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.

working out at homeSix weeks have passed since ringing in the New Year with all of those promising resolutions to get healthy. We set our intentions and march forward to sign up for those “unbeatable” gym specials. However, Old Man Winter can get in the way of leaving the house so we can keep up with those promising resolutions.

Whatever the reason that kept you from using that newly minted membership card, look no further. Here are my suggestions on ways to stay active without having to leave your home.

The benefits of incorporating resistance training far surpasses hours on a cardio machine.  Resistance bands have become one of my absolute favorite tools to have.  The versatility as well as the safety and ease of use are suitable to almost all fitness levels.

Bands are available online or at any retail store. Depending on the brand, prices can range from $5-$30+, a very worthwhile investment.

If you have any medical concerns that may preclude you from exercising, be sure to discuss it with your physician before beginning any exercise regimen.

My Band Resistant Workout: Recommend 3x/week

Warm-up: 7 minutes

Block 1: Repeat 2x rounds.  Tie band around a sturdy structure so that both ends are available to hold. (ie a wall pillar, couch leg, a tree etc)

  1. Band squats. Extend arms straight holding on to end of the band, squat, one sec pause at the bottom and then stand. Repeat 15x reps.
  2. Alternating lunges. Extend arms straight holding on to end of band, alternate reverse lunges

Repeat 15x reps each side.

  1. Squat jack. Extend arms straight holding on to end of the band, sit low in a squat and begin jumping jacks. Repeat 30x low squat jack.

Cardio:  2 minutes high knees

Block 2: Repeat 2x rounds. Free up band from structure.

  1. Lateral pulldown. Hold band in the center with approximately 12 inches between each hand, then raise band overhead and while pulling down to chest, pull the bands apart. Stop mid chest and slowly extend back overhead. Repeat 15x reps.
  2. Bicep curls. With hands in same position as 1st exercise, rest the hands on the thighs palms facing up. Next, create tension on the band by pulling it apart in opposite direction as you flex the elbows to the foreheard. Lower back down slowly. Repeat 15x reps.
  3. Chest pull aparts. Keeping band at chest level, begin pulling the band in opposite directions to outside of chest, 3 sec pause, slowly return to center. Repeat 15x reps.

Cardio: 2 minutes run in place

Cool down/Stretch: 7 minutes.

This format is only a starting point to get you motivated to stay focused on your health. There are any number of resources (online videos, books or magazines, personal trainers) that maybe utilized to take these few exercises and transform them into a consistent way of life, no matter what the outside circumstance maybe.

Be greater than your excuses!

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.

Exercise EquipmentHave you ever walked into a gym, took one look at the equipment, and turned right around and walked out?

All the latest and greatest gadgets can not only be daunting, but they can also leave one to ponder who comes up with this crazy stuff.

Well, let me tell you, this is my absolute favorite thing to write about. I love and adore anything fitness. Some people reach for the latest upgrades to their Smartphones. Not me, I reach for the most convoluted apparatus to hit the market.

Don’t let lack of experience deter you from your fitness goals. If the gym is not your thing, no problem.

However, there is no excuse not to exercise.  Our aging bodies need movement to keep the joints mobile, hormones in check, metabolism up and mental sanity functioning.

Listening to your body’s cues will help streamline what type of exercise is optimal for you. Once you start on this journey, you will never want to live without it.

For those that prefer to workout in the privacy of their homes or in the nucleus of Mother Nature, here are 5 must have equipment staples:

  1. MAT. Your mat is there to support you, ground you and keep you safe. Yoga, pilates, core work, deep fascial stretching, restorative meditation are just a few of the opportunities the mat brings. Have one in the car at all times. You never know when you may have free time in your day to take to the mat.
  2. DUMBBELLS. Resistance training is a non-negotiable component to exercising. While doing cardio formats are great, strength training is where systemic balance occurs. We all know resistance training helps maintain bone strength. But did you know it also helps lower cholesterol, improve insulin resistance, decrease cellular inflammation and increase metabolism? For optimal results, strength training should be done 3-4x/wk.  Begin with the basic exercises: squats, lunges, pushups, planks. As your strength improves, begin adding weights. With those that are affected by orthopedic injuries, water aerobics is an excellent alternative.
  3. RESISTANCE BANDS. Just like my purse, these go EVERYWHERE with me. How can a latex tube cause so many muscles to cry out for mercy? That is because they are just awesome. Lightweight, compact and so versatile, bands are the best travel accessory one can pack. Resistance bands are colored for the varying intensities. Each resistance level represents the weight in pounds. For example, depending on the manufacturer company, a blue band may have enough resistance of lifting 8-10# dumbells.  This is one purchase that is a must have.
  4. SUSPENSION STRAPS.  This is where the fun begins! Straps were initially used in the military to train soldiers in various structural suspended planes. Just as the name implies, the majority of the exercises are done in a suspended manner relying on your core and the straps to keep you from falling. I bought my first set of straps 10 years ago and it still continues to be my go to on a day when I need to go all out. Many different companies have created off-brands that make it easily affordable.  Suspension straps are for every level.  That’s what makes them so great! Trust me. You will not regret adding this to your collection.
  5. FOAM ROLLER.  Cardiovascular and resistance training causes micro tears in the deep muscle fibers. The body’s natural defense mechanism is to increase blood flow and lay down new tissue to repair the damage. In the process of regeneration, scar tissue begins to develop. Over time, the scar tissue will start to inhibit range of motion in the joints. This restriction leads to injuries and avoidable traumas. Foam rolling is used to ‘knead’ out those scar tissues. If possible, do it daily for 5-10 minutes. Those that foam roll on a regular basis, notice an improvement in their overall quality of exercise.  Foam rollers also make great tools for pilates/strength exercises. Relying heavy on the core, rollers help improve balance and postural stability.

There are many other available modalities, other than those listed here, that constantly challenge our physical form.  The five listed above is a great starting point for beginners and a must-have for all advanced athletes.

We must continuously change our approach to our body and evolve our techniques so that we may keep up with the emerging science and aging self.

Be mindful and practice safe proper form.  Remember, how you work out is how you will end up looking. There are a plethora of online videos that show correct technique. Find your favorite instructor and bring the training home to you.

We all have to climb this mountain of healthy living someday.  Start now when you GET to rather than waiting until you HAVE to. The choice is YOURS! Choose YOU! The view from the top really is more breathtaking!

fatigueFatigue. It is something that plagues us more often than it should, and stands before us in ways and reasons we least expect. Tiredness is an all-encompassing umbrella of symptoms we use when we don’t know what is wrong with us. Some common things we tell ourselves typically are:

* I’m getting older.

*Work is getting the best of me.

*Maybe this is how life is supposed to be.

Let’s get real and talk about it. Not just chalk it up to “this is how life is.” So before filling that next prescription, or reaching for caffeine, let’s look at some causes.

  1. Hormonal imbalances. The female cycle begins entering peri-menopause around the age of 35 as it prepares to head into menopause.  The fluctuating and many times irrational hormonal swings disrupt the adrenal, thyroid and insulin metabolism. This then causes an imbalance in the hormonal ecosystem. Similarly, declining testosterone levels in men results in hormonal fatigue. Pay attention and make note of any symptoms. While blood work doesn’t always confirm hormonal shifts, the body can clue us in on the upcoming changes.
  2. Food sensitivities. Just like with environmental allergies, the attack on our GI tract triggers an immunomodulated response via the mast cells. When the body is exposed to foods that it may be sensitive too, histamine is released causing a catalyst of inflammation. If you experience itchy skin, rashes, joint swelling, sudden depressive symptoms for no reason, headaches, runny nose, itchy eyes, etc, instead of checking the mold count, start looking in your pantry as to what might be causing it. Many times the tiredness we are experiencing starts in our own kitchen. Assume everything and anything is causing it, UNTIL you prove it othewise.
  3. Change in prescription manufacturers. This can be an entire blog by itself. In my 20 years of practice, I have never seen more symptoms arising from the very treatment that was designed to help the initial complaint. Regulations for quality control of medications that enter the U.S. are expected to maintain a level of “purity.” A single generic medication can be manufactured by multiple different companies. If you notice your medications look different from month to month, look at the label for the manufacturer name. All prescription labels will have either MFG or NDC#. The NDC# is the number given to each manufacture company. While the same generic medication you have been taking for years, now looks different, that very well could be exactly what is leading to more time spent on the couch. I advise all of my patients to keep a log of every single medication, the manufacturer, the appearance of the medicine, date filled and any corresponding symptoms. Having all the information in one table helps rule out a simple manufacturer change as a source. So before adding another thing to help you feel better, take out the possible offenders.
  4. Supplements. Since when did we need to start taking so many extras to slow down aging? Generations before us only needed what nature provided to live. So what has changed that we now require a pill box to keep our supplements straight? That is right, we don’t! First of all, ask your body what it is lacking that only replenishing with external sources will help. Next, check those levels. If levels are low, find out why they are low before adding another to the list. Most of the supplements we consume are not even necessary. Bring the body back to basics. Bring it into its natural healing. The fillers, binders, preservatives, and other chemicals dilute the active component. So we are again intoxicating our system with sources that is worsening the very symptom we thought was improving.
  5. Movement. It’s such a catch 22. We are so tired, we become sedentary. By being sedentary, we are adding to the fatigue. So how to stop this hamster wheel? Simple. Take the first step. Being inactive causes more than just a few lazy days. Studies have shown limited activity increases risk of cancers, heart disease, diabetes, auto-immune diseases and so on.  You don’t have to go run a marathon. But you do have to lace up those shoes and take one step. One step will lead to two, and then three and then before you know it, your life will transform into a haven of energy and healing.  I have friends who I have encouraged to get active, but they resist. I have better luck getting them to the gynecologist! I tell them this very same thing. At some point in each of our lives, we are ALL going to have to climb this mountain. It is inevitable. It is better to climb it now when it is not that steep and you have more people on your team to give you a hand up. The longer you wait, the harder it becomes and the lonelier it feels.  May as well do it while you can. Work smarter! Not harder!
  6. Poor sleep. This seems obvious but I am going to bring it to you from an unconventional angle. YOU CANNOT CATCH UP ON SLEEP! We sleep so the human vehicle is able to” pull into the gas station” and fuel up and be ready to go the next day. If we compromise on our sleep, the body is expected to operate like it was on a full tank of gas but only half full. The great human machine’s only purpose is to keep us alive and operating. If it runs low on fuel, it pulls its resources from the hormones. Ahhhh……now you get it……..another way your hormones are affected!! You can’t expect the body to guzzle down a full tank so it can “catch up.”  Just the same, each night we compromise on our sleep, is another opportunity lost. Turn off the screen and restore your life.

Fatigue is not some rare disease that we are trying to discover. It is an everyday symptom that is often times self-induced, knowingly or unknowingly.

Heal the body by taking things out. Remove the strangulation from gimmicky health promises. Escape the trap of fearing something is wrong with you. Allow this glorious physical existence to talk with you. Everything you need to know and hear is being conveyed to you. The human body has an enormous unimaginable ability to heal.  Look 365 degrees in every direction and you will see that you have the ultimate power to discover and accept exactly what you need to live an optimal, healthy and flourished life!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance. For more information on natural ways to relieve stress, CONTACT  our office today to schedule your appointment.

You can learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.

 

 

 

ways to combat cabin feverIs it winter? Is it spring? Well, yes it is!

If you are a St. Louisian, you know it is only a matter of hours before we go from freezing temperatures and a wind gust stronger than the Arctic to walking around in shorts and flip-flops!

What you may not know is the effects of drastic temperatures changes on our health. It is not the frigid winter woes or the smothering summer heat that drives us crazy. It is the sudden fluctuating extremes that affect the body’s ability to adapt.

Lingering colds, food cravings, joint pain, fatigue, mood changes are just a few of the symptoms we experience. There is nothing we can do about Mother Nature. But there is always something we can do to take care of our physical and mental health.

When Meteorologists advise us to stay indoors, WE DO IT. We so often feel that we must be productive to stay healthy.  But the greatest form of health comes from stillness. It is in utter silence, the very essence of life begins to heal!

Don’t let this year’s weather create frustrations of cabin fever. Here is your opportunity to refuel and recharge.

Just a few ideas to get you started.

  1. Get into your PJs. Grab your beverage of choice (ETOH totally fair game J). Open your favorite book. And get lost in the pages of your favorite story.
  2. Binge  your favorite show. If books aren’t your cup of tea, no problem. Turn on your favorite TV show/Movie and enjoy hours of distraction or until your eyes see double, whichever comes first.
  3. Begin planning Spring Break. Ok, granted we have no clue when spring will shine upon us, but thinking to exciting times can raise endorphins and boost mood.
  4. Declutter. There is nothing like clearing your energy within than by releasing what doesn’t serve you. It doesn’t have to be a deep clean, but maybe one or two drawers to start. You would have accomplished something and feel good doing it.
  5. Workout in your PJs. I had so much fun with this one this year! If your gym cancels your favorite HIIT class or you just can’t spend one more minute on the treadmill, get into your favorite sleepwear and grab resistance bands or simply use your own body weight to enjoy a quick 15 minute workout. Don’t underestimate the power of short bursts of exercises.
  6. Journal. Writing (or typing on the computer) offers a safe place to release anything you hold within you. You could journal your thoughts, write about your dreams, outline a game plan for your workouts or inscribe handwritten letters to friends who would love to get a card in the mail.  This is a great way to slow down, reflect and revive the lost art of communication. Spending time in gratitude is more effective than anything else.
  7. Talk. When was the last time you picked up the phone and CALLED your friend? (Texting doesn’t count!) I am guilty of this.  I am not much of a talker and do way better in text than verbal dialogue. Even though it was out of my comfort zone, I picked up the phone and reconnected with friends I hadn’t spoken to in months. Hearing about their lives lent happiness and joy to mine.
  8. Meditate. My all-time favorite. Trust me. I am NO yogi and can sit still maybe for all of 10 minutes tops. But those 10 minutes is all that is needed to reflect on how amazing we are! In 10 minutes, you can create a path of where you are and where you desire to go. Time is a scarcity. Time is the bridge between what was, what IS and what will be. Time is the mirror that reflects absolute truth.  Time is and always will be the ultimate gift given to everyone equally-we just have to choose to accept it.

Take time to thank Mother Nature for reminding us of the gift that is always above us, below us, within us and surrounding us.

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance.

For more information on natural ways to relieve stress, CONTACT  our office today to schedule your appointment.

You can learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.

balance hormones naturallyIt seems like just when I have the hormonal pathways figured out I am gently reminded of how much I don’t know. To me, that is the beauty of trying to understand a system that continues to elude us. The learning is endless.

In my previous blogs, I have discussed the varying components to hormones. What are the different hormones? What are the functions of each one? Why do they become imbalanced? How do we check for them? What medications can we use?

This month is all about my two favorite topics: Hormones and anything natural!

The complexity of the hormonal pathways is similar to our highway system. One road may lead to multiple different avenues with multiple different ways to get there. Just so, there is no one correct way to bring things into alignment.

Let’s take a look at how we can naturally keep our hormones balanced and how to naturally bring them back into balance if an imbalance were to occur.

  1. Maintain weight. With a higher body fat percentage, more adipose tissues are available to covert to Estrogen. This conversion results in worsening estrogen dominance, which leads to decreased metabolism, insulin resistance, increased weight gain, and subsequent imbalance.

    Solution:  Strength train 3-4x/wk. Increasing muscle mass helps maintain insulin regulation and metabolism resulting in lower body fat.

  2. Adequate sleep. Without proper quality and quantity of sleep, cortisol levels may fluctuate greatly throughout the day in an effort to support basic daily functioning. When cortisol levels are unable to synchronize with our natural flow, it places the body into “stress mode.”  In anticipation of the stress, insulin, once again, is down-regulated and thyroid functioning slows. This leads to cravings, mental fogginess, slowed reaction times, and decreased metabolism. This can cause an increase in weight and therefore, worsening estrogen dominance.

    Solution: Sleep. Sleep. Sleep. Allow the body to rest in the full capacity it needs. Many people have told me, “Oh, I can function with just 4 hours of sleep.” Sure, maybe in the short-term. But in the long run, the body can’t sustain optimally under constant tension. Just like a car can’t run on empty, neither can you. Fuel up with sleep.

  3. Limit supplements. Why take something if your body doesn’t need it just because some limited research claims it can prevent Disease X or Symptom Y, only to come back in a few years claiming it is not beneficial at all. Overloading with a garland of drugs in a hopeless promise to health is becoming one of the leading causes of imbalances. Supplements stimulate the adrenal glands in ways we don’t yet understand. So what is all of this REALLY doing to us a decade from now. Be picky with what goes in your body.

    Solution: Have an open discussion with your physician regarding any non-prescription medications, even if you think it is not significant. Blood work can be done to check certain vitamin levels. If you are depleted, taking a supplement maybe beneficial. But only after asking the question, why are the levels abnormal in the first place?

  4. Meditate: Google “meditation” and you will find no shortage of studies proving meditation is ONE of the BEST healing therapies available. It doesn’t have to be for a gazillion hours or on top of a mountain. It can be for a few minutes with your feet firmly planted on the ground. Meditation is an ancient remedy that has gotten lost in the confusion of our techno-driven world. As meditation is finding its way back to us, it is worth trying.

    Solution: Take five minutes daily in a quiet uninterrupted place and observe your breath. Observe the chaos leaving and peace entering. Envision your entire system coming into balance working harmoniously so that you can become the best version of yourself.

  5. Self-Love.We have been conditioned to believe that taking time out for ourselves is selfish. When we allow self-criticism, judgement, and negativity to invade our space, our system starts to believe that we are less than. We begin to feel we are not worth the effort it takes into becoming healthy. Before we know it, the downward spiral has begun. This self-destructive process leads to depression, anxiety, poor sleep, and addictive behaviors. These choices once again puts the body into the familiar space of fighting stress.

    Solution: Daily positive affirmations are powerful tools. Every morning before starting the day, choose an affirmation, look yourself in the mirror and repeat it until you believe it. Then walk out the door with your head held high knowing you are worth SO MUCH more than ANYTHING that defines you.

Listening to your body is one of the best ways to ensure never getting lost on the road to healing!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance.

For more information on natural ways to relieve stress, CONTACT  our office today to schedule your appointment.

You can learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.

holiday recipeI 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)

Ingredients

  • 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

Spices

Whole Spices (available at any Indian grocery store)

Instructions

  1. 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.
  2. Once the whole spices start to sizzle and sputter, add the green chili, onion, ginger and garlic. Sauté until the onion becomes transparent.
  3. Add tomato and spices. Mix well with other ingredients. Next add the potatoes and mixed vegetables. Mix until everything is blended.
  4. Add the rice and water. Mix well. Close the lid with vent in sealing position.
  5. Change the InstaPot to MANUAL for 4 minutes/high pressure.
  6. 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.
  7. 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!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance.

For more information on natural ways to relieve stress, CONTACT  our office today to schedule your appointment.

You can learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.

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.

 

adrenal fatigueIt has been some time since I have talked about Adrenal Fatigue. As with anything in medicine, there is debate as to whether this is a real condition or a made up label for where there is no answer.

Before we can answer that question, it is important to understand the purpose of the adrenal glands.

The adrenal glands, also known as suprarenal glands, are small, triangular-shaped glands that rest on top of the kidneys. Their primary role is produce hormones that help regulate your metabolism, immune system, blood pressure, and regulate an appropriate response to stress.

The specific hormones released by the adrenal glands include:

  • Cortisol – Cortisol helps control the body’s use of fats, proteins and carbohydrates. It suppresses inflammation, regulates blood pressure, increases blood sugar and helps control our sleep patterns. Cortisol is released during times of stress to help in the flight or fight mode.

  • Aldosterone – Aldosterone regulates blood pressure by directly by affecting the sodium and potassium pump. Aldosterone sends signals to the kidneys that direct sodium into the bloodstream and release potassium out into the urine.

  • DHEA and Androgenic Steroids – These are precursor hormones that are converted in the ovaries into female hormones (estrogens) and in the testes into male hormones (androgens).
  • Epinephrine (Adrenaline) and Norepinephrine (Noradrenaline) – These hormones increase the heart rate and force of contractility of the heart muscles. This leads to an increase in blood flow to the muscles and brain. Epinephrine and norepinephrine are often activated in stressful situations when our body needs additional resources and energy to endure ongoing stressors.

So what does all of this mean?

Let’s simplify our understanding. Adrenal glands are needed to live. Period. It is our fuel tank. When we are born, the tank is full. Then, life happens that requires us to tap into those reserves. And when the demands out weigh the supply, a deficit occurs.

As we have understood from above, the hormones released from the adrenal glands are needed for overall survival. What happens when we run on empty? Fatigue sets in. Hormones are in chaos. The entire ecosystem of the human structure and function is in peril.

How do you know if you have this? Well, this is where we need to take a step back and really understand what our body is going through.

With the current lifestyle the world lives, I am sure we all have some degree of adrenal fatigue. Google the symptoms and I am sure most of us check off 90% of the list.

However, the difference between adrenal fatigue and adrenal insufficiency (Addison’s Disease) is that the latter is a TRUE diagnosable medical condition.

Those that suffer from Addison’s disease are unable to produce the hormones in adequate supply to maintain bodily function. The diagnosis is confirmed with laboratory testing. Every symptom must be watched and treated quickly and aggressively. Time is of the essence with Addison’s.

Conversely, adrenal fatigue doesn’t always have abnormal test results. This doesn’t mean that patients don’t have some diminish of hormone production. It just means that it is not as profound as in Addison’s.

I am sure you’re thinking that is great but how do I treat this so I can move on with my life?

When I first started learning and understanding about adrenal fatigue in 2007, I was sure the answer was replenishing with unproven garland of supplements. What I soon discovered was the supplements caused more issues than the fatigue itself. It didn’t make sense to treat one thing only for it to lead into another issue. Over the years, I have continuously asked myself how can we treat something we are not sure is a real entity? Whether the label is real or not, the symptoms are!

Ok. So we know it is real, but now what?

How about looking back through previous years and recognizing the habits that could have led to this?

  • How much processed foods did you consume?
  • How strict were you about your sleeping habits?
  • How active were you, really?
  • How much did you handle and resolve stress rather than sweeping them under the rug?
  • How many times did you make a choice you knew wasn’t right?
  • How many days did you neglect your “me time” thinking it was selfish?
  • How many times did you put yourself at the end of the priority list?

There is no judgement here. We have all been there. Hind sight is 20/20. But it is never too late to refuel, replenish and revive!

Try and begin with these five basic steps.

1.     Move at least 20 minutes a day.

2.     Stop all screens 1 hour before bedtime.

3.     Take a 5 second pause before acting on any choices you make.

4.     Move yourself up on the priority list.

5.     If it isn’t going to matter in one year, let it go.

This will take time. Keep expectations out of the equation. Work for a lifestyle change. Not for an immediate gain. It all starts with simplicity. Simply staying present. Simply starting. Simply observing. Simply being!

Dr. Raman’s Concierge Medical Practice is focused on holistic care and good health maintenance.  For more information on natural ways to relieve stress, CONTACT  our office today to schedule your appointment.  You can learn more by following Dr. Raman on Facebook, Twitter, LinkedIn and Pinterest.

hormone therapyThere comes a point in our lifespan where the hormones biologically begin to slow down production and we begin to consider hormone therapy. When our body senses the slowing of stressors in our crazy lives, it has no need to keep up with the high demands of life. While this is a good thing, the decrease in quantity of the hormones results in a potpourri of symptoms. While more intricate endocrine pathways are being discovered, the global hormonal function remains constant. We feel fantastic when all hormones (estrogen, progesterone, testosterone, thyroid, adrenals, insulin) are in a synchronized balance.

We all know the body WILL change. We may long to feel like we did in our 20’s. I am here to tell you, we can feel even better. There truly is no great mystery to understanding aging. Mid–life and menopause doesn’t have to be the “dreaded” era. In fact, if approached correctly with love and patience, it can be some of the best times of life.

Another thing to keep in mind is that hormonal changes don’t occur just in women. Men can experience the same degree of symptoms. We’ve all heard and some have experienced these symptoms. The symptoms of hormonal changes are extensive and exhaustive. Most of which we are all well aware.

The only thing that needs to be understood is SYMPTOMS OCCUR BECAUSE OF HORMONAL IMBALANCES. Each hormone plays a role in contributing to various symptoms. So how do you know if hormones are right for you? Before answering, ask yourself, “Are your symptoms debilitating enough that it is affecting quality of life?”

If the answer is yes, then hormones maybe what you need.

Hormone supplements are not a forever thing. You may only need them for a certain duration when life feels off balance. The goal should be to use the lowest dose possible for the shortest time possible. Do not depend on only hormones to help you. Stay committed to healthy nutrition, regular exercise and optimal sleep.

If you do choose to begin hormone therapy, continue to work towards creating a healthy lifestyle so that you may begin the process of weaning off of the hormones as soon as the body is able to hold its own.

What are the pros and cons to beginning Hormone Replacement Therapy?

Pros:

  1. Alleviates hot flashes and night sweats
  2. Helps with vaginal dryness
  3. Helps maintain or restore bone strength
  4. Improves sleep
  5. May aid in weight loss
  6. Possible cardiovascular benefit but evidence is still unclear
  7. Possible decrease risk of colon cancer
  8. Helps in restoration of skin, hair, and nails
  9. Improves mental clarity and mood

Cons:

  1. Small increase risk in breast and uterine cancer
  2. Increased risk of DVTs
  3. Slight increase in cardiovascular disease and strokes (The WHI study found a 29 per cent increased risk of coronary heart disease in those taking combined HRT)
  4. Small increase in gall bladder disease

The decision to start HRT (Hormone Replacement Therapy) should be well thought out. Having an extensive discussion with your physician can alleviate any anxiety about the uncertainty of hormone therapy. Each case is unique with varying factors. Listening and honoring your body will lead you to the right decision.

Remember, the minute you decide to start HRT, do everything you can to get off of them as quickly as possible. Use hormones as a crutch, not a permanent companion.

These truly can be the best years of your life! Aging is inevitable. Aging gracefully is optional. That is why I never tire of this topic. Embrace this passing cloud of inconvenience because the rainbow is waiting on the other side.

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.