Showing posts with label Vivian Kominos. Show all posts
Showing posts with label Vivian Kominos. Show all posts

Tuesday, March 27, 2018

Choosing Safer Makeup

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


About 10 years ago, I was surprised to learn that my lipstick contained lead! This brought up images of the children I had treated during my pediatric rotations with lead poisoning. Lead can lead to brain damage, kidney damage, high blood pressure and other diseases. Was the makeup company trying to poison me? It turns out that the lead in lipstick finds its way there by accident through pigments. The pigments are washed free of most of the lead leaving only a small amount. But no one knows that there is any safe amount of lead. We are exposed to lead through air, water and food so why electively add more lead through lipstick?

I went on a quest to find the safest makeup possible which led to an increased awareness of potentially toxic chemicals in other products I used for my body and my home. 

Our skin has an enormous surface area. It is the largest organ in our body. A lot of what we put on our skin can be absorbed, enabling us to use the skin as a mode of entry into the bloodstream for certain drugs. Some chemicals cannot be absorbed due to their size, but many of the products found in cleansers, moisturizers and makeup are designed to be absorbed. That is how they exert their skin plumping, wrinkle releasing and deep cleansing effects. But some of these compounds can cause skin irritations or allergies, disrupt hormones, damage skin and increase risk for cancer. 

The Environmental Working Group reviews many products and ranks them according to their safety. Although the list of unsafe ingredients is too long, there are a few general guidelines:
  • Opt for products that have few ingredients 
  • Use fewer products 
  • Just because something is labeled as “natural” or “gentle” it doesn’t mean that it is safe 
  • Avoid tricolosan, fragrance, parabens, toluenes and oxybenzone
Stay safe while enhancing your beauty and click here for more information. 

Tuesday, December 19, 2017

How to Prepare for your Medical Visit

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

Nobody knows more about you than you. Go to your medical visit prepared to get the most out of it. The face-to-face time you have with your doctor or nurse practitioner is limited so take advantage of this time. Studies have shown that patients who fill out detailed checklists prior to their visit are more satisfied with their medical care. Here is a list to get you ready:

Symptoms and concerns:  If you have specific questions or concerns, write them down and bring the list with you. If you are having any symptoms, keep a diary. Include what you are feeling, when it starts, how often it happens, how long it lasts and if anything makes it better or worse. If you are having any pain, make sure you note the type of pain (e.g., burning, sharp, dull), the location and whether it travels to any other part of the body. Also include any symptoms that occur with the pain.

Medications: Make a list of all your prescription and over-the-counter medications including dosages. You should know why you are taking these drugs. Update this list often and keep it with you in your purse or wallet.

Supplements: If you are taking any supplements, you should list the brand, the supplement and the dose.

Allergies: If you have allergies, list the reaction. For example, you may have had an itchy mouth, hives or wheezing.

Family history: It is recommended that you review your family history prior to your visit. List your relatives, living and decreased, along with ages and their diseases.

Your medical history: Make sure you are familiar with your own medical history. List dates of operations, procedures and illnesses. It is a good idea to keep a “chart” of your own history.

Your lifestyle: Be prepared to be honest about the food you eat, the amount and type of exercise you participate in, any relaxation techniques you use and how you sleep. Be honest with yourself and don’t be afraid that you will be judged.

Finally, make sure you feel comfortable with your doctor or nurse practitioner. Is she/he forming a partnership with you? If the answer is yes and if you prepare for your medical visit you will be happier with your medical care!

At Hackensack Meridian Integrative Health & Medicine, we take a patient-centered approach and partner with you to provide personalized care. We understand the provider/patient relationship is a vital component in your health, and seek to optimize wellness for your mind, body, and spirit.

Yours in good health!

Wednesday, September 20, 2017

Tips on Reducing Environmental Toxins

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

I thought I was doing a good job protecting the environment: I recycle, grow organic vegetables, try to walk for chores instead of getting in the car, and buy food that is locally sourced. Then I read that my dental floss was toxic! It is coated with PFCs - perfluorinated chemicals. These are man-made slippery compounds that help the floss glide easily between teeth. PFCs are also the substances that are used in many products to make them waterproof, stain resistant and non-sticky. They are found in clothing, cookware, carpeting and furniture that are treated with Gore-Tex, Teflon, Stainmaster, and Scotchguard.

So what is the problem with PFCs? They have been linked to thyroid and fertility problems, immune system damage and hormone instability. So if we are using dental floss, the PFCs can be absorbed in our blood. And when we dispose of articles that contain PFCs, they eventually enter the waterways where they pollute our environment. We are surrounded by many toxins besides PFCs --- bisphenol A and phthalates in plastics, pesticides in fruits and vegetables, and antibiotics in meat, to name a few. Luckily, there are just as many ways to reduce exposure to these poisons.

We each have a responsibility to care for our earth the same way we care for our bodies. Follow these 10 tips to make our homes and planet safer:
  1. Use dental floss that is made with natural fibers, such as silk or flax, which is coated with beeswax.
  2. Use only organic teas. Non-organic teas may contain toxins; the longer you steep non-organic tea, the greater the chance you will be drinking metals and poisons. 
  3. Store food in reusable, lidded glass containers to cut down on plastic, foil and paper.
  4. Recycle paper, glass and appropriate plastics. Do not put paints or electrical appliances in your regular garbage. Instead check with your town to see if they have a special and safe depository. 
  5. Buy local, seasonal and organic food. This decreases the amount of fossil fuels used to transport food. Organic farmers do not use toxic herbicides or pesticides. Shop at farmers markets. 
  6. Use public transportation, share rides, walk or bike when you can.
  7. Eat less animal protein. Raising meat uses more resources than plants.
  8. Turn off lights when you leave a room, unplug electrical appliances when not in use and turn off the faucet while brushing your teeth. Run the dishwasher and washing machine only with full loads. 
  9. Use environmentally safe cleaning products for your body and your home. Refer to ewg.org (Environmental Working Group) for specific product information. This site has a wealth of information regarding safety in everything from cosmetics to fish to sunscreens. 
  10. Start an organic vegetable garden if you have the space and time. It is easy to grow herbs and salad greens in pots even indoors by a sunny window. And if you garden, use organic pest and weed control products. Look at OMRI.org for a list of products.

Tuesday, June 13, 2017

Lowering Your Blood Pressure

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

Hypertension, defined as blood pressure greater than or equal to 140/90 mm Hg, is very common. About one in three Americans have hypertension and only about 60% of these have their blood pressure under control. Hypertension increases the risk for stroke, heart attack and kidney failure. There are many factors that contribute to the development of hypertension. Examples include: poor diet, genetics, inadequate physical activity and too much stress. In addition, blood pressure tends to increase as we age. The good news is that there are many steps you can take to control your blood pressure.

As an integrative cardiologist, I often see patients with hypertension who are looking for natural and alternative therapies and who wish to stop their medications. When I first evaluate a patient with hypertension, or pre-hypertension (130-139/81-89 mmHg) I review their medical history, family history, physical activity, work and home environment, sleep, medications and psycho-social factors. I partner with the patient in their treatment plan - which often includes modifications to diet and exercise, supplementation with micro-nutrients and stress reduction techniques. I also recommend frequent measuring of blood pressure out of the office. This is easy to do and there are many simple, affordable devices available for home use.

There are simple steps you can take right now to optimize your blood pressure:

1. Medications. Take your medications as prescribed and never stop or reduce them without your doctor’s approval. Stopping an anti-hypertensive medication suddenly can cause a “rebound” where your blood pressure rises to dangerous levels. Even if you are unhappy about needing medication, develop a gratitude practice for them. Before taking your pill, invite a smile on your face and look at it with gratitude. This causes your brain to release hormones that recruit the relaxation response. Your blood pressure will lower naturally allowing your medication to work better. Over time you may be able to reduce the amount of medication that you need.

2. Nutrition. Eat a DASH (Dietary Approaches to Stop Hypertension - https://www.nhlbi.nih.gov/health/health-topics/topics/dash/) or Mediterranean style diet (http://www.mediterraneandiet.com/). This eating pattern is high in fresh vegetables and whole grains and low in processed foods, salt, saturated and trans fats, and sugar. Too much sugar causes increased levels of the stress hormone, cortisol that increases blood pressure.

3. Relaxation. All of us have stressors. The stress response is a protective mechanism that gets our body ready to flee or fight danger. The problem is that we often view minor stressors as major catastrophes. Too much stress causes an increase in blood pressure, damages blood vessel function over time, causes dangerous changes to the brain, and destroys our mood. There are simple steps to reduce stress. Try the 4-7-8 breathing technique (Inhale through your nose to the count of 4; hold your breath for a count of 7; exhale through your mouth to the count of 8) or learn how to elicit the relaxation response.

4. Biofeedback. There are several devices on the market that can help reduce blood pressure. One that is specifically approved for blood pressure reduction is RESPeRATE (http://www.resperate.com/shop-resperate). This is an easy to use breathing assisted device that uses a 2 tone melody that causes breathing to become slower and deeper. When used for 15 to 20 minutes most days of the week, BP can be reduced by up to 10 mm Hg!

5. Supplements. Although there are several supplements that can help reduce blood pressure, it is best to discuss these with your integrative practitioner to see what is best for you. Beware that taking too many supplements can cause dangerous interactions. And some supplements such as ephedra, licorice, ginseng, yohimbine, and kola nut can raise blood pressure.

6. Exercise. I cannot say enough good things about exercise. Any increase in physical activity will help reduce blood pressure, improve sleep, increase well-being and reduce risk for most chronic diseases including some cancers.

7. Sleep. Like physical activity, sleep is necessary for health. Practice good sleep hygiene. Stop looking at TV and all devices at least an hour prior to going to bed. Develop relaxing night time rituals such as meditation or breath work, read relaxing material or write in a gratitude journal. Go to bed when you are sleepy. And develop a regular bedtime schedule. If you suffer from excessive snoring, daytime sleepiness and insomnia, get help from a sleep specialist.

8. Excessive alcohol. Drinking more than two alcoholic drinks daily for men or one daily for women can increase blood pressure.

9. Prescription and over the counter drugs. Tell your doctor EVERYTHING you are taking. Oral contraceptives, steroids, ibuprofen and decongestants for example increase blood pressure.

What can you do right now? Put a smile on your face. Your brain will think you are relaxed even if you are not. The relaxation response will be activated, lowering your blood pressure and improving your health.

For more information, visit our website at MeridianIntegrativeMedicine.com and follow us on Facebook and Twitter.

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, February 28, 2017

Staying Healthy During the Winter

By Vivian A. Kominos, M.D., FACC
Integrative Medicine Physician
Meridian Integrative Health & Medicine

The winter is a festive time, but it also is a time when many of us get sick. What causes winter coughs and sniffles? The misconception is that cold temperatures cause illness. Dry air and cold temperatures can constrict nasal blood vessels and cause mucosal dryness, providing easy entry for viruses and bacteria. But this is not the main cause of winter ailments. Our behavior is mainly responsible. We travel in big groups in trains or planes with poor air quality. We attend large gatherings where we shake hands, hug and kiss. We stay indoors, often in close contact with others who are sick, with stale and recycled air. These factors along with stress, poor nutrition from food high in sugar, and decreased physical exercise causes our immune system to become taxed and it is easier to catch colds. But there are things you can do to prevent illness.

1. Get fresh air. Our homes and offices are well insulated against drafts. This is good for our heating bills but not for our air quality. Opening the windows and doors, even for a few brief moments helps to disperse germs. Go out to breathe fresh air at lunchtime, during breaks and after work. This is good for the lungs and the soul.
2. Continue to exercise. We tend to become less active with cold weather. But physical activity is important for our bodies and souls. It improves our sleep, brain function and releases anti-inflammatory hormones that help us fight illness.
3. Get enough sleep. An occasional late night of partying is not harmful. But staying up late night after night shopping, planning, and drinking can wreak havoc on our normal sleep cycle.
4. Practice stress reduction techniques. Get into the habit of meditating daily. A good way to start is by practicing the relaxation response for 5 minutes in the AM and PM. Click here to view Dr. Herbert Benson. Or learn some simple breathing techniques that help active the relaxation response. Look at Dr. Weil’s 4-7-8 relaxation breathing technique.
5. Wash your hands often. Anything you touch contains viruses and bacteria. After shaking hands, touch anything in public use (think door knobs, light switches) use simple soap and water to wash away the germs. And keep your hands away from your eyes, nose and mouth.
6. Eat healthy food and drink enough water. Stay away from sugar, eat lots of vegetables and fruit and stay well hydrated. Whole food is good medicine!

Tuesday, February 14, 2017

Heart Disease in Women

By Vivian A. Kominos, M.D., FACC
Integrative Medicine Physician
Meridian Integrative Health & Medicine

The number one killer of women is heart disease. Yet when I talk to women, many cite breast cancer as their chief health concern. Here are the statistics: breast cancer kills 1 out of 36 women; heart disease kills 1 in 3. In fact, heart disease kills more women than all cancers put together. We need to increase awareness of heart disease as a major threat and promote research specifically for women’s heart disease.

When it comes to the heart, women are not just small men. Our hearts are different than men’s hearts in many ways. Men’s heart disease often presents with the “classic” heart attack: grabbing or severe pain in the center of the chest. Women also often feel chest discomfort if they are having a heart attack; however, they often get other symptoms such as fatigue, shortness of breath, lightheadedness, or palpitations. In addition, a woman’s arteries may look different than a man’s. Women, more often than men, have a diffuse or mild blockage in the heart’s arteries. Therefore, on angiograms, a woman’s arteries may look normal. Yet, the arteries may still be diseased and not dilate properly to allow oxygen-rich blood to enter the healthy muscle cells.

Many women with chest discomfort are told that their symptoms are not from heart disease. Yet, studies researching women’s hearts from the Women’s Ischemia Syndrome Evaluation reveal that when a woman has chest pain and mild or no blockage, her chance of dying from heart disease doubles and quadruples compared to a woman with no chest pain.

So what is the good news? We know from research that MOST HEART DISEASE CAN BE PREVENTED with a healthy lifestyle!

If you smoke, stop! A woman who smokes has six times the risk, twice that of a male smoker, of dying from heart disease compared to a non-smoker. You can get help to quit: check out NJ QUITS or try the app “Craving to Quit.”
Eat mostly a plant-based diet. Stop all soda, decrease added sugar and processed foods. Attend one of our nutrition lectures that are given throughout the year.
Increase your exercise. Sitting time is dangerous. A recent study of at least one million people found that those who sit more than three hours a day have a higher chance of dying from heart disease. The connections between the mind and heart are very powerful.
Reduce your stress. Be optimistic, surround yourself with good people, go out in nature, and learn to meditate. Find what brings you joy.
Get adequate sleep. Insomnia increases your risk for heart disease, obesity, arthritis.

Check out our website (www.MeridianIntegrativeMedicine.com) for more information on how you can get help with improving your health. And most importantly, know your body. If you think that something feels wrong, get help.

Tuesday, January 31, 2017

Vivian Kominos, M.D. Discusses Integrative Health & Medicine on WOBM


The Hackensack Meridian Integrative Health & Medicine program, now part of the Hackensack Meridian Health family, focuses on the health and wellness of the whole person – mind, body and spirit. We address the impact of lifestyle, environment, and genetics on an individual’s health and well-being, and understand that the provider/patient relationship is a vital component in the healing process. Through personalized care, our program goes beyond solely treating symptoms of an illness or managing chronic disease, but seeks to optimize health over one’s lifespan addressing the unique circumstances of the individual. Integrative medicine goes beyond treating patients’ immediate symptoms to address the complete range of physical, emotional, mental, social, spiritual and environmental influences that impact day-to-day health. We make use of all appropriate therapies, including conventional evidence-based medicine as well as complementary treatments such as acupuncture, nutrition counseling, health coaching, health psychology, movement therapy, and massage therapy.

Tuesday, November 29, 2016

Yoga and the Heart

By Vivian A. Kominos, M.D., FACC
Integrative Medicine Physician
Meridian Integrative Health & Medicine

I started practicing yoga over 20 years ago while training for my first long distance race, a half marathon. I noticed that I was becoming stiff after my runs. I thought that yoga would help me regain flexibility. I quickly realized that yoga’s benefits exceeded the physical: yoga made me calmer and less anxious. My muscles became stronger and my mind became tranquil. Soon I was craving my yoga practice as much as my runs. 

Yoga originated in ancient India for physical and spiritual fitness. Yoga incorporates movement poses known as asanas, breathing exercises or pranayama and meditation or dhyana. Recent studies found that yoga reduces many of the risk factors for heart disease: it improves glucose, reduces blood pressure, decreases weight and even increases lung capacity. Even more important may be the relaxation that results: yoga reduces stress, one of the most potent risk factors for heart disease. 

Yoga has become very popular in the United States and the number and types of classes available can be confusing. The important thing to remember is that yoga is not a competition and that you do not have to twist like a pretzel for it to be effective. Anyone can practice yoga regardless of fitness or flexibility. Look for a class suited to you. This may be a therapeutic class where you may be sitting on a chair or it may be an energetic power flow with advanced poses. All good yoga classes begin with the teacher asking if there are any injuries or problems. The class starts with breath work and meditation followed by poses and movements that gently stretch and strengthen the muscles. The ending incorporates a closing meditation called savasana

The National Center for Complementary and Integrative Health is a good resource to learn more about the benefits of yoga: https://nccih.nih.gov/health/yoga/introduction.htm. And remember, anything that is good for the heart is good for the entire body, mind and spirit.