Primary Care With An Integrative Twist

Patient Centered Healthcare & Wellness takes a compassionate, integrative approach.

Dr. Cindy Grow ARNP, DNP, owner and founder of Patient Centered Healthcare & Wellness, is the architect behind this twist on primary care. Not only does her practice make quality health care accessible to everyone, but it takes a personal approach. Cindy believes in developing relationships with patients and developing a proactive treatment plan over a reactive one. With primary care and a holistic focus, Cindy has brought the best of both traditional and integrative medicine to her private practice.

“I really believe health care needs to be personalized for each patient. There is no one size fits all when it comes to a person’s health and wellness,” Cindy says.

Cindy met her partner Georgia Gonzalez, MSN, ARNP several years ago. They both share a love of helping others, enjoy the investigative aspect of ailments and chronic disease management and guide patients in learning to take control of their health.

Shortly after, Georgia joined her team, and they developed memberships to provide comprehensive and a ordable health care.

“We’ve always both had a passion for finding out the why,” Georgia says. They assess each patient’s risk for disease and look for the root cause of illness, rather than just treating symptoms.

PCH Wellness now o ers membership options for individuals, couples and families, whether insured or uninsured. They also o er self-pay visits for non-members, but the benefits of membership cater to those with high-deductibles or no insurance coverage.

Because the price of insurance can be high for the services many patients seek, PCH Wellness o ers an a ordable and comprehensive alternative to meet your health care needs.

PCH Wellness o ers everything from primary care services, weight loss management and aesthetic services to family planning, men’s and women’s health care, health coaching and chronic disease prevention and management. If a patient needs something ordered outside of the practice, PCH Wellness o ers wholesale pricing on labs and diagnostic services ordered. This includes imaging services and labs outside of the routine wellness panels o ered in the membership.

How do they do it? They keep a low overhead and manage the practice e ciently to ensure they can spend quality time with each patient.

“Our practice is very patient centered, and our patients will always get the time they need at the o ce,” Cindy says. “They’re not going to come to the o ce and feel rushed. We believe in taking all the time required to fully assess each patient.” Cindy and Georgia find ways to help their patients meet their health goals and maximize their wellness.

For members, all primary care services are provided—including exams, physicals, wellness exams, follow-up appointments, sick visits, referrals, labs, diagnostic testing and imaging procedures— along with access to virtual visits through their online portal. Non-members enjoy the same quality care on a self-pay basis, and patients do not need to be insured to become members.

As nurse practitioners, Cindy and Georgia o er the same quality care physicians do but with an integrative twist. The training for nurses is di erent than physician training. Cindy and Georgia are focused on mind, body and spirit wellness. This means identifying a patient’s genetic risk and helping them adopt lifestyle changes, as well as develop a treatment plan that focuses on prevention and management of chronic disease.

“Integrative is really where we’re just taking a combination of conventional medicine practices with alternative therapies and personalize a plan of care for the patient,” Cindy explains.

Whether you have insurance or not, PCHWellness is the primary care practice for you and your family. Moreover, the primary care membership options, which are free from insurance constraints, provide the health care value you deserve. PCH Wellness provides comprehensive, quality care to meet the needs of families, with a compassionate patient focus.

A new diabetes drug shows great promise for treating Parkinson’s and Alzheimer’s diseases.

By Jim Gibson

A diagnosis of Parkinson’s or Alzheimer’s disease can be devastating. Both these neurodegenerative diseases involve the death of vital brain cells, and at the present time, neither has a known cure. Even the cause for either disease is unknown, but the end result is the same: progressive loss of physical and mental capabilities and eventual death.

These diseases have many di erences but also have some basic similarities that have led researchers to seek a common treatment for both diseases. But the complexity of neurodegenerative diseases has made this a daunting task. Much like the search for a cure to cancer, researchers have cast a wide net, looking for answers in virtually every branch of science while leaving no stone unturned. The pharmaceutical industry, using vital research from each of these branches, is investing billions of dollars into the search for a cure.

Parkinson’s disease is a nonfatal progressive neurological illness caused by the death of dopamine-producing brain cells. Dopamine is a chemical neurotransmitter that carries “messages” between di erent parts of the brain, ensuring smooth, controlled muscle movement. As the dopamine-producing brain cells die, there is less dopamine in the brain and smooth muscle movement diminishes. The disease is characterized by tremors, sti ness and slowing of all physical movement. Many people with Parkinson’s also develop cognitive disorders, such as dementia as the disease progresses.

Researchers have no idea what causes the dopamine-producing brain cells to begin dying, and they have no idea how to stop them from continuing to die once the process starts. No present treatment can halt or even slow the progression of the disease.

Presently, the primary treatment for Parkinson’s is the oral medication L-DOPA, or levodopa. Levodopa is turned into dopamine once it enters the brain, thereby replenishing diminished dopamine levels. The problem is that levodopa therapy is fraught with side e ects, one of which is dyskinesia. Dyskinesia is the abnormal and involuntary movements many times seen in Parkinson’s patients.

Alzheimer’s disease is a fatal neurological illness caused by the formation of proteinbased plaques and tangles in the brain that leads to overall cell death and brain shrinkage. Here, cell death is widespread and not confined to just dopamineproducing neurons. The cause of the formation of these protein-based plaques and tangles is not known.

Scientists believe that clusters of tangles inhibit messaging between neural cells and, in many instances, triggers inflammation, which then causes the body’s own immune system to kill the disabled brain cells.

Whereas Parkinson’s a ects motor activity first and then may lead to cognitive disorders, Alzheimer’s a ects cognitive status first and then leads to motor skill degeneration. Present treatment involves drugs that boost the presence of neurotransmitters in the brain. This type of treatment may slow the symptomatic progression of the disease but cannot stop the disease itself.

It is standard practice in the pharmaceutical industry for companies to test drugs created to treat certain specific diseases in an e ort to determine if they might also be of benefit in preventing or curing other diseases. This is called multi-targeted therapeutics, and in some instances, this practice has been highly successful. One drug that immediately comes to mind is the erectile dysfunction drug Viagra that was initially produced by Pfizer to help treat cardiovascular disease and pulmonary arterial hypertension. Today, Viagra is used to treat both hypertension and erectile dysfunction successfully and is one of Pfizer’s top-selling drugs.

Recently, a drug developed by Metabolic Solutions Development Company in Kalamazoo, Michigan, to treat type 2 diabetes has proven that it too may very well have alternative uses. Early research has shown that the drug MSDC-1060, a next generation insulin sensitizer, could either be, or lead to, a potential cure for both Parkinson’s and Alzheimer’s.

MSDC-0160 inhibits the activity of a protein named mitochondrial pyruvate carrier (MPC). This protein’s function is to carry the molecule pyruvate into the mitochondria of each cell in the body. Once inside the mitochondria, pyruvate is turned into glucose, which is then used to power the cell.

MPC also has many other functions, one of which is to help control mTOR, a substance that controls cell growth and metabolism. Researchers believe that an overabundance of mTOR activity in Parkinson’s patients leads to a lack of communication between neurons and is one of the primary causes of cell dysfunction and many of the disease’s symptoms. As MSDC-1060 lowers the activity level of MPC, it concomitantly lowers the activity level of mTOR, and the end result is increased neural communication and a lessening of Parkinson’s symptoms.

MSDC-0160 therapy may also aid in the treatment of levodopa-induced dyskinesia. Researchers have found that an over activity of mTOR is a definite causative agent of this type of dyskinesia and believe induced dyskinesia, and clinical trials are now being undertaken to determine the e ectiveness for actual Parkinson’s patients. If trials prove the drug to be e ective, then Parkinson’s treatment with levodopa would be greatly enhanced. disease. A multi-center, 12-week, phase 2 trial conducted by Metabolic Solutions and coordinated by Medpace showed very promising results in the treatment of type 2 diabetes. During the study, patients received an oral, once-a-day dose of the medication, with “no safety concerns” noted. Blood sugar levels were lowered significantly, and further study is underway.

MSDC-0160 also helps treat neurodegenerative diseases in another way. An abundance of pyruvate, which is digested by the cell, means an abundance of cell waste. This waste is usually taken care of by the body in a natural process called autophagy. In Alzheimer’s and Parkinson’s patients, autophagy is greatly diminished and waste materials collect, adversely a ecting overall cell health and encouraging inflammation. Research shows that autophagy increases as mTOR activity decreases, so when MSDC-1060 inhibits MPC activity (and thereby decreases mTOR activity), it helps increase autophagy and aids cells in getting rid of unwanted waste materials naturally. Reduced inflammation in the brain reduces the body’s immune response and, therefore, reduces cell death.

MSDC-0160 also has the ability to “protect” neural cells against genetic or environmental damage. In the laboratory, dopamine-producing cells are protected when the drug is introduced and they no longer continue to die in Parkinson’s preclinical models. The brain cells a ected by the plaques and tangles in Alzheimer’s patients are also protected. This could be the most important aspect of the drug’s possible ability to aid in the treatment of Parkinson’s and Alzheimer’s—it may have the ability to slow or even stop cell death.

As for Alzheimer’s tests, they show that MSDC-0160 possibly has the ability to help the ailing brain maintain glucose levels in certain areas of the brain that would normally diminish as the disease advances. Further studies are scheduled.

Pre-clinical evidence for the use of MSDC-0160 to be a major player in the fight against Parkinson’s and Alzheimer’s is promising. MSDC-0160 seems to have the ability to improve communication between neural cells, assist in the natural removal of cellular waste, lower mTOR levels (which should decrease levodopa-induced dyskinesia) and has the ability to protect neural cells from genetic or environmental damage. These results are now being used to design studies that will determine if this drug, or this class of drugs, might just be, or lead to, the eventual cure for Parkinson’s and Alzheimer’s diseases and other neurodegenerative disorders.

Sources: alz.org, mayoclinic.org, msdrx.com, onlinelibrary.wiley.com

BY BRETT BALLANTINI • • • PHOTOGRAPHY BY JOHN JERNIGAN

When most of the country is packing up balls and bats and racquets for the winter, Florida athletes lick their lips in anticipation of some of the most temperate outdoor sports weather of the year. And you can’t beat the variety of sports found in Central Florida. Here’s a primer on the games available to you in the months ahead.