Some how it is December 2017. In a typical weekday evening at home, I am reminded why this time of year has the uncanny ability to fill your heart with cheer….and boil it over with overwhelm and stress.
I was home later than I wanted to be. Unable to wrap up completely at work, doing the best I can to meet the needs of here and now and today. As always. I walk in. My kids are cute, hungry, 3 and 5 years old. They go from adorable to hangry monsters within the first 20 minutes of my arrival. I had wanted to make the gingerbread man due at school with my daughter. She is in Kindergarten and helping her with her projects is a precious experience, one I consciously try to fit in my schedule as busy as it can be. She starts gluing and using glitter (of course) on the kitchen table and for a moment I am startled by the rapid sequence of mess making that ensues. I go to say something and then catch myself. I remember, this is on the N.A.B.D. list. Not A Big Deal.
We started the NABD list when my son turned 3. Three is precious, and terribly challenging. My son can be the worlds cutest human and then a beast within seconds. When the threenager collided with the emotional mood swings of a kindergartener we coined the term. I have said countless times in the last six months…
“Honey, there are BDs (Big Deals) and NABDs which one is this?” That is right, NABD. Not A Big Deal. Almost always.
As I sit to join the gingerbread project it becomes apparent that food must appear immediately in front of the 3 year old. But the window was missed and now he is in his room having a fit. I am whisked to cooking. To be fair, I am lucky and this is not my typical role. My husband is a phenomenal cook. I will forever be the mom that just “made food.” Healthy, yes. Tasty, not always. But my husband is working late tonight. I cook fast and furiously and have tacos on the table in no time. Phew. We can all eat and relax. We talk about the good things and the challenges of our day.
The glitter is moved to the appropriate art table and we dive in. There is glitter everywhere now, a little on each surface and the floor. Gingerbread man turns out beautiful. Turns out this is a BD (Big Deal), doing art with your child. I am amazed at the calm it brings me to come into the moment and glue the fine details when she needs my help. Then the 3 year old gets wind of the glitter project and more glitter goes everywhere. Of course. Not A Big Deal.
I am reminded of the book, “Don’t Sweat the Small Stuff” by Richard Carlson. I never read it but always wished I had. I felt I learned it all in the title. I probably missed some key elements since I just figured out the N.A.B.D. list and the book was published in 1997. Yes, that was 20 years ago.
My husband comes home. The dog, who is a hundred pound eight year old fur baby wags his tail vigorously in a very cute fashion. He also happens to whack the closest child cup that spills milk across the entire room. Couch, floor, art table. Luckily not the precious gingerbread man was safe, having moved to a higher surface for stabilization and drying. For a moment I look at the mess and think, “Are you kidding me?” Then I remind myself. Spilled milk. And you know what they say about spilled milk? Not worth crying over. Not A Big Deal.
It is the holidays, officially. What can you let go of? What can get crossed off the infinite “List” of “to do” so that you can have some more moments “to be”? In giving ourselves permission to add to our N.A.B.D. list we make room for the things that are a B.D.
Let the Big Deals sink in. If it is Not A Big Deal, let it go.
When I considered getting out of corporate medicine, seeing one patient every 15 minutes day in and day out, I was excited by the possibilities I saw in Direct Primary Care. But I’m not the type to recommend a big change that I haven’t tried myself, so I changed my employer based insurance for myself and my family from a low deductible plan to a high deductible plan combined with a Direct Primary Care Membership. I was amazed that by switching, not only did we have a better health care experience, we saved $183 a pay period, or $366 a month by making the simple move from a low deductible to a high deductible plan.
This year, I decided to price out on the health exchange how the math might work out for a family in 2018 converting from a low deductible plan to a high deductible with Direct Primary Care.
Certainly, some people choose Direct Primary Care because they want a stable provider who is going to be their doctor no matter what. Others choose it because of the customer service: they value getting an appointment when they need one and talking directly to their doctor when they are concerned about something. For many, however, the deciding factor is financial.
Let’s Do some Driect Primary Care Math
I performed a search on the Colorado exchange, Connect for Health Colorado (http://connectforhealthco.com/). Using a family of four as my example, I searched for plans in Denver for “low need” patients, without a subsidy. Here’s what I found:
So the total savings by switching to Direct Osteopathic Primary Care with High Deductible Plan is $763.36 per month! That is a 42% savings!
If that family put all of that saved premium into a savings account, they’d have an extra $9,160.32 per year to cover emergencies and costs subject to their deductibles.
Regular office visits, wellness visit, most urgent care issues and day to day care would be covered through Direct Osteopathic Primary Care. Health insurance is then left to act like car insurance, to cover you when you an emergency hits. For daily savings, at Direct Osteopathic we use our discounted lab services and our in house pharmacy which can beat the big box pharmacies on generic medications. For example, our basic wellness lab panel is $29 and we get Flonase for $8.
For families looking for even more savings, Direct Primary Care can be combined with a cost-sharing insurance plan as an alternative to traditional health insurance. One of them, Liberty Health, actually reimburses for a portion of the monthly membership fees (https://www.libertyhealthshare.org/).
Now that Open Enrollment has come around again, think about how you might save if you think outside the box about healthcare this year. Even if you are lucky enough to have insurance through your employer look closely, you too might save by switching to a high-deductible plan plus Direct Primary Care.
At Direct Osteopathic Primary Care we want to keep your out-of-pocket costs low. We are built on core values of cost effectiveness and cost transparency. It's the way Direct Primary Care was started. Personally, I can never turn back.
Its that time of year again! The viruses and bacteria just had a big party because the lovely small people are back in school creating a perfect environment for spreading germs. Even if you are shielded from the littles, you are bound to come into contact with some one with a cough, a cold or a mystery nose over the next few months.
As an Osteopath, I believe the body is always trying to heal itself. Its not a matter of running around the world in a bubble and not getting exposed. The question is, how do I give myself the building blocks so even if I encounter germs, I can fight them off? My daughter and I talk about this beauty of the immune system as “the fighters”. She once asked, “do your fighters have swords?” Here’s how to arm yours for the winter battle.
Getting a cold isn’t the worst. But getting the real respiratory flu or influenza is terribly uncomfortable (sometimes life threatening) and can keep you down for weeks. If you are older than 50, have a chronic illness or are a kid, getting a flu shot is one of the best things you can do. At Direct Osteopathic, we have a limited supply for ages 3 to 64. We are using Fluzone, quadrivalent (four strains) in preservative free, single dose vials.
Text “I want a flu shot” to the office at 303-422-2236 and we will ear mark one for you. First come first serve. We have a limited supply, $25 each. If you are over 65 or want your insurance to pay for it, get the shot at your local pharmacy.
Cheers to your health all winter long.
Last weekend I was lucky to attend a conference with pharmacists, physicians, naturopaths and holistic practitioners literally from around the world. Several speakers were from Europe and the UK. There was also a gastroenterologists, neurologist and several general practitioners practicing holistic medicine like myself. This was the first time I have been to an entire conference on one treatment, low dose naltrexone or LDN.
I started using LDN several years ago or so when I came back from an integrative conference at Scripps Institute. The chronic pain specialist spoke on alternatives to narcotics for chronic pain. He mentioned things I had heard about like Tai Chi and something new, LDN. Around that time an initial study came out using it for patients with fibromyalgia who often have chronic pain and sleep that is not restorative. The first time I used it, I had an adventurous and insightful patient that noted better sleep, improved mood and decreased pain.
The compounding pharmacist that was making the medication for this patient and I became friends over this novel therapeutic and she asked if I had ever used it for Hashimoto’s or autoimmune thyroiditis. I said I had not. The pharmacist, Wendy Medved PharmD, sent articles my way about its mechanisms and how it worked in auto-immune disease. It was from there that I learned how many applications this new option could offer my patients. It has served many of my hypothyroid patients since.
LDN is made from an old generic drug naltrexone. Naltrexone has long been used for its opioid antagonist effects. If you overdosed on opiates or heroin your life would depend on this medicine or its cousin naloxone, 100 mg would be the dose. If you suffer from alcoholism, we can use it at 50 mg to help curb the urge to drink. When we start LDN we start at 0.5 to 1.5 mg and work up slowly to 4.5 mg. That is why is it compounded. And because it is compounded it adds a bit on the monthly budget ($45-60 depending on where you get it and getting to the right dose). The other problem with compounded medications is that industry isn’t motivated to study them because they can’t be “blockbuster” drugs lining their pocket books.
I went to the conference last weekend put on by a consortium of pharmacists, doctors and others that have been looking to collect research and data on the many applications of this new treatment. I went primarily to find out:
And guess what? I learned!
I am excited to share with exploration of the wonderful world of medicine with those of you that follow these blogs and articles. Like all medications, if you don’t work with me, talk to your doctor before trying something new like this. Do your research on why it might (or might not) be good for you.
Read the book: https://ldnresearchtrust.org/ldn-book
Check out the research: https://ldnresearchtrust.org/ldn-clinical-trials
Never stop learning.
Do you remember the very first time you could perceive stress? Chances are you can look back on your childhood and remember a time you were impacted by stress around you. Perhaps you can marvel at how you were not impacted the presence of stress. But do you remember when you could first feel it in your body? When you noticed its presence in your mind? Are there any illnesses now that you can attribute to stress in your life? Lets deconstruct stress together and figure out if we can find the line where stress can be good but before it weighs you down.
Originally, I intended to write about berberine and bergamot, two of my favorite new supplements for heart cholesterol lowering. Or perhaps talk about turmeric, known for its potent anti-inflammatory effects, and its ability to lower your dangerous cholesterol. These topics, interesting as they are, will be covered in depth at my upcoming talk, Taming the Fire of Cholesterol. Stay tuned for details.
This blog changed, however, when my aunt died this week. Suddenly, in her sleep. It was an unexpected death, cause to be determined. As a physician I suspect a stroke or a heart attack. Either way, cholesterol is the common denominator. Losing my aunt reminds me how powerful the heart is as an emotional center, something we physicians do not often discuss. In the wake of her death, the hearts of all of those close to her are affected. In fact, her sister and best friend had a mild heart attack later that same day.
When I do Osteopathic treatments, I often note tightness in the fascia, muscles and ribs that brace the back of the heart, the mid and upper back. So many of us hold tension here. I place a hand of the tight fascia and find the direction of ease. I take musculoskeletal connections to the heart where they want to go to rest and unwind. As I do this, a natural conversation often arises about what lends to this tightness. What are the stressors caving in on you? How are you handling it? How are you taking care of yourself? Are you living in line with your passions, your goals, your dreams? Can you hold your own heart in a loving embrace?
There are books on stress management that I love by a company I have known for years, HeartMath. HeartMath talks about “congruence” and “heart rate variability”. They have biofeedback sensors and fancy computer games where people can learn how to live in “sync” with their heart. HeartMath has become so prominent in the field that when I was in medical school, cardiologists were implementing their programs to help patients practice techniques to lower their stress levels and prevent second heart attacks. They have research to prove that you can calm down erratic heart patterns and actually physically lower heart disease risk through mindful awareness and slowing down. These books and techniques remind us of the powerful intersection between our physical and emotional selves.
Stress is pervasive in our culture and epidemic in our time. My next blog series will likely be on stress and its effects. Our hearts are emotional centers that track our stress physiologically. It is important to remember that hearts need our attention. Hearts need healthy food. Hearts need oxygen, exercise and exertion (30 minutes 5 days a week is what the American Heart Association recommends to be exact). Hearts need to be in sync with our rhythm, at peace in our chest. Hearts need “in fill” time as much as they need connection with others.
When I was in medical school, I was fascinated with everything I learned. When we studied the heart I was learning the anatomy, electricity and various sounds it makes. One night, in my dorm room, I placed my stethoscope on my chest as I lay down to sleep. Lub dub lub dub. That is the sound it makes. I listened and listened. What an honor it is that our hearts keep beating, never stopping, until the end.
Next time you want a little practice to get in touch with your heart try this. It's from adapted from the work of HeartMath:
Shift and Activate
Rest comfortably, sitting, standing or laying down.
Close your eyes.
Shift your breathing to your belly.
Activate a positive emotion. Any positive emotion will do, no matter how big or how small.
How you feel seeing a loved one.
Watching a beautiful rainbow.
Drinking your morning cup of coffee.
Feel the positive emotion through your chest, expanding.
Breathe with it as long as you can.
Open your eyes.
If you want more practices like this, the heart will be the subject of our next Mindful Mondays on Monday July 10 at 5:15 PM at the office, 16 Lakeside Lane. If you are a member, this event is free. Join us and bring a friend who will love us too for a donation. Please share this email, share our invite on social media and spread the word.
Last week we discussed cholesterol and the debate about when and what type of treatment is necessary. Now what do you do when it is clear that high cholesterol is a health concern? One thing you can do is put your numbers in this calculator and see what the standard medical community thinks: are you at risk?
Remember, if your risk of heart disease or stroke over the next 10 years is over 5 to 7.5%, a medication in the class of "statin" will be recommended. Check your numbers yourself with your last cholesterol reading and a recent blood pressure.
Play with this this calculator, look at how high your risk is now, then age yourself 5-10 years on the calculator. This tells you that even with numbers that are low risk now, age itself is a powerful risk factor for heart disease and in ten years you may be talking statin medications with your doctor if you don't get a hold of the factors that influence your health now.
This week we will start our supplement spotlights. When people go to the health food store to look for alternative options to standard prescription on cholesterol they will encounter a selection. How do you know what to choose? I will give you a review of a few of my favorites over the next few weeks.
Please remember these statements are not supported by the FDA and supplements are unregulated. Do not purchase supplements for cardiovascular disease without consulting your physician (or come see me, Dr Brie!) to see what is right for you. Supplement quality varies greatly, buying pharmaceutical grade supplements that are third party tested and verified are best. I have options for these quality therapeutic brands, and pass along the whole sale costs I receive to current members. It is always best to check with your doctor before purchasing something at a grocery store or GNC.
Red Yeast Rice
Red yeast rice is a supplement made from fermented rice. It creates a mold that grows a compound very similar in structure to statin medications. In fact, it is considered a naturally occurring statin compound. Statins and Red Yeast Rice, act on the liver to help decrease cholesterol production.
What is good about RYR?
Red yeast rice is good because it does act as a "weak statin". It will help decrease cholesterol production in the liver. It may have the other benefits that the statin class of medications has as well such as lowering inflammation and stabilizing plaques although further research is warranted. If your doctor says that you really "should" be taking a statin but you choose not to, this is good option. This treatment option primarily targets lowering your LDL or dangerous cholesterol. Some studies have shown that people who are statin-intolerant have been able to take RYR without untoward side effects, making it an important alternative option.
What is bad about RYR?
RYR quality varies a lot. There a an excellent consumer lab that reviews and verifies that supplement ingredients compared to labeling and detects for contamination. This review of RYR shows significant variation in quality referencing standard available store brands.
The consumer lab review shows a Whole Foods brand that is contaminated with citrinin, a potential toxin, and other brands that have unusually low amounts of the effective component, the monacolins. Some would argue that if you are going to take a statin, you might as well take one that is regulated, tested, and formulated to be exactly what it should be, not something in disguise. The other problem is that this medication has one strength, and at that dose it might not be enough to make the clinical impact you want to see.
As with all statin medications, RYR can deplete your body of the anti-oxidant coenzyme Q10. If you are taking RYR or a stain, it is best to take it wth CoQ10 because it can lower your risk of side effects such as muscle soreness that can come along with the medication effect.
The Bottom Line:
Red yeast rice might be good if you feel very strongly that you want a natural supplement and not a pharmaceutical. However, the quality of the RYR over the counter counter is variable so do your research or ask me where you can purchase wisely. If your cardiovascular disease risk is high, it may be safer and more cost effective to consider a traditional statin medication along with CoQ 10.
Information in this article references the following studies:
It started with eggs. Egg whites became the rage. "Heart Healthy" appeared on packages. Lowering your cholesterol seemed directly linked to saturated fat. It was the 1990s. Actively involved in the integrative medicine community in the Bay Area at the time, I listened to several talks by Dean Ornish M.D., who was reversing heart disease with a plant based diet.
Fast forward. It is 2017. Paleo and primal eating are the rage. Fat is back in, in large amounts. People have steered toward a protein rich low carb diet, and guess what? Some people lower their cholesterol that way.
It turns out that the story between your cholesterol, particularly the LDL cholesterol and your diet (including fats and carbs) is a much more complicated story than we thought 20 years ago.
When I was in my training we were taught to monitor cholesterol and get people to their "goal" LDL (the "dangerous cholesterol"). If you had had a stroke, a previous heart attack or diabetes your goal was under 70. For most people optimal was 100-130. If you had risk factors: family history of a male with a heart attack below 45 or a female with heart attack below 55 we wanted you lower than 130. If you were a smoker or had high blood pressure we wanted you below 130. If you had a good level of good cholesterol, we subtracted a point on your scale of risk factors. If you were older than 45 as a male or 55 as a female you were losing your protective traits of youth and your risk went up. It was a simple, mathematical calculation of goals. If there were no risk factors your LDL could be as high as 160 to 190 before physicians were talking medication management.
A few years ago there was a major over haul of this approach. The cardiovascular specialists were trying to make sense of people that had "good" cholesterol numbers, but still died of heart attacks. Or the ones with "bad" LDL numbers and lived many years, sometimes unmedicated.
To address this Doctors developed an algorithm and put out a calculator called the ASCVD risk estimator, taking into effect the big risk factors we know effect heart disease: age, high blood pressure, smoking and diabetes. They worked to move physicians away from a number-driven approach for LDL goals and instead wanted us to focus on the estimated percentage risk for heart disease over a ten year period. They determined that on the ASCVD risk calculator, anyone with greater than a 5% risk of having a heart attack in the next 10 years should be on a statin medication.
That is when the controversy came. Since the ASCVD risk calculator came out, I have determined the risk percentage with every cholesterol reading I've taken. One day I realized that it was over 5% in Caucasian males over 55 so often that, according to the guidelines, I should be recommending statins regularly.
So I decided to play with the values. I attempted to make the perfect 55 year old Caucasian male. One that was 55, with HDL (good) cholesterol as high as the calculator would let me guesstimate, total cholesterol 150 (very low), and of course a non smoker, non diabetic, and non hypertensive. That imaginary person didn't get the recommendation for a statin. Practically everyone else did.
I was not the only practitioner that held this grievance with the risk based approach. It seems, with 5% as the threshold, the risk for heart disease for any man over 55 or woman over 65 is so high that we might as well put statin medications in the water.
Luckily, the cardiologists have moved the mark and now 7.5% is an acceptable risk before medication is deemed necessary. Good thing, because I have been letting healthy five percenters off the hook for years.
The truth is, science continues to understand more and more about the complexity of cholesterol and heart disease. We now know there are dangerous forms of your LDL and less dangerous forms. There are attributes we can measure on your HDL to see if it is capable of doing its job to sweep up the cholesterol out of the plaques in your arteries (that is what makes it good). There is a role of inflammation, and we have markers in blood work we can follow to see if you are at risk for heart disease based on inflammation or inherited types of dangerous LDL known as Lp(a). For years I have referred to this testing as "fancy cholesterol" tests. Indeed, they cost more money but the value of further dissecting your risk is worth it in my mind.
Not everyone needs a fancy cholesterol test. However, if your cholesterol is high or you have the major risk factors (family history of early heart attack, smoking, diabetes, high blood pressure) you should talk with me about getting the in depth test at least once. We can even find out if you are someone who is more likely to respond to diet changes or if you are more genetically susceptible to getting a side effect front the statin medications.
Many people come to me because I try to manage cholesterol holistically as often as possible, and I do not force statin medications on patients that do not want to take them. I do see a role for these medications. They stabilize plaques, reduce cholesterol numbers effectively, and decrease inflammation in your arteries. I also recognize that medications have risks, and statins (Lipitor, etc) are no exception. There is a time and place for everything and sometimes we need this tool.
However, if you want to manage your cholesterol on your own, without a statin, I can help! I have been studying effective alternatives for years and actively use a variety of supplements and lifestyle changes to modify cardiovascular risk. We can do a Calcium Score, which is a coronary (heart) artery cat scan that helps us know if you have evidence of current heart disease. With this test, we can decide together if your risk of heart disease is high enough that you need the traditional medications, or if we have room to try some of the alternative options.
Stay tuned over the next several weeks for highlights from some of my favorite options for an alternative management of cholesterol. But please, don't stop any medications without consulting your doctor. If you aren't seeing me now, think about joining the practice or coming for a consultation on this issue so we can decide together the best approach for you. At the end of the day, personalized medicine is best, and I want to make sure we get this right.
I went to the annual meeting of the American Academy of Osteopathy this past month at the Broadmoor in Colorado Springs. It is a convention that meets every three years here in Colorado and other years on either coast. I have attended all but two over the past 13 years.
Osteopathic medicine is one steeped in tradition and art. We follow lineages of teachers and are apprentices of masters. At the Broadmoor in years past I had coffee with some of the "greats" in my profession while they attended the conference in their 80s and 90s: the late Viola Frymann D.O. FAAO and Stanley Schiowitz D.O. FAAO to think of a few.
The quintessential component of the conference is always the enthusiasm and participation of the students. When I was a first year medical student 2 people from my class at Touro University College of Osteopathic Medicine in Vallejo, CA attended. Now, annually 50-75 students from Touro attend. The students are in awe of the magic of our hands on art, they are seeking expertise and kernels of treatment recommendations. There are nights when "stars and stripes" get together and Osteopaths practice manipulation of each other until the wee hours of the night, hand over hand with the great minds and hearts in our field.
This year the conference changed for me. It is the first year in my career that I have given more to students than I have received myself in teaching from mentors. I attended a few great sessions as usual. However, I also assisted as a "table trainer" in two sessions and spoke on a panel to students about "how to start your own practice". I returned to Denver energized and rejuvenated just as I have each year. Though the energy was flowing out to students, as always, it flows back in.
Osteopaths listen to and seek the Health. Our founder, AT Still D.O. is famous for saying "To find health should be the object of the doctor. Anyone can find disease". Isn't it true, that imbalance in our lives or our health is often more obvious than balance? As Osteopaths we do not simply focus on the aspects of western medicine that lend to the "find it, fix it, make it go away" approach. While we want our patients to feel better, we seek sustainable solutions, the root cause or as traditional Osteopaths call it, the "key lesion" from which the imbalance arises that blocks true Health from flourishing.
Another year has passed and this year a new tradition has started. It is time that Dr Brie Seefeldt walked the two way part of the path where giving and receiving flow together. May all the students that walk after me see the light of my teachers in me.
I have a number of male patients who are near and dear to my heart. Do not feel left behind but this February, in honor of the heart, I explore what lies in the center: moms and babies.
I became interested in women's health at UC Berkeley circa 1998. The "democratic education at Cal" series were student taught, student run courses. I joined, and later taught, the women's health and sexuality course. We learned about women's bodies, women's wisdom and women's rights from health care to the rights of sex workers in San Francisco. After being involved in the strong circle of women that ran this class, after graduating I recreated and joined several monthly women's circle when I moved to Santa Cruz, CA.
In medical school, I was fascinated with the reproductive health education. This is when my interest in birth sprouted. As a third year medical student I worked at Rose Midwifery, a rotation I had sought out on my own. I remember sleeping in the call room after seeing my first birth, exhausted and exhilarated.
During my training I actively pursued catching babies. In fact, for residency, I applied to 25 programs to be an obstetrician and only 5 family medicine programs! I heavily considered being an OB/GYN but knew in my heart of hearts that I was not a surgeon, I was a family doctor. I recognized the value and importance of men and their role in many families, their need for a trusting provider. Plus, at that point, I had fallen in love with babies.
As a third year medical student at Presbyterian St Luke's hospital, I worked with babies that were admitted to the hospital. I watched lumbar punctures (spinal taps) on babies less than a few months old. I saw a child with meningitis after a severe ear infection. My very first month of residency training was at The Children's Hospital and I fell deeply in love with the little people and their incredible resilience in the face of grave illness. I knew then that my passion for women's health was reflected in my love for children, mirror images of the same flame.
When I was in my training, and even throughout my early career, I would tear up often at the moment of placing a newborn baby on moms belly. As the mother and father wept with joy, I fought back tears many times, my heart glowing with theirs. So many times after I left a birth, I would soar on the sacred and beautiful moments I was able to share with families and single mothers. I have watched many women bravely face labor and delivery and then vulnerably hold their new little life.
Becoming a mom myself, growing a small human inside me and giving birth was a fascinating and incredible experience. Considering I was fascinated with women's health since I was eighteen, and gave birth to my first child fourteen years later, it was long over due for me to walk in the path of the mother and not the doctor. As we all know, there are not words to describe the depth of this part of the journey.
Now a new iteration of my passion for moms and babies is blossoming. Starting March 7 Keiko Yoneyama-Sims LMFT and myself will host a post-partum women's workshop series: The Fourth Trimester: Supporting Life with your Little one. Culminating my work with women and their reproduction we step into the next phase, finding balance within ones self and re-entering your life as a mother. As always, I continue to treat mothers and babies everyday from a holistic perspective, guiding health back to center with herbs, supplements, lifestyle changes or medications. Empowering women to keep their strength and resilience is one of my greatest clinical joys.
As I write I am on my way to a seminar on safe, bioidentical hormone replacement therapy. I am paving the way for the next portion of the path, menopause. (Don't worry men, there is a seminar on male hormone replacement which I plan to study intensely as well).
A deep thank you to all of the families that have graced my path as a physician and mother.
May we step into the balance and find the Health together.
A poem from my journal just for you:
I walk in the confidence of
My own shadow.
Finding my voice.
Finding my place.
Balance is not a state of perfection.
It is a state of holding all of the balls in space,
knowing they will drop from time to time
But picking them back up
To keep going.
Some days I am
Deeply proud of where I am
I am, what you might call,
A strong woman.
Not strong like an immigrant woman,
Or a minority woman
Fighting the good fight.
Not strong like a single mom
Or a widow
Or a mother who has lost a child
Not strong like someone
Who is trans living fully out of the closet.
Those are life changes paths I know
That I know
But I am strong.
Like a girl who grew up
A big fish in a small sea
Who made it to an ocean
But did not get lost.
I am strong like a woman who has seen the
Ugliness of men
And survived it.
I am strong like a woman who can get up and
Time and time again.
When I am exhausted.
I can put in another load of laundry.
I can get up in the middle of a tired night and tend
To my children
Or deliver a baby.
I can sleep less and do more.
I can nourish and rest.
I can dig deep.
When I do not want to
I hope that my children
Will see me for my strength.
Will see me for my resilience.
Will know that I am not perfect.
And love me in my frailty and vulnerability.
For now I walk on