Tuesday, May 23, 2017

PREP: Pre-Hospital Empowerment Program

By Sara Scheller, BSN, RN, CPN, CCRN
Integrative Health Coach

If you knew you were going to the hospital for a planned surgery or procedure, how would you feel? Would you feel stressed, worried, and anxious or would you feel confident and empowered to be the driver of your healthcare experience? The truth is, there is no one-size-fits-all hospital admission. This is a highly individualized, unique process. According to EMPATHie (empowering patients in the management of chronic diseases), “An empowered patient has control over the management of their condition in daily life. They take action to improve the quality of their life and have the necessary knowledge, skills, attitudes and self-awareness to adjust their behavior and to work in partnership with others where necessary, to achieve optimal well-being.” One benefit of having an expected hospital admission (for surgery or other procedure) is that you can plan for it! You may not know exactly what to expect, but you can create and build practices to help you self-regulate this process.

Resilience is the ability to bounce back after adversity. Here are three ways to build more resilience with any challenge in your life:

1. Change your perspective, or how you look at things. You can shift to look at your experience as an opportunity to heal, learn, grow, and/or rest. We are born with a “negativity bias” or fear, vulnerability, and worry as a natural response to negative stimuli. But, you can leverage your ability to re-wire your brain through conscious efforts to find the good. According to Dr. Rick Hanson, author of Hardwiring Happiness, “The brain is like Velcro for negative experiences but Teflon for positive ones.” With support and practice, finding the good can become automatic, leading to more resiliency following tough times.

2. Find what activities or practices create balance or joy in your life. Lissa Rankin, M.D. in her book Mind Over Medicine encourages, “if you’re exposed to stressors you either can’t change or aren’t ready to change, you must prioritize activities that induce the relaxation response as a way to counterbalance the stresses in your life…creative expression, sexual release, being with people you love, spending time with your spiritual community, doing work that feeds your soul, and other relaxing activities such as laughter, playing with pets, journaling, prayer, napping, yoga, getting a massage, reading, singing, playing a musical instrument, gardening, cooking, Tai Chi, going for a walk, taking a hot bath, and enjoying nature.” If you aren’t sure which of these works to induce your relaxation response, try experimenting! Find what works for you.

3. Learn tools which you can practice on your own and/or with support, prior to your admission that you can use both during your hospitalization and in other challenging times of your life. These include mindfulness, 4-7-8 breathing, guided meditation, and other techniques where you can learn to become aware of how you are triggered and respond to stress. Once you become aware of this, you can use these tools to shift your body out of fight or flight. Allowing your body to shift into the relaxation response, you can rest and digest, reduce inflammation, and allow your body to heal naturally.

When you partner up with a health coach or other health care professional for support, you can become empowered to co-manage your health and well-being. You can be responsible for your own health, and tap into the resources of an expert creating a balance between self-management and shared decision-making. Through education and a holistic approach (mind, body and spirit), you can create a plan to optimize your body’s natural response to stress, allowing your body to work for you instead of against you.

PREP (Pre-Hospital Empowerment Program) assists you in preparing for a planned hospital admission for your surgery or procedure. To learn more, please email me at Sara.Scheller@HackensackMeridian.org.

Wednesday, May 17, 2017

Essential Oils 101: Part 1

By Lisa Sussman, PsyD
Health Psychologist

What do lavender, peppermint, lime, cedarwood and clove all have in common? They are essential oils! What are these potent drops which burst with aroma? Essential oils are volatile, aromatic compounds that are found in the leaves, stems, bark, flowers, and/or peels of plants and trees. They protect the plants/trees and help them in their survival. Essential oils have a long history of human use dating back to biblical times, and even further before that! Today, many people use essential oils as a tool along with nutrition and exercise to promote their wellness and self-care. There are many research studies which show that essential oils can help the body and mind in a number of ways. You may find information on the studies done on specific essential oils at www.pubmed.com or www.aromascience.com.

Each essential oil is comprised of hundreds of chemical compounds which give them their versatile uses and multiple purposes. They are naturally anti-bacterial and anti-viral, and because the molecules are so tiny, they can be absorbed into the skin, pass through cell barriers, and in some cases, pass through the blood-brain barrier. Essential oils are much more potent than herbs. For instance one drop of peppermint essential oil is equivalent to 28 cups of peppermint tea! Essential oils have their own intelligence and vibration, and as they help plants, they can help humans, supporting the body to function optimally physically and mentally.

Using a good quality, therapeutic grade essential oil is a must. Although many essential oils are considered GRAS, or Generally Regarded as Safe for Consumption by the FDA, they are not regulated by the FDA. You need to do your homework to make sure the essential oil is safe to use. The three things to consider when choosing an essential oil are purity, potency, and testing. Purity means the essential oil is free of toxins, fillers, and pesticides, and that it contains only what the bottle says it is. Potency refers to the strength and chemical constituents of a given oil. This can vary with where the plant is grown and harvested, the condition of the soil, and the species of the plant itself. Testing refers to the multiple methods of analysis that the essential oil is subject to before getting the green stamp to be sold, and can include tests such as mass spectrometry, gas chromatography, sensory evaluation, and third party testing.

Certain types of essential oils are known for their different properties and historical uses. For instance, lavender, and most florals, have a calming effect on the skin and in the brain. Mints, such as peppermint help focus, uplift mood, and have a cooling effect. Citrus oils, like lemon and orange, serve as gentle cleansers, in and out of the body, while they uplift. These are just samples of the many properties and uses of essential oils. Go to your nearest bookshop or search online to browse all of the books about essential oils and how to use them. You can learn as much as you’d like about different essential oils and the ways they can be used to support your health.

I hope this gives you a better understanding of what essential oils are, how they work, where to look for studies about the benefits of essential oils, and how to check for a good quality essential oil that is safe to use. In my next blog, I will describe the three methods of essential oil application: aromatic, topical, and internal.

Tuesday, May 9, 2017

Tai Chi Qigong for Health and Wellness

By: Paula O’Neill, MS, RN-BC 
Clinical Program Manager

Activity, one of the Five Pillars of the Meridian Integrative Health & Medicine Care Model, is an important part of your health plan. But does the thought of exercise make you cringe? Do you feel that you’re not in shape or that you are too weak to exercise? Well, I may have the answer for you…Tai Chi and Qigong. Tai Chi and Qigong are examples of two activities that you can do regardless of your fitness level.

Tai Chi is an ancient mind-body practice that originated in China as a martial art. Sometimes referred to as "meditation in motion," practitioners move slowly and continuously through a series of motions while breathing deeply and meditating. Qi (life force energy) Gong (the skill that develops with consistent practice) is a practice that incorporates postures, breathing techniques, and awareness.

Tai Chi and Qigong promote the balance and smooth flow of Qi throughout your body, which can help you maintain or improve your health.

Both practices are low-impact and consist of slow gentle movements that can be adapted for anyone, from those who are fit to individuals who are confined to wheelchairs or recovering from an illness or surgery. They are perfect for people of all ages and fitness levels.

Studies have shown that Tai Chi and Qigong can improve balance and stability, help manage the pain associated with osteoarthritis, fibromyalgia, back and neck pain, and improve quality of life in individuals with cancer and those with chronic illnesses.

There’s no time like now to start an activity routine. You and Tai Chi/Qigong may be the perfect fit!

For more information about Tai Chi and Qigong at Hackensack Meridian Health, please email IntegrativeHealth@hackensackmeridian.org.

Tuesday, May 2, 2017

Acupuncture and Headaches

By Judson Chaney, ND, LAc

The changing of the seasons from winter to spring can be a wonderful time of year. The days grow longer, warmer, and life outside begins to wake from the slumber of winter. Recently, I was enjoying time working in my garden, and I reflected on how fortunate I am to practice acupuncture. I feel this way because of the many wonderful changes and benefits I see this gentle therapy can have for patients. In my experience over the years, I have found that it works better for some conditions more than others.

One condition in particular I have seen positive and consistent benefits are in the treatment of headaches. Spring is a wonderful time, however its bounty and beauty can have a hidden effect on the observer. The unfurling of leaves, and budding of flowers can trigger allergies, and inflammation in many of us. In some, that allergy and inflammation can contribute to sinus pain, headaches, and even migraines. I have used acupuncture in my practice to effectively benefit both migraine and tension headaches, for people with short term episodes, as well as individuals who have been suffering chronically for years. I am not alone in this observation, as recent studies are indicating more and more that acupuncture can be beneficial for people suffering from chronic headaches.

One of my favorite aspects about the therapeutic use of acupuncture is that it is a drug-free, gentle, and safe approach. If you, or someone you know suffers from headaches I would encourage you to consider trying acupuncture as part of your therapeutic treatment plan. Whether the headache is from stress, tension, or just all the beautiful flowers outside, acupuncture may help ease the discomfort so you can get back to life, or in my case, back to the garden…

Please call 732.994.7855 to schedule your treatment. 

Tuesday, April 25, 2017

Blue Zones - Where People Live Longer and Better

By Emma Stafford, RN, APN-C, ACHPN, APHN-BC
Nurse Practitioner
Meridian Integrative Health & Medicine

I have just re-read the book The Blue Zones and highly recommend it to those who want to live longer and better. Our bodies are meant to live to a healthy 90 years old…in reality we are living to age 78, most with many chronic diseases. Some of us believe longevity and overall health is determined by our genes, but science is proving that environment and lifestyle are responsible for 80% of our health. The “Blue Zones” are areas in the world where a higher percentage of the population live longer. Residents of these areas are able to retain health and vitality well into their 80’s, 90’s and even into their 100’s. Brothers Dan and Tony Buettner identified these areas as Ikaria, Greece; Sardinia, Italy; Okinawa, Japan; Loma Linda, California, and the Nicoya Peninsula in Costa Rica. Their book, The Blue Zones outlines nine lessons that are associated with health and longevity:

1) Move naturally - Be active without thinking about it. Walk, bike, garden. Do not sit for more than 20 minutes. 
2) “Hara Hacha Bu” - In Okinawa, you will hear them chant this before meals. It is a reminder to stop eating when your stomach is 80% full. 
3) Plant Slant - Avoid meat and processed foods. Eat a plant-based diet with beans and meat in small and limited portions. Strict Adventists in Loma Linda, California take their dietary cues from the Bible. Genesis 1:29 “Then God said, Behold, I have given you every plant yielding seed that is on the surface of all the earth, and every tree which has fruit yielding seed: it shall be food for you.”
4) Grapes of Life - Drink red wine in moderation and always with friends or family. Three quarters of a glass for women and two glasses for men daily (no saving up for the weekend binge ).
5) Purpose Now - Take time to see the big picture. Have a strong sense of purpose and be able to articulate it – it is why you wake up in the morning. This helps reduce stress and reduces the chance of suffering from Alzheimer’s disease, arthritis, and stroke. 
6) Down Shift - Take time to relieve stress. Inflammation is the body’s reaction to stress and chronic inflammation promotes age related chronic diseases. Adopt a daily stress management program and be amazed at the changes it will make in your life.
7) Belong - Participate in a spiritual community. Studies have shown that attending religious services—even as infrequently as once a month—may make a difference in how long a person lives. 
8) Loved Ones First - Make family a priority. Invest time and energy in your children, your spouse, and your parents. Play with your children, nurture your marriage, and honor your parents in whatever way you can. 
9) Right Tribe - Be surrounded by those who share Blue Zone values. 

Small changes can make a big difference in your health—the choice is ours. Commit to changing one health behavior as outlined above and start your journey toward a longer life.

Thursday, April 20, 2017

The Most Effective Way to Prevent Heart Disease

By: Vivian A. Kominos, M.D., FACC
Integrative Physician

A study recently published in the prestigious medical journal, The Lancet, found that the Tsimane have the healthiest arteries. The Tsimane are a group of people in a remote corner of the Bolivian Jungle who farm and forage for food. Anthropologists who have studied this population for many years report that they have very few risk factors for cardiovascular disease. In a research project, over 700 Tsimane traveled for days to get CT scans of their hearts. These scans showed that most had no calcium in their arteries. Calcium is a marker for blockages in the arteries: the more calcium, the greater the risk for heart disease. The researchers found that the average 80 year old Tsimane had the arteries of a 50 year old American!

Scientists have asked the question, why are they the healthiest people on earth? Is it possible that the answer can be found by looking at their lifestyle? While processed foods make up more than half of the standard American diet, the Tsimane eat mainly wild game, fish, maize, fruits and nuts. Their diet is very low in saturated fat and most of their calories are from plants. And while the typical American walks 6,000 steps, the Tsimane walk 17,000 steps. They have to walk for their food: they hunt, fish, and farm. They live in a connected culture where they have large families and strong community connections.

Cardiologists agree that up to 80% of premature heart attacks and strokes can be prevented by living a healthy lifestyle. Maybe we can take lessons from the Tsimane. Besides diet and social connectedness, the amount of physical activity differs greatly from Americans. The Tsimane walk 8 miles a day just to live their normal every day existence while the average American walks 2.8 miles. We live in a sedentary culture where food is delivered to our doors, meetings take place over the computer, and the TV connects us to the rest of the world. More and more evidence has revealed that sitting time is dangerous. Those who sit and watch TV more than 4 hours a day have 50% greater risk of death and 125% greater risk of heart disease when compared to those that watch TV less than 2 hours a day.

I am not advocating that we give up our modern conveniences. But it is obvious that we need to move more. The current recommendations from the American College of Sports Medicine recommend that we get at least 150 minutes a week of moderate physical activity and 2 sessions of some form of resistance training that work our major muscle groups. Examples of moderate physical activity include walking 30 minutes, five times a week at a brisk 3-4 minute mile pace, riding a bike at 5-9 miles per hour, ballroom dancing, or playing doubles tennis. But suppose you cannot exercise this much? I tell all my patients that ANY exercise is better than no exercise and simply to become more active.

There are many ways to build activity into your day. Park at the farthest space in the lot rather than the closest to the store. Stand when you are on the phone. Walk to colleagues’ offices when you need to talk to them instead of texting or emailing. Create multiple work stations at work and at home so that you do not sit in the same position for extended periods. And if you do have a sedentary job, see if you can get a standing desk. And if you have to sit for long periods, get up every 20 minutes and walk for a couple minutes. When you go to concerts or games, don’t bring a chair but stand and pace. Cook your own food and go for a brief walk after eating.

I have been physically active my entire life. I started running at the age of 38 and completed 5 marathons. I no longer run long distances but run for fun, health and fitness, 15 to 20 miles a week. I hike and kayak. I practice yoga for resistance training and for the peace it creates. I would love to help you achieve a more active life and achieve more fitness and strength. Join me at one of my 2-hour “Creating an Active Life” workshops. You will not only learn about the benefits of exercise, but we will exercise together. Visit www.MeridianIntegrativeMedicine.com for more information or call 1-800-DOCTORS to register.

Tuesday, April 18, 2017

An Integrative Approach to Clean Eating - Part 3

By Nicole Cerillo, RD, LDN
Integrative Medicine Nutritionist 

The last few nutrition posts have been all about clean eating and making the commitment and New Year’s resolution to eat clean for 21 days. If you missed any of these posts you can find them here - An Integrative Approach to Clean Eating - Part 2 and Committing to Clean Eating.

Now that you have read through the introduction and the guidelines, I am sure you are thinking something like, "this sounds great—but what do I eat!?"

To keep it super simple, just eat FOOD! A whole lot of real food! Eat fresh and organic vegetables, fruits, nuts, seeds, wild fish, dairy, meats, oils, and whole (unprocessed) grains…that’s it! Let’s look into each group in more detail.

Non-Starchy Vegetables
Vegetables are your main source of nutrient dense vitamins, minerals, and fiber. Shoot for 6 cups of non-starchy vegetables each day. Non-starchy vegetables include mushrooms, tomatoes, zucchini, carrots, onions, kale, spinach, lettuce, broccoli, cauliflower, asparagus, green beans, cucumbers, etc.

Starchy Vegetables & Legumes
Starchy vegetables are also nutrient dense and are high in fiber. Include 1 or 2 servings per day (1 serving = 1/2 cup) of starchy vegetables such as pumpkin, summer and winter squash, red or white potatoes, sweet potatoes, corn, peas, beans, and lentils, which also count as a starch.

Fruits contain a high amount of antioxidants due to their bright colors and deep pigments which scavenge free radicals and can prevent against many types of cancer. Aim for 1 to 2 servings of fruits per day (1 serving = 1/2 cup berries, 1 medium apple or orange, half a grapefruit, 1 kiwi, 1 small banana, etc.)

Limit any processed dairy and switch to grass-fed butter, ghee, and unsweetened nut and seed milks (such as almond, cashew, hemp, flax, coconut, and hazelnut).

Enjoy grass-fed, organic, sustainable raised lamb, beef, bison, venison, organic chicken, duck, turkey, and pasture-raised eggs.

Fish & Seafood
Eat wild fatty fish such as sardines, mackerel, herring, black cod, and wild salmon. Shellfish, including clams, oysters, mussels, wild shrimp and scallops, and crab should be enjoyed in moderation. Avoid farm raised fish and fish high in mercury.

Nuts & Seeds
Include nuts such as almonds, macadamia, cashews, walnuts, coconut, pecans, and Brazil nuts. Include seeds such as hemp, chia, pumpkin, sesame, and flax. Nut and seed butters are also great options as long as they don’t contain added sugars or refined vegetable oils. Include 2 to 3 servings of nuts and seeds per day (1 servings = ¼ cup seeds, 1 ounce or about 22 almonds or walnuts, and 1 TBSP nut butter).

Whole Grains
Whole grains are complex carbohydrates that have abundant fiber and nutrients. Include gluten-free whole grains in moderation such as organic jasmine rice, buckwheat, quinoa, millet, arrowroot, and oats in their pure and unprocessed form.

Good Fats & Oils
Include healthy fats such as avocado, pure 85% organic dark chocolate, and olives. Increase consumption of healthy oils such as organic virgin cold-pressed unrefined coconut oil, organic extra-virgin cold-pressed olive oil, MCT oil, organic flax seed oil, organic expeller-pressed refined avocado oil, walnut oil, pumpkin seed oil, pistachio oil, and hemp oil. Aim for 1 to 2 servings per meal of healthy fats (1 serving = 1 TBSP oil, ¼ avocado, 1 ounce or 1 small square dark chocolate, and 8-10 olives).
*Portion and serving sizes may vary depending on specific body composition, energy needs, and your goals. If you have specific health goals, please make an appointment for optimal results.