Health & Wellness February 2022

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Tri-City offers TAVR for heart valve disease

H SLIPPERY ELM is also known as ulmas rubra, Indian Elm and Red Elm. Photo by Will Cook

HERB OF THE MONTH Slippery Elm

I

By Bonnie Kydd

was once asked at an herbal conference what herb I would want if stranded on a desert island. I didn’t have to think hard and answered Slippery Elm. Not only does it treat nausea, heartburn, constipation, car sickness, sore throat, UTI pain and wounds, it also contains calcium, magnesium, manganese, iron, phosphorus, potassium, selenium, zinc, beta carotene, Vitamin C and B complex. You can literally live on it for a while if stranded on a desert island. This herbal is safe for kids and pets, and the only contraindication is pregnancy or those who are trying to get pregnant because

its a mucilage which coats the mucus membranes in the body and soothes and protects with a thick sticky substance when it passes through the body. When a tablespoon of Slippery Elm is mixed with ¼ cup of warm water it tastes a bit like Cream of Wheat. I suggest adding a little honey if you use this method, but just plain is fine. It can be purchased in bulk online or you can buy it prepackaged . I prefer the warm water technique, but I suggest packing gel caps for those who prefer taking pills. I’ve even made slippery elm cookies for my dog who was recuperating from a GI bleed. Another of many success stories about Slippery Elm.

eart disease continues to be the leading cause of death for Americans, according to the American Heart Association (AHA). During the pandemic, many people experiencing chest discomfort, fatigue or shortness of breath are hesitating before going to the hospital believing that they are experiencing COVID-19 symptoms that will pass or they are afraid of getting the virus at the hospital. Physicians and surgeons at Tri-City Medical Center’s Cardiovascular Health Institute (CVHI) want to remind San Diegans about the importance of going to the hospital when they have these types of symptoms to ensure that they are properly diagnosed and receive the best possible cardiovascular treatment. The AHA’s “Don’t Die of Doubt” campaign was created to raise awareness about this issue and reinforce that hospitals are the safest place to be for heart-related emergencies – even during a pandemic. Just ask James Robbins, a retired restaurant cook, who delayed going to the hospital until his daughter made him because he was having difficulty breathing

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DR. AARON YUNG, interventional and structural cardiologist and director of Tri-City’s structural cardiology program. Photo courtesy of Tri-City Medical Center

and walking more than 10 feet on his swollen ankles. He attributed his symptoms to COVID-19. Once a negative test ruled this out, the emergency department staff at Tri-City quickly determined that James was having heart problems and brought in Aaron Yung, MD, FACC, an interventional and structural cardiologist, who diagnosed James with aortic valve stenosis. Aortic stenosis occurs when the heart’s aortic valve, located between the aorta and left ventricle of the heart, has thickened and its flap doesn’t fully open causing reduced blood flow from the heart to the body. In turn, this makes the heart work harder to pump blood, weakening the heart

muscle, and may eventually lead to heart failure. Aortic stenosis is a progressive disease and will become more severe over time. “In the past, the only way to replace this aortic valve was through openheart surgery,” said Dr. Yung Director of the Structural Cardiology Program at Tri-City. “Today, we perform transcatheter aortic valve replacement, or TAVR, in our cardiac catheterization lab in about an hour. This safe, minimally invasive procedure involves deploying a collapsed replacement valve to the diseased valve site through a catheter inserted into the femoral artery in the leg. Once the new biological tissue valve is inserted inside the old valve, it is expanded and takes over regulating

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blood flow.” Using a collaborative approach, Dr. Yung and one of his colleagues, Dr. Darrell Wu or Dr. Yuan Lin, both cardiothoracic surgeons at Tri-City, assess a patient’s age, condition, comorbidities and risk category to determine if a person is a surgical candidate or not. The surgical risk assessment is based on the Society of Thoracic Surgeons (STS) score which calculates the short-term risk of mortality and morbidities for cardiac surgery as low, moderate or high. If a patient is not a surgical candidate, then TAVR is performed with one of the physicians assisting Dr. Yung during the procedure to help deploy the heart valve into place. Tri-City began offering TAVR in June 2021; since then, Dr. Yung and his team have performed about 20 procedures and anticipate a yearly volume of 50 or more. “For James, TAVR was the best therapeutic option,” said Dr. Yung. “Numerous studies show that even for low-risk surgical patients, TAVR is a safe alternative resulting in better outcomes.” The benefits of TAVR may include: • reduced hospital stay • shorter surgical and recovery times • less infection, pain and/or anxiety • smaller incisions so minimal scarring • relief of symptoms. “It was a good thing I came in when I did as my heart function was very low,” said James. “If I had waited any longer, I might have had a heart attack and needed open-heart surgery. Even though people might consider going to the hospital and having a procedure to be a bad thing, it was the best thing that ever happened to me. TAVR has given me back my life.” To learn more about heart and vascular care at Tri-City Medical Center, visit Cardiovascular Health Institute.


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Loneliness may raise heart disease risks  UCSD study shows risk climbs as much as 27% By City News Service

REGION — Loneliness and social isolation among older women can increase heart disease risk by as much as 27%, according to a UC San Diego-led study published this week. The findings of the study, published in Wednesday's online issue of JAMA Network Open, reveal that social isolation and loneliness independently increased cardiovascular disease risk by 8% and 5%, respectively. However, if women experienced high levels of both, their risk rose 13% to 27% compared to women who reported low levels of social isolation and low levels of loneliness. “We are social beings. In this time of COVID-19, many people are experiencing social isolation and loneliness, which may spiral into chronic states,” said first author Natalie Golaszewski, a postdoctoral scholar at the Herbert Wertheim School of Public Health and Human Longevity Science at UCSD. “It is important to further understand the acute and

long-term effects these experiences have on cardiovascular health and overall well-being.” According to the researchers, social isolation and loneliness are mildly correlated and can occur at the same time, but are not mutually exclusive. A socially isolated person is not always lonely and conversely a person experiencing loneliness is not necessarily socially isolated. “Social isolation is about physically being away from people, like not touching or seeing or talking to other people,” said senior author John Bellettier assistant professor of epidemiology at the Wertheim School. “Loneliness is a feeling, one that can be experienced even by people who are regularly in contact with others.” Compounding the issue is the fact that social isolation and loneliness are associated with health conditions that increase the risk of heart disease including obesity, smoking, physical inactivity, poor diet, high blood pressure and high cholesterol. When researchers included all of these factors in their study and adjusted for diabetes and depression, high social isolation and loneliness remained strongly linked with in-

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FOR THE STUDY, 57,825 postmenopausal women living in the United States were sent a questionnaire assessing loneliness and social support in 2014 to 2015. Courtesy photo

creased risk for heart disease. According to the U.S. Centers for Disease Control and Prevention, heart disease is the leading cause of death for women in the United States, responsible for one in every five deaths. A quarter of adults 65 and older report social isolation and a third of adults 45 or older report being lonely. “We do not yet know whether the increased risk of cardiovascular disease is due to acute exposure to social isolation and loneliness or whether prolonged exposure accumulated over

a lifetime is the culprit. Further studies are needed to better understand that,” Bellettiere said. According to previous research, women tend to experience more social isolation than men. For the UCSD study, 57,825 postmenopausal women living in the United States were sent a questionnaire assessing loneliness and social support in 2014 to 2015. The participants were followed through 2019 or when they were diagnosed with heart disease, which affected 1,599 of them.

Revivorship’s holistic therapies for cancer side effects

revivorship

steve leisher

O

ver past two years the term “health is wealth” has hit home in a way that many never considered before. The value of a healthy body was a lesson I learned the hard way — being diagnosed with head and neck cancer. Until that point I thought myself pretty indestructible. I was working too hard, playing too hard, not eating the best, and stressed out all the time. The cancer and chemo and radiation treatment stopped me in my tracks and made me reconsider my life priorities. This was not a contemplative assessment based on pros and cons. It was a non-optional hard stop — my body said, “Steve, lay down and don’t move.” I had a feeding tube, couldn’t talk, couldn’t even walk to the mailbox. After treatment I had visions of going back to my “normal” way of living, but that was not to be.

REVIVORSHIP Holistic Cancer Wellness Center in Encinitas can help those dealing with cancer-related side effects, such as nausea, neuropathy and pain. Courtesy photo

My energy was completely depleted, neuropathy numbed by hands and feet, I couldn’t taste food or gain weight. I was skeletal. The things I prioritized pre-cancer slipped away. The only thing that mattered was getting my health back. I started researching integrative modalities that could help me recover. I found an Ayurvedic practice of “swishing” with sunflower oil returned my salivary gland function. A specialized massage therapist worked the tightness in my legs and arms till the neuropathy receded.

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Yoga therapy and personal training restored my strength and vitality. Chinese and Ayurvedic herbs tonified my digestion and I gained weight. Slowly but surely these complimentary therapies gave me my life back. Too many cancer patients and survivors don’t know where to get this kind of help. Medical professionals are in support of integrative care, but it’s not always available through the Western medical system. That is why I opened Revivorship Holistic Cancer Wellness Center. Revivorship is the place where you can get help with all

cancer related side effects; nausea, lymphedema, neuropathy, pain, etc. All our practitioners are specialists in their fields of acupuncture, yoga therapy, massage, nutrition, cranial sacral therapy, talk therapy, and more. We are fully integrative and integrated. This means our specialists communicate with each other and your medical team, if requested, to make sure all the treatment you receive at Revivorship is the best option for your specific situation. Integrative modalities can be supportive for so many different health situations. Now that we all have a much greater appreciation for “health as wealth,” Revivorship is partnering with Coast News to gather and share the best wellness advice available on a wide range of important topics. You can look to this monthly column for simple, accessible tools and practices that can help us all live longer, healthier and happier! Steve Leisher is the founder of Revivorship Holistic Cancer Wellness Center located at 162 S. Rancho Santa Fe Rd. in Encinitas. For more information, call (858) 956-0077 or email info@revivorship.com.

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What is the microbiome? holistic dentistry

dr. carey o’rielly

T THERE IS NO shortcut to weight loss, so it is important to find an ally who is invested in your success and can tailor a personalized solution for you. Courtesy photo

Personalized weight loss plan healthy living

dr. kern brar, m.d.

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ebruary brings spring into the air and this season is a time when some people start to make goals for the upcoming summer. Patients and colleagues often share their stories in weight loss. I recently met a patient who had read multiple books and tired just about every diet to lose weight. Being in the healthcare field, she had access to podcasts, apps on her phone to track her meals and steps, and memberships to fancy gyms. She may have had too many options and information and was unable to make a decision to achieve her goals. Good communication is a key in the weight loss journey and having a personal relationship with a doctor who understands

your life and specific concerns is extremely important. It is important to know what has worked and what did not. Weight loss is never a simple pill or medical procedure for long term success. It takes energy and willpower to change ethe habits that caused increased weight and the good news is, you can see some results in as few as 4 weeks. One should request for an objective medical viewpoint that is free from commercial bias like Jenny Craig, Optavia, Weight Watchers or apps that often charge their clients over $500 a month for foods that are processed and unpronounceable. These programs may sometimes help individuals lose weight in the short term, but often end up with patients eventually gaining weight. I believe in my patients, and over the past few years they have collectively lost thousands of points of fat. It takes just 3-4 weeks to set a habit, so consider learning about

medically monitored weight loss that focuses on you and what works. Having an accountability partner, health coach, or life mentor can definitely help you on your journey, but reversing Obesity and Type 2 diabetes and no longer needing to inject insulin is a game changer. There are hundreds of books, support groups, podcasts, websites, endless products pushed by an industry focused on profits over results. It is possible to change some habits today that can improve how you feel and how you look tomorrow. Biochemically, we can trend how these changes affect blood levels. There is no short cut to weight loss, so it is important to find an ally who is invested in your success and can tailor a personalized solution for you. Dr. Kern Brar is a board certified internal medicine physician, partner at Tri City Primary Care and resident of north county. For more info call (760) 940-7000.

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he terrain of our bodies, its “microbiome,” is host to trillions of microorganisms. Some are beneficial and some are not. You might hear about the “microbiome of the gut,” as well as the “microbiome of the mouth.” Given that the digestive process begins in the mouth, the two are interconnected. Aside from the role the gut plays in digestion, it is also the source of approximately 70% of our body’s immune cells. The connection between the microbiome of the mouth and illness has been known for a while. Oral bacteria circulating in the body have been linked with a number of systemic diseases, including gut diseases. But how do these microbes get into the different parts of the digestive tract? There are four ways: 1) Microbes from the mouth can directly penetrate the esophagus, the

ORAL BACTERIA circulating in the body have been linked with a number of systemic diseases, including gut diseases. Courtesy photo

muscular tube connecting the throat with the stomach. This can be enough to unbalance the digestive tract’s ecosystem. 2) Bleeding gums due to gingivitis and gum disease can give oral microbes access to the bloodstream, allowing them to circulate systemically. 3) Bacteria living along and under your gums can live in an oxygen depleted

environment. These “anaerobic” bacteria release very toxic waste and byproducts (basically bacteria poop) into any gaps between your gums and teeth. The toxicity of this waste causes inflammation, redness and bleeding gums. Recently, microbial metabolites directly affecting the gastrointestinal tract have been identified. Metabolites, AKA bacteria poop, can lead to various chronic diseases of the digestive tract. When absorbed into the blood steam, they can cause a low grade inflammatory state. One of the worst offenders in periodontal disease is P. gingivalis. It has been found in the intestines, where it can contribute to “leaky gut.” This inflammatory condition allows food particles and toxins to pass back into the bloodstream. 4) Oral bacteria and other microbes found in the mouth can reach the stomach through swallowed saliva, nutrients and drinks. These bacteria generally don’t colonize in a healthy intestine, but in cases where there is gum disease they will multiply and may cause chronic inflammation. There are also plenty of TURN TO DENTISTRY ON A26

Harmony Grove: Pathway to recovery

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HARMONY GROVE Recovery rehab facilities in San Diego provide mental health treatment for children, adolescents and adults in group and individual settings. Courtesy photo

best quality care and assist in making treatment an enjoyable experience. Harmony Grove Recovery’s addiction treatment center understands the detoxification process. This is the first step in the addiction treatment recovery process. Our experienced staff makes this as comfortable as possible. Medically supervised detoxification is always the best choice. This option can provide comfort medications to drastically improve the withdrawal process. Co-occurring disorders like trauma, abuse, anxiety and other behavioral health issues are at the center of addiction. We completely address these issues to help release you from the grips of addiction. The intensive outpatient program is extremely flexible. Our treatment options allow individuals to maintain employment and

spend time with loved ones. We provide in-person groups and individual sessions as well as our telehealth option. When we develop the individualized treatment plans, the outpatient program is custom tailored. This approach provides the best options to continue functioning in society. Harmony Grove Recovery provides mental health treatment for children, adolescents and adults in group and individual settings. We provide tailored treatments with all the necessary tools to promote a healthy lifestyle. If you or someone you know is struggling with addiction and/or mental health issues, call today at (760) 697-0497 or visit harmonygroverecovery.com. We provide a caring and supportive environment to help reduce the pain and suffering and find stability for individuals and families.


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Staying attuned in a world of anxiety intentional living

angie & marc rosenberg

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he messages we keep hearing: “Stay home,” “social distance,” “mask up,” “don’t see family,” “gather,” “don’t gather,” “double mask,” “get vaccinated,” “get boosted,” “get your kids vaccinated,” “trust the vaccine,” “don’t trust the vaccine,” “isolate,” “wash your hands,” “sanitize,” IS ANYONE else experiencing heightened fear, confusion “only one parent allowed,” “send your kids to school,” or anxiety since the pandemic began? Courtesy photo

“keep them home.” Is anyone else experiencing heightened confusion, fear, or anxiety? Before COVID-19, we saw plenty of mood and anxiety disorders in our practices. As the pandemic has continued over the last few years, everyone has had to make difficult choices from a handful of confusing and difficult messages. We are all continuing to adapt, get creative, learn new ways to function, and ultimately, simply do our best. As you saw in our January piece on reflection, maybe you’ve seen yourself really grow through the pandemic. Maybe this has been

incredibly tough on you and your family. Remember your fears are valid and they do protect you, but only to a certain extent. Allow your fear to provide clarity on what your concerns are, validate that for yourself, and then ask yourself what you need as a result. Try not to stay stuck in the anxiety cycle or the negative thoughts. Spend some time with them, but don’t live there. Express yourself, get support, and move forward with what you need next. It’s ok, you’re ok, how you feel is ok, and what you need is exactly accurate to you and your situation.

NTENTION OF THE MONTH

Attunement

In support of your fears and anxiety: 1. Trust yourself 2. Go with your gut 3. Pause, meditate 4. Journal 5. Reflect, ask yourself what you need These techniques build a greater sense of self-awareness and intuition. For more on our support and services, and to join our NTENTION Setter community, visit us at www.4NTENT.com or follow us on instagram, @4NTENT.

In February, the focus is on maintaining a healthy heart bite size

health pearls

sadi jimenez, n.d.

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1 st

t is no secret that February is about the heart. It is the month we celebrate Valentines and the month the wellness community brings awareness to cardiovascular health. In the same month, we get to explore our hearts from a physiological and psychological way. I believe we intuitively know that one experience cannot be separated from the other. I aim to understand just a bit more about the beating muscle in our chest. Questions like How is a women’s heart affected around menopause by the decline in estrogen? Can hormone replacement therapy help my fe-

male patients prevent heart disease if they are on estrogen? I went looking. I usually research places such as Ebsco. A database for clinicians. I can enter keywords and have access to 1,000 research papers. Part of my job is to decipher what is relevant, and what can impact the life of my patients, my community, and my own health. The most recent re-

ual ann

search 2021 reaffirms what other papers have proven before, and therefore puts the health question to rest.

Hormone replacement therapy can be protective in women against cardiovascular disease. Outcomes are timing dependent. • Hormone replacement therapy reduces cardiovascular heart disease and allcause mortality only when initiated close to the onset of menopause. • The sweet spot seems to be pointing to age group aged 50–59 years. • The benefit is that estrogen seems to be protective, lowers your LDL bad cholesterol and might increase your HDL your good cholesterol. But not all estrogen is created equal. Read more about the different estrogen types here. There was a research

paper published back in 1996 that suggested that hormone replacement therapy could be linked to higher cardiovascular incidents in women, however followed up research has found that the risk seems to be associated with starting hormone replacement therapy ten years from menopause. These are the check marks that I review with my patients to check if they might be a good candidate for hormone replacement therapy. • History of cancer in yourself, mom, sister, grandmother, or aunt. • History of Cardiovascular Disease in yourself or other first-degree relatives. • Ability to detox hor-

mones such as estrogen through Functional testing. • The last time performed a mammogram or a thermogram. • Last time a pap smear was performed. In the end the choice should be determined by you and your clinician. I always council my patients to talk about the risk openly, goals and expectations. To take into consideration your own personal history and symptoms that might be relieved by the therapy. Dr. Sadi Jiminez is a licensed Naturopathic Doctor. For more info email her at ask@drsadi.com or call 760284-1042.

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