was not able to sleep. The shaman responded by asking why that was a problem, and by suggesting that night would be a wonderful time to meditate. I explained that when I didn’t sleep, I felt terrible. The shaman agreed that that was indeed a problem, if it was true, and asked me to explore whether or not it really was true that I was feeling badly all the time because of it. I started looking into every moment, and I discovered that my story was not only not true, but was creating an unfavorable reality. When I moved into the present moments of my experience, I found that there were many moments in which I was just fine. There were some moments in which my eyes were tired, or I felt nauseous, or my head hurt. But those moments were definitely in the minority. Little by little, and with a supreme act of will, I was able to refute the definition of myself as an insomniac, the false story that I consequently always felt terrible, and the sister thought that I would never sleep again. I stopped speaking of myself as an insomniac. I stopped obsessing about my “condition,” and I started affirming the sleep and well being that I did enjoy. “I slept 3 hours last night!”, rather than “I hardly slept at all last night.” Little by little, I slept normally once again, and I almost always feel well even when I don’t. We can choose to emphasize the moments, experiences and conditions of being that are as we would like them to be or we can choose to emphasize those that are not. Sri Yogananda explains that when we concentrate on the gripping power of disease rather than the possibility of a cure, we permit the illness to be a mental as well as a physical habit. These “idea habits” create vibrational grooves in the brain and strengthen our tendencies towards sickness or well being. One way to transform idea habits is through effective affirmation, affirmation that permeates the subconscious mind. As Yogananda says, if you affirm “I am well”, but think in the background of your mind that it is not true, the effect is the same as if you took a helpful medicine and at the same time swallowed a drug that counteracted the effects of the medicine. Wrong thoughts neutralize right thoughts, and you don’t get the desired effect. (If you’re doing affirmations, and not getting the desired effect, chances are you are doing the affirmations incorrectly. There IS a science to it. See the booklet Scientific Healing Affirmations.) Thoughts are remarkable in their power. In fact, mental reality creates physical reality. Mind governs all physiologic processes and all living cells. Mind has the power to effect healing. And mind has the power to effect dis-ease or imbalance. This certainly does not mean that we should feel guilty when we are ill. We are subjected not only to our individual consciousness, but also to the collective consciousness, as well as to that myriad of factors mentioned above in the musings. Nor does it mean that we can ignore physical reality. Until we transcend it, we live our lives bound by the laws of physical reality. That physical reality is impacted by and reflects all energy input, whether from internal or external sources. Where there is dis-ease, we seek and utilize synergistic healing modalities, whether they be based on thought, light, sound, physical, biochemical, or energy medicines. What an array of ways we have to heal ourselves and transform our realities! Good health is more than the state of not being ill! It is a radiant state of inner well-being. Physical illnesses may be cured by medicines. No medicine, however, can induce that boundless energy which comes when every cell in the body cooperates with the mind willingly, joyfully, in all that it seeks to do.Such radiant well being comes after the mind has been cleared of every shadow of unwillingness, of fear, and of doubt; when one has learned to say yes to life; and when one has learned to love. ” — Affirmations for Self Healing by Swami Kriyananda Dr. Hernandez is one of the naturopathic doctors we’ve been fortunate to meet through our work at Koshland Pharm.  To find out about Dr. Hernandez’s consulting services, see her webpage at www.pacificnaturopathic.com, or to learn about the work of more California naturopathic physicians, see Koshland Pharm’s referral page.  Be well! ~Peter www.koshlandpharm.com

Slow Medicine and Healing Health Care

An inspiring book recently came out, written by a Bay Area doctor who has practiced medicine for many years at Laguna Honda Hospital in San Francisco.  In God’s Hotel , Dr. Victoria Sweet paints a vivid portrait of lessons learned from her direct experience treating patients facing complex medical diagnoses; from working in a health care institution rooted in older practices of medicine that was forced to modernize, for better and worse; and from researching in-depth the medical writings of a medieval German nun, Hildegard of Bingen.  Dr. Sweet manages to weave these three narrative storylines together in a way that provides insight into some of medicine’s, and life’s, core questions:

*What is the essence of the animating life force that makes us who we are, and that leaves us when we die?

*What helps a doctor make correct diagnoses, and what can a doctor do to facilitate healing?

*What elements from pre-modern medicine have we lost that we would benefit from re-incorporating into our modern-day health care practices?

Throughout the book, Dr. Sweet makes a convincing case for “slow medicine.”  She explains a core healing principle from pre-modern medicine, viriditis, which didn’t just refer to “greening or greenness,” but to “…the power of plants to put forth leaves, flowers, and fruits,” analogous to the “…power of human beings to grow, to give birth, and to heal” (p. 86).  In this kind of approach to healing, a doctor’s role includes a careful physical examination of a patient, the building of a relationship with the patient, and an ability to remove obstructions to and fortify a patient’s own viriditis with good nutrition, deep sleep, fresh air, sunlight, and time (p. 125; 82; 96).

Dr. Sweet’s advocacy for slow medicine reminds us of the practices of many inspiring integrative medical and naturopathic doctors, nurses and physician assistants whom we have had the opportunity to meet through our work at Koshland Pharm. To read more about God’s Hotel, see Dr. Sweet’s website: http://www.victoriasweet.com.  Her book sheds light on what it means to heal, for health care practitioners and patients alike.

~Krista Shaffer, Guest Author and Outreach Director at Koshland Pharm

www.koshlandpharm.com

12 Tips to Treat Dry Skin

To treat dry skin this winter season, consider the following 12 tips, reposted here from the blog of Kristen Riddle, Pharm.D:

1. 3000 mg of Omega-3 Oils daily or Omega-3 rich foods daily.  Our diets are low in healthy fats and fatty acid imbalance is very common.  This leads to dry, itchy skin.  Fatty acids are essential building blocks for your body, including your skin, hair, and nails. A person taking Omega-3s can quickly tell a difference in their skin.

2. Apply moisturizer to the body while the skin is slightly moist after showering or bathing.  Note that highly perfumed or fragranced moisturizers are drying to the skin.

3. Hot showers dehydrate the skin. Use warm water in the shower or bath.  (Hot showers can also worsen rosacea skin as well.)

4. Avoid the use of bar soaps which are drying to the skin.  Healing botanical facial cleaners and moisturizing body washes should be used through the dry winter months.

5. Limit foods and beverages that lead to water retention and dehydration, such as caffeine,  alcohol, salty & processed foods.

6. Drink plenty of fluids- 2 liters of water daily.  This sounds like a lot a water, however, that is just 4 bottles of Dasani everyday.

7. Use a humidifier.  Increase the humidity level in your home during the dry season. Dry air from furnaces and heating sources deplete the moisture in the skin.  It is best to try and  keep the moisture in your skin, as well as applying a moisturizer.  (Hot air from heating sources also dries out nasal passages, which leads to sinus problems.)

8. Be sure to take care of your hands and feet during dry winter months.  Always apply hand cream after washing your hands and wear gloves to protect them from the elements.  Apply cream to your feet after bathing and before bed.

9. Look for ingredients in skin care such as hyaluronic acid which is a humectant and holds water in the skin.  It hydrates without making the skin oily.  Facial serums commonly contain hyaluronic acid (many times listed as sodium hyaluronate on the label) but be sure to find a product that does not have less than 0.5% hyaluronic acid.

10. Pharmacist Kristen Riddle recently added Cupuacu butter to Rx Skin Therapy’s hydrating mask.  The Cupuacu tree grows in the north region of Brazil. Its capacity of water absorption is extremely high, approximately 240% higher than Lanolin or other animal or vegetable sterols. Cupuacu butter is an emollient that leaves the skin soft and comfortable, restoring natural moisture and elasticity.

11. Another ingredient that is highly emollient and moisturizing is shea butter.  Shea butter can be used for the body or for dry facial skin. Shea butter helps the skin to feel silky soft.  It should be reserved for dry skin because it is comedogenic, which means it can clogged pores if used at too high of a level.

12. Exfoliate at least twice weekly.  The exfoliant for the face should be a mild scrub to avoid micro tears in the tender facial skin.  An all over body scrub can be a heavier mechanical scrub such as a salt or sugar scrub.

These tips for dry skin come from the developer of Rx Skin Therapy, a skin care line we carry at Koshland Pharm.   Here’s to healthy skin this winter!

~Peter

www.koshlandpharm.com