Health and Wellness

Health and Wellness http://kaplanclinic.com/health-and-wellness/ en-us Nucleus CMS v3.63 © Weblog http://backend.userland.com/rss http://kaplanclinic.com/health-and-wellness//nucleus/nucleus2.gif Health and Wellness http://kaplanclinic.com/health-and-wellness/ Mid-Life Irritability & Fatigue Improved by Hormonal Balancing by Lisa Lilienfield, MD xml-rss2.php?itemid=192

Mid-life is when both women and men often experience changes in mood, sex drive and energy levels. Many tend to think it is “normal” or “a phase”; but it may actually be hormonal imbalance. While this phase is more common with women in and before menopause, science shows that men experience hormonal imbalance and its side effects, as well.

As there is no single solution that works for everyone, it is best to be tested and have an individualized approach prescribed for you; with options for natural remedies, as well as other treatments.Female Hormonal Fluctuation

Peri-menopause, the time leading up to menopause, gets little attention, but should. It is characterized by night sweats, irritability, and can cause havoc for over a decade before women experience menopause—heavy and/or sporadic periods, hot flashes and, ultimately, menstrual cessation. [The good news is, there are natural hormonal balancing remedies such as herbs that can provide significant relief from peri-menopause symptoms with little or no risk (e.g. Chaste Tree Berry and Shepard’s Purse.]

Hormone Replacement Therapy (HRT) and Bio-Identical Hormones

But when herbs and supplements cease to offer relief, hormone replacement therapy (HRT) can relieve many of those unpleasant symptoms, but it is not without risks. It is important to have a specialist review your entire medical history and condition prior to considering HRT. A family history of breast cancer, stroke or heart disease may make this type of therapy inadvisable. Those specific risks may not be a concern with “bioidentical” or “natural hormones”. This is the approach we favor most, based on its safety. A bioidentical hormone mimics the body’s natural state, and has been synthesized from a natural botanical source. We prefer that these hormones be administered transdermally, so that the hormones bypass the liver and go directly through the skin and into the bloodstream; then onto the target cells (e.g., the brain, skin, vagina).

Male Hormonal Imbalances DO Impact Social/Work Life

It isn’t only women who experience serious disruptions to their work or lives, men are greatly affected, as well; although it is generally less publicized. When it was disclosed that Steve Jobs suffered from hormonal imbalance, it gained more attention. Men manifest some symptoms similar to women; however, often the fluctuations in men are fleeting. When hormonal imbalance affects men’s bodies, moods, and concentration, it is seldom noticed.

Just as with women, hormones in men tend to fluctuate more with age. Imbalances in men and women may cause bone loss, depression, irritability, weight gain, and weight or muscle loss; but men additionally may experience impotence or erectile dysfunction, as well.

If you know someone with any of the symptoms described above, look for a specialist who takes everything--all medical and natural options--into consideration before recommending a personalized approach to regain a more stable, symptom-free life.]]> General xml-rss2.php?itemid=192 Wed, 9 May 2012 06:02:37 -0400 Are Statins the Best Means of Preventing Heart Disease? (6 Ways to Reduce Your Cardiac Risk without Prescription Medication) by Dr. Gary Kaplan xml-rss2.php?itemid=185

Odds are, you or someone you know is currently taking a “statin,” a category of cholesterol-reducing medications commonly prescribed to decrease the risk of a heart attack or stroke. Usually recognized by the brand names “Crestor” and “Lipitor,” statins are a multi-billion dollar industry, with millions of new prescriptions filled each week. In fact, in 2010, sales of Lipitor alone totaled $7.2 billion -- an amount higher than for any other prescription medication sold in the US!

Looking at the rate of new prescriptions one might think that we’ve finally identified a drug that can successfully prevent heart disease.Statins are being widely prescribed to patients who have higher than normal cholesterol levels – in hope of reducing their risk of developing heart disease.Unfortunately, the medical research to date indicates that statins have very limited usefulness in preventing heart disease unless the patient already has a personal history of heart disease.

The usefulness of statins revolves around the difference between primary prevention – preventing the development of any heart disease – and secondary prevention – preventing the worsening of heart disease in someone who has already suffered a heart attack, stroke or other symptoms.

A 2010 study found that statins, when used for the purpose of primary prevention, helped prevent the development of heart disease in only 2 percent of patients with a medium cardiovascular risk, and in only 3 percent of patients with a high cardiovascular risk. One’s level of risk was assessed by reviewing a number of factors including: whether an individual smoked, was overweight, or had diabetes, high blood pressure, high cholesterol, rheumatoid arthritis, chronic kidney disease, or a family of history of heart disease. Note that “high cholesterol” is only one of a number of health factors used to assess one’s risk of developing heart disease.

On the other hand, when taken by patients who had already had a heart attack, a stroke, or been diagnosed with heart disease, statins were able to reduce cardiovascular mortality by up to 36 percent. Therefore, using statins for this group of individuals may make sense.

But as you can see, statins aren’t effective in preventing heart disease for a majority of patients, even those categorized as “high risk.” One reason for this is that statins are designed to reduce cholesterol, but cholesterol is only one factor that puts an individual at risk for having a heart attack or stroke.

Inflammation is a much more reliable predictor of one's risk of developing heart disease than is cholesterol. And inflammation is best measured by looking at a patient’s C-reactive protein (CRP) levels.

The good news is that very often inflammation can be reduced dramatically by making lifestyle changes, such as adopting an anti-inflammatory diet, engaging in regular exercise, practicing daily meditation, not smoking and getting enough sleep. Consequently, at the Kaplan Center we work with patients to help them reduce inflammation.

Do we ever prescribe statins? Absolutely. But only on a case-by-case basis, where the patient has a history of heart disease and when lifestyle changes haven’t succeeded in reducing inflammation.

Some patients ask, “Even if the effectiveness of statins is limited, why not prescribe statins to every patient – what harm could it do?” My answer: “plenty!”

Unfortunately, taking statins involves significant health risks. In response to a growing body of medical research, the FDA recently updated its safety guidelines for statins. The new guidelines warn patients and health care providers that statins may cause memory loss and increase a person’s risk of developing Type-II diabetes. Statin’s established side effects already included: muscle pain or weakness, headaches, sore throat, sinusitis, nausea, and liver problems.

In sum, there are considerable medical risks associated with taking statins, and for most individuals, there are better ways to reduce the risk of developing heart disease.

Here are six steps to help you reduce inflammation, lower your risk of heart disease and improve your overall health and sense of well-being:

1. Make sleep a priority. Quality sleep of 7-9 hours each night will reduce inflammation and is essential for optimum physical and mental health.

2. Incorporate meditation into your daily routine.

3. Take part in regular, physical exercise.

4. Maintain a diet high in antioxidants and low in inflammatory foods.

5. Supplement your diet with 1.5 grams/day of Omega-3 fish oil. Omega-3 fatty acids provide a range of health benefits to reduce your risk of heart disease, including reducing inflammation, cholesterol levels and blood-pressure levels.

6. Take 100 mg/day of CoQ10. This enzyme works as an antioxidant and enhances the energy production within the cells. If you are over 50 years old, take 100 mg/day of UBQH, a form of CoQ10 that’s easier for your body to absorb.

Ultimately, there is a lot each of us can do to prevent heart disease without turning to statins or other prescription medications. You and your physician can work together to figure out the best course of action for your unique situation and to determine whether medications are right for you. ]]> General xml-rss2.php?itemid=185 Thu, 22 Mar 2012 10:27:21 -0400 Dr. Kaplan Discusses the Health Benefits of Eating Chocolate xml-rss2.php?itemid=181

Video requires Javascript.

Did you know that dark chocolate is chock-full of antioxidants that fight dangerous free radicals in your body? Dr. Kaplan also explains how dark chocolate helps to reduce blood pressure, increase the elasticity of the blood vessels, reduce inflammation, and reduce LDL (low-density lipoprotein) cholesterol. In sum, including dark chocolate in your diet can significantly reduce your risk of developing cardiovascular disease!

]]> General xml-rss2.php?itemid=181 Mon, 30 Jan 2012 16:59:00 -0500 8 Tips to Help You Manage Your Medication by Dr. Gary Kaplan xml-rss2.php?itemid=174

A recent study, published in the New England Journal of Medicine, revealed that four commonly used drugs, namely: Warfarin (Coumadin), Insulin injections, Oral anti-platelet injections (including aspirin) and Oral hypoglycemic agents (oral diabetes medications) cause two- thirds of the drug-related emergency hospitalizations in older adults (age 65 and above).

And fully two-thirds of these drug-related hospitalizations are due to unintentional overdoses. By contrast, only about one percent of these hospitalizations are caused by "high-risk" medications, such as narcotics, amphetamines, barbiturates, and antihistamines.

And not all the studies are new . . .Earlier studies involving all age groups have demonstrated that adverse drug reactions (ADRs) leading to death have increased both for patients taking "high-risk" drugs and for those taking commonly-prescribed drugs, like those listed above. A study published in 1998 by the Journal of the American Medical Association indicated that ADRs were the sixth leading cause of death among hospitalized patients.

The results of these studies certainly should not cause anyone to stop taking their prescribed medications; obviously, medications provide critical health benefits. What these studies do point out is that careful monitoring is needed to ensure correct, effective, and safe dosing.

Below please find 8 simple tips to help you safely
manage your medication intake:

1)  Know all the medications you are taking, the prescribed dosages for each, and why you are taking them.

2)   Review your medications with your physician on a regular basis (every 3-6 months) to ensure that the medications and doses are still appropriate.

3)   Call your doctor to report any new symptoms you are experiencing.

4)   Be sure to tell your physician about all of the herbal remedies and nutritional supplements you are taking -- they can interact with your prescribed medications.

5)   Ask your physician about potential side effects and interactions of your medications, medicinal herbs and supplements.

6)   Always keep a written list of the medications (and doses) you are taking in your wallet or purse.

7)   Before you travel, refill any of your prescriptions that may be running low, and organize your medications so that you can easily adhere to your routine.

8)   In the event that you are hospitalized, make sure that the person who will serve as your healthcare advocate has a complete list of your medications. In this way, he or she can follow up with the hospital medical staff about your care.

In sum, remember: It's your body, so be sure you know what medications you're taking and what they're supposed to do for you. If you have questions about your medications, don't be shy; talk with your doctor as soon as possible.

For even more information on this topic, please visit the U.S. Health & Human Services' "Tips for Using Your Medications Wisely."]]> General xml-rss2.php?itemid=174 Mon, 19 Dec 2011 14:01:10 -0500 Will Going Gluten-Free Improve YOUR Health? By Dr. Gary Kaplan xml-rss2.php?itemid=168

According to a Washington Post article, more and more people are choosing to live without bread . . . well, at least without bread containing gluten, a complex protein found in wheat, rye and barley.

For those diagnosed with celiac disease, an autoimmune disease that interferes with digestion of gluten and the absorption of nutrients, abstaining from gluten is essential. But what if you don't suffer from celiac or gluten sensitivity? Is it advisable to abstain from foods containing wheat?Dietician Cheryl Harris points out that although eliminating gluten is critical if you have celiac disease or gluten intolerance, simply eating gluten-free products does not mean you've adopted a healthy diet!

According to Cheryl, "Often the gluten-free version of a product (for example, gluten-free cookies) is less healthy than the original version. This happens when more sugars and fats are added in an effort to keep it as tasty as the original product. In addition, most wheat cereals, breads and even cookies are fortified with vitamins and minerals, whereas gluten-free products typically are not."

On the other hand, if you have celiac disease, consuming even a tiny amount of gluten can lead to bloating, intestinal pain, joint pain, migraines, skin irritations, depression, and other symptoms. Getting a correct diagnosis, therefore, is essential, though sometimes difficult because it shares symptoms with so many other medical conditions. In addition, the lab testing is sometimes inconclusive.

Recent research also indicates that there is a subset of individuals who although they do not have celiac, do suffer from "gluten sensitivity." Although these folks do not have an autoimmune reaction to gluten, their inflammatory factors are likely to be higher, which can lead to more joint pain, fatigue, and other symptoms.

The "Let's see how you feel test"

What do I advise patients? Whether someone has a diagnosis of Celiac, a measurable wheat allergy, or indications of a gluten sensitivity, my advice is to stop consuming all gluten products for about six months. It can take a few days or weeks for a person to become completely gluten-free.

Once a clean diet is established, time is needed for the antibodies or antihistamines to leave the body, so the symptoms can subside and the body to heal itself. This does not mean, however, that a person with celiac disease or gluten sensitivities can safely recommence eating gluten-containing foods. They cannot.

Fortunately, there are many healthy foods that are naturally gluten-free, such as fruits and vegetables, nuts, seeds, dairy, fish and poultry. There also are many helpful resources for anyone who is gluten-free. For a registry of local gluten-free restaurants, grocers, bakeries, caterers and more, click here.

The Kaplan Center specializes in diagnosing and treating Celiac disease. For more information, click here. If you are suffering from symptoms including fatigue, abdominal pain, gastrointestinal issues, or weight loss, call 703-532-4892 or click here to make an appointment today to determine if, in fact, you should be following a gluten-free diet.]]> General xml-rss2.php?itemid=168 Mon, 19 Dec 2011 13:12:53 -0500 Concussions: Know the Signs & Protect Your Mind by Gary Kaplan, DO, and Pat Alomar, PT xml-rss2.php?itemid=154

“Walk it off!” “Get back in the game!”

Great character-building advice, right? Well, maybe sometimes. But if you or someone you know has suffered a concussion, this advice is absolutely WRONG!

Concussions are not uncommon, and they are a serious health problem. According to the Centers for Disease Control and Prevention, about 1.7 million Americans suffer from a traumatic brain injury (TBI) each year, and three-quarters of these are classified as concussions. Any blow or jolt to the head or neck can cause a concussion, but most are sports-related.

Although we’re well into the fall sports season, it’s never too late to refresh your understanding of how to identify and respond to a concussion. Above all, never underestimate the danger of the condition. The health consequences of ignoring a concussion can be severe. If your child suffers a blow to the head during practice or a game, he or she should be taken off the field

immediately. Ignoring the incident and allowing him or her to continue to play could result your child suffering additional concussions. Area high school districts have developed protocols for dealing with students’ sports injuries, so if you have questions or concerns, talk with your child’s coach or community sports director.

Research indicates that with each additional trauma to the head/brain, there is a slower recovery in neurological function. In addition, the cumulative effect of multiple concussions increases one’s risk of developing neurodegenerative health problems later in life.

In recent years, the media has covered the topic of sports-related concussions extensively. In one high-profile case, retired NFL players are suing, claiming that the League mishandled their game-related head injuries which led to long-term neurological damage. Both the National Football League and the National Hockey League have implemented stricter protocols for diagnosing and treating concussions. Following suit, many high and middle schools around the country are working diligently to increase concussion awareness among coaches, students and parents.

This said, be assured that most of those who suffer a concussion do make a complete recovery. To improve your chances of recovery, follow these steps:

     1) Familiarize yourself with the symptoms* of a concussion, including:

          • Temporary amnesia of the injurious event
          • Decreased concentration or “brain fog”
          • Difficulty learning new material
          • Headache or blurred vision
          • Sensitivity to noise or light
          • Emotional lability
          • Anxiety or depressed mood
          • Fatigue
          • Sleep dysfunction
          • Dizziness or imbalance
          • Nausea or vomiting
          • Physical weakness
          • Slurred speech

* Important Note: Despite what you see in movies and on television, loss of consciousness typically does not occur with a concussion. Also, the onset of symptoms can be delayed for hours or even days after a head injury, so stay alert for any new symptoms or behavioral changes during this post-injury period.

     2) Seek immediate medical attention for anyone exhibiting the following symptoms:
          • A change in consciousness, manifesting as difficulty staying awake or alert, not making sense when talking or not being able to understand what is being said
          • Headache is getting progressively worse
          • Increasing nausea or vomiting
          • Pronounced physical weakness
          • Slurred speech

     3) If a head-injured person does not exhibit any of the five big danger signs listed above, follow these recommendations to ensure a complete recovery:

       • REST! Give your brain time to heal.
       • Get on a regular sleep cycle where you sleep 8-9 hours per night at roughly the same time each day.
       • Stay hydrated.
      • Avoid watching TV or spending too much time in front of a computer screen. Although it may be difficult to deny yourself or your child access to on-screen entertainment, watching television and playing on the computer strains your brain. Resting quietly is the best way to allow your brain to heal.
      • Be gentle with yourself. Make sure you take enough time to fully recover before returning to your normal activities. If symptoms return after beginning an activity, stop, and take more time to rest.

Fortunately, 80 to 90 percent of individuals recover within 10 days of the incident, simply by following these simple recommendations!

    4) Communicate with your physician throughout your recovery, especially if your symptoms aren’t improving or your recovery is slow. In addition to physical symptoms, an untreated concussion can cause changes to the brain structure that result in cognitive difficulties, personality changes and altered emotional functioning.

   5) Consider using supplemental medical resources to support your recovery from a brain injury, including:

     • Arnica is a homeopathic remedy that reduces inflammation and swelling from an acute injury and is available either topically or in pill form.

     • Glutathione, taken intravenously, helps to decrease the free radicals that can build up after a brain injury. Free radicals destroy neural synapses and lead to cell death that can cause brain damage.

         • Dietary supplementation: Omega-3 is proven to improve brain function and may help reduce the neural inflammation caused by a concussion. Vitamin-B12 is essential for proper neurological function.

         • “Brain Gym” is sometimes described as “physical therapy for your brain.” It can help those who have suffered a brain injury regain brain-related functions such as memory, vision, speech, emotional balance, physical coordination, learning and expression.

        • Craniosacral Therapy is a very gentle form of manual manipulation that releases physical imbalances and restrictions as well as residual emotional trauma that has been stored in the body’s membranes and connective tissue. It frees the central nervous system to perform optimally, strengthening immune function and providing pain relief.

        • Specialized Blood Testing can be useful if a patient’s recovery from a concussion is slow or incomplete. This testing can identify genetic markers that indicate the propensity for developing chronic inflammation. When the markers exist, steps can be taken to proactively reduce inflammation so the body and brain can heal more efficiently.

     6) Be realistic about the course of your recovery. Whether someone suffers a mild concussion or a severe TBI, the course of recovery generally follows the same pattern: an initial period of impaired brain function; a period of improving, but not yet complete recovery of mental function; and a period where the mental functioning stabilizes without significant additional deterioration or improvement. All of these stages can last hours, days or months, or the case of severe injury, years. Other factors affecting the extent and speed of recovery include the resiliency of the injured brain, the recurrence of brain injuries or sickness, and lifestyle choices such as getting proper rest, nutrition, exercise, and mental activity.

The best medicine is always prevention, but when a head injury does occur, a prompt diagnosis and appropriate treatment are essential to minimizing or avoiding serious health consequences. Give your brain time to heal. The two-pound tissue between your ears is worth protecting! ]]> General xml-rss2.php?itemid=154 Mon, 31 Oct 2011 18:19:33 -0400 Pain and Depression: A Fire in the Brain by Gary E. Kaplan, D.O. xml-rss2.php?itemid=150

You’re not imagining it. The majority of individuals who suffer with chronic pain also suffer with depression, and the majority of people who suffer from depression also suffer from chronic pain. At first glance, these statements may seem like a double-dose of bad news for any patient suffering with fibromyalgia, painful autoimmune disorders, or any other serious, chronic pain condition. But there is some good news to be found here. Recent medical studies of patients dually diagnosed with chronic pain and depression are revealing that these patients have a unique disease process. And this discovery is pointing toward some promising new diagnosis and treatment options.

The idea that patients with chronic pain in many cases also suffer with depression is hardly shocking, but you may be surprised by the numbers:• Of the 47 million people who suffer from chronic pain each year, over half also meet the diagnosis criteria for a Major Depressive Disorder, and
• Fully two-thirds of the millions of individuals who are diagnosed with depression every year are also suffering from chronic pain.

A UNIQUE DISEASE PROCESS. Medical researchers are arriving at a new understanding of the physiological relationship between chronic pain and depression. A growing body of evidence is revealing that the disease processes occurring in a person who has been diagnosed with both chronic illness and depression are quite distinct from the processes occurring in someone who is suffering with only one of these conditions. I expect that this new understanding will lead not only to changes in treating individuals who are dually diagnosed, but also to improved protocols for diagnosing and treating patients who currently are diagnosed with only chronic pain or depression.

CSS. The new term “Central Nervous System Sensitization Syndrome (CSS)” describes the unique process governing the interplay of chronic pain and depression within an individual. CSS is an inflammatory condition that damages the structure and undermines the functioning of the nervous system. It is both “neurodysregulatory” and “neurodegenerative.” Neurodysregulation refers to the extent to which CSS interferes with the healthy functioning of the body’s nervous system, undermining neural activity in the brain, spinal cord and other neural pathways throughout the body. Furthermore, when a person’s nervous system is operating sub-optimally, their hormonal and immune systems are likely to falter, which in turn, can lead to even more complicated health problems. Neurodegeneration refers to the actual injury and destruction of neural tissue in the brain and body. Both conditions (neurodysregulation and neurodegeneration) can cause or exacerbate physical pain, emotional suffering, and erode mental clarity. The mediating factor in this process is the production and release of inflammatory substances in the brain.

FACTORS THAT CONTRIBUTE TO CSS. CSS is a complex syndrome; many factors can contribute to its development, and it can manifest in a variety of ways. Underlying conditions that can increase an individual’s susceptibility for developing CSS include Lyme disease, hormonal dysfunction, periodontal disease, post traumatic stress disorder (PTSD), mold-toxicity disorders, chronic viral infections, celiac disease, heavy metal burden and sleep disorders such as sleep apnea.

AN INFLAMMAORY CASCADE. To protect us, these underlying problems activate an inflammatory cascade within the body and brain. Here’s an example of how it works: A patient with celiac disease remains untreated for years. Consequently, inflammation develops, which disrupts the healthy functioning of her gastrointestinal system. This, in turn, compromises her ability to digest and absorb essential nutrients, eliminate waste and toxic substances, and keep out harmful substances. With her ability to absorb essential nutrients undermined, she develops nutritional deficiencies in magnesium, essential fatty acids, essential amino acids and calcium. These deficiencies weaken her immune system and lead to more pain and depressive symptoms. In response to her gastrointestinal system’s inability to prevent the entry of harmful substances, the body responds with even more inflammation. It does this to create a hostile environment for the invading toxins, but the reaction also works to intensify the patient’s pain and depression.

CSS helps to explain why the symptoms of so many chronic conditions overlap and why obtaining an accurate diagnosis and effective treatment plan can be so challenging. In my practice, I often see patients who have been “correctly” diagnosed with one condition (accurately in the sense that the patient met the diagnostic criteria), but the patient’s health remained compromised because an underlying problem had not yet been identified or addressed. For instance, I have seen several patients who have been diagnosed and treated for fibromyalgia, but whose symptoms never improved until their underlying condition of mold toxicity was treated. Similarly, patients are sometimes accurately diagnosed and treated for thyroid disease, but the patients fail to regain their full health and vitality until their celiac disease is addressed.

In these examples, the point is to identify what was setting off the neuro-inflammatory syndrome known as CSS. In sum, conditions such as fibromyalgia, chronic fatigue syndrome, peripheral neuropathies, and PTSD and depression associated with pain, may be better understood not as diseases unto themselves, but as manifestations of Central Nervous System Sensitization Syndrome.

TREATING CHRONIC PAIN. Unfortunately, some of the most common ways of treating chronic pain can, in some cases, make a patient’s situation worse. For example, the long-term use of opioids such as morphine and oxycodone, and benzodiazepines, such as Valium, Klonopin, and Xanax, appear to exacerbate the inflammatory processes throughout the brain. Increased inflammation may promote or exacerbate pain and depression and can make both conditions even more difficult to resolve.

TREATING CSS. To combat the damaging effects of CSS, your treatment plan needs to include

neuroregenerative therapies, such as sufficient sleep (7 to 9 hours per day), exercise (15-30 minutes aerobic activity per day), meditation (20 minutes per day), good nutrition (primarily low-carb diet with plenty of vegetables, fruit, low-fat protein, and supplements such as fish oil, Vitamin D and magnesium), and medication, as prescribed by your doctor. Second, all underlying medical problems need to be properly identified by completing a comprehensive medical history with your physician and undergoing laboratory testing as appropriate. Otherwise, the symptoms of CSS may persist even if other symptoms are being addressed. Finally, your treatment plan should include time with your physician to evaluate your progress and to discuss strategies that help you achieve your health goals. This may include treatments for sleep disorders, medication changes, physical therapy, acupuncture, psychotherapy or nutritional counseling.

The intersection of chronic pain and depression is complex, but the medical research is beginning to show us a way forward. CSS is a new model of disease that I believe will help better equip us to identify the factors that are causing a patients’ pain and suffering. It also provides us with incentive to adopt a more integrative treatment approach that will help more of our patients regain optimal health.

About Dr. Gary Kaplan and The Kaplan Center for Integrative Medicine: Gary Kaplan, DO, is the founder and medical director of The Kaplan Center for Integrative Medicine in McLean, Virginia. He and the Center’s medical team have been finding solutions for individuals suffering with chronic pain and illness for over 25 years. Dr. Kaplan is a board-certified specialist in Family Medicine and Pain Medicine. A leader and pioneer in the field of integrative medicine, Dr. Kaplan is a Fellow of the American Academy of Medical Acupuncture, a Clinical Associate Professor at Georgetown University School of Medicine, and he has served as a consultant at the National Institutes of Health (NIH). ]]> General xml-rss2.php?itemid=150 Thu, 6 Oct 2011 14:30:52 -0400 Lymph Drainage Therapy: A Gentle Way to Reduce Chronic Pain & Support Your Immune System by Linda Glick, CMT, and Gary Kaplan, DO xml-rss2.php?itemid=145

Just had surgery? Feeling swollen and sore? Lymphatic Drainage Therapy (LDT) can provide tremendous relief!

LDT is a deeply relaxing massage that is useful for relieving chronic and subacute inflammations. While it is most commonly used in the treatment of cancer-related lymphedema (swelling from fluid retention), it also has many other applications. For instance, it helps to remove toxins from the body and can be a valuable addition to a detoxification protocol (i.e., patients undergoing treatment for heavy metal or mold toxicity). It also can relieve post-surgical edema, remove residual anesthesia from the body, and alleviate fibromyalgia symptoms.Very briefly, the lymphatic system is a complex network of lymph vessels and organs that circulates lymph fluid and specialized cells throughout the body for the purpose of destroying pathogens and filtering waste so it can be eliminated from the body. The lymph system also supports the immune system by delivering nutrients, oxygen, and hormones from the blood to cells throughout the body.

Serious illness can compromise the effectiveness of lymphatic system, which in turn can obstruct the proper functioning of lymph vessels and lead to an accumulation of lymph fluid. For example,

surgery, muscle tightness, shallow breathing and lack of exercise, can lead to edema, inflammation,chronic pain and an impaired immune system. The good news is that lymph drainage therapy or manual lymph drainage (MLD), as it is sometimes called, can alleviate the symptoms of lymphatic system dysfunction and help your body to work at its optimal level.

In lymph-drainage therapy (LDT), a practitioner very gently massages a client’s skin surface to detect and redirect lymph flow and facilitate proper drainage of excess fluid.

As noted above, LDT or MLD has been found to be beneficial for many conditions, including:

     • Lymphedema (swelling in the limbs due to obstruction in the vessels and accumulation of lymph fluid) caused by cancer, radiation therapy, infection or surgical removal of the lymph nodes. A recent study indicates that providing lymph-drainage therapy to breast cancer patients before any signs of swelling are detected reduces the risk of developing lymphedema.

     • Post-surgery edema. Surgery often causes inflammation in the body that can be relieved through Lymph Drainage Therapy.

     • Post-surgery removal of anesthesia. LDT aids the lymphatic system in quickly expelling anesthesia from the body after surgery.

     • Chronic or sub-acute inflammation or swelling due to other conditions.. LDT can provide pain relief for individuals suffering from inflammatory pain associated with Muscular Sclerosis, arthritis, and musculoskeletal injuries, including broken bones and sprained joints.

     • Chronic pain and anxiety. LDT has a calming effect on the sympathetic nervous system, which in turn can help reduce chronic pain and decrease emotional stress and anxiety. LDT has even been shown to provide anxiety-relieving benefits for otherwise healthy patients!

     • Fibromyalgia. After receiving lymph drainage therapy, fibromyalgia patients reported lower pain intensity, a lower pain-pressure threshold, less morning tiredness, less anxiety and an improvement in their overall quality of life.

     • Heavy-metal or mold toxicity. Incorporating LDT into a patient's treatment program can assist the lymphatic system in removing toxins from the body.

About Linda Glick, Certified Massage Therapist at the Kaplan Center for Integrative Medicine: In addition to having advanced training and many years of experience in administering Lymph Drainage Massage, CranioSacral Therapy, and Oncology Massage, Linda Glick is a Reiki Master, a Brain Gym instructor and a key part of the Kaplan Medical Center’s rehabilitation staff. Talk with your physician about LDT and whether it could be helpful to you.

Sources:

Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. Lacomba M, et al. BMJ 340:b5396, 2010

Effects of manual lymph drainage on cardiac autonomic tone in healthy subjects.
Kim S, Kwon O, Yi C. International Journal of Neuroscience 119(8):1105-17, 2009

Comparison of manual lymph drainage therapy and connective tissue massage in women with fibromyalgia: a randomized controlled trial. Ekici G, Bakar Y, Akbayrak T, Yuksel I.
J Manipulative Physiol Ther. 2009 Feb;32(2):127-33.]]> General xml-rss2.php?itemid=145 Mon, 26 Sep 2011 13:09:10 -0400 Meditation: Can It Help Reduce Your Pain? by Dr. Gary Kaplan xml-rss2.php?itemid=119

Meditation, which can be practiced in many different forms, has been used for thousands of years to benefit the mind, body and soul. Now there is a growing body of medical research proving that meditation not only modifies brain function, it can actually change the way we experience physical pain.

A recent study reported in the Journal of Neuroscience showed that patients who had received only a little more than 60 minutes of meditation training were able to dramatically reduce their experience of pain. Patients experienced a reduction in "pain intensity" of about 40 percent and a reduction in "pain unpleasantness" of 57 percent. According to the lead author of the study, Fadel Zeidan, "Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs, which typically reduce pain ratings by about 25 percent."These results are exciting, and they confirm what we have seen clinically in our own patients at the Kaplan Center for Integrative Medicine. In fact, in the mid-1990's, I had the opportunity to serve on an NIH Consensus Panel that confirmed the effectiveness of relaxation and behavioral approaches in the treatment of chronic pain and insomnia. Meditation training has been part of the Clinic's comprehensive treatment program for over 20 years.

In the meantime, medical research has demonstrated that many difficult to treat chronic pain conditions, such as fibromyalgia syndrome, chronic fatigue syndrome, celiac disease, and irritable bowel syndrome, are mediated by central nervous system sensitization. It is only logical that meditation, which improves nervous system functioning, would help to alleviate chronic pain.

This is not to say that meditation is the entire answer; but can be a powerful part of an individual's comprehensive treatment, along with physical exercise, dietary changes, nutritional supplementation, physical therapy, and appropriate medications.

The following are some practical resources on meditation and working with physical pain, offered by experienced meditators:

• Working with Pain,

an audio talk by Jonathan Foust, founder of the Meditation Teacher Training Institute of Washington, recorded January 2011.

• How to Meditate: A Guide to Formal Sitting Practice, by Tara Brach, PhD, Insight Meditation of Community of Washington, Website, February 26, 2011.

• Physical Pain and Meditation, An Interview with Jon Kabat-Zinn, Tricycle Magazine, 2002.

My hope is that these tools and the encouraging research results listed below will inspire you to commit to your own meditation practice.

• A recent study conducted by Massachusetts General Hospital found that mindfulness meditation, over the short period of only 8 weeks, increased the amount of gray matter in regions of the brain involved in learning and memory, regulation of one’s emotions, and self-awareness. This new study is very exciting because it suggests that meditation may be able to help heal the brains of people who suffer with chronic pain, depression, and anxiety disorders.

• Other studies have shown that regular meditation helps improve immune function and reduce individuals' feelings of anxiety and fear and enhance their natural creativity and problem-solving abilities.

• Practicing mindfulness meditation has been shown to increase our empathy for others allowing for improved communication and relations with colleagues, family and friends.

• Research indicates that a regular practice of meditation, by facilitating relaxation of the body and mind, also can help improve sleep, lessen the sensation of pain, and lower blood pressure.

• There is also clinical evidence that meditating can help improve depression and increase one's overall sense of well being by providing a method of letting go of fearful thoughts and decreasing emotional reactivity.

About Gary Kaplan, D.O.:
Dr. Kaplan founded the Kaplan Center for Integrative Medicine in 1985. He serves as the Center's Medical Director and as a Clinical Associate Professor at Georgetown University School of Medicine. He is a Fellow of the American Academy of Medical Acupuncture, and he has served as a consultant at the National Institutes of Medicine (NIH), including on the NIH Consensus Panel that authored a paper on the Treatment of Chronic Pain & Insomnia with Relaxation Techniques.

All rights reserved by the Kaplan Center for Integrative Medicine.]]> General xml-rss2.php?itemid=119 Mon, 12 Sep 2011 17:31:50 -0400 Using Acupuncture to Boost Fertility by Lisa Lilienfield, MD xml-rss2.php?itemid=115

Dealing with infertility can be frustrating, financially draining, and in some cases, can lead to feelings of hopelessness. The problem of infertility is far from rare, however; according to an often-cited research study, fully 10-15% of couples in the US have difficulty conceiving. Fortunately, medical breakthroughs including new medications, and high technology treatments such as in vitro fertilization (IVF) and intrauterine insemination, have helped many couples overcome fertility problems. But what’s new in the arena of infertility treatment may surprise you: Medical research has demonstrated that acupuncture is clinically effective in boosting fertility.Numerous studies have shown that pregnancy success rates increase when acupuncture is provided in conjunction with IVF (a process where the woman’s eggs are removed, fertilized with the man’s sperm, and then the healthy embryos are then implanted in the woman’s uterus). Overall, the research is very strong: In general, a woman may be up to 65% more likely to become pregnant if she is receives acupuncture combined with IVF treatments, as compared to receiving IVF treatments alone.

Of course, men also can have infertility issues, and although there are fewer studies examining male infertility and acupuncture, the existing research suggests that acupuncture also plays a positive role in improving male fertility. Finally, and just as important, the research indicates that there are no adverse side effects associated with using acupuncture to treat infertility.

So, how does this procedure, which has been used for thousands of years to alleviate pain and boost the body’s immune system, help to improve fertility in women? This is how:

      1. Acupuncture increases uterine and ovarian blood
flow. Acupuncture increases oxygenated blood flow and thickens the uterine lining, increasing the chance of conceiving.
    2. Acupuncture modulates the body’s neuroendocrine system. The neuroendocrine system is the combination of the nervous and the endocrine systems. Acupuncture stimulates the brain to release hormones that then stimulate the ovaries, adrenals and other organs involved in reproduction.
    3. Acupuncture decreases the body’s stress response. Stress can contribute to infertility, and acupuncture mitigates the body’s stress response.

To date, most of the research on acupuncture and infertility has examined the effect of acupuncture when administered at or near the time of the IVF embryo transfer. As noted above, however, acupuncture elicits several beneficial physiological responses in the body, so it can be an effective, low-cost, and safe treatment not only for women undergoing IVF, but for anyone wishing to get pregnant.

Keep in mind that each couple’s infertility situation is unique. In women, medical conditions such as polycystic ovarian syndrome (PCOS) and primary ovarian insufficiency (POI) can affect ovulation and thereby undermine their ability to conceive. Also, lifestyle factors such as smoking, excess alcohol use, stress, poor diet, excessive athletic training, and maintaining an unhealthy weight can create obstacles to getting pregnant.

Finally, age also plays a prominent role in fertility. As the years pass, a woman’s ovaries gradually become less able to release eggs, and the eggs produced are fewer and less robust. This said, it is still very possible to have a healthy baby (or babies!) at an older age. In fact, according to the Centers for Disease Control and Prevention, 20% of women have their first child after age 35!

If you are under 35, and have been trying unsuccessfully to conceive for a year or more, talk with your physician to determine what fertility treatments would be most effective for you. If you are over 35 and interested in getting pregnant, fertility experts recommend not waiting more than 6 months before seeking professional, medical assistance. Your doctor should administer fertility tests to determine the root of the problem. Identifying the cause of infertility will help determine the best course of action.

Most importantly, don’t lose hope. At the Kaplan Center, we can provide you with a comprehensive evaluation and treatment plan, paying special attention to any chronic medical issues you may have, measuring your intracellular magnesium and vitamin-D levels, assessing your hormone balance, and helping you manage any situational stress you may be experiencing. We will partner with you to create a treatment plan that includes acupuncture, and we will be happy to coordinate your care with your fertility specialist or aid you in choosing a specialist.

Dr. Lilienfield, MD, specializes in treating hormonal imbalances through the use of natural hormone replacement and alternative thyroid medications. She is board-certified in family medicine, and is a member of the American Academy of Medical Acupuncture. Dr. Lilienfield also serves as a Clinical Assistant Professor at Georgetown University School of Medicine's Department of Community and Family Medicine.

All rights reserved by Kaplan Center for Integrative Medicine.

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