I remember a time when the only place you could find me was in the kitchen. No silly…..it wasn’t because I was eating all the time, it was because I loved feeding others. I still do.
In 2014 in a matter of months, I developed sudden food allergies to delicacies I used to love to cook and indulge in. Being a vegetarian since childhood, I was already limited in my food choices. When the list of what I couldn’t eat became longer than what I could eat, the kitchen was the last place I wanted to be.
I didn’t even care to find alternatives to my favorites, I just quit searching.
For health reasons, I took my nutrition one step further and became vegan May 2018. I feel better now than ever before. Over the last couple of months, I have started tip-toeing back to the one room in the house that once gave me solace.
I thought this month we could have a little fun with a holiday recipe. I have been experimenting with the Instapot to see if my life could become any easier with the InstaPot. Verdict is still out!
Enjoy this Indian variation of a holiday favorite of mine.
Vegetable Pulao InstaPot (Main Course)
- 1 cup Basmati Rice– rinsed
- 1 tbsp Oil
- 1 Green Chili Pepper
- 1/2 cup Onion sliced
- 1/2 tbsp Ginger minced
- 1/2 tbsp Garlic minced
- 1/2 cup Tomato chopped
- 1 Potato medium, cut into small peices
- 2 cups Mixed Vegetables (Carrots, Green Beans, Peas, Corn, Edmame) frozen or fresh
- 1 1/4 cup Water
- 1/2 tsp Ground Turmeric (Haldi powder)
- 1/2 tsp Cayenne or Red Chili powder
- 1/2 tsp Garam Masala
- 1 tsp Salt
Whole Spices (available at any Indian grocery store)
- Turn on InstaPot to saute mode and allow to heat. Add oil and once oil warm add the, whole spices. Sauté 30 seconds until the cumin seeds change color.
- Once the whole spices start to sizzle and sputter, add the green chili, onion, ginger and garlic. Sauté until the onion becomes transparent.
- Add tomato and spices. Mix well with other ingredients. Next add the potatoes and mixed vegetables. Mix until everything is blended.
- Add the rice and water. Mix well. Close the lid with vent in sealing position.
- Change the InstaPot to MANUAL for 4 minutes/high pressure.
- As the InstaPot begins to beep, do a natural pressure release (NPR) for approx. 10minutes. Once all the pressure has been released, open the lid.
- Fluff the rice gently with a fork to mix the rice with the vegetables that may have settled at the bottom.
Pulao is a hot ticket item at any party! Enjoy the warm comforts of home cooking without the unnecessary calories of processed foods!
Wishing you and your families a happy, safe and joyous holiday season!
For more information on natural ways to relieve stress, CONTACT our office today to schedule your appointment.
Gratitude. Grateful. Thankful. So many ways to express all that is right in the world.
It seems like the world is always in a race to get to an imaginary finish line. We run at the speed of light, knocking down everything standing in our way, but not quite sure why we are running in the first place.
It’s not our fault. It is just the way the world is, and we are just trying to keep from falling behind.
Work pressures squeeze us like fresh lemons off the tree. Family life spins us from soccer practice to dance recitals, from dinner making to microwave zapping, from fresh sheets to unemptied dishwashers (kids, when you see the little green light come on, that is your clue that you better put away the dishes instead of ignoring it hoping Mom doesn’t notice. 😊)
Even our “Me” time has become a task to cross off.
Before I began writing this month’s newsletter, I sat back for a moment as a spectator to my life and observed the stuff that I let clutter my days. What things was I hoarding in myself that I would be better served without it there? And why was I doing it?
I am beginning to realize that half of the things that I do, I am not even sure why I do it or why I feel like it would be of any benefit. Why do I worry so much over things that won’t even matter in a few days? Why do I become defeated when I feel I can’t help everyone get better?
When I fill this space with things that don’t serve me, it doesn’t help me grow. It only robs me of more. I don’t sleep as well. I am more fatigued. My mood is blah. I find no motivation. Simply put, I feel sicker-physically, mentally, and spiritually.
The analogy is like this. When we binge on our favorite goodies, the first few bites feel amazing. But the more our stomachs fill up, the emptier we feel.
The physical symptoms we experience manifests from our internal chaos. The worry. The fear. The inability to control everything. The sadness. The anger. All of it. They are the leeches that invade our ecosystem and pollute the very fiber of the life we live.
Imagine the overtime the body must do to compensate for this disruption. I can’t even begin to remotely understand the extent of it. Even though we may not understand it, we experience it every time our body crops up with another symptom.
When we know better, we do better.
The neuroscience of gratitude is one of the most powerful areas of medicine making headlines. More and more physicians incorporate gratitude healing into their practice and with their patients, I know I do.
How exactly does expressing gratitude help us to live a healthier life?
According to Positive Psychology, a study done in 2014 by Zahn, Garrido, Moll, & Grafman, showed people who repeatedly express gratitude were found to have a higher volume of grey matter in the right inferior temporal gyrus.
Gratitude increases serotonin and dopamine levels, two neurotransmitters that are responsible for our mood and a ‘feel good’ vibe. Higher dopamine levels can also help improve pain by down regulating pain receptors.
Dr. Alex Korb, author of the book ‘Grateful Brain,’ (2012) said that our brain is conditioned to function in a repeated way. When we continue to respond to situations with worry and fear, we subconsciously re-wire our brain to expect the worst for every outcome. But when we practice gratitude, we train the brain to redirect thoughts and emotions towards positive, hopeful outcomes.
The Mindfulness Awareness Research Center of UCLA stated that gratitude does change the neural structures in the brain and make us feel happier and more content. Feeling grateful and appreciating others when they do something good for us triggers the ‘good’ hormones and regulates effective functioning of the immune system. Scientists have suggested that by activating the reward center of the brain, gratitude exchange alters the way we see the world and ourselves.
Establishing a practice of gratitude doesn’t need to be another “thing” we do. It simply means we need to stop running long enough to capture that “selfie”. Translation: Stop and smell the roses.
Here are simple ways to begin incorporating an attitude of gratitude into your life:
- When you see your reflection either in a mirror or window, stop and tell yourself how awesome you are. Before you can give thanks to the world, you must be thankful for who you are. Then take three deep healing breaths before moving on.
- Say ‘thank you’ to inanimate objects. I do this all the time. When I am at the store, I will say ‘thank you cart for carrying the weight of everything I put on you’. I will also talk to the vegetables and pots and pans as I am cooking, or when I am doing laundry. I basically walk around saying thank you to everyone and everything for being on my team and for supporting and providing me all that I need to live the life in the way I choose to live it.
- Gratitude list. If you are not into journaling, it is ok. Simply write down three things daily that you are thankful for. Keep it as simple as on a sticky note or as public as posting it on your social media feed. Where you write it is not as important as that you do. Whenever I write a check, I write “TY” in the note line. TY is my code to say thank you Universe for providing me with the financial means to be able to afford to write that amount.
- Dollar a Day. Much like a penny jar, every time you catch yourself thinking, feeling, or speaking a moment of gratitude, put $1 (or whatever amount) into the jar. At the end of the month, you should have a minimum of $30. With each month, try to do better than the last. Repetition helps re-wire old patterns into new healing.
- Spread the flames. This one maybe a little harder to do than the rest, but I think it is worth trying. When everyone around us is negative, it won’t be long before we join the party. But imagine if we strike the match of gratitude within ourselves and paid it forward, how different the world would look. If things can go viral on Tik-Tok, why not in real life! Everyday tell either a stranger, a family member, your social media groupies, colleague, anyone other than yourself how grateful you are for them, to them, because of them. What do you think that will do for their lives? Wow! A lot! More than we realize. If each one of us did that daily to just ONE person, happiness would fill our thoughts, productivity would dominate the workplace, healing would occur in our body, tolerance and understanding would blanket humanity.
It is possible. It can happen. And it only takes one strike of the match to start! We must not focus on everything that is wrong in our lives, but we must stay present with all that is right with us. You can begin to harness your power of healing in this vast space of stillness and gratitude.
Just be and listen.
Wishing each and every one of you a safe and grateful Thanksgiving.
Food is fuel. Nutrition is a lifeline. Eating is survival.
The one constant that remains with us in each decade of life is the need to exercise and the necessity to replenish things lost during exercise. Our cells thrive or die based on the choices we make.
This is not yet another lecture telling you how bad “processed foods” are or how if you want to lose weight, you must give up everything that excites your palate. No. That is not it at all. When you understand what is happening at the cellular level, you will have no cravings to fight nor will there be any battle of will power, because you will only want to choose what is best for your body and for your health.
Nutrition is a Pandora’s box that I will save to open for another day. All we really need to understand is that nutrition starts early. The habits practiced in our early years is the quality of life we live in our later years.
It is never too late to start healing. How many of you can tell me you actually ate clean as a kid?
I would be kidding if I said I did. Being thirty pounds overweight for most of my life, my breakfast consisted of three doughnuts, lunch was a standing date with the vending machine, afternoon snacks were whatever I could sneak into my backpack, dinner was the only meal that resembled anything close to the food pyramid and late-night snacks were those cute little powdered doughnuts and a whole bag of buttered ACT microwave popcorn, remember those?? If you don’t believe me, you should look at my high school pictures!!!
If I only knew then what I know now. When you know better, you do better. It wasn’t until 2010 that I began to know better. As I learned, I changed. There was nothing easy about it. It is still not. In 2014, fortunately or unfortunately, I developed a gluten sensitivity that helped curb my doughnut addiction. But man, what I wouldn’t give for a chocolate caked doughnut.
I was nearly into my 4th decade of life when I finally realized how I had treated my body. I didn’t dwell on the repercussions of my earlier choices, I focused on how to stop the self-destruction standing in the present and walking into the future.
As we age, just like everything else, our nutritional needs change.
The stomach is a powerful muscle in the human body. Just like other muscles, it also atrophies. Due to the smaller size of the stomach, it is unable to hold the same quantity of food that it once did. Naturally this causes us to eat less. While this may seem like a great thing, but remember by consuming less food we are also consuming less nutrients.
Aging also affects digestion and absorption of important vitamins and minerals. Combine this with the diminished calorie intake, the cells no longer have the necessary lifeline it needs to keep us healthy.
So, what do we do?
First, we take a deep breath. The human body is a machine of epic proportions. It has this unrelenting need to fight for homeostasis. Just because our activity levels naturally decline with age, we don’t become sedentary, right? We just make it a point to put in more effort to keep moving. Same thing with nutrition. While we may not be eating as much as before, we must train our habits to eat foods that are nutrient dense and calorically satisfying.
Here are few simple ways on how you can start to do that:
- Hydrate. It is easy to forget to drink, especially when thirst mechanisms also change. I recommend everyone fill a pitcher of water every morning or the night before. Infuse your favorite flavors if you wish. You can even put time markers on the pitcher reminding you how much you should have drunk by that time. By the time bedtime comes, the pitcher should be empty. When we don’t quantify our efforts, we overestimate.
- Make a weekly grocery list. Pick one day of the week that is dedicated to planning your health needs for that week. Sit down with a pen and paper and write down foods that are around the periphery of the grocery store. Shop only according to the list. If shopping is difficult, most grocery places provide home deliveries. When we plan in an environment that promotes calm and tranquility, our choices will reflect the same. So, do the planning at home and the shopping in the store.
- Be deliberate about protein choices. While protein maybe one of the most important components to health, it is not the most obvious. It is easy to bypass reading the food label. To spend time daily figuring out if you have had adequate protein is cumbersome and well, frankly, boring. That is exactly why we need to be very calculated and deliberate in planning our meals. One of the fastest ways to know you are getting in your protein is with a protein shake. Add fruits or nuts. Make it with water or a milk of your choice (coconut, almond, oat, skim etc). Watch those extra calories that tend to get added. Once scoop of most protein powders offers 20g/serving. Those 70 years and older or those that have difficulty chewing due to dental concerns, can add one can of Boost or Ensure drink per day. Both offer nutrient dense calories to the diet.
- Supplements. As most of you know, I am not the biggest fan of taking or recommending a list of supplements. Personally, I feel it is better to get it from its most natural source, mainly food. As we age, this may not be possible. Taking a good quality multivitamin along with Calcium and Vitamin D offers immune protection and cellular support. Some evidence suggests adding additional B6, Folate, Magnesium Vitamin E, Omega-3 may offer limited benefit, but further research is needed. Take only what you need. Eat real. Eat green. Eat natural.
- Sleep like a baby. Move like a teenager. So simple, yet so profound. The three most important gifts we can give to ourselves are sleep, exercise, and fuel. Sleep to restore. Exercise to rejoice. Eat to replenish. No matter our chronological age, we must do at least this much every day. While we can’t prevent everything, we can go to bed knowing we tried.
To live a healthy life is just listening to where our body is guiding us. Where we get lost is when we listen to the illusionary advice of the outside world. Every webpage, every article, every ad, every corner you turn, someone is giving us advice.
Is advice really what is needed? I don’t seem to think so. Once I was able to answer this question for myself, I began to change how I practice medicine. Of course, I still use all my medical knowledge to diagnose. But I have painted a very different picture for how I treat.
If we just listen for a moment, our bodies are telling us how to heal. Sleep. Exercise. Fuel.
Yes. It really is that simple.
There still lies a doughnut loving teenager inside of me, and she will continue to be with me in my daily choices. But the difference now is, she knows better. She is me. I am her. And together, our future self will remember the memories of enjoying those “sweet” teenage moments, but is thankful for delivering us to a hopeful, healthful, happy future.
Aging is a process of existing. But living is a choice of privilege.
It is never too late to begin. You are only as old as you think you are young!
Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health, CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.
The quest for great hair, skin and nails seems a lot more difficult to achieve in the winter months. Dry itchy skin, brittle fly-away whispys, chipped nails – sound familiar? The tell tale signs of winter are in the air! Understanding why colder temps affect our skin can go a long way to help remedy the problem areas, but it is important to understand the role a balanced endocrine system plays as well.
Inflammation is the single most important contributor that affects our skin, hair and nails due to the stimulation of free radicals, which accelerates aging by attaching to and damaging cells. In addition, studies have shown that there is a connection between sugar and inflammation in the body.
The main hormones that play a direct role in contributing to the decline from inflammation include:
I have written in the past about how these hormones become imbalanced, which leads to external changes we see. But for this month, I would like to focus specifically on how colder temperatures become a factor.
As we have understood, the fundamental rudimentary cause for the external changes we see is due to hormonal imbalances. The same carries true during winter months.
The longer, darker days lowers our Vitamin D levels. The waxing and waning of the temperatures directly impacts our thyroid levels. Estrogen, Progesterone and Testosterone levels ebb and flow to try and keep the body in balance. This endless cycle causes a rise in cortisol, therefore triggering an inflammatory response which leads to cellular inflammation, disruption and malfunction.
Other contributing factors include:
- Drier air from vents
- Poor hydration
- Increase in consumption of comfort foods (mainly sugar)
- Lack of exercise
- Prolonged hot showers/baths
- Irregular sleep patterns
Until Spring can shine upon us, here are some simple tips to help :
- Increase hydration. It is vital to keep the body hydrated with at least 90 oz/water/day. Without the essence of water, cellular healing cannot begin.
- Humidifier. Worth the investment. Having one by the bedside and in rooms that are frequently occupied helps prevent skin dry out.
- Limit hot showers/baths. Skin that is immersed for prolonged periods of time in hot water strips the natural oils causing hair and skin to become dry. It does feel great to stay for extended time in that warmth, but that causes more harm that good. Limit showers to 7 minutes at most.
- Coconut oil/butter. Nothing like solid saturated fats to hydrate the skin. Apply to hair and skin and allow it to soak for 45 minutes to an hour and shower afterwards. Or leave it on overnight for better absorption.
- Limit sugar intake. This is not specific to winter only! Refined sugar causes insulin levels to spike thereby leading to inflammation. Be mindful of this hidden culprit.
These are very simple, yet effective means to help control and possibly prevent winter skin ailments.
As the saying goes, we can’t stop the clock. Spring will be here before we know it as soon as we get through the craziness of St. Louis winter swings!
Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on healthy eating habits and achieving and maintaining OPTIMAL health, CONTACT our office today to schedule your appointment. You can also learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.
The world of nutrition can be just as overwhelming as choosing your pizza toppings.
Keto? Paleo? Carnivore? Mediterranean? Vegan? Vegetarian? Lacto Vegetarian? Ovo Vegetarian? Lacto-Ovo Vegetarian? Pollotarian? Pescatarian? Flexitarian?
I am seriously not making this stuff up. There really are such things, but is there truly only one path that leads to success? Trying to pick just one is like trying to pick your favorite child. The fitness and nutrition industry continues to be a multibillion-dollar revenue stream that promises to FINALLY get you the results when other “diets” have failed to do so.
If we really believe that to be true, how come the US still has the highest obesity rate compared to all other nations? That is because we have created a societal culture of believing there is only ONE right way that is superior to the other. Because we are so desperate for results, we have failed to realize that every time we “diet” hop, we are disrupting the homeostasis of the human metabolism.
There are no bad foods. Let me repeat. THERE ARE NO BAD FOODS! THERE ARE ONLY BAD CHOICES.
THE POISON IS IN THE DOSE!
As part of a Sports Medicine Internship program I am currently in, I have the privilege of learning and being mentored by some of the industry’s best nutrition scientists. The science is clear and the equation is on point: 1 + 1 does equal 2. This means your weight loss journey comes down to one simple formula:
CALORIES IN CALORIES OUT.
It is simple math. If you are taking in more calories than you are putting out, you will gain weight.
It really is just that simple.
We underestimate how much we eat and overestimate how much we workout. This may sound harsh. I prefer to call it tough love. Don’t let the promises of a marketing agenda discourage you from following where science has always had it right.
If you want what you set out to seek, then you must put in the work. Diets are excuses that only take you further away from your goal. Be honest with your intentions. And get real with your expectations. Better yet, don’t have any. There is two parts to the equation. Both are equally important. There is only so much you can succeed with nutrition alone. – and you can never outrun a bad diet.
Blaming aging metabolism is a distraction. You must become comfortable with the discomfort of the process. Face the reality of how much you are really consuming versus how much you perceive to be consuming.
No foods are off limits. There is no need for extreme elimination, unless there are medical conditions that require it.
Our bodies didn’t get here overnight. So, how is it fair to demand change in two months? It is not. That is why we are in this tsunami of failure.
YOU can stop this vicious cycle!!
It is not going to be easy, and the reason it won’t be easy is because you are going to have to do something that you may not have done before. Let go of the idea that the answer is in some best selling book. It is not! It has always been within you.
Would you rather have short term results or long-term success?
This sounds great in theory, but what about in real life? I hear you. I could workout 24 hours a day, no problem, but if you asked me to give up my favorite desserts, you would see a very hangry person.
It has taken me 21+ years to get out of my comfort zone and open up to trying a new way of eating. I was always one of those, ‘I am going to eat whatever I want because I work out hard’ people. While part of that is true, there are so many better ways to do it. You really can have your cake and eat it too. You have to just be willing to try a different approach than what you are used to.
Here are just a few of the things I do for myself that help me stay the course:
- Hydrate. I strive to maintain a minimum of 90oz/water day. Some days are better than others. But on those off days, I do not sulk into self-judgement. I look at it for what it is and remind myself I get tomorrow to try again. And more times than not, tomorrow will be better.
- Measure your food. Uggh! Not going to lie! This is painful. Early on in my journey, I learned about portion control through measuring and weighing food. I was able to visualize what a “serving” looked like. For one month, I weighed everything I ate. I was shocked to see that 1 tablespoon of peanut butter is actually not ½ the jar. It was not easy to do this, but this was the turning point that has kept me consistent for the last 21 years. Unless you are an elite athlete or competitor, you don’t have to do this every single day. But try it for a month. I guarantee anyone that tries it will be reaching out to me after a month telling me how much this experience has changed them. It does take work, but it will be worth it.
- Strength train. In my opinion, this is actually the most important aspect to getting real. There is no other form of exercise that physiologically has as much of an effect on our health like resistance training. Designing a strength training program that incorporates progressive overload and movement pattern exercises will result in weight loss for any person at any level. Cardio is fine if you need a day to zone out, but don’t expect it to get you to the same place that only strength training can. I totally get it. I am a runner and dancer and I love to swim and spin. Until 2002, Cardio is all I used to do. But once I began to understand the power of lifting and its physiological benefits, my physique took a dramatic turn. It wasn’t until earlier this year that I took my lifting to a different level. I lift heavier than I ever thought I could and let me tell you, my blood work results have never looked better. It is not about the number on the scale that matters, it is about getting real on how insignificant that number actually is IF you are putting in the work needed to do this right. Don’t allow yourself to blame external factors. Get real with your intensity. Lift heavy!
- Just Eat Real Food. Just EAT people!!! Don’t be so concerned about searching for the best diet. The best one is the one that is sustainable. If keto works for you, great. Stick with it. If you enjoy eggs, great, stick to a Ovo Vegetarian diet. It doesn’t matter. Because at the end of the day, it is CALORIES IN CALORIES OUT. Period. Don’t underestimate your intake. Don’t overestimate your activity.
- Sleep. The body needs time in stillness to restore. You may think you can get by with six hours of sleep, but you can’t. None of us can. There is a threshold of time the body needs to adequately replenish. It is like trying to put gas in your car. If you drive off before it has had a chance to fill up, it can only take you a short distance. But you would get significantly more mileage with a full tank. The body is no different. Don’t rush the restoration process. The body will not take any more time than it needs. Just like the gas pump, it will let you know when it is full and ready to go. Turn off the devices. Quieten the breathing. Settle your thoughts, and make sleep a priority. I promise – you will see a difference.
I used to complicate my life by spending so much energy looking externally to the experts who I thought knew so much more than I did. I trusted their opinion because after all, if it was open to the public, there must be some truth to it, right?
After years of disappointments, I came to realize that only I had the answers. It was I who I was seeking. It was me that was holding open the pages that held the secret code of life. I didn’t have to reconfigure the formula, I just had to understand the simplicity of it. One Plus One DOES Equal Two.
I keep my realness simple:
- Daily workouts
- Daily meditation (only few minutes a day)
- Adequate hydration
- Quality sleep
- Eating the way my body guides me, not the other way around
- Letting go of expectations
- Trusting the process
Please remember that it is YOU who is the real thing. You don’t need outside influences convincing you that you need their opinions to succeed. Do your own research. Be your own experiment and find what works for you! Makes choices in your life that is a representation of your authenticity and keep it simple. You may not get there in the time you want. But you will get there!!
You just keep doing you!!
September 2021 will be ten years since changing to concierge medicine. A lot has changed in the last ten years! But the one thing that has remained constant is my belief of how healthcare should be delivered and received.
There was a time in my early years of practice when my patient schedule would be bookmarked with 20+ patients, all spaced in increments of 15 minutes. I barely had time to say ‘Hi’ to them and next thing I knew, I was walking out the door. There was no time to ask them how they were doing or how the family, kids, work were. We had time to address only one problem at each visit, leaving the rest for a future appointment.
I will never forget the day that I decided I needed to make a change. It was March 2011, and as usual my schedule was double booked with no breaks in sight. As a person who is time conscious, I make it a point to stay on time, but one small set back in the day would put me behind by at least an hour. The day started like any other. I was feeling good that I was on schedule and the stars were aligning. By late morning, a quick 5 minute break opened. I felt like I hit the jackpot. I walked into to see my next patient before that break, only to find out her beloved husband had suddenly died. How could I leave her in the middle of her anguished tears just because the timer on the 15 minutes was ticking down? I couldn’t! So I stayed there to be with her.
I was very well aware of the angry patients that began to line up after her. They also had places to go, things to do, people to see. But I couldn’t bring myself to tell her that our time was finished. I wanted to give her the respect of my time as she began telling me about the special love she shared with her soulmate for over 50 years.
I also knew it was not fair to the others who were waiting after her because their time was just as important and valuable.
The internal tug-o-war was too much for me to handle. Both pulled at my heart strings and I didn’t know what the right thing to do was – stay and comfort or politely excuse myself?
It was in that moment I knew I couldn’t do this anymore. How was I to take care of somebody in 15 minutes when they were placed so much trust in me to help them? I went home that night 2 hours behind schedule only to collapse into a pool of defeat.
When I graduated from medical school, I took an oath “First Do No Harm” NOT “First Do No Harm, but only for 15 minutes!”
This realization left me with no choice except to make the decision to change to Concierge Medicine.
In September 2011, I began my new practice. There was an exponential learning curve during those initial days. I had to give myself permission to take my time. I had to get used to the fact that there was no reason for me to rush. What a feeling of freedom and joy I had!! Nine years later, my patients have become like family. I cherish hearing their stories. I relish in their experiences and I rejoice in their healing.
To me, the most profound experience has been the process of learning together with my patients. I always say I don’t have all the answers, but why not find out together. To engage in dialogue that brings about mutual growth and discovery is the best platform I know how to offer.
The time I now have gives me the chance to earn your trust and I hope it allows you to feel heard.
Why I am writing about this now is because everything around us, outside of us and inside of us is chaos and confusion? When equal trust spans between physician-patient, you know you have an anchor to always hold onto.
Practicing Concierge Medicine is the reason my bond with each of you allows me the space to say “You know what? I don’t know what is going to happen. I don’t know when things are going to be okay. But together we will figure it out.”
“You can’t pour from an empty cup.” “You can only love others as much as you love yourself.” “You are no good to others if you are not good to yourself.”
Golden words that have never been truer. Isn’t that how it was always supposed to be? So how did we get this so wrong?
Ok. Let me stop for a moment. I am not judging anybody. But, let me be clear! By taking care of you, it doesn’t make you selfish. It doesn’t make you greedy. It doesn’t make you arrogant. It doesn’t mean you don’t care.
It just means that you respect yourself enough to do the work to become the best version of YOU. So therefor, collectively as a society, we can all become better!
It took me years to understand this, let alone accept it. I am still not sure I totally get it. But what I do know is that when self-care is first on the to-do list, the list doesn’t seem so daunting.
One of my greatest pet peeves is hearing “I don’t have time.” What do you mean you don’t have time? We all have the same 24 hours. It is how we use that precious commodity that matters. When we get stuck in the notion that time is finite, we lose ourselves in the maze of excuses. Once excuses become part of our everyday vocabulary, health, peace, joy and happiness becomes a distant dream. Then the tsunami of failing health, mental fatigue, hopelessness and desperation hits.
We all HAVE it! We breathe it 24 hours a day. It is in our faces every minute. To say we “DON’T HAVE TIME” seems like a little bit of an oxymoron.
I know! I know! I am usually not this gloom and doom, but when it comes to prioritizing self-care, I have a pretty low tolerance of hearing excuses. Every single one of you is deserving of your “ME TIME,” but it is up to you to seize it. The spectrum of longevity and quality of living is determined by the time and effort you put into you.
It is not a luxury! It is a necessity! Self-care is an act of lovingly giving to yourself what you deserve without judgement or guilt. The path is different for each of us. In whatever way you replenish yourself, remember why you are doing it.
While in that “ME TIME,” remember to allow the flurries of joy to arise within you. Don’t silence it just because the task is finished or the clock tells you your time is up. Stay there. Enjoy that strange feeling, that familiar feeling from childhood when joy was all we knew and has now become a faint distant memory of adulthood. That’s where we are going. Back to that place where self-care wasn’t an option. It wasn’t something we had to choose to do. We just lived it. And we were so much healthier because of it.
Everyone has different ways of getting back there. Take your time finding yours.
The road for me continues to be under construction. Different phases of my life have offered different opportunities and experiences to become healthier. I am learning new ways of healing while unlearning old patterned ways of destruction.
I like to keep it simple.
As many of you may know I am a Friends freak. I watch very little, if any, TV. However, when I see that my fuel tank is getting close to ‘E’, I will watch a couple episodes of my most favorite show! During those 60 minutes or so, I don’t worry about what has been left undone or how much time I am “wasting” in mindless glare of the screen.
For me, those few precious minutes remind me of the 20-something year old girl that is still within me and the carefree spirit she once danced through life with. That memory reminds me that no one has taken anything from me. I had just forgotten that part of me that was buried deep into the caves of other people’s expectations of me.
When I give myself permission to climb out of that burial site and allow myself to experience that joy, an internal glow of warmth takes over and it reminds me that I am enough just as I am – and that all is ok and all will be ok.
And all of this because I gave myself 60 minutes to live, laugh and love. That feeling is what healthy living looks like.
Some of the other ways I utilize self-care in my healing are:
- Strength train 5-6x/wk. If one long block of time is not possible, break it up into 3x-10 minute sessions throughout the day.
- Meditation daily. This is a work in progress. Currently only doing it for 5-7minutes/day.
- Read one page out of any book.
- Look at my reflection in the mirror and tell myself one positive affirmation a day-OUT LOUD. This one is weird in the beginning and will take some getting used to. It is one thing to say it in your head, but it is another thing to say “You are total awesomeness” out loud. But trust me, it will change your day.
- Stretch for 180 seconds before bed. Notice how I didn’t say three minutes? Why? Because our thoughts will immediately tell us we don’t have time. But when we hear ‘seconds’, it is like, ‘oh, I can totally afford to take out a few seconds.’ Outsmarting the mind is the only way to recondition our engraved societal thought patterns of ‘I can’t’; ‘I don’t have time’; or the ‘go big or go home-all or none’ mentality.
- Every month, do ONE thing that scares you. Now why would we do something that is going to skyrocket your cortisol levels? Because when we do what we think we can’t, we realize just how capable we are and this will cause the endorphins to multiply exponentially.
As you can see, I try to keep things simple. It only takes spending a few minutes with yourself every day. Here are some other fun easy ideas:
- Sports games with friends
- At home mani-pedi
- At home spa day
- Diffusing essential oils
- Sleepovers with your BFF’s-Pillow fights and all-nighter movie marathon allowed
- Bubble baths
- Head oil massages
- Sidewalk chalk art
The possibility to be creative is endless. Doesn’t matter what you do. Just do it.
I used to write out complicated timelines and elaborate visions of how I was going to take the ‘best’ care of myself. They often required more time or more planning and if just one thing didn’t go according to plan that day, my whole intention was derailed. I would find myself in a fast tailspin towards mental and physical collision.
I have learned that when healing is kept simple, more space is available for us to learn, play and enjoy the experiences.
If we are patient enough, we will learn that the open grounds of life’s experiences will lead us to health and healing. When we truly begin loving ourselves and all of our perfect imperfections, we begin to love everyone around us just the same.
And that my friends, is what we call SELF-CARE.
Self-care is a mosaic of your best work: a one-of-a-kind masterpiece of infinite potential buried under the misconceptions of other people’s perceptions.
YOU DO YOU! Because there is no one else like you!
Be safe. Stay healthy.
Dr. Raman’s Concierge Medical Practice is focused on caring for each person as a whole, not just a list of symptoms. Our office is committed to helping our patients stay well and maintain good health rather than treating patients only after they become ill.
As I sat down to write this month’s blog on natural remedies for allergies, I thought, “That’s easy. Stay indoors. Move out of St. Louis.” Done. That’s the easiest blog I have ever written. Especially since we got another shot of winter weather this week.
But nothing can be that simple, right?
As always, it is important to understand what is happening on a cellular level before intoxicating it with medicines it may not need. Medications can interfere with the body’s natural immune response and alter pH balance.
An allergy is defined as a hypersensitive response to anything that enters the body or touches the skin. The allergen could be environmental, food, chemicals, heavy metals, or anything your body deems as foreign.
Once the allergen enters the host, it causes an activation of an immunoglobulin called IgE. Although everyone has IgE, those prone to allergies produce them in larger quantities. The allergen then binds to the IgE receptors. This binding triggers a “degranulation” of mast cells and basophils. Degranulation causes the mast cells and basophils to break open releasing histamine. Histamine is responsible for all of those classic allergy symptoms that keep us from feeling our best.
We all know those pesky symptoms and if you live in St. Louis, likely you have experienced a majority of them. So let’s skip over to the important stuff.
Aside from the standard treatments of an antihistamine, eye drops, nasal spray or the ultimate allergy shots, let’s look at some natural ways that may provide relief.
- Avoidance. While this may seem obvious, there is much more we come in contact with then we realize. Allergies are not all from pollen, grass or mold. With a weakened immune system, one can become sensitive to day to day exposures (i.e. household products, foods, daily use chemicals etc). Assume everything and anything is contributing to your symptoms until proven otherwise. Begin an elimination process by taking out one allergen every 2 weeks.
- Eat an anti-inflammatory diet. Eating foods that are more alkaline help restore pH balance and thereby strengthening the immune system. Foods such as garlic, lemons, green leafy vegetables, bone broth, coconut milk, almond or almond milk are great sources.
- Apple Cider Vinegar. ACV has some promising clinical response to decreasing cellular inflammation. Add one tsp in a glass of lemon water first thing in the morning at the onset of symptoms or add one tsp in your Netti pot solution.
- Netti Pot. There is nothing like clearing out the nasal passages with good ole saline. I like to call the Netti Pot “IV fluid for the nose.” Word of caution: make sure to use distilled water. Tap water is contaminated with chlorine and fluoride that can aggravate the sinus passages.
- Essential oils. Dr. Axe has provided great tips for use of oils. Oils help by reducing inflammation and improving detoxification of harmful bacteria, parasites, microorganisms and toxins that can trigger an attack. An all time favorite is eucalyptus oil. Add few drops into a Netti pot solution and diffuse it in each room. Or mix with coconut oil for a topical saav. Homemade “Vicks” with the added benefit of smelling minty fresh.
- Healthy gut. Healthy life. And there it is again! Everything comes back to the lumens of the GI tract. Eliminating gluten, dairy, soy, and sugar goes a long way in controlling those sniffles.
So, next time you long to be one with those peonies, give these tips a try. It is a whole lot easier than moving across the country.
Dr. Raman’s Concierge Medical Practice is focused on caring for each person as a whole, not just a list of symptoms. Our office is committed to helping our patients stay well and maintain good health rather than treating patients only after they become ill.
In 1984 Naltrexone was approved by the FDA in the US for the treatment of opioid addiction, when used at doses of 50mg to 100mg per day. Acting as a pure opioid antagonist, naltrexone in higher doses blocks the effects of endogenous endorphins, that are seen in our own natural endorphins as well as those in drug abuse. Used in opioid overdose and opioid addiction, naltrexone suppresses the “high” experienced with drug use as well as helping minimize withdrawl symptoms in patients going through opioid recovery.
During the peak of the AIDS epidemic, researchers noted that when naltrexone was given in small doses to HIV/AIDS patients, T-cell levels improved! The increase in circulating T-cells helped regulate the immune system and thereby slowing down the disease progression.
It was this discovery that led to further research on understanding exactly how LDN, also known as low dose naltrexone, could be used in clinical practice as one of the greatest treatments for immune support and restoration.
Since LDN works on the deep cellular receptors, it proved difficult to find consistent ways to measure data and therefore not a lot is known on the EXACT mechanism by which LDN works. Due to the limited clinical trials, LDN could only be studied anecdotally by following the patient’s clinical response to treatment. Because of this, LDN never made it to main-stream medicine, until now.
Recent clinical research has shown that LDN, in doses of 0.5mg-4.5mg, although a pure opioid antagonist, does not appear to suppress the endorphins as seen in the higher dose, but in fact, has shown to stimulate the T-cells within our immune system.
According to LDNResearchTrust.org, LDN
- Causes increased endorphin release
- Increased endorphins that modulate the immune response
- Reduced the speed of unwanted cells growing. Dextro-Naltrexone is an antagonist for at least one, if not more immune cells
- Antagonizes “TLR,” suppressing cytokine modulated immune system
- Antagonizes TLR-mediated production of NF-kB – reducing inflammation, potentially downregulating oncogenes
Taking Naltrexone in larger doses of 50-300mg seems to negate the immunomodulatory effect by overwhelming the receptors, so for the effect to work, the dose must be in the range of 0.5-10mg, usually maxing at 4.5mg in clinical experience.
Since LDN will only block opioid receptors for three to five hours, the body experiences a rebound effect which greatly increases the production and utilization of endorphins. Once the LDN has fallen off the receptors and excreted, the increased number of endorphins bind to the now more-sensitive and more-plentiful receptors. As a result, these new and improved receptors assist in regulating cell growth, promoting healing, reducing inflammation, and increasing immunity and autophagy.
So what does this mean for you or me?
A few years ago, I began noticing that many of my patients were being treated with LDN for SIBO/Leaky Gut Syndrome by the Gastroenterologist. In the following months, Rheumatologists began prescribing it to help treat Auto-immune conditions. What I observed was that when LDN was added to their other medications, overall severity of symptoms and relapse rates in health drastically reduced. I was truly dumbfounded and confused as to how a medication in lower doses that was used to treat opioid addictions was life changing in autoimmune conditions.
I began my research into this potential “miracle” treatment. Given that LDN is not used in mainstream medical practice, it made me a bit leery to begin prescribing it, but it did not stop me from learning everything I could about it.
In March 2020, when the pandemic first began, I was so troubled to see young healthy individuals affected by the virus to a degree that you would not normally expect. Why would they have this much of a hyper response of their immune system?
The great Dr. Fauci explained it so eloquently. When the virus enters the host (us), it triggers varying responses in our immune system to be able to fight off the virus. This is normal. This is what the body is supposed to do. Some systems may have a small inflammatory response, while others have a massive explosion of their cells.
Think of this analogy: a small fire (the virus) occurs while you are cooking. Putting the fire out with a glass of water (normal immune response) would take care of it without causing any serious issues (mild symptoms). However, if the pipes burst and flood the whole kitchen (severe Covid symptoms) in response to such a small fire, then we have bigger problems (ventilator, death, Covid long-hauler syndrome.)
In essence, the immune system is our built-in sprinkler system. It helps put out any fire that occurs in our bodies.
Exercising, adequate sleep, limiting processed foods, minimizing stress, avoiding excess alcohol etc. keep the fire from being created.
However, due to aging, genetics, poor health choices, medical conditions etc, the immune system finds it difficult to handle even small imbalances and begins to over-compensate the response by releasing excessive cytokines and other chemicals that cause a degree of inflammation that is out of proportion to the minor problem that occurred.
The over production of inflammatory components disrupts the natural defense mechanisms and begins signaling to attack our own cells. The body gets confused as to who is the good guy and who is the bad guy, so it attacks anything that comes in its way. Hence the term AUTO immune.
The vicious cycle of inflammation-attack-inflammation-attack causes cells to mutate and develop into what we know as the disease state. This mutation further weakens our immune system which makes each cycle of inflammation worse than the one before.
So how do we stop this hamster wheel of destruction? That is the million-dollar question. No one has the definitive answer, but LDN has some promising scope.
Months into the pandemic, the science community began to develop some understanding of the nature of Covid’s behavior. However, my attention and worry turned to the potential long-term effects of the attack on our immune system, irrespective of the severity of the symptoms one experienced.
Have you ever wondered why everyone you know suddenly is affected by some form of autoimmune?
Much research is focusing on “Post Infectious Inflammation” as a potential cause of the rise in autoimmune conditions in the last decade.
Remember when you were a kid and were diagnosed with mono or were around your friends who had it?
One theory is that the Epstein-Barr virus, the virus that causes mono, triggered an initial immune response to the virus. Rather than clearing the body of the virus, the EBV remained dormant in the immune system. When there was an external (environmental or lifestyle choices) or internal trigger, it activated the immune system years after the initial infection. Once again, it was our immune mediated hyper-response that led to a decline in our T-cell function. Similar findings were also discovered in post Ebola and SARS infections. This is the same pattern being seen in Covid long-hauler phenomena.
The decline in T-cell functioning is thought to be the epicenter of where disruption and breakdown of the body system begins affecting every organ and every disease process.
I am extremely terrified of what this virus could be doing to our immune systems 5-10-15 and even 20 years down the road. The idea is not to live with the worry of ‘what ifs.’ But if we can understand other viruses’ response to our bodies, maybe we can do the same with Covid.
The symptoms we experience on a day to day basis – headache, weight gain, vision changes, joint pain, problems sleeping, GI issues, hormonal imbalances, and the list goes on and on, is thought to be a step from the exaggerated immune response.
Even as we identify the “cause” of those symptoms, why did the “cause” even happen? Let’s say you have been having weight gain and after blood work we identify the weight gain is coming from low thyroid. So we have an answer to the weight gain, but do we have an answer to why is the thyroid not optimally functioning?
That is how deep into the cells we need to go. LDN is helping us find and fix the cause for the causes at the root – where the real healing occurs – in the immune system. That is where we need to go. We are not just going to the root. We are going to where the seed was first planted.
On January 28, 2021, a double-blinded placebo-controlled study testing LDN 4.5mg in Covid long haul patients began. The study is scheduled to finish August 2021 with preliminary results 12 weeks from the start of the study. Early indications look promising with patients reporting mild improvement in fatigue and muscle aches. That is a start!!
After seeing the results my patients were having with the LDN and after hours, months and even years of LDN research, I felt confidant to begin prescribing it to patients I felt could greatly benefit from the additional immune support.
Since LDN is not commercially available in the lower doses, it must be compounded at an accredited compounding pharmacy.
Doses can start as low as 0.25mg/day, as tolerated and titrated weekly as tolerated until reaching optimal dose of 4.5mg/day.
For some, the optimal dose may not be as high as 4.5mg/day. The body may respond at 1.5mg or 3.35mg. There is no perfect dose. As long as there is clinical improvement, the dose will remain effective for safe long-term use.
LDN is also used for many autoimmune conditions, MS, various cancers and a wide spectrum of other disease processes.
While LDN certainly does not replace the current standards of diagnosing and treating, nor do I believe this is the “one” pill to fix everything, I remain cautiously and excitedly optimistic.
While nothing can ever take the place of our bodies’ own power to heal, it is nice to know that there is something out there that can potentially help take healing beyond the root of the problem and into where the first break occurred.
There is hope!
Stay well. Stay healthy. Stay present. And remember, just breath.
It is all ok! We got this!
According to the CDC, someone has a heart attack every 40 seconds while one dies every 36 seconds. Coronary artery disease, caused by arterial inflammation and plaque deposits, is the number one cause of heart disease in the United States.
It is so important to take heart health seriously. The greatest risks for coronary artery disease are obesity, significant tobacco and alcohol use, sedentary lifestyle, consuming a diet of processed foods and living in a chronic state of stress. These are the stereotypical images we see in doctor’s offices, magazine covers, pharmaceutical advertisements and even people in our own lives. We are all at risk and we must work to minimize those chances.
While we can’t prevent everything, we can at least try!
The disease process begins with microscopic cellular damage. We may often have no symptoms or mild symptoms, which we will likely dismiss as a nuance. However, as the damage becomes more intensified, the symptoms become more pronounced until we can no longer ignore it. Given the great mechanism of the human body’s ability to heal and regenerate, many diseases can be brought under control and even reversed. But why wait and get to the point of damage control?
February is all about the heart! The heart of Valentine and the heart of YOU!
Making good lifestyle choices has been engrained into our psyche. It is not enough to know that it is important. We must know WHY it is important. Understanding what is happening on a molecular level will make being disciplined in our day to day living a bit easier.
Let’s talk about some of the ways we can minimize our risks of heart disease.
- Physical activity. According to numerous NIH studies, exercising consistently lowered LDL (bad cholesterol) and increased HDL (good cholesterol) levels. Another study showed regular exercise at a moderate intensity decreased platelet aggregation thereby decreasing the risk of clotting. An active lifestyle also aids in vascular remodeling and angiogenesis. This phenomenon allows for greater blood perfusion to all tissues and organs while decreasing the chances of ischemia. Some of the more commonly known benefits to exercising are lower BP, lower glucose levels, better weight control and overall reduction in cortisol. Undeniably, numerous studies and data points show a direct link between sedentary living and increased risks of heart disease. So, lace up and start moving.
- Diet. We all know processed foods are not good for us. But what exactly is happening at a cellular level with consumption of high fat foods? There is still much debate on the “perfect” heart healthy diet, and that is in part because of the varying ways crops are grown and harvested in different parts of the world. Let me explain. Our food system was once dominated by local markets with little modification to the crops. However, our modern food chains, depending on the part of the world, have fallen into the hands of government regulations as a part of a global business endeavor. This transition has led to changes in processing, packaging, and distribution of our food source. Hence the term GMO has become a household name. That is not to say that everything we put into our mouths is bad. We just need to become educated on how our food crops are grown. According to an NIH article, “a large Danish prospective cohort study of the impact of replacing saturated fats with high-GI carbohydrates found that when high-GI carbohydrates replace saturated fat, myocardial infarction (MI) risk increases 33%.” Refined carbohydrates, saturated fats, excessive sugar intake, low protein and fiber diet have been shown to increase blood sugars that can lead to diabetes. Excessive glucose in the blood stream increases the likelihood of platelet aggregation and thrombosis. While we do not need to deprive ourselves of our favorites, we must understand that daily indulgences can increase the risks. So rather than worrying about which diet is the right one, focus more on taking out the processed foods. Remember, shop local and know your crops.
- Minimize supplements. The jury is out on this one. I believe ‘less is always more’. Many ads convince us by taking multitude of ‘natural’ supplements we can ‘prevent’ diseases from occurring. Since most supplements have not been FDA approved, we do not really know how ‘pure’ the ingredients are. And what’s not to say that some of the fillers used to bind the supplements, couldn’t in some way increase our risk to the heart. I see so many patients come in with bottles and bottles and bottles of supplements in hopes of maintaining optimal health. Wouldn’t it be fantastic if that were the case? But the secret to longevity is not by putting more things into our body, it is taking things OUT. Our bodies are equipped with everything it needs to heal and reset and knows exactly what to do. Why jam the process by adding ‘extras’? Vitamin D, Magnesium, Omegas, Aspirin all have their place and do provide some protection. My concern with supplements is while it may claim to help now, what happens in five or ten or fifteen years? What if it is later proven that they do more harm than good? We do not know that. It is a calculated risk. But if we give our bodies a chance to restore and protect with its own natural mechanisms, it won’t let us down. We just need to do our part by making the right lifestyle choices. Exercise, eat clean, sleep, sleep, sleep, hydrate and decrease stress levels.
- Calm the mind. This one will take lots of practice and conscious effort. Stress causes our bodies to mount a defense against the oncoming attack. This defense triggers inflammatory chemicals to be released into the system. While these components play a vital role in protecting the immune system, it comes at a price. The cost, cellular inflammation, and DNA mutation. Translation? The start of a disease process before even a single symptom is felt! We all know what those stressors look like – not getting enough sleep, becoming physically over exerted, staying in constant states of worrying, holding onto to things that are not for us to carry. But all is not lost. Take a step back and ask yourself, ‘how did I get here’? Here – to this place of scurry, hurry and worry. Was it worth it? IS it worth it? Did it get me to where I thought I wanted to go? Or have I dug myself in deeper? My guess is the latter. It is awesome when we become aware of what we have been carrying and even more powerful when we choose to set down that burden. The inflammatory effects of stress are real people! Just because we can’t see it, doesn’t mean it won’t jump out of the closet one day. But we can lower this fury. How? By literally taking a deep breath. Begin to spend time in activities that will help lower the anger of the adrenal glands. It only takes five-seven minutes a day to do this. Try this:
—As soon as you wake up, instead of checking your social media posts, sit up in bed for few minutes with your eyes closed and envision your cells happy and joyous. Create how you want your day to look.
—Another way is when you are brushing your teeth or in the shower, choose a mantra and repeat it until you finish that activity. Some of the mantras I have created for myself, “My body is the vehicle that helps me live my dream. And I need to honor that purpose.”
“My health is important because it is through my body that I can serve others in ways they deserve.”
“When I invest in my health, I invest in living my life’s purpose.”
“Healthy living doesn’t have to be hard if I choose to live in simplicity.”
You get the point. These are just some I play around with. Some days, affirmations occur on the spot. Just go with it. We must not underestimate the power of the spoken word and its effects on the cells which will rise up and match those healing intentions.
—Meditation, Tai-Chi, Yoga, Pranayama, Essential Oils are some simple resources that can be utilized. However you choose to focus on you, just choose wisely and lovingly.
Writing this blog was a bit of a challenge because I wanted to include just enough data to convince you and me why we should be doing a better job of taking care of our health without sounding like a medical journal regurgitating volumes of stats and case studies.
With every article I write, I always learn something new. But this month was different. This month, I was inspired.
Reading the extensive NIH studies and the concluding data, I was utterly astonished as to just HOW much our simple choices can make a profound difference, good and bad. I have become inspired to be a bit more conscious of my choices and not take for granted every heartbeat.
While we can’t prevent everything, we can at least try.
Happy Heart Month to you all!