July 2015

Trust Your Gut…..And Care For It!

I have a patient who moved away and recently decided to see me for a holistic health visit.  She is a woman in her early 70’s who had spent a good part of her adult life dealing with fibromyalgia.  For the many years that I cared for her, I tried to impress on her the importance of a healthy, Mediterranean-style diet.  It did not click with her until she moved away.

When I saw her, I was amazed.  Not only had she lost 10 pounds, she looked amazing.   She had a healthy glow, and there was no vestige of pain.  Her fibromyalgia went away ;with the refined carbohydrates she kicked out the door.  She is truly well.  She adopted a Mediterranean diet and is loving life.

We have known for a very long time that the Mediterranean style diet rich in lean protein, fruits, vegetables, whole grains and olive oil, reduces our risk of heart disease, diabetes, depression, stroke, dementia and even Parkinson’s disease.  The question is, why?  Granted, the food is chock full of the good stuff, and is devoid of refined sugars. That is part of the story.  What we are finding is that it all comes down to the fact that the diet keeps the tiny, healthy bacteria in our gut happy. A happy gut makes for a lean, healthy person.

Our gut hosts trillions of microorganisms that help boost our immunity and make certain vitamins.  If we keep these bacteria alive and healthy we are healthy. More and more evidence is being uncovered that is connecting a variety of conditions with sick gut bacteria. These include anxiety, behavior and mood disorders, allergy and asthma, obesity, fibromyalgia, chronic fatigue and irritable bowel to name just a few.

A healthy gut is seen with those who keep to the Mediterranean diet, eat fermented foods, avoid antibiotics whenever possible, and avoid processed foods and refined sugars.  A recent study done on college students at the College of William and Mary found that those students who scored high on a test looking at neuroticism did not manifest it if they were eating a diet rich in fermented foods.

There was a case report of a thin patient who was given a fecal transplant from a heavy patient and she started gaining weight and was unable to lose it. An animal study done on rats found that when a fat rat was given a fecal transplant from a skinny rat that it too became thin but also became anxious.

There is growing evidence to support the idea that gut health is essential for overall physical and mental health. The expression “you are what you eat” is proving to be true. It is never too late to change your eating and eating pattern to become a leaner, healthier you.  There are some great Mediterranean style cookbooks out there. Buy one and get started now.

All That Gas By Robin Miller MD MHS

I would estimate that one out of every 4 women I see complains of having too much gas. Over the last 5 years I have had 2 men bring up gas issues, and they only did it because their wives told them it was a problem. I find this an amusing phenomenon. Most women are embarrassed by flatulence or farting, where men are proud of the gas they pass.

I have some family members (you know who you are!) who deny that they have ever farted. Of course, that is a physiologic impossibility. If we did not pass gas we would ultimately explode. Which brings me to the question, why do we pass gas?

Two thirds of the gas in our gut comes from swallowed air. Every time we swallow we also ingest 2-3 cc’s of air. When we eat an apple we gulp down 20 cc’s of air. Drinking 10 cc’s of water adds 17cc’s of air to the belly.

The rest of the gas comes from bacteria that swallow cells that are dying and being replaced in the large intestine. They also help digest starches and fiber that makes its way to the colon. These substances are broken down into chemicals that smell and can help protect us from cancer and provide energy to the colon cells for metabolism. These bacteria make up most of the solid part of our stool.

The particular odor and volume of gas depends on what we eat and how much air we swallow. The major smell makers are sulphur containing compounds and methane. The average numbers of farts range from 7-17 a day. If we eat a lot of fiber it could be as high as 30 a day. Gum chewing, sugar substitutes, fruit juices, carbonated beverages, and ill fitting dentures can all increase the amount of gas we pass.

There has been research (believe it or not) on a small number of subjects that looked at men and women to see who had the higher volume and worse smelling flatulence. It looks like women have stinkier gas but a smaller volume. Men had a higher volume so, that in the end (pardon the pun) it was a wash. If you want to decrease the amount of gas in your system this is what you can do:
• If you smoke, quit or cut down.
• If you wear dentures, see your dentist and make sure your dentures fit correctly.
• Don’t chew gum or suck on hard candies.
• Avoid carbonated drinks, such as soda and beer.
• Drink less fruit juice, especially apple juice and pear juice.
• Avoid or eat less of the foods that cause you to have gas.
• Eat more slowly
• Beano and GasX may also be helpful
If you are one of those women who are having problems with gas, you might want to see your doctor to make sure you do not have an underlying problem. If you have a healthy gut then you might want to man up and embrace your bodily functions. You do not need to light them on fire (like some men do), butt realize this, you are not alone because everybody farts!

Whose Decision Is It Anyway? By Robin Miller, MD MHS

I am an Integrative Medicine physician. I see each patient as a unique individual, and I come up with a plan to help him or her to heal.  In order to tailor a plan to each patient, I utilize both complimentary (herbs, acupuncture, energy medicine, etc.) and conventional medicine. Unfortunately, some patients come to me thinking that I am only going to use a natural approach to their care.  However, there are certain illnesses that do not respond to herbal remedies and lifestyle changes alone. Cancer is a good example.

We have made amazing strides with chemotherapeutic agents and early diagnostic techniques such as colonoscopy and mammography. A recent study found that for men and women between the ages of 50 to 64 diagnosed with cancer, the risk of dying within 5 years was 39 to 68 percent lower than for people the same age diagnosed between 1990 and 1994.  Hodgkin’s Disease is almost always curable these days thanks to the chemotherapeutic regimen designed by Dr. Vince DeVita. Breast cancer is no longer a deadly disease, and there are many more cancers that are now survivable due to effective medical treatments. There are alternative approaches that do not cure cancer on their own but can augment therapy. Diet, exercise, acupuncture and certain supplements such as medicinal mushrooms and melatonin can be extremely helpful.

I am writing about this now, because I have had several patients recently who I have diagnosed with a variety of cancers, which have been potentially treatable.  Some suspected cancers I tried to diagnose early, but the patients refused due to the expense of testing.  Unfortunately, a late diagnosis has resulted in cancers that can now only be contained for a short while. They were potentially curable early on.  Others are dying of diseases that they could have easily survived with proper treatment.

I am not sure if I am seeing a trend, or if this is an unusual set of people who have such a strong distrust of the conventional medical complex that they are allowing fear and suspicion to cloud logic.  I understand that money can be an issue, but what good does it do to save money by not doing testing when the risk is not being around to spend it anyway?

People should definitely be allowed to choose what treatments and type of testing they do or do not want. Autonomy as a patient is very important. However, I see an increasing level of cynicism and suspicion in patients who look at the medical field and feel as though they are not getting the whole story.

My patients who are refusing treatment point to others that they watched being tortured with radiation and chemotherapy many years ago.  They also quote discussion sites on the Internet where people claim to be cured by all kinds of odd remedies.  I have tried to explain that although treatment is not exactly a walk in the park, there are now many ways that patients can be helped so that it is not as painful or disabling.

I am hoping that those of us in the medical field can do a better job to allay the fears of patients who are refusing treatment, and I am hopeful that no one should have to delay essential diagnostic testing due to financial concerns as insurance issues are worked out in the future.  I also suggest that patients read information from trusted medical sources such as Johns Hopkins, Mayo Clinic and Harvard, and that they have a little more faith in the health professionals in their community.

I suggest that they search out second opinions, talk to former patients, and do whatever it takes to feel comfortable with their care. A holistic approach to healing is great, but it should be based on good information. It is hard for me to watch people refuse care and die of treatable diseases.  On the other hand, it is something that has helped me to understand that patients will choose their own road to follow, and as hard as it is, I must respect that.



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