Why Great Hair, Skin & Nails Comes From A Balanced Endocrine System First

hair skin & NailsThe 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:

  1. Estrogen
  2. Progesterone
  3. Testosterone
  4. Thyroid
  5. Cortisol

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:

  1. Drier air from vents
  2. Poor hydration
  3. Increase in consumption of comfort foods (mainly sugar)
  4. Lack of exercise
  5. Prolonged hot showers/baths
  6. Irregular sleep patterns

Until Spring can shine upon us, here are some simple tips to help :

  1. 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.
  2. Humidifier. Worth the investment. Having one by the bedside and in rooms that are frequently occupied helps prevent skin dry out.
  3. 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.
  4. 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.
  5. 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 FacebookTwitterLinkedIn and Pinterest.

Why I Switched To Concierge Medicine

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.”

Why Self Care Should Be At The Heart Of Healthy Habits

self care“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:

  1. 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.
  2. Meditation daily. This is a work in progress. Currently only doing it for 5-7minutes/day.
  3. Read one page out of any book.
  4. 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.
  5. 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.
  6. 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:

  • Massages
  • 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.

For more information or to schedule an appointment with Dr. Raman, please contact us today.

Have You Seen My Metabolism Anywhere?

metabolismWe all know it is coming. We fight it tooth and nail. We don’t give into the relentless annoyance of it. But yet, somehow it always seems to have the upper hand. And by “it”,  I mean your metabolism or lack thereof.

How is it that three little numbers makes us lose so much sleep?

Before starting yet another dieting spree, let’s take a step back and understand what metabolism is and how it changes through the aging process. If we don’t understand it, we can’t change it.

Metabolism is a “series of chemical reactions that sustain the living state of organisms and cells.” Metabolism can slow one to two percent each year after the age of 30.

Nutrition is the KEY to metabolism! Carbohydrates, protein, fats, minerals and vitamins comprise the majority of fuel needed to keep metabolism operational.

Let’s take a brief look at how each one plays a role.

  1. Carbohydrates: This includes starch, sugar and fiber. When eaten in moderation, carbohydrates are broken down to fuel metabolism.
  2. Protein: Proteins are the main tissue builders in the body. They are part of every cell in the body. Proteins help in cell structure and function. They are also vital in supplying nitrogen for DNA and RNA genetic material and energy production.
  3. Fats: Fats produce twice as much energy as either carbohydrates or protein. They help form the cellular structure, help absorb fat soluble vitamins and provide a reserve storage for energy.
  4. Minerals and vitamins: Minerals do not play a direct role in energy needs but play an important role in metabolism. Vitamins are essential compounds that the body doesn’t produce and therefore relies up nutritional intake.

What are some other potential causes of a slowed metabolism?

  • Hypothyroidism and other endocrine issues
  • Inadequate sleep
  • Chronic stress
  • Exogenous hormone intake
  • Hormonal imbalance (low estrogen and testosterone)
  • Medication side effects
  • Excess supplement intake
  • Excess fat intake
  • Calorie deprivation
  • Low muscle mass

The good news is that there are ways to naturally increase our metabolism. But first understand something. Chasing after a “goal” weight or “ideal” size is unrealistic and can lead to frustration and disappointment. The scale doesn’t take in to account skeletal density, muscle mass or fat reserves. It only tells you an absolute number, a number which is false and misleading.

Don’t panic yet. We are not doomed forever. Here are some simple ways (many of which we have seen before) to raise your metabolism.

  1. Assessing the Resting Metabolic Rate (RMR). The Resting Metabolic Rate test (RMR) determines the amount of calories your body is using at rest. The results of a Resting Metabolic Rate test can tell if you have an increased or decreased metabolism, and if your body primarily uses fats or carbohydrates for energy. This information can be used to determine the amount of calories you need to eat each day to maintain or lose weight. The testing is done by breathing into a mask that measures your Oxygen –Carbon Dioxide exchange.
  2. Increase muscle mass. Strength training three to four times a week is mandatory when trying to increase metabolism. Developing and maintaining muscle mass allows the RPR to increase. Every pound of muscle uses approximately six calories a day to sustain itself, while each pound of fat burns only two calories daily.
  3. Eat. Calorie deprivation causes the body to go into crisis mode. As a preservation mechanism, the body slows down its metabolic response by storing fat and calories. Adding protein to every meal allows a constant release of glucose and maintains insulin regulation.
  4. Drink up. Dehydration is the killer when it comes to a slow metabolism. Calories need water to process. Even small levels of dehydration can cause  a slowing of the RPR.  Try for a goal of 90oz/day. If you struggle to get down your daily water quota, consuming fresh fruits that contain natural water is a great alternative.
  5. Sleep. Think of sleep like pulling into the gas station. We have to bring the car to a complete stop before we can fuel up. Just the same, sleep forces us to stop so that the body may refuel. If we compromise on sleep, we wake up on an empty tank of gas and expected to go the same distance as if the tank was full. Not possible. To sustain life, the body saves energy by decreasing metabolism.
  6. Question your medications and supplements. Just because it doesn’t say it on the package insert doesn’t mean it can’t happen. Assume everything going into your mouth is the cause until you proven otherwise. See what lifestyle changes you can make that could help you get off of prescription drugs.
  7. Maintain zero expectations. Our body will never be how it was in our 20’s and 30’s. So how can we expect it to respond in the same manner? Don’t be disappointed because you lost “only three pounds”. Be happy you didn’t gain three pounds. Body fat percentage, changes in clothing fit, how you feel is the REAL goal.

Don’t set yourself up for disappointment by looking for a solution under every advertisement. In the US, the weight loss market is a billion dollar industry! If these companies claim to have the answer, then how come we are still the most overweight nation? These are empty promises. The diet pills, the latest calorie restricted programs that leave you emaciated and crabby, the guaranteed “to lose 20# in 20 days” nonsense.  THEY DON’T WORK.  Don’t waste your money. Our parents and grandparents didn’t seem to struggle as we are now. So how come it is the topic of almost every conversation? What was once a simple seamless process of aging has now become a race against who can promise the fastest results.

If we stop for a second and reflect, in every moment of life our bodies are in constant conversation with us. The symptoms we experience are the body’s attempt to get our attention. A slowed metabolism isn’t something to become consumed by.  It is an opportunity to live a healthier lifestyle. Rather than trying to “fix” it, listen to what it has to say.

There is no fast way to lose weight. Let me repeat….there is no fast way to lose weight. Dropping weight faster than the body can handle is a sure fire way to crash the metabolism to an all-time low.

Be gentle and patient with yourself. No matter what the scale says, you will always be worth more than those three little numbers.

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.

For more information or to schedule an appointment with Dr. Raman, please contact us today.

Think Pink: October is Breast Cancer Awareness Month

breast cancerIt’s likely that you or someone you know has been affected by breast cancer. Studies indicate that 1 in 8 women will be diagnosed with breast cancer in their lifetime. This staggering number makes breast cancer the second leading cause of death among women, and an important reason to pay attention to your breast health, not just in October…but every day of the year.

Women spend a great deal of time tending to the needs of others. Whether you work full time or are a stay-at-home-mom, there’s always something that needs your attention. If a child or family member gets sick, women are usually on the front lines, ready to take action and care for a loved one in need. If the PTA calls asking for an extra two-dozen cupcakes for an upcoming fundraiser, or your boss needs you to attend an after-hours event with a new client, it’s often difficult to “just say no”. Always with good intentions, women end up neglecting their own health and any warning signs that may go along with an illness because they are helping others. It’s important to know, breast cancer does have a higher success rate for a cure when caught early, so awareness is the first step to a healthy, cancer-free you.

It’s still unknown why people develop breast cancer, however experts do know that breast cancer occurs when cells start to develop abnormally. Dividing more quickly than healthy cells, a “lump” can form within the breast tissue, lymph nodes or other parts of your body. Although it’s more common for women to develop breast cancer, it can affect men as well. Obesity, age, sedentary life, and a family history of breast cancer increase the risk for developing breast cancer. More recently, it’s been discovered that certain genetic gene mutations such as BRCA1 and BRCA2 also increases likelihood. Unfortunately these same genes can also increase the risk of other cancers, such as ovarian cancer.

Genetic testing may be considered if there’s a family history of breast cancer. Simple blood or saliva tests are used to identify any inherited mutations in BRCA or other genes.

Because a new lump or mass is the most common sign of breast cancer, it’s important to be aware of changes to your body. Regular mammogram screenings have decreased the number of advanced breast cancers, making it an important appointment to make when scheduling your well visits. Fifteen percent of breast cancers cannot be detected on mammograms, making self-exams another key component of your wellness routine.

Other breast cancer symptoms to watch for include breast size changes, swelling, skin irritation, breast or nipple pain, or inverted nipples, puckering of the breast skin or discharge from the breasts that is not related to child rearing. Breast cancer treatment has come a long way as more and more research and funds are invested into identifying the cause of breast cancer. As women are becoming more in tune with their bodies, they are learning the importance of   putting themselves first.

It’s important to take your health seriously, and scheduling regular well visits offers optimum health benefits that aren’t just essential for your quality of life, but for your family as well.

Dr. Raman’s Concierge Medical Practice is focused on caring for each patient’s individual needs with comprehensive, individualized treatment options and health programs.

For more information or to schedule an appointment, please CONTACT our office today! You can also learn more by connecting with Dr. Raman on FacebookTwitterLinkedIn, and Pinterest.

Why Am I So Tired? The Truth Behind an Improperly Functioning Thyroid

There are so many articles out there about an improperly functioning thyroid, it is hard to know where to begin! Let’s start at the top. How many of these symptoms describe you?Improperly Functioning Thyroid

  • Extreme fatigue
  • Weight gain
  • Irritability
  • Muscle aches
  • Depression
  • Rapid hair graying
  • Decreased libido
  • And too many other “little issues attributed to aging”

These little issues could be caused by a small gland with some big responsibilities. That gland is your thyroid.

The thyroid gland produces and stores hormones through an integral and complex pathway that is directly linked to your hormones and adrenals. The thyroid plays a part in EVERYTHING AND EVERY CELL IN YOUR BODY. It is butterfly-shaped and is found in the lower part of the neck, wrapped around the trachea.

Hypothyroidism: A Common Condition, But Frequently Misdiagnosed

Hypothyroidism is a condition where the body, for various reasons, doesn’t produce enough thyroid hormone or is unable to utilize the thyroid at a cellular level. No matter what the cause, this diagnosis has debilitating and frustrating consequences.

Being diagnosed with hypothyroid myself in 2002, I have spent the last 13 years researching, studying,
and understanding the complexity of this “little gland.”

According to the U.S. Department of Health and Human Services, about 4.6 percent of the U.S. population (approximately 18 million people) age 12 and older has hypothyroidism. As prevalent as hypothyroidism is, most people are not correctly diagnosed when they first present symptoms to their doctors because there is not a standard interpretation criteria for screening tests—meaning that one doctor may think a slight dip below the normal range is acceptable while others would argue otherwise.

Your thyroid can be affected if your adrenals are not balanced or if your hormones are constantly fluctuating. Due to the minute-to-minute variability of ALL the hormones in your body, patients are often under-diagnosed.

A single thyroid level test is insufficient to make the determination of hypothyroidism.

Many other thyroid levels also need to be checked. These could include TSH, Free T4, Free T3, Thyroid Peroxidase Antibody, Thyroglobulin Antibody, Magnesium, Iron, Zinc, Vitamin D, Hormones and Cortisol.

A patient who self-educates and self-advocates is in the best position to work collaboratively with his or her doctor to determine the best course of treatment for the symptoms and diagnosis of hypothyroidism. Self-advocacy is much easier when you choose a doctor who has experience in recognizing the symptoms of hypothyroidism as well as other hormonal conditions such as diabetes and adrenal gland issues.

Treatment of Hypothyroidism

Once hypothyroidism is diagnosed, there are many treatment options that need to be considered. Synthetic thyroid (Synthroid or Levoxyl) medication is not the only option. There are T3-only medications such as Cytomel or combination of T4 and T3 medications such as Armour Thyroid or Nature Thyroid. Patients even have the option of having their thyroid medication compounded with an accredited compounding pharmacy.

Hypothyroidism is not a cookie-cutter diagnosis and neither should be the treatment.

It is extremely important to work closely with your physician to monitor symptoms and continue to regularly check your thyroid levels.

The discussion of thyroid disease is more extensive than I can capture in a single blog post. In my 15 years of practicing primary care, I have diagnosed and corrected misdiagnoses of many patients with hypothyroidism. I understand and have experienced every symptom you may be having. I know the frustrations, I understand the suffering and I continue to live with this diagnosis everyday.

If you are suffering from any symptoms that are interfering with your life, Please contact our office today to schedule an appointment.

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.

For more information or to schedule an appointment with Dr. Raman, please contact us today.

Why I Got Into Concierge Medicine

concierge medicineIt feels like every week the world becomes a little more upside-down and inside out. What do we believe? Who do we believe? How do we make the simple day to day decisions that once took mere seconds have now extended into days? When will the vaccine be ready? Will a vaccine be ready? Where do I go to get tested? Can I have my antibody levels checked? What do I do about sending my kids to school in the fall when I am scared to let them out of my sight? And the list goes on and on……

The truth is, I don’t know that any of us have the answers –  it is okay not to know. It is perfectly okay to be feeling everything you are feeling. Don’t dismiss it. Don’t justify it. Don’t talk yourself out of it. Accept that everything you are feeling is legit and valid.

I have spent a great deal of time during these last four months in meditation and introspection.  My intention for these monthly articles is to always in some small way inspire each of you. But what do I write about that isn’t already out there? How can we have a conversation that doesn’t include a left or right or an up or a down? How can I translate my thoughts into words and hope it will inspire a wave of health and healing?

The only way I know how to do that is to be myself. Raw and authentic.

I thought I would share the story of how I came to practice with the principles and beliefs that I hold.

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, or work life was going. 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. However, 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 placing 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 the 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.

Concierge medicine has allowed me to scale down my patient volume from having a panel of 3000 patients to a panel of 300 patients.  This gave me the opportunity to take care of patients in a way I never thought possible. The concept of Concierge Medicine has only come to the forefront in recent years. As more focus is directed towards preventative medicine, concierge practices will soon become mainstream medicine. The last nine years have offered me the opportunity to engage in full dialogue with each one of you. I no longer feel a sense of urgency to stop the appointments in mid-sentence in an effort to stay on time. For 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 gives me the chance to earn your trust and I hope it allows you to feel heard.

We don’t always get it right – but we always have something to work towards.

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.”

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 FacebookTwitterLinkedIn and Pinterest.

Why Great Hair, Skin & Nails Comes From A Balanced Endocrine System First

hair skin & NailsThe 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:

  1. Estrogen
  2. Progesterone
  3. Testosterone
  4. Thyroid
  5. Cortisol

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:

  1. Drier air from vents
  2. Poor hydration
  3. Increase in consumption of comfort foods (mainly sugar)
  4. Lack of exercise
  5. Prolonged hot showers/baths
  6. Irregular sleep patterns

Until Spring can shine upon us, here are some simple tips to help :

  1. 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.
  2. Humidifier. Worth the investment. Having one by the bedside and in rooms that are frequently occupied helps prevent skin dry out.
  3. 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.
  4. 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.
  5. 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 FacebookTwitterLinkedIn and Pinterest.

Staying Healthy Through The Holidays

staying healthy through the holidaysDo the holidays have you jumping for joy or running for the nearest exit? Labeled as “The Most Wonderful Time of the Year,” the holiday season can be stressful and overwhelming for some. If you are in need of a vacation to refuel after all that joy, how about trying something different this year? Staying anchored amidst the peripheral chaos will not only keep you healthy, but also give you a chance to enjoy in the merriment.

Here are some simple things to keep this year’s festivities filled with glee.

  1. Exercise. Moving the body helps to mobilize stagnant energy. Inducing a heart rate response helps delivery of oxygen to those much deprived sedentary tissues. Plus, it keeps the waistline in check. If you are able to maintain your regular schedule of workouts, fantastic! If not, try using resistance bands at home. Ten minutes in the morning and ten minutes before bed provides enough resistance training to keep your muscles from winter atrophy.
  2. Meditation. Studies have shown just three minutes of mind-stillness is enough to lower cellular inflammation significantly. One of my go-to meditation apps is ‘Insight Timer’.  It is a free download that offers 24,000 meditation options ranging from two minutes up to three + hours.  Set your alarm clock five minutes earlier than you would normally get up and head to your favorite spot. Set a timer. Turn on your favorite music or have no music at all and just let your mind get lost. Don’t stop any thoughts, emotions or feelings that arise. Let them come to the surface and just observe. Go deeper into your diaphragmatic breath as each inhale/exhale brings you to a place of calm.  Once the timer goes off, you get to choose if you are done or if you want to continue longer. There is power in stillness.
  3. Increase protein. With so many tempting processed foods surrounding us this time of year, even the most disciplined cave to the pressures of home baked goods. We all know how we get when we eat too much sugar – crabby, anxious, irritable, depressed, fatigue, joint pain, swelling – and this is all before the weight gain even starts. Do yourself a favor. You know what the outcome of a sugar splurge is going to feel like. So don’t go ALL the way there. Yet, you don’t want to deprive yourself of the simple pleasures in life. You can have your cake and eat it too, but in smaller quantities. If you know you are headed towards the dessert table, load up on high protein meals prior to start of the party. High fiber, high protein snacks curb cravings while making you feel fuller. Stock your pantry this season with nourishing snacks like dates, nuts, fruits, cut meats, pre-made protein shakes (my favorite) or anything else you find nourishing and satisfying and eat it thirty minutes before partying it up.
  4. Water. We all know water helps with satiety, but more importantly water’s function is to keep the cells operating fully and completely.  As our body begins to acclimate to the cooler temperatures, it is vital that we become more diligent with water consumption. Regulating our internal thermostat causes dehydration even before the onset of symptoms. All it takes is just a little effort to see how easy drinking water actually is.  To make the process a little easier, use water bottles with clear markings so it takes the guess work out of the equation. For those that don’t enjoy the taste of fresh water, add fresh fruits through an infuser to sweeten the deal.  Recommended intake is ½ oz per body weight in pounds/day.  Set phone reminders. Having an alarm go off every 15 minutes is surely an annoying way to keep anyone on track. Don’t underestimate the importance of staying hydrated.
  5. Relax. I often tell my patients, “Let’s work really hard the first 11 ½ months of the year so when these last two weeks roll around, we can play.”  Come on guys.  Isn’t life stressful enough as it is? Why do we want to make the “Most Wonderful Time of the Year” like all the other stressed out days? Family can be stressful. Cooking can be tedious. Hosting can be exhausting. Sleep can be deprived. Weight can be piled on. House can be random chaos. But soon everything will go back to its organized, fast-paced, hurried, no-time for each other life. Let it go. The pie doesn’t have to be perfect. The decorations don’t have to be like HGTV paid you a visit. Just breathe and remember holidays are of course about celebrating family and the joys in our lives, but it is really about celebrating YOU. It is an opportunity to reflect on who you have become this year and who you are becoming into the next. It is about all that you have learnt and all that you have released. It is about slowing our heart rate and pausing with each breath. Take the pictures. Eat the food.  Enjoy the moment. You know why? Because January 2nd is right around the corner and we will soon be back on this hamster wheel in a game we call ‘life’.

Wishing you and your families a most joyous holiday season. May 2020 be a year of healing, happiness and prosperity!

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 FacebookTwitterLinkedIn and Pinterest.

5 Science Backed Things You Can Do To Reduce Your Risk Of Breast Cancer

breast cancerOctober has become synonymous with breast cancer awareness. Everywhere you look, pink is the color you will be sure to find.

This months’ blog is dedicated to anyone who has personally been affected or knows someone with breast cancer.

It seems every day we hear about someone else that was diagnosed. Has breast cancer really become more prevalent? Or has medical technology advanced so much that we can pick up a ‘speck’ of something with the earliest of screening? I believe the answer is a little of both.

According to The National Foundation of Cancer Research, today,  the lifetime risk of getting breast cancer is about 1 in 8 for U.S. women and 1 in 1,000 for U.S. men.

While we can never 100% prevent cancer. Let’s look at the 5 scientifically proven ways to REDUCE the chances of developing breast cancer in ones’ lifetime.

Maintain healthy body weight. Excess fat converts into estrogen. High estrogen levels in the body leads to mutation of cells which can eventually lead to cancer. The American Cancer Society recommends 150 minutes of moderate intensity exercise/week. This includes aerobic as well as strength. Just another reason to get moving.

Limit alcohol. In its Report on Carcinogens, the U.S. Department of Health and Human Services lists consumption of alcoholic beverages as a known carcinogen. “Excessive and prolonged alcohol use can weaken the immune system, which is important for preventing and controlling cancer,” says Robert L. Ferris, MD, PhD, chief of the Division of Head and Neck Oncologic Surgery at UPMC. The ethanol in alcohol breaks down to a toxic chemical that can damage DNA. Alcohol may prevent the body from absorbing nutrients that may decrease cancer risk; and it increases estrogen, which is linked to breast cancer. Cancer-causing chemicals could also enter alcoholic beverages during the fermentation process. Moderate alcohol, particularly red wine, may have anti-inflammatory properties that contribute to a larger preventative goal,” Dr. Francis says. Women who drink 3 to 6 drinks per week of any type of alcohol have a 15% increase in their risk of breast cancer. You don’t have to give up your occasional cocktail just yet. Just be mindful of the amount consumed.

Breastfeeding
. Research proves mothers who choose to nurse lower their overall risk. Breastfeeding decreases the levels of free estrogen. To those mothers who struggled with this, it is absolutely ok. There are many other things you can do to protect yourselves. If breastfeeding is an option for you, choose it. The benefits clearly outweigh the discomfort of those initial nursing days.

Limit processed foods. The many revealing documentaries have exposed many of our food industry for what it is. With our crops, livestock, and even non-living products being tainted with estrogen, it is no wonder why breast cancer is climbing the charts as the leading cancer of women. Limit your red meats. A recent study from the University of North Carolina showed that eating grilled and barbecued meat increased the risk of death among breast cancer survivors. “Dangerous chemicals called heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) can be produced when cooking muscle meat like beef, pork, poultry, and lamb at high temperatures over open flame or hot coals,” says Shayna Komar, a licensed and registered dietitian at Piedmont Healthcare in Georgia. “These chemical reactions cause compounds in the meat to change into potentially cancer-causing agents.”

Know where your foods and other household products are coming from. Go green while eating as local as possible.

Let go of the stress. Stress hasn’t been proven to link to cancer, but recent studies are beginning to point in that direction.  “Studies over the last 30 years have identified psychosocial factors including stress, chronic depression, and lack of social support as risk factors for cancer progression,” state authors of the study at UTMD Anderson Cancer Center.  Another study at Ohio State University showed that stress actually turns on cancer genes. Next time you begin to get worked up, ask yourself, “Is it worth it?”

The discussion of cancer prevention is just as exciting as it is daunting. Although there are many proven ways to decrease your risk, new findings suggest we may have barely scratched the surface.

While we can’t prevent everything, we sure can try!

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 FacebookTwitterLinkedIn and Pinterest.