Integrative Medicine: What’s Behind The Name? By Dr. Michele Couri, MD, FACOG, ABIHM

Almost all absurdity of conduct arises from the imitation of those whom we cannot resemble.”                                                                                                                                                ― Samuel Johnson, The Rambler

Integrative Medicine Image rocks leavesLet’s face it. Your health is a precious commodity and should never be taken for granted. You should protect your health and do everything in your power to live as healthy as possible to help ensure a long and vibrant life. “Preventive medicine”, “Lifestyle medicine”, and “Anti-aging medicine” are all very popular terms currently, and there are many “clinics” opening up nation-wide that cater to patients’ desire to lose weight, balance hormones, regain energy, reduce stress, and fight the natural forces of aging. While some of these clinics may be legitimate, many others are merely a scam intended to try to financially capitalize on patients’ naivety. I have some heart-felt advice – buyers beware.

Unfortunately, individuals who do not have the training or credentials to deliver the level of care that they advertise staff these clinics. Just having “M.D.” behind one’s name does not guarantee that that individual has training in wellness medicine, otherwise known as Integrative or Functional Medicine. Many times, these M.D.’s are physicians that work in other specialties and use their name and credentials as a formality since these stand-alone clinics require “medical directors” to comply with medical licensing issues. Quite often, these physicians are not actively practicing at these clinics at all. They are usually staffed by nurse practitioners that may or may not have any advanced training in Integrative or Functional Medicine.

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative. 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 21st 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.

Neither Integrative nor Functional Medicine is traditionally taught in conventional medical school curricula. They are areas of medicine that require additional postgraduate study and training, most comprehensively delivered in Fellowship models. The Couri Center for Gynecology and Integrative Health provides both Integrative and Functional Medicine alongside traditional Western medicine to ensure that our patients receive the absolute best, individualized care that is targeted, personalized and effective. The road to providing this level of care was not easy. It required thousands of hours of training spent in lectures, conferences, and online learning. Time spent with family and friends was sacrificed month after month in order to fulfill the requirements of the Fellowship curricula.

I graduated residency in Obstetrics and Gynecology in 2001, and I have spent the last fourteen years in private practice. When I realized that I wanted to add Integrative Medicine concepts to my practice, I sought out the world renowned Dr. Andrew Weil. In 2010, I began my training in Integrative Medicine at the University of Arizona Center for Integrative Medicine. This Fellowship in Integrative Medicine at the Arizona Center for Integrative Medicine is a 1,000-hour, two-year distance-learning program. Created by Andrew Weil, MD in 2000, the Fellowship in Integrative Medicine has achieved international recognition as the leading integrative medical education program in the world. Shortly thereafter in 2013, I completed a two-year Fellowship in Metabolic and Nutritional Medicine through the University of South Florida and the American Academy of Anti-Aging and Regenerative Medicine. All combined, this additional training cost me over one-hundred-thousand dollars. However, the knowledge that I gained was priceless. I was honored to have the opportunity to learn what is commonly regarded as the “future of medicine”. In my mind, my patients deserve the very best, and anyone that knows me, knows that I never compromise quality of care.

Nothing makes me more upset than unqualified practitioners who have a “lifelong interest in health and fitness” but no formal medical training whatsoever managing clinics that lure patients in with clever marketing schemes promising to “add years to life”. I firmly believe in the power of Integrative Medicine, but quite frankly, Integrative Medicine is not simply the act of replacing a prescription medication with a supplement or recommending the HCG diet for weight loss. Integrative medicine involves the healing traditions of ancient cultures and cannot be delivered by using “cookie-cutter” treatment algorithms to uniformly treat the masses.

The proudest day of my medical career has and likely will always be when I graduated medical school and stood before God and my family to recite the Hippocratic oath. I vowed to “first do no harm”. By nature, I am very protective. I am a protector of my family and my patients. I want nothing more than to see my patients empowered with the tools to master disease and flourish in health. Those tools come from a toolbox that combines the best of Western medicine with evidence-based healing paradigms of ancient traditions. Just make sure that the tools recommended to you come from those of a Master CraftsmaQuote body's abilityn and not from a cheap imitation. My good friend and mentor Dr. Tieraona Low Dog stated it best by saying, “We should all be thankful for
the amazing gifts of modern medicine. I am. That’s why I wanted to become a physician, so that I could share those gifts. There are times we need the heavy hand of chemotherapy, surgery and/or drugs. I also know in the deepest core of my being that the human body and spirit are strong, stronger than we can even imagine. Every scar, seen and unseen, reminds us that we are capable of healing.”

To Your Health, Dr. Couri

Personalized Contraception: Finding A Birth Control That Is Right For You. By Hope Placher, PA-C, MMS

Contraception Options Image

Deciding on a method of contraception can be overwhelming. At the Couri Center, it’s a decision that we help our patients make nearly every day.  Patients can choose from timed abstinence, condoms, diaphragms, oral contraceptive pills, vaginal rings, intrauterine devices, an injectable shot, or tubal ligation. I feel very fortunate that so many options are now available for women who are not yet ready to start a family. I often pose these questions to my patients to help tailor their decision for birth control:

 

 

  1. Do you have a schedule that would allow you to take a pill at a consistent time, every day of the week?
  2. Are you taking any medication that may interfere with the effectiveness of a birth control?
  3. Have you ever experienced a blood clot, or been diagnosed with a bleeding disorder?
  4. Are your periods extremely heavy, painful or irregular in occurrence?
  5. What is your timeline for starting a family? Are you anticipating the need for contraception to be greater than one year?
  6. For religious or personal reasons, would you prefer to use a method of non-hormonal contraception?
  7. Do you smoke?

Once you are comfortable answering these questions, it’s much easier to select a contraceptive method that is best for you. Schedule an appointment with your provider to personalize your decision.

Hope Placher, PA-C, MMS

 

 

Is Your Food “Fair”? By Leslie Rusch-Bayer, RD, LDN, CPT

Fair Food Logo

Is your food “fair”?

Slavery was abolished in 1865. Labor laws were passed in the early 1900’s. One would think that these laws would prevent sexual harassment, violence and forced and child labor violations with in business in the United States. It may surprise you that labor laws are nearly non-existent is some parts of the food industry.

In 1960, CBS reported on the “Harvest of Shame.” It exposed the awful conditions that many migrant workers were exposed to while harvesting fruits and vegetables in rural Florida, North Carolina and New Jersey. When it came time to harvest, migrant workers would flock to Florida farms for work. Many farmers ignored labor laws. Workers were forced to work for long hours and were given no relief from the heat. Most were paid pennies per hours and it was not uncommon to see a boss beat up a worker for complaining of their pay.

Dan Rather continued the story in 1995. Not much had changed. Tomato fields were full of migrant workers who had no rights. They were not given breaks, water or shelter from the sun.

In 1993 an activist by the name of Greg Asbed came to Immokalee, Florida. Asbed co-founded the Coalition of Immokalee Workers (CIW). The group’s main purpose was to force fairness and proper worker’s rights in the Florida fields. The coalition tried for many years to make a difference, but no farmers would talk to them. Seven years later they took a different approach: start from the top of the food chain. The CIW made a deal with Taco Bell in 2005 as part of their Fair Food Program. Taco Bell agreed to pay one-cent increase per pound of tomato. The one-cent was guaranteed to go directly to the workers. Also part of the deal; Taco Bell would only deal business with other participating farmers. McDonald’s, Chipotle, Trader Joe’s and Wal-Mart have also signed on to the Fair Food Program. A new seal that assures tomatoes are “fair,” can now be found in many retailers. Over ninety percent of Florida tomatoes are now grown on “fair food” farms.

One may ask how farmers are held accountable? The Fair Food Standards Council is an independent group that monitors all “Fair” farms. The penny premium guarantees farmers have zero tolerance for forced labor, child labor and sexual harassment. Farmers must also go beyond what is legally necessary in Florida and provide proper shade and job training.

Even though progress has been made, the CIW still faces challenges with many retailers. Florida’s largest grocery chain, Publix, has not signed on because it feels it is not their place to be involved in the problems of its suppliers. Publix did release a statement on the matter: “We expect our suppliers to follow the laws established to protect and promote a safe and healthful workplace for their employees,” the company said. “We believe all parties would be better served if appropriate wages were paid by growers to their workers, and we were charged accordingly.”

As a consumer we need to not only look at the quality of our food, but we need to begin to think about the “chain” that the food has to go through to reach the supermarket. I encourage you all to view this story in its entirety found on the Sunday Morning website. Because of the progress with the Florida tomato farmers, the CIW is now working with the second biggest vegetable export out of Florida: bell peppers.

Leslie Rusch-Bayer, RD, LDN, CPT

http://www.cbsnews.com/news/the-growing-demand-for-fair-food/

Amazing Asian Chicken Salad

csaladPrep
 20 m

Cook
 45 m

Ready In 1 h 35 m

Ingredients:

  • 1/4 cup rice vinegar
  • 1/4 cup sesame oil
  • 3 green onions, chopped
  • 2 cloves garlic, minced
  • 2 tablespoons white sugar
  • 2 tablespoons ground ginger
  • 2 tablespoons soy sauce
  • 1 tablespoon vegetable oil
  • 1 teaspoon ground coriander
  • 2 teaspoons prepared yellow mustard
  • 4 skinless, boneless chicken breast halves
  • 1/4 medium head shredded green cabbage
  • 1/4 medium head shredded red cabbage
  • 2 large carrots, shredded
  • 3 green onions, chopped
  • 1/2 bunch cilantro, coarsely chopped leaves
  • 1/2 cup slivered almonds

Directions

  • Whisk together the rice vinegar, sesame oil, 3 green onions, garlic, sugar, ginger, soy sauce, vegetable oil, coriander, and mustard in a mixing bowl until the sugar has dissolved. Pour half of the dressing into another container, and refrigerate for later. Place the chicken breasts into the remaining dressing, and coat on all sides. Cover, and refrigerate 30 minutes to 1 hour.
  • Preheat an oven to 350 degrees. Remove the chicken breasts from the marinade, and shake off excess. Discard the remaining marinade. Place the chicken into a baking dish.
  • Bake the chicken breasts in the preheated oven until no longer pink in the center and the juices run clear, about 45 minutes. An instant-read thermometer inserted into the center should read at least 165 degrees. Remove from the oven, and allow to cool. Shred the chicken using 2 forks and set aside.
  • To assemble the salad, combine the green cabbage, red cabbage, carrots, 3 green onions, cilantro, almonds, and cooled chicken in a large mixing bowl. Pour the reserved dressing on top and toss to coat.

ALL RIGHTS RESERVED © 2015 Allrecipes.com

 

Having Trouble Sleeping? By Terry Polanin, MSN, APN, FNP

sleepy womanThe American Thoracic Society (ATS) just released a policy statement with recommendations for achieving good-quality sleep. “Sleep plays a vital role in human health, yet there is a lack of sufficient guidance on promoting good sleep health,” according to Sutapa Mukherjee, PhD, Chair of the ATS committee that produced the document in the June 15 issue of American Journal of Respiratory and Critical Care Medicine journal.

At the Couri Center, we often hear of people not sleeping well. Good, quality sleep is critical for good health and overall quality of life. Getting too little or too much sleep can have adverse outcomes on our health. The ideal duration for adults to sleep in order to achieve optimal health is about seven to nine hours nightly. Sleepiness in the work place, at home, or when driving can have devastating effects. Driving while drowsy plays a large role in fatal and non-fatal motor vehicle accidents. The ATS recommends better education for people to recognize the symptoms of drowsy driving as well as the effect of shift working hours and its the association with workplace injuries.

Sleep disorders in the U.S. are more common than one might think. Many individuals with sleep disorders and obstructive sleep apnea remain undiagnosed and untreated. It is important to address any sleep related issues, fatigue, or daytime drowsiness with your health care provider. Undiagnosed sleep disorders may be responsible for contributing to high blood pressure, heart disease, diabetes, obesity, and other serious medical conditions. Don’t be afraid to talk with your health care provider about obtaining a sleep study and receiving the appropriate treatment. You will be amazed at how rejuvenated you feel after getting a good night’s rest!

Hormonal factors, psychological factors, irritability, depression, and pain syndromes are common concerns aggravated by lack of sleep. Persistent insomnia may lead to fatigue, drowsiness, decreased daytime functioning, and problems with memory, concentration, and weight gain. People with persistent insomnia are even more prone to respiratory, gastrointestinal, and musculoskeletal problems. Studies have shown that major weight gain in women was associated with reduced sleep time in middle aged women, though no such associations were found in men.

What can you do to help improve the quality of your sleep? Certainly, talking with your health care provider is very important. Sleep studies and other laboratory tests may be ordered when evaluating your problem. There are several types of sleep dysfunction. At the Couri Center, we often evaluate hormones to determine if a hormone deficiency could play a role in sleep dysfunction. A thorough history of your sleep problems will need to be acquired as well. If you have a sleeping partner, you might also ask about snoring or waking yourself up at night when you briefly stop breathing. If that is the case, a sleep study is vital to assist in the diagnosis of your problem.

We at the Couri Center strive to support natural healing alternatives, when possible. Consider herbal nutrition supplements that are natural and non-habit forming. Natural ZZZs is recommended at times for occasional sleeplessness, difficulty falling asleep, or waking too early. The natural ingredients found in Natural ZZZs are: Valerian root (long known for its effect on minor anxiety and promotion of muscle relaxation); Jujube Seed (used in traditional Chinese medicine for centuries, shown to be an effective sleep aid); Passion Flower, and L-Theanine (a natural herb found in green and black teas, promoting rest and healing to reduce daily stress while counter-balancing the effect of caffeine on the body). Cerenity PM is another unique herbal formula designed to help boost the body’s sleep-regulating neurotransmitters such as serotonin and GABA (an amino acid that is found in the central nervous system; acts as an inhibitory neurotransmitter) to help promote relaxation. It also contains phosphatidylserine, calcium, magnesium, and 5-HTP to help reduce frequent waking through the night allowing one to wake up feeling rested and rejuvenated.

Natural Progesterone is another female hormone which is often deficient in peri- and post menopausal women. When replenished, it allows for more restful sleep.

Please talk with your health care provider about these products and see which might be right for you. You would not want to take them with other prescription medications for sleep, anxiety, or depression.

Lastly, I would like to share some “lifestyle secrets for quality sleep”:

Good Sleep Hygiene Practices:

  • Create a bedtime habit.
  • Relax before bedtime with a pre-sleep routine of reading quietly, listening to relaxing music, or practicing deep relaxation breathing exercises.
  • Go to bed only when sleepy.
  • Get up at about the same time each day (no matter what you did the evening before).
  • Eat several small meals throughout the day to stabilize your blood sugar level.
  • Avoid heavy, hot, or spicy meals, consuming caffeine, or alcohol at least within 5-6 hours before bedtime. Some sleep physicians suggest no caffeine throughout the day if you have insomnia.
  • Avoid exercise right before bed.
  • Avoid smoking. If you do smoke, avoid smoking close to bedtime.
  • Avoid sleeping pills longer than periods of a few weeks as they can easily become habit forming.
  • Maintain a regular daily schedule that includes exercise, downtime, and regular meals. If you do need to take a daily nap, try to take it at a regular time in the afternoon to avoid dozing in the early evening as it will make it difficult to get to sleep at night.

Restlessness and difficulty falling asleep are often the root cause of many daytime problems including reduced energy, concentration, and productivity. If you are experiencing any of these sleep-related problems, please talk with your health care provider for further evaluation.

September commences back to school and establishing a new fall routine. We wish you all health and joy as you approach the colorful fall season. Don’t forget to schedule your Couri Center yearly exam and take time to think about yourself now that the children are back in school!

Happy fall,

Terry Polanin, MSN, APN, Family Nurse Practitioner