Stone Turtle HealthNaturopathic Medicine and Massage Therapy for the Whole Family

A new article on Newsweek's website: Why The Campaign to Stop America's Obesity Crisis is Failing talks about the same things that our friends over at The Metabolic Effect have been talking about for years! Namely, all calories are not created equal. Calories affect insulin levels differently. Insulin unlocks the door to fat cells, allowing them to uptake blood sugar and store it, making themselves (and the humans who have them) larger over time. 

This is why the basic principles of the Metabolic Effect diet (eating whole foods that do not significantly spike your blood sugar, and therefore your insulin) are sound principles to live by. Eating lean proteins and complex carbohydrates from fruits & vegetables are two very good ways to do this. The low glycemic index food, as they're called, are much preferable to the empty calories of refined and processed sugars and carbohydrates.

Another point to make is to look at "real" foods versus low-calorie or low-fat foods. Our bodies know how to process the proteins, fats and sugars found in whipped cream, for example, including our satiety sensors, which tell us when we're full. But what does our body do with the list of water, hydrogentated vegetable oil, high fructose corn syrup, sodium caseinate, natural and artificial flavors, modified food starch, xanthan and guar gums, polysorbate 60, sodium monostearate, sodium polyphosphates, and beta-carotene? Many of these are naturally-derived ingredients, like guar gum and beta-carotene, but what the heck is a polysorbate 60? And how does it affect insulin and our fat cells.

My first rule of food is: If I can't picture it growing, I don't want to eat it. Now, I know there are no marshmallow bushes, but I've made marshmallows myself and, as long as the ingredient list only has ingredients I used at home, I'm fine eating it. No, I ENJOY it. 

While listening to Dan Savage's podcast the other night, I heard a head and neck specialist discussing the throat cancer and how an overwhelming percentage (70%!!) of them are caused by HPV, instead of tobacco use (study link here). Although vaccinations are an issue that many people feel strongly about, the HPV vaccine (which is currently being recommended for both girls AND boys) specifically focuses on HPV-16 and HPV-18, the two types of HPV that cause throat cancer, anal cancer (in both sexes) as well as vaginal and cervical cancer (in women). I've included a few links here, from the Oral Cancer Foundation and the CDC. While no one wants to think about children having sex, the window between vaccination age (beginning at 11 years old) and sexual experimentation may be, unfortunately, not that long. 

http://www.oralcancerfoundation.org/hpv/index.htm

http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm

As young adults in our late teens and early twenties, we can be exposed to HPV through oral sex or transference from another partner who has it in their throat (from performing oral sex on their previous partner) and the oral cancer will not show up in us until our late 30's or early 40's. Given that oral sex is generally seen as a "less risky" sexual behavior when discussing HIV and pregnancy, these findings are quite concerning because they may lead people to go back to more risky, penetrative intercourse to avoid exposure to a cancer-causing virus. As always, condoms, condoms, condoms!

Happy New Year! Every January, many people make New Year's resolutions but very few of them follow through. We've all purchased gym memberships, hoping to shed a few pounds, only to see them lapse after a few visits or dedicated ourselves to a new hobby, spending money on shiny new gear only to find that same gear in the back of the closet when we do our spring cleaning a few months from now. Why do we make resolutions in the first place and why don't they stick?

I believe that we make resolutions for a few reasons- 1) peer or family pressure, and 2) eternal optimism. With the former, external pressure to make changes might be an initial motivator but won't allow us to maintain those changes. It's a stick without a carrot. The latter is just the opposite, in my opinion, the undying hope that maybe this year will be different, that we have it within ourselves to be better people, that if we only try YET AGAIN to make changes, THIS is the time they'll be successful. Neither of these are bad reasons to make resolutions or life changes, but I don't believe that they are enough to make lasting changes. 

If you change for another person, no matter what the reason, you're not fully investing yourself in that change. It's not happening because you want the end result but because you know someone who does or who won't stay if you don't change. Better to consider their request as one factor in a list of pros and cons for making the change YOU want to make. List all the positive results AND all the negative consequences AS THEY WOULD HAPPEN TO YOU. If your spouse wants you to lose weight because they're worried about your health, list all the health benefits you would attain from losing weight and all the repercussions for staying at your current weight (including the possibility of adding more) and determine for yourself if the benefits outweigh the costs. Quitting smoking? Not just because your partner wants you to, but because you will reduce the risk of cardiovascular events, breathe more easily, and be able to live a longer, healthier life with more time for your family. 

Be realistic. I always tell my patients that if they have a drinking problem, I'm not going to tell them to quit cold-turkey, but I do want them to stop drinking before noon. Then, before 4. Then every other day. We sabotage ourselves by creating unrealistic goals and then being unable to stick to them because we don't change everything in our lives to make it more convenient for us to stick with the changes. Want to drink more water? Add an extra water bottle to your daily intake or make sure you drink a full glass of water before each meal. Want to exercise more? Start with stretching for 10 minutes every morning, a 20 minute walk on your lunch break or scrolling through the yoga video options on Netflix and adding some to your queue. By making realistic changes you are providing yourself with an opportunity for sustainable life changes that will lead you to your goals. Try working backwards when planning- where do you want to be in 12 months? What goals need to have been met in 6 months for you to be on track to meet that year-end goal? How about in 3 months? Next month? Next week? break it down to doing one or two simple steps every day that will allow you to reach your objective in a measured and attainable way.

Finally, create your own cheering squad. Tell a few friends and family members (those who you find supportive) what your goals are long-term and how you're meeting them this week. Make sure you tell SOMEONE; this will make you accountable in your mind and will make it less likely that you will quit. Offer unconditional support to them on their goals and provide them with a sounding board for their challenges. It is my hope that all my patients will make realistic, sustainable changes in their lives in 2012 and will find themselves at the end of the year healthier and happier than they began it. Happy New Year!

I had the wonderful experience of going to a musician's memorial the other night. Dave Conant, a mentor to my partner and a friend to my partner's family, passed away ten years ago. His daughter, widow, and friends decided to hold a wild night of music and memories in his honor, providing a large part of Seattle's music scene an opportunity for remembrance and celebration of his life at Hale's Palladium, the venue for the local Moisture Festival. I only knew a very few people and was initially uncomfortable to be the odd man out, but quickly found myself enjoying the music and feelings of camaraderie I found there. It was a very touching tribute, telling me as much about his friends and family as it did about the man himself.

Last night, my partner and I got to talking about what he wanted to pass on to his son. I was thinking in terms of tangibles and he meant values and lessons. This led us to a discussion about parenting, me questioning the best ways to pass on lessons to kids at different stages of development, what values are important to pass on and how to get the message across. These kinds of discussions are ones I cherish the most with my partner; I learn more about him and come to respect him even more each time we talk about serious issues because of his thoughtful and thought-provoking musings. He had recently watched Pearl Jam's documentary "20" and came away with the idea that we, as parents, try to instill a set of "guard rails" to help our kids survive and thrive in society, but it's the kids who push against the guard rails at an early age that become breakout stars in their field.

I look around and see so many parents struggling for the fine line between being overly permissive and being resented by their kids by being too strict. I struggle with my own experiences with finding my niche in our combined family, developing a relationship with my partner's son is on my mind a lot. I love him to pieces, I want to be of support to him as he grows into a young man, I have the best intentions. Hell, I even have a degree in Human Development (with a focus on early child development) and a minor in Psychology and some of the time, it doesn't help a damn bit because I'm fumbling in the dark when it comes to our interactions. It's not my responsibility to raise him, to teach him my values. I understand that, but I also believe that as a human being I have a responsibility to be a good role model for any child in my life, be they family, friend, or patient. I feel honored that I have an opportunity to share experiences with some pretty special young people and I want to be a positive influence, something that helps them as they grow and learn to be good people.

Growing up, I thought my parents and grandparents knew everything there was to know about raising kids. I never questioned whether I was loved, I never was abused, I rarely even THOUGHT about disobeying them (though it's true that if there wasn't an explicit rule for a given situation, I might be found carving my initials in the bathroom door and blaming my sister for framing me). Now, I find myself missing my deceased grandfather because I feel he would be better able to get a handle on things in our house, he would know what to do to restore order. Or questioning my mother at dinner the other week, trying to find out what her secret was, how she got the three of us girls to do what she said almost every time just by lowering her voice and narrowing her eyes. How my father could tell us we were going to do chores and we just DID them. I never resented them and never questioned that they were doing the right thing, but I find myself envying them sometimes. How will I ever get a two-year old to put on clothes that are appropriate for the given weather? How will I keep a ten-year old from starving to death when he won't eat vegetables or food that doesn't come from a box? And, dear lord, what in the world can I do when my kids get old enough to date, to drive, to sneak out at night, to have SEX?!? What kinds of values can I instill in them that will keep them alive, happy, and successful in whatever way they define? How will I prepare them, share the best things that I've learned with them to help them in their lives?

Maybe it's too soon to be worrying about these things, without a child of my own yet, but I think it's good to have these discussions with myself, and with my family and friends, to continuously develop ways to live a life consistent with my values so that I can honestly say when I leave this world that the kids in my life knew who I was and what I stood for and that I made a positive difference in their lives.

Little ghosts and goblins are excitedly gearing up for Halloween in less than 2 weeks. We all remember how fun it was to dress up and rampage through the neighborhood, collecting candy and playing tricks. Some of us had the best houses mapped out or even descended on housing developments from our country neighborhoods to maximize our candy-collecting efficiency. From Madonnas to monks, clowns to crickets, witches to Wonder Women, many of us have fond memories of costumes that we wore year in, year out. 

This year, make sure that your kids are safe by following these rules from the Centers for Disease Control and Prevention : 

S- Swords and knives (and other blades) should be soft and flexible

A- Avoid being alone. Kids should be accompanied by an adult. If you feel your kids are old enough to go on their own, make sure they're in a group & check in frequently via cell phone or coming home every hour.

F- Fasten reflective tape. If your child will be trick-or-treating after dark, pick up some inexpensive reflective tape and attach it to their costume so drivers can see them better.

E- Examine all treats! Make sure everyone gets a filling dinner before going outside, so that kids are less likely to be tempted to eat candy before you have checked it out. Look at each piece of candy for evidence of tampering with the wrapper. Do not accept homemade candy from people unless you know them well.

One of the best websites for child (and adult) Halloween safety tips, www.halloween-safety.com, offers more in-depth advice, such as not going into strangers' houses, making sure that costumes are flame-retardant and do not inhibit vision or movement, fire safety with candles and jack-o-lanterns, and pet safety tips. It is a great resource for parents and I highly recommend it!

As the days get cooler, many people are becoming less active or are worried about putting on weight with holiday food. Tailgating for football games can be damaging to your waistline, too. It all begins with what you put in your mouths, what your options are, and what you provide for your family. Here are some healthy recipe links that run from less processed, homemade sweets for Halloween to healthy and delicious Sunday dinners that are seasonal and easy to prepare.

Halloween:

Burnt Sugar Lollipops

Chocolate Bark with Pistachios and Dried Cherries

Apple "Bites"

Melon Brain

*recipes from www.FamilyFun.Go.Com and www.EatingWell.com

Tailgating Recipes:

Guacamole with Chipotle Tortilla Chips

Spicy Black Bean Hummus

Cajun Oven-Fried Chicken

Roasted Potato Salad with Mustard Dressing

Homemade Chunky Chicken Chili

*recipes from www.MyRecipes.com and www.recipes.kaboose.com

Sunday Dinner:

White Bean Soup with Kale and Chorizo

Roast Chicken with Wild Rice Stuffing

Poached Pears in Merlot with Figs and Hazelnuts

Poached Pears in Merlot

4 large pears

1/2 c. hazelnuts, chopped

1/2 c. dried figs, chopped

2 c. Merlot

1 glass baking dish

Preheat oven to 350 degrees. Core pears, leaving skin on and removing core & seeds. Combine nuts and figs and stuff pears, standing them upright in glass dish. Pour Merlot over tops of pears, cover with foil. Cook at 350 for 30-40 minutes or until pears are cooked and easily pierced with fork. Serves 4 (try adding non-fat vanilla yogurt on top for a decadent twist).

*recipes from www.CookingLight.com and Stone Turtle Health

Lions, and Tigers and Bears, oh my! It's time for touchdowns, tackles, and tight ends. Whether you're watching your kids play, watching the pros, or playing the weekend warrior playing a pickup game on the front lawn or in the park, fall means football (and soccer) for a lot of people here in Seattle and across the US. Here are a few ways to add some healthy habits to your season!

Stretch! Get all those muscles nice and warm. Stretch your large muscle groups (upper legs- front AND back, calves, biceps & triceps, back muscles and neck muscles) to improve circulation and prevent injuries. Sitting on the couch through a Sunday's-worth of games can take a toll. Get up and move around, grab another glass of water, and keep moving. If you or your kids are on the field, warming up before the game is a MUST to avoid Monday remorse. 

Snack! Healthy snacks, like carrot sticks, orange slices, and peanut butter with crackers are perennial favorites for teams. At home? Add a twist to plain old chips and salsa by making a mix of shredded cabbage, diced tomatoes, onions, garlic and jalapenos to serve alongside. Buy the baked chips this time. Fruit plates, veggie trays with healthy dips like hummus, and chicken skewers instead of ribs and burgers are all great options that are lower in fat and calories. Chili is great, but skip the sour cream and mountains of shredded cheese & bacon bits.*

Drink! Water, that is. The more well-hydrated you are, the less sore you're going to be. Water helps remove waste products from active muscles, making for a more pleasant morning after the big game. Make sure to replace your electrolytes, such as sodium and potassium, which are lost when you sweat and can't be replaced by plain water. Healthy options, such as Recharge or Emergen-C are good alternatives to Gatorade and other electrolyte replacement drinks that use artificial ingredients.

Let's be realistic. Lots of folks like a beer while they watch the game. If you're going to drink alcohol, make sure you have a designated driver. Alternate each alcoholic drink with a large glass of water to avoid over-consumption (by filling up with water, you'll be less inclined to drink more alcohol to satisfy your thirst mechanism, and a stomach full of water will also help to stop you from eating the whole bag of chips by yourself). Know your limits. No one likes to deal with drunks at public sporting events or bars, so be aware of how much you're drinking. 

Have fun! Parents, remember that your kids are playing sports to have fun! Overcompetitive parents and those who argue with the referees, coaches, or other attendees are no fun for anyone. If you're playing, go with a laid-back approach. You're there to have fun, get some exercise, and spend time with your friends and teammates. Enjoy!

Remember Stone Turtle Health for school sports physicals (only $40 or insurance), therapeutic massage for sports injuries, and prevention.

*(Check back tomorrow for fall recipes that are great for entertaining during or after the game.)

With predictions of wet and windy La Nina months ahead, now is the time to prepare your immune system for the onslaught of viruses that cause colds and flu. At Stone Turtle Health, we have a wide variety of conventional and alternative options for cold and flu prevention.

Kids can get flu shots at our office, true, but we also offer an array of choices for natural immune support and safe, alcohol-free choices for dealing with nasty coughs, runny noses, and fevers if your child already has one. Common ingredients include kitchen spices that are known to have antibacterial and antiviral effects, like thyme, hyssop, garlic, and oregano, vitamins and minerals like vitamin B, C and zinc, as well as botanical medicines like astragulus, echinacea, and elderberry, all extracted in glycerine for alcohol-free formulations that are safe for children and pregnant women. 

If you can't make it in to the office, or it's the middle of the night, we've got a handy Handout on Home Remedies on this website that can earn you some relief from common symptoms, such as earaches, nausea and vomiting, cough and cold, fevers, and headaches. Perfect for getting a few more hours of sleep for you and your child. 

We're open until 7 at night on Tuesdays and Thursdays, as well as Friday and Saturday mornings to keep kids in school as much as possible. Please contact us today to schedule your child's flu shot, your immune wellness appointment, or your acute care appointment to keep your family healthy all through the year!

Aloha!

Having just returned from my very first vacation to Hawai'i, I have decided to celebrate my return to the cloudy, sleepy fall weather by sitting down to explain to you the wonders of modern medical insurance. I'll discuss what you're paying for, why you wind up paying more than you thought you would, and how we do things differently here at Stone Turtle Health. 

What you're paying for:

Let me start off by saying that I'm not opposed to insurance. I think it is a deeply flawed system, but I believe that many people would be wiped out by the costs of healthcare, were it not for their insurance policies. But it can be so darn confusing! Here are some basic ideas to help you understand it better.

You're paying a premium (monthly fee) just in case something bad happens that would cost you more than you can afford. You're gambling that the amount your healthcare costs will outweigh the amount you pay in your annual premium, co-pay, deductible, and co-insurance. You pay your premium, then you have a deductible (the amount you have to pay before coverage kicks in), co-insurance (that part in your policy about out-of-pocket maximum and a percentage of the charge, generally about 20% of whatever's left of the charge after your deductible is paid), and your copay (due at the time of your appointment). 

Why you wind up paying more than you thought you would: 

There is a formula to creating a fee schedule, which is based upon numbers released by Medicare every January. Using those numbers and basic rates for a given zip code (which I guess is supposed to factor in an average cost for overhead), and plugging them into the formula, health care providers (outpatient or inpatient) come up with a list of costs for specific services. There is very little wiggle room, but if you turn in your fee schedule to the insurance company with your contract and you are so many standard deviations outside of what your colleagues are charging (which does tend to be 3-4 times what you are reimbursed), there is a red flag on your account and your credentialling (becoming an in-network provider) is held up until they try to figure out WHY exactly you're charging what you expect to be paid. After all this, you are sent a fee schedule from the insurer showing what they are actually willing to pay you. For naturopathic doctors, who code the same services, but spend 5-10 times as long in an office visit, we get about 30-40% of what we bill (remember, still having to fit in with the averages so we don't raise any concerns). For an MD, typically 60-80% of what they bill for the same code (and thus should be the same charge, give or take a few bucks) for a 5-10 minute visit. So, what you see on the Explanation of Benefits is just a silly little game that we're required to play in order to be covered by your insurance. 

So, providers are required to come up with a crazy number, just to fit in. Then insurers say they'll only pay a portion of that (which was already agreed upon in the provider contracting process, but showing it on your bill makes US look like the bad guys and the insurer look like the good guy), then you get stuck with all or some of that, which is generally STILL more than if you'd paid cash. Dizzy yet?

How we do things differently at Stone Turtle Health: 

The challenge comes from working with large organizations that won't lower the remainder of the bill (your deductible, your co-pay, your co-insurance) to reflect the fact that you're not an insurance company that we're playing the game with, but an individual who has obligations like mouths to feed, rent to pay, insurance to buy. However, there's a clause in every insurance contract I have ever signed that says something like "the provider agrees that they are NOT REQUIRED (emphasis mine) to charge the member (that's you) any uncollected amount between the allowed and paid amounts". The allowed amount is the amount the insurer agrees to pay and then, more often than not, foists upon you as part of your deductible, co-insurance, and co-pay (or sometimes, as a non-covered charge, even though it is legitimate and supposed to be covered, which is another nightmare to deal with altogether).

Since I run a small practice, I am able to let the insurance companies apply that $100-$200 (that they didn't cover in your allowed amount) to your deductible and only charge you $75 for it, saving you $25-125 or more. For a 30-60 minute visit instead of a 5-8 minute one. Like that idea? Give us a call and we'll get started working with you to provide you with safe, effective, and financially-conscious health care.

Stone Turtle Health is pleased to announce that we have entered a grant competition created by Intuit, the makers of Quickbooks. The prizes include $25,000 grants and a shot at a second $25,000 hiring grant. The first level of grants are awarded via lottery to companies that make a difference in their communities. The second grant is awarded to one of the three quarterly winners, by a panel of judges, on the basis of merit. With this grant, Stone Turtle Health would expand the hours we can provide care as well as offer more community outreach programs to better serve our neighbors.

If you are reading this, hopefully you're a fan and maybe even a patient of Stone Turtle Health's. Please take a moment to to vote at LOVE A SMALL BUSINESS between July 1st and September 30th. Thanks for all your support as we work together to improve the lives of our community!