Aug 1

5 Reasons I Don’t Recommend Antibiotics for the Treatment of Acne

1. Bacterial Resistance & MRSA

The over-prescription of antibiotics has led to antibiotic resistance and the development of superbugs like MRSA that cannot be treated with the currently available medications. If you haven’t heard of the superbug MRSA, you need to know that this is a very dangerous type of staph infection. One main reason MRSA is so dangerous is that it is resistant to most antibiotics. Experts believe that MRSA evolved because of the overuse of antibiotics and dermatologists treating acne primarily with antibiotics is a prime contributor. In addition, P. acnes bacteria that contribute to the development of acne lesions is becoming drug-resistant, meaning that the antibiotics previously used to treat the skin are less effective.

2. Immune Impact

According to a study in the September 2005 Archives of Dermatology, people who use antibiotics are more than twice as likely to catch colds. The common cold is a virus – not directly affected by antibiotics; but antibiotics not only attack the harmful bacteria, but also the beneficial bacteria that are part of the body’s defense system. This results in an increased frequency of viral infections.

3. Digestive Disturbance

One of the most common side effects I see after a patient has taken antibiotics, whether for acne or other infections, is the development of digestive concerns such as diarrhea, constipation, bloating, heartburn, etc. These concerns are the result of the antibiotics impacting the vulnerable gut microbiome and can persist long after the discontinuation of antibiotics.

4. Yeast Infections

Women who take antibiotics are at increased risk of developing recurrent vaginal yeast infections. Vaginas maintain their own balanced mix of yeast and bacteria. A type of bacteria called Lactobacilluskeeps the vagina slightly acidic, which isn’t welcoming to yeast. Antibiotics not only eradicate problematic bacteria but also wipe out beneficial bacteria, including Lactobacillus. Without enough Lactobacillus, your vagina becomes less acidic, making it an ideal environment for yeast.

5. Long Term Failure

Clinically, I have seen countless women and men who have been taking antibiotics off and on for years to treat their acne without complete resolution. While Propionibacterium (P) acnes is implicated in the pathophysiology of the condition by producing an inflammatory cascade, acne is not the result of bacterial infection because all adults have acne in follicles and the severity of acne does not correlate with P. acnes counts. I have found that an appropriate topical regimen to prevent the build-up of cellular debris within the pores, reduce inflammation and balance oil production is more successful with long term management and treatment of acne when paired with professional guidance about lifestyle modifications that address the underlying imbalances.

Dr. Jen Newell, ND is the founder of the Naturopathic Skin Care Clinic at the Integrative Health Institute. She is committed to helping others resolve frustrating skin issues because she struggled with hormonal cystic acne and mild rosacea for over 10 years. Dissatisfied with the results from oral contraceptives, antibiotics and other conventional treatments, Jen decided to take matters in her own hands and find a safer and more sustainable solution to achieve healthy, glowing skin. She is now a leader in her field and a pioneer for a holistic approach to skin care.

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Jul 5

Honing Your Side Hustle

By Lauren Berger, MSW, RSW

The side hustle is really having a moment these days.  You’re probably noticing that some of your friends have an extra gig or passion project apart from their nine-to-five.  You may be looking at your friends and thinking, “how do you have energy for this?!”, but many side hustlers find that the extra to-dos actually energize them.  What are the benefits of a side hustle and could it be right for you?  Read on, and I’ll break down the benefits of having a side hustle in this edition of Lauren’s Top Tips.

1. It’s fun! 

Newsflash: Work can be fun and energizing.  Before you call “fake news” on me, hear me out.  Many people find their work draining for different reasons: their colleagues are annoying, their boss is demanding, the deadlines induce pressure, or the work itself is mindboggling.  The side hustle gig is typically still work, but instead of finding that it is another thing to do in an already hectic day, many find that it is an escape.  You can focus on something that you really enjoy and feel passionate about, but can give it more attention than you give a regular hobby.  It’s easier to justify time spent on the hustle as it typically embodies a business, perhaps earning you some money and engaging others in your project.  You may find that this is the “work” that really gets you jumping out of bed in the morning.

2. You make new friends.

Having a little somethin’-somethin’ on the side is great for your social life.  Like everything else these days, engagement on social media is typically part of the package in order to promote yourself.  This usually lends itself to connection with like-minded people.  The support and enjoyment from having this network is a great confidence and energy boost.  Having great friendships has the potential to reduce symptoms of depression and anxiety.  You may even find that you’re more likely to venture out of your comfort zone and meet up with your new buds.  What a bonus!

3. See ya, time wasters! 

Being busy with your passion project means you will likely cut down on time wasters.  When you have some free time, you can now dedicate it to something meaningful rather than falling down a scrolling rabbit hole or watching another Netflix series.  You can still spend your free time doing something you enjoy, but feel a great satisfaction in knowing you’ve accomplished something.

4. Feel secure. 

Another plus of the side hustle is that it is on the side, meaning you get to maintain the security of your day job.  But these projects often lead to financial gain, so you’re really winning in the earning department!  Whether you’re starting a YouTube channel, selling your baked goods, or photographing events, you may find it really gives you a bang for your buck!  Besides the extra moolah, you may find that having this positive focus on your passion project gives you renewed tolerance and happiness at your day job.  When you realize that you are not just your job, and that you are in fact made up of many other interests, you can view your job as what you do and not who you are – this is a very freeing concept that releases the mental shackles that often come along with a day job.

5. Take Your Time.

Does this all sound great, but you have no idea where to begin?  Don’t fret; time is on your side.  As the side hustle is an “extra”, the only deadlines are those that you impose on yourself.  Of course, it is important to set some goals for yourself so that you don’t let your project fall by the wayside, but you can have a more relaxed timeline when you need to.  Some people also find it takes time to discover what they want to do.  Experiment!  Take note of what others are doing… or what no one is doing yet.  The key to the best side hustles is enjoyment.  Find what you love, and start there.

Engaging in a passion project has tons of potential to give you some great extras – friends, fun, a creative outlet, and money are all at the top of the list.  Have fun discovering all the perks, and enjoy all the benefits it has to offer.  Hustle on, friends!

**Disclaimer:  The advice in this article is for informational purposes only and does not replace the diagnosis/treatment of a licensed medical or mental health professional.**

Lauren Berger is a Registered Social Worker Psychotherapist providing counselling and psychotherapy at IHI.  Check her out at www.laurenberger.ca, drop her a line at lauren@laurenberger.ca, follow her on Twitter: @LaurenBergerMSW, or sneak a peek at her Instagram: laurenberger_msw.

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Jul 5

Guide to Intermittent Fasting

Have you ever felt that no matter how hard you exercise or how diligent you are with your nutrition, the weight just keeps slowly creeping up? The weight increases and slows you down, causing fatigue, pain and inflammation. You are not alone in the fight against weight gain, and there is a smarter path to walk down.

Functional medicine, including techniques like intermittent fasting, helps you re-envision the weight-loss process as a set of skills you can develop to combat chronic weight-gain. These skills are focused on shifting our environment, and not fighting against our amazing bodies. Done correctly, lifestyle skills like intermittent fasting can save time and energy, promote productivity and ultimately lead to longevity.

While intermittent fasting is a very popular topic right now in the wellness community, it is important to remember that the practice of fasting dates back to our earliest human cultures and spans most religious and spiritual practices. Fasting is not new, but due to the flood of new evidence on the benefits of fasting, we have a new way of talking about it.

As a Naturopathic Doctor with more than 12 years in clinical practice helping 1000s of professionals lead with their health, I can help you understand the benefits of intermittent fasting so that you can consider using it as a tool for your success.

This guide is for information purposes only; always check with your primary care provider before you make changes to your health plan.

Why do I care so much about intermittent fasting (IMF)?

Your energy matters: it is the fuel for your success. IMF can help you make more energy by optimizing your metabolism.

Here’s how it works:
  • Mitochondria are the energy manufacturing machines that live in every single cell of your body. They are highly concentrated in your brain, liver and muscle tissue.
  • Your muscle mass is like an energy investment with a quick and high return, the more you have the more energy you can make efficiently and easily.
  • Body fat on the other hand is like an investment that is very difficult to access, it is very difficult to get your energy out and the more you accumulate the more inflamed, tired and sluggish you feel.
  • For longevity and optimal health, we want to work to increase our ratio of muscle mass to body fat, which naturally declines with age. Fasting can help us do that.

Intermittent fasting is like a genetic switch that:

  • Improves insulin sensitivity, which is a key component of an increased metabolism, putting you in the fat burning versus fat storing mode. This is how we combat those long hours at a desk that promote our growing belly fat.
  • Increases growth hormone, which is a powerful anti-aging hormone that does amazing work for our body. It repairs tissue and helps us grow stronger and more resilient. Growth hormone dramatically declines after the age of 25. The more we can promote it naturally as we age the younger our cells will be.
  • Increases cellular repair and waste elimination. IMF promotes autophagy. Autophagy is the body’s natural process of identifying old and dysfunctional cells, breaking them down and removing them from the body. It is the ultimate detox process, like the body’s natural “KonMari” method. Let go of all of the old stuff that no longer serves us.
  • Optimizes gene expression. Our DNA is not exactly our destiny. Functional medicine can support optimal gene expression, which is like putting your best genetic blueprint forward for replication. There are many negative environmental influences on our gene expression like stress and pollution. IMF can help tip the scale in favour of our best health.

The health benefits of IMF are significant, especially as we face a growing number of metabolically-linked diseases like type 2 diabetes, Alzheimer’s, dementia, cancer and heart disease. Fighting metabolically-linked disease with drugs alone is not enough to win the war. The pressures of the modern world have moved us away from our optimal rhythm, and functional medicine can help to bring us back.

What does IMF look like?

Fasting simply means not eating any energy-containing foods. You should drink water and can drink herbal tea while you fast. We already fast every night while we are sleeping. Research shows that we need to be mindful of the number of hours we spend in a fasting state. Our culture of late-night dinners, wine before bed and stress eating after long hours at the office have decreased the amount of time we spend fasting.

How long do I need to fast?

There is a large body of evidence to support the “13 hour fast”. This would mean for example eating breakfast at 7 am and having dinner by 6pm. Long term repetition of this pattern is very promising for fat lost and metabolic balance over the course of the lifespan.

  • Your “feeding window” would be 11 hours.
  • Your “fasting window” would be 13 hours.

Other studies show that fat loss may be more significant with a 16-18 hour fast. This might look like eating your first meal at 10 am and your last meal at 6pm.

  • Your “feeding window” would be 8 hours
  • Your “fasting window” would be 16 hours
Do I fast every day?

No.

While some people may feel the benefit of doing a 13 hour fast regularly, the intention behind longer periods of fasting is not meant to be daily but intermittent.

The frequency of fasting should be determined by your specific health goals. While most of us are not fasting enough, some of those who have caught on to the popular health trend are fasting beyond what the research is showing is beneficial.

A good analogy for how much fasting is right for you is to compare against running for exercise. What is your end goal and where is your starting point?

Training for a 13 hour fast is like training for a “couch to 3-5km”: it’s doable and it’s sustainable. You can do it most days to feel good, but you don’t need to do it every day to reap the health benefits on your metabolism.

Training for a 16-18 hour fast is like training for 7-10km. At first it is going to feel uncomfortable but over time your body will adapt, grow stronger and be better able to regulate. If you completed this fast every day you would certainly be “over training” and stressing your body. This type of fasting is best done 1-2 times a week.

Training for a 24 hours fast or longer is like training for a marathon. You don’t run a marathon without training and preparation first. You need to ensure you are committed to supporting your overall health though out this practice of you risk over stressing your body. You are likely completing this type of fasting 1-4 times per year to achieve the health benefits and the research is not yet clear if more is better.

What do I need to do before I start fasting?

Let’s walk you through our functional medicine checklist:

  • You need to have your sleep cycle dialed in.

The benefits of fasting depend on your sleep: the two metabolic processes go hand in hand. Fasting can help to improve the quality of your sleep, but you are not going to experience the fat loss benefits if you are staying up late.

  • Your nutrition game needs to be strong.

Fasting is not about starving your body. It is about cleaning house and requires nutrient optimization. Your “feeding window” needs just as much attention as your “fasting window”. Your diet needs to be nutrient dense: you need to eat well, and you will need to plan ahead.

  • Your liver needs some love.

Your liver is the main controller of the fuel you use to make energy. It is an overlooked organ that plays a major role in your metabolism. Removing stressors to your liver like alcohol, sugar, hydrogenated and some saturated fats, and potentially even coffee, might be necessary to kick your metabolism into the gear it needs to be in to achieve your goals.

  • Your bowels need to move daily.

Remember that this process is also about elimination. If your bowels are not moving, you might not feel good while you are fasting, and long fasts might contribute to more constipation. Address this with your Naturopathic Doctor before you start.

  • You need to stay hydrated.

The process of burning fat for fuel requires water. The more you practice fasting the more your body’s need for water will increase. If your bowel movements slow down or you start feeling really tired your hydration levels are the first thing you should consider. Many people forget to drink plenty of water when they are focused on avoiding food.

  • You need a plan.

A good plan considers how fasting might contribute to your overall health and also considers how it might also take away. Each person has a unique set of metabolic circumstances that should be evaluated.

When intermittent fasting might not be a good idea:

  • If you are taking insulin or have been diagnosed with diabetes you should only fast under the direct supervision of your healthcare professional. Fasting will affect your blood sugar regulation and could be fatal in this circumstance if not monitored.
  • If you have a history of gallstones or constipation, fasting may aggravate your condition. You can address these factors with your Naturopath.
  • If you have battled eating disorders or are triggered by obsessive thinking around your nutrition or weight loss, then tracking your fasting window may exacerbate obsessive behaviour. There is certainly an argument that fasting can be a loving expression of eating in tune with our natural circadian rhythm. It can also be used as a tool for self -deprivation. A deep understanding of our motivations and how we approach selfcare should be explored before you start.
  • If you are pregnant or breastfeeding, your body has a different metabolic priority. It is focused on building and feeding your baby. This is a time to build, not a time to clean house.
  • If you are experiencing malnutrition or malabsorption for any reason. While fasting can play a role in the management of inflammation and autoimmunity, if you are currently experiencing malnutrition due to an IBD flare or your celiac disease is not well managed, correcting malnutrition and malabsorption must be accomplished before fasting could be beneficial. Fasting while malnourished will only add to your state of nutrient deprivation.

Intuitive fasting and mindfulness are the keys to long-term success. Working from a functional approach that considers your metabolic starting point and tracks your success using:

  • Body composition analysis (BIA)
  • Waist circumference and additional markers of insulin sensitivity (HBA1C)
  • Preliminary lab work to establish nutrient status and liver function
  • Sleep quality apps or heart rate variability monitoring as markers of stress reduction and optimal recovery

Working on a program and with a health coach will help you avoid the most common mistakes, including:

Giving up too soon:
  • Many people start and stop too soon without understanding the impact they have achieved, or the success they could have if they make fasting a long-term pattern.
Unnecessary and unproductive suffering:
  • Feeling angry and tired is not a badge of honour. It is a sign that you are not “fat adapted” and your liver needs support before you start fasting on a regular basis.
When fasting goes too far and becomes disordered eating:
  • It can be difficult to accurately assess our own behaviours. A coach can help you stay accountable to your highest self.
Not eating enough nutritious food:
  • Fasting requires nutrient optimization. Our program focuses on nutrient dense, easy to access foods that will help you nourish and recovery your best health. Our health coach will ensure the program is tailored for you based on your unique metabolic needs and activity level.

Like exercise, fasting is about improving our long-term metabolic health benefits it is not about short-term weight loss (although that is often a nice side effect).

The greatest influence on your health is you. It’s time to stop fighting your body and shift your environment in favour of your metabolism.

Get Started

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem or looking to optimize their health.

Dr. Erin Wiley is a Naturopathic Doctor with a strong focus on preventative and integrative medicine. She is the Owner and Clinic Director of the Integrative Health Institute, an integrative medical clinic located in downtown Toronto. Erin has a strong clinical emphasis on autoimmune conditions, stress related illness, anxiety, depression and hormone balance. As a naturopathic doctor, Erin is passionate about working with people to help them better understand their health and achieve their health goals.

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Jul 4

Is it Anxiety or Overload?

Working with many patients who present with the High Sensitivity Person Trait, I come across many individuals who think they have anxiety. So, how does someone know if anxiety is the actual problem or not? What does the High Sensitivity Trait have to do with this?

First, let me describe the High Sensitivity Trait so we have a frame of reference. One fifth of all humans have this trait. The trait endows these individuals with five characteristics. The first two characteristics are that they are very perceptive and have high sensorial acuity, which results in sensing and “getting” more out of what is happening in the environment. This also results in more body awareness.

High Sensitivity Individuals also have a capacity for deep processing thoughts and perceptions. The fourth trait is that they have more intense emotions than the average individual, including both negative and positive emotions. They are very observant and process situations figuring out the many possible outcomes.

High sensitivity individuals tend to have a limit to their tolerance for highly stimulating environments. They are not necessarily shy but sometimes they need to take a step back in crowded places, or rowdy parties, due to getting overloaded with stimulation and their capacity to empathize and “get” others. They sense danger before others, because they have a keen sense of how things turn out. Occasionally, they get overwhelmed or overloaded if they don’t take a break from stimuli.

Many High Sensitivity people misunderstand their feelings of being overwhelmed by stimulation, with having anxiety. So… what is the difference?

Anxiety is generally a fear-related response. The individual becomes afraid that something might happen, and responds to the situation with fear, avoidance or changes in their behaviour. Symptoms include frequent worry, feelings of restlessness, and physical symptoms, such as changes in heart rate, sweating, and tension.

Most individuals do not like to feel overwhelmed, and most individuals do not like feeling fear, either from a real situation or from an imagined projection. It is possible that a High Sensitivity individual might be anxious of becoming overwhelmed, but in general, this is not the case. For individuals with the High Sensitivity trait, taking a break from the stimulus allows them to go back to baseline and feel tranquil again. This is a simple process.

The good news is that as soon as High Sensitivity individuals do not feel overwhelmed by the specific stimulus any more, they can go back to the situation and continue having fun or doing whatever they were doing.

On the other hand, treatment for anxiety takes more effort than just going into a room and having some quiet time. For people that suffer from anxiety, going back to the environment that caused the fear response is more complicated, because of a fear loop.

The good news is that there are many different ways to address the discomfort a person with anxiety feels, including psychotherapy, counselling, herbs, diet, exercise, and other means. I hope this helps address these two different concerns.

If you think you may be needing some help distinguishing between these two different situations, both Lauren and I offer free Meet and Greet appointments where we can discuss options for solving your concerns positively.

Ariel Blau has a formidable passion for helping his clients energize a joyful, loving and creative life. He has more than 30 years of experience helping people bloom. His formal education includes a Master’s degree in Social Work from New York University, a Master’s in Fine Arts from Brandeis University, and a great number of workshops, certificates and seminars. He has been studying mindfulness and how to bring compassion into the world for more than 15 years. His passion for helping others is matched by his enormous drive for continuous learning. Ariel completed his professional clinical training at Yale New Haven Psychiatric Hospital and served as  Lead Clinician at the Jewish Family Service of Greater New Haven.

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Jun 3

Adulting.

adult·ing/əˈdəltiNG,ˈaˌdəltiNG/ noun : “the practice of behaving in a way characteristic of a responsible adult, especially the accomplishment of mundane but necessary tasks.”

Clearing up the confusion.

Recently someone asked me about what “adulting” means. I have the word in my website under the list of things that I can help with. It does sound a bit cryptic, and it may confuse people not familiar with the term. Basically, “adulting” is about completing the developmental tasks that turn us into adults.

In Canadian society, a few markers show that you have become an adult. One is becoming a citizen with right to vote. Another is having formed a more or less self-defined identity. There is more!

As an adult, one is expected to be a productive member of society and have mature long-term relationships with other consenting adults. Adults can “manage,” do our laundry, buy food, and take care of ourselves, and even others.

What is the path?

In traditional cultures, when you reach a certain age, you follow a ritual or rite of passage that clearly marks the change from one status to the other. In many cultures, once you are sexually developed, you are an adult. It’s all about the plumbing!

In such a culture, your place in society is pretty much planned for you. If you follow the plan, you will do just fine. It is different in less traditional cultures, where the path for “adulting” is not so easy to figure out.

In our less traditional culture, even though we may already have the “plumbing,” we are not considered adults. We live for a period as adolescents, stuck between being a child and being recognized as an adult. What is worse, in our contemporary society, the path to adulthood can feel like a mystery.

If you are lucky, you get parents who are good at raising you and providing you with the tools you need to grow up and be happy. They have managed to get there, and they know how to help you get there too!

For many, it is not like that. Their parents might not have been so sure about how to grow up. Different events in their own lives may have prevented them from finishing their growing-up journey in certain areas. Many were touched by events larger than themselves.

Past to present perspective.

A huge change in expectations framed the experience of those growing up after WWII, in the 1960s and 1970s, where ideas about what one should be changed radically.

A huge change impacts those leaving their native countries. Like many Canadians, straddling two cultures has impacted them.

Cultural changes brought about by technology, and mindsets like “globalization” have also undermined what was left of models for how to live. Today, most people grow up facing a potentially confusing and bewildering set of circumstances.

Where in the past you had a prescribed path, now you have to find it yourself. Changing sexualities, work conditions, shifting economies, and information overload conspire to add to our bewilderment.

Ideas like leaving behind oppressive forms of patriarchy and secularism leave us bereft of clear positive models after which to mold our lives. It can feel very unclear!

Learn to see opportunities.

While the idea of adulting can be unclear, there are resources to help us. We may be lucky to have friends or parents with more insight. A teacher may be happy to mentor us. Someone in our family, like an uncle or aunt, may be there for us, if we ask. We don’t have to do it alone.

Changing conditions can be an opportunity to let your imagination thrive. It is an opportunity for exploring possibilities and engaging with one’s internal image. It can be a chance to meet the world with our unique amazing gifts.

For those who have not looked at their particular gifts, it can be an opportunity to take steps to find your niche. You can take steps to find what makes you “tick” and root your ideas in the world. It can also be an opportunity to build a better society.

Some traditional customs in many cultures and religions were not exactly “people friendly.” We have the opportunity to embrace the shifts of our times and direct them, as leaders or professionals, in the direction of a more just and compassionate world.

It may feel a bit scary, or too adventurous, but it does not have to feel lonely. There are people in this world that can be your resource. Look around, and you will see organizations of folks that embrace ideas that may match yours, or mentors, or people like me, who have made it a career to contribute to society by helping others get there.

If you are willing, you will find someone to help you figure it out and stand by your side!

– – – – –

For those interested in the “adulting” idea or feeling they can use support, Ariel Blau has appointments available to start the conversation.

Ariel Blau has a formidable passion for helping his clients energize a joyful, loving and creative life. He has more than 30 years of experience helping people bloom. His formal education includes a Master’s degree in Social Work from New York University, a Master’s in Fine Arts from Brandeis University, and a great number of workshops, certificates and seminars. He has been studying mindfulness and how to bring compassion into the world for more than 15 years. His passion for helping others is matched by his enormous drive for continuous learning. Ariel completed his professional clinical training at Yale New Haven Psychiatric Hospital and served as  Lead Clinician at the Jewish Family Service of Greater New Haven.

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May 27

Self-Care Struggle

By Lauren Berger, MSW, RSW

Self-care is a huge buzzword (buzz phrase?) these days. The premise is sound: do things throughout your month, week, day to care for yourself amidst everything you “have to” do, such as go to work, care for your kids, and make sure your home isn’t a total dump. The subtext of self-care is that it should be special, decadent, or ultra-relaxing – think: spa day, candle lit bath, entire chocolate cake from a famous patisserie. While a lovely idea in theory, not everyone can swing an Instagrammable self-care experience on a regular basis, due to lack of time, funds, energy, or other resources. This seems to leave many feeling that self-care is an all or nothing premise.  Well, here I am to squash that theory! Self-care can be accessible to everyone, we just have to redefine its parameters. How, you ask? Dive into my top tips for accessible self-care. Let’s go!

1.Rework your definition of self-care.

If the self-care items on your list are limited to decadent moments, it’s time to redefine the term. Self-care isn’t meant to be something unattainable that you strive for; a more helpful way to frame it is as something that nurtures your wellbeing. That can be done in many ways. Consider the different aspects that make up your wellbeing. What are you eating? A self-care moment that reflects how you feed yourself doesn’t need to take place in a fancy restaurant. Maybe it’s inviting a pal over to eat with you, so you can talk face-to-face instead of over text. Maybe it’s learning to make a version of your favourite restaurant meal so you can enjoy it any time you please.  Or maybe it’s even making a swap, trading out some junk food for something fresh or more nutritious to give your body a boost it may be craving. These are all ways to serve yourself, even if they don’t seem so out of the ordinary. 

2.Reframe the parts that are holding you back. 

Does there always seem to be something in your way when you’re trying to have a moment to yourself? Try building that thing into your self-care time.  Want more time to exercise but your work hours are just too long? Suggest a power walk meeting. You may be surprised at how your colleague may find that a welcome change to a boring office meetup. Is your daily commute zapping your time and incurring your road rage? Download a cool podcast or create a relaxing play list for your drive to turn that time into something more fun or peaceful. If your commute is on public transit, you can even aim for some meditation or guided relaxation on your route (sorry drivers, don’t operate heavy machinery while attempting deep relaxation! Take the streetcar if this is your aim.). Or follow my lead: when I had to spend some time in the hospital with an IV bag, I silenced my phone (bye bye, email alerts!) and brought along the book I’ve been meaning to read… all of a sudden, the potentially crummy and boring medical experience was transformed into some uninterrupted me-time. Even the act of receiving the IV can be looked at as self-care; hey, I was getting my body something it really needed, and that is an excellent way to care for myself!

3. It looks different to everyone.

Some people would give their right arm for a massage while others can’t bear to be touched. That’s cool! No need to force something just because it’s “meant” to be enjoyable or relaxing. Some people crave time with friends while others crave an hour of solo Netflixing. There is no wrong or right way.  You’ll know it’s right for you if you feel a sense of fulfilment, wellbeing, or happiness doing your chosen activity. Most people wouldn’t choose to chill at the hospital for an hour and a half with a needle in their arm, but hey, for me it ended up being a great morning and I walked out with a smile on my face. Our self-care needs are diverse, so don’t worry about it fitting into a pre-determined box.

4.Consider quality vs quantity. 

I think a valid argument can be made for both quality and quantity when it comes to your self-care. Trial and error are key here to finding out which is more beneficial to you. Some people thrive on spending a year looking forward to a two week vacation while others much prefer to take a three day weekend once a month. This also applies to low key self-care; do you need an hour to decompress at the end of the day, or do you need to take five to ten minute breaks throughout the day to re-energize? Experiment and see what’s best for you.

5.Build it in. 

Still finding it hard to get that self-care moment in? Maybe it’s time to build it in to the things you already do. Reframing an everyday task as a self-care moment can make a world of difference. Try looking at your daily shower time in a new way. If you usually rush through it without much thought, try amping it up with some things to take it next level (a new body scrub or a couple drops of essential oil in the steam to relax/invigorate you?), or finding ways to take pleasure in what you already do (pay attention to the sensations while you wash your hair… suddenly it feels like a wonderful scalp massage). 

Caring for yourself should definitely be a non-negotiable, but you can absolutely negotiate what self-care means to your life. With my tips I’m sure you can find a way to fit it in without it feeling like a chore or something out of your reach. Enjoy!

**Disclaimer: The advice in this article is for informational purposes only and does not replace the diagnosis/treatment of a licensed medical or mental health professional.**

Lauren Berger is a Registered Social Worker Psychotherapist providing counselling and psychotherapy at IHI.  Check her out at www.laurenberger.ca, drop her a line at lauren@laurenberger.ca, follow her on Twitter: @LaurenBergerMSW, or sneak a peek at her Instagram: laurenberger_msw.

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May 24

Postpartum Running and Exercise: When can I REALLY return?

“When can I start doing “x” after I’ve given birth?”

Up until just recently this question was only answered at the 6-week postpartum check-up.  After some quick questions and *possibly* a physical exam, new Mamas are cleared for activity or told to return when they feel ready using the common refrain, “listen to your body”. 

But what if I don’t know what I’m listening for?”

Exactly.

Even as an experience physiotherapist, who knows what to look and listen for, it was not until I became a mother twice that I understood how our current postpartum healthcare framework sets up women to have very low expectations about their physical health after birth. 

“You had a baby, what did you expect? That’s normal”

What is often “normal” expectations for how women will return to activity after birth – which is one of the most physically intense activities their body will experience – is actually quite different from how most athletes get cleared to return to sport after major injuries.  This process involves weekly rehabilitation for anywhere from 6-18 weeks and then testing for range of motion, pain levels, muscular strength and a Functional Movement Screen (FMS). FMS is a pre-participation screening tool that is highly effective in isolating and identifying imbalances in muscle mobility and stability through seven fundamental movement patterns. Once deficiencies have been identified, a program of corrective exercises is then developed with the goal of moving efficiently and avoiding musculoskeletal injury. The seven movements are scored from 0-3 points, with the sum creating a score ranging from 0-21 points. Scores lower than 14 are correlated to higher risk of injury.

So Mamas, if the professional athletes with low FMS scores aren’t getting clearance to return to sport by their doctors, why aren’t our doctors being just as discerning with our bodies?  Exercise is so crucial to stress management, energy optimization and mental health so let my unique professional training and personal pregnancy experience guide you back to activity in the same way a pro would return to their sport. My vision for Mamas includes pain free movement, running without “accidents” and returning to your sport/activity of choice without risk of injury.

Parenting is hard enough.  New Mamas take EXTREME measures to avoid all viruses and sickness when they have their newborns. Imagine we took that approach to our physical strength programs to avoid injury and optimize our return to athletic endeavors?  There are so few moments in a Mama’s day, let me simplify and target how you make use of that precious time to be #momstrong.

“But wait, I ran all through my pregnancy so can I return when I feel like it?”

Not exactly.

Pain, whether you think you can control it or not, alters our movement patterns.  We will always move to avoid a pain pattern and each of us interprets pain differently.  This is why some Mamas seem to jump back to a regular routine and others may not make it out of bed that day.

Think about how you start to limp when you get the smallest of blisters from a new pair of shoes. So now picture how may have “waddled” carrying 20-40 baby pounds on your frame.  Or to be more direct, recall how you walked after a human exited your vagina or maybe, after that human exited through an incision that cut through 10 layers of your abdomen, which is supposed to control your core/pelvic movement. 

Suffice to say, we may not be moving in the most efficient or optimized way. So why would we add load (weights) or repeat movements (running) to dysfunctional movement patterns?

“I’m not an athlete, I’m just a Mama who wants to be healthy.  I looked up these tests and I can’t do any of them”

I got you Mamas. I can modify most of the seven movements to determine a better start for you. I understand intimately how pregnancy changed your body movements. I want to provide you with an experience that builds confidence of what you CAN do and not what you CAN’T.

For the first time in women’s postnatal care, let’s be objective about how our bodies are moving to determine if we’re returning to activity safely.  No more arbitrary timelines. It is no longer about 6 weeks, 8 weeks or 12 weeks postpartum when you can start activity. It is about starting at the week when your body is ready to handle momentum, load and repetitive movements like running. No two pregnancies or births are the same so this process is unique to you and an FMS is bespoke postpartum rehabilitation to optimize the RIGHT time to fully return to what you love doing actively.

                                                                        ***

Learn more – Book a complementary call with Kate to find out if you should be completing a Functional Movement Screen to return to activity.

Let’s get started!  Kate is accepting new clients on Tuesdays at Integrative Health Institute

Book your Initial Assessment to determine what your body is ready for.  At this time,  she can also assess if your pregnancy put you at risk for Diastasis Recti vulnerabilities and what can be done to regain functional control of your abdominal muscles.

She was certified in FMS in 2011 and has 14 years of sport medicine experience. She has conducted these screens on all populations and was invited to the Toronto Maple Leaf training camp last year to screen our hometown boys.  Kate is a mom of two kids who used to score an 8/21 on an FMS and now scores a 16/21. 

Kate has been a physiotherapist for 14 years at one of the top sport medicine clinics in Toronto.  After the birth of her two very large babies, she became a busy, athletic mom with all the “common but not normal” post-partum incontinence symptoms.  She has since become a certified pelvic health therapist and a Studio Lagree Pilates instructor.  Her extensive background in all these areas lets her be uniquely suited to restoring pelvic floor function and overall functional movement in women and men trying to be active and accident-free.

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May 22

Don’t Jump Outside Your Comfort Zone, Expand It

There is an interplay between how our brain functions and how we experience the world. We are complex beings whose genes, history, and culture are in collaboration with the complex structure that is the brain. Learning how our brain works and how to best leverage its strengths is key to how we perceive, and therefore how we choose to show up in life.

The brain interprets input through a system of layers in which everything is about a predictability model and expectation violation. It uses our past experiences to search for familiarity in our present circumstances to see if we are what it perceives to be ‘safe’, and re-creates an expected outcome—a processing that occurs in an instant and without our conscious awareness.

If someone touches you, for example, your skin receptors are the first to interpret if you have experienced that in the past and to let you know if you like it or not. If the input is familiar at that level, there is no need for further analysis. If it is not familiar, the next step is at the level of your spinal cord, where you may have a reflexive response based on past information. The brain stem is the next level— it decides if the situation is threatening in a life or death sort of way. As we continue through the levels, we become more specific in our analysis. At the level of the thalamus, we begin to distinguish what is the kind of touch: Human? Animal? Mosquito? Should we still be unsure about the nature of the situation, we get to the level of the cortex where perception happens and we apply further reason to the investigation. With each level, the complexity goes up, and so too the potential for entropy (chaos)!

As we are urged to look at our ‘limiting beliefs’ and ‘step out of our comfort zone’, it is important to understand the system we are dealing with and what it was designed to do…

To actually jump outside of our comfort zone can be a threatening thing. Should we venture outside the box and get smacked down, the zone can recoil and we are then less inclined to try it again, as that becomes the past experience to which our brain ties all future risk-taking. The trick is to expand our comfort zone by pushing the boundaries—putting ourselves in an uncomfortable context in a limited way which will create a positive feedback loop. This decreases the perception of threat and gives us an opportunity to ‘fail successfully’.

A framework for what this looks like is this:

1. Do things that are in a novel environment.

  • Introducing variability increases your tolerance for it.

2. Connect to something that is bigger than you.

  • The less it is actually about you, the less pressure you perceive!

3. Emotionally prepare for ‘negative’ feelings, feedback,
or results.

  • Being prepared improves your resiliency and lessens impact.

4. Have someone who gives positive feedback.

  • Have people in your life that encourage and support you.

As an illustration of this process, for the second year, I am acting in a musical in a community theatre production. Although it causes some frustration and anxiety at times, and challenges me in many ways, it also allows me to challenge the belief that I have that I cannot sing.

Without natural aptitude, everything about singing and dancing feels complex, so I must look for variables that I can control—which are those that arise internally. The tendency to compare myself to the best singer and the best dancer does not decrease my anxiety or increase my performance—once our stress response is activated, we become more reactive and have less bandwidth to learn new things. So, I can choose instead to see how I am better than I was last week, thereby feeling more capable, expanding my zone, and managing that particular stressor.

I can also choose what I hope to gain from the experience and the goals I set for myself. Finding the balance between accepting the challenge of the task but setting a base value of what I want to get out of it. I am not aiming for Broadway, rather looking at how this might serve me to become better at life. If I explored something new and uncomfortable, and if I tried really hard to do my best, then that alone is magical, regardless of the outcome or what other series of events may occur.

And I can embrace the knowledge that a certain amount of chaos (entropy) is inevitable! Even within a controlled environment, with practice, and under direction, there is a fluidity to the experience. The uncertainty of the performance, all of the other people involved, and the irritation that arises when the director changes things on the fly and we have to adapt again after so much preparation. Yet one of the most beautiful things about acting is that 90% of it is reacting to what is happening in the present moment—which is a challenge in and of itself.

Our beliefs may be so deeply ingrained that they are interwoven into our DNA, influenced by epigenetics and the many facets of our environment that we have experienced since childhood. The challenging thing about beliefs is that we see the world through them, and we have a bias toward things that validate them. I am far more likely to take criticism than compliments when it comes to my singing, as that supports my belief. Yet, as we add a greater degree of consciousness and expose ourselves to feedback, we can observe if the reality actually matches our belief system.

While having a growth mindset may involve believing that you can change your beliefs, the main thing is to not let those beliefs govern your life. Being able to behaviorally push the boundary can help to immunize us to such beliefs, yet we must also understand that as we do so, the bar usually continues to raise! While I may continue to have the perception that I am not a great singer, I can shift the belief that, as an extension of speaking, I still have a right to sing.

For myself, I am challenged by my clients to practice what I preach, so whatever anxiety or discomfort I may feel, or whatever ego hits I may take in the process, it is by design to become a better clinician and to be more vivid and clear in my own voice. When I ask you to think or do things differently, I know how hard it is to change those patterns and confront those beliefs so, in that way, we have a shared skin in the game.

Expand your comfort zone by challenging your assumptions and controlling the complexity. Choose goals, situations, and perspectives that allow for the feedback and lessons that will diffuse into other aspects of your life, and celebrate your own small wins along the way. Regardless of the complexity or chaos that life is bound to throw your way, having the courage to sing your own song is part of the dance of life in which we all have a role to play.

Dr. Tabrizi is a chiropractor, osteopath and a passionate member of both the local and scientific community, whose goal is to teach that the pursuit of optimal health and wellness is much more than being symptom-free. His practice is rooted in the philosophy of treating the person rather than just treating the illness or ailment. As a result of his interdisciplinary training, Dr. Tabrizi has developed a neuroscience-based therapeutic education approach to treating his patients, focusing on healing illness from a wider perspective, placing equal responsibility on patient as well as practitioner. Dr. Tabrizi aims to educate his patients and provide them with the tools and framework needed to integrate pain management and healthy living into the fabric of their everyday lives.

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May 13

Is it PMS or PMDD?

Premenstrual syndrome (PMS) is a many-headed beast – with over 150 different symptoms attributed to PMS, many women find the days, or week, before their period to be a challenging time. But what about those women who are completely destroyed by their PMS? Who suffer with severe mood changes, insomnia and fatigue? Those women may in fact be suffering from PMDD – premenstrual dysphoric disorder. 

A Diagnosis of PMDD

PMDD is classified as a type of depressive disorder. It is not the same as clinical depression because it only occurs during the second half of the menstrual cycle, after ovulation, and it resolves within a few days of starting your period.

For the 2-6% of women who experience PMDD, it can lead to significant negative impacts on her life. Known to cause severe distress, it can impact a woman’s ability to function and to maintain her quality of life. But still many of the women don’t seek treatment and instead suffer each month with severe symptoms. 

PMDD is different from PMS in the severity of symptoms and the consequences of the mood changes. The diagnosis is made by using symptom tracking reports and needs to meet the following criteria:

Treatment of PMDD

Conventional treatment of PMDD gives women two limited options: the birth control pill, or an antidepressant. While these treatments may be effective for some women, many more women are seeking a more natural, empowered approach to managing their PMDD.

Natural Approaches to PMDD

I previously wrote an article called Ten Natural Treatments for PMS where I highlight ten of the best researched and most effective treatments for managing PMS. I suggest all women with PMDD also follow those recommendations. But for PMDD I tend to take a more aggressive approach – the symptoms are often severe enough to warrant a very targeted and bold plan. 

Vitamin B6

Used in both PMS and PMDD, vitamin B6 is necessary for the production of cortisol, progesterone and serotonin – all hormones involved in PMS and PMDD. Taking high (orthomolecular) doses of vitamin B6 can be helpful at reducing symptoms of PMS and PMDD. Vitamin B6 is usually taken all month long, but higher doses can be used in the second half of the cycle if needed. 

Calcium

Calcium has been found in studies to reduce a wide variety of symptoms associated with PMS. While I don’t generally find it to be useful on its own, in a robust protocol calcium can play a role in reducing both the mood and physical symptoms of PMS and PMDD. 

L-tryptophan and 5-HTP

Two supplements that can increase the production of serotonin in the body, L-tryptophan and 5-HTP, show a ton of promise in the treatment of PMDD.  Using a similar mechanism as antidepressants, these two treatments can support the serotonin production and response – considered to be one of the most effective means of treating PMDD.  L-tryptophan and 5-HTP are the direct precursors of serotonin and can significantly reduce mood symptoms of PMDD. These supplements are not recommended to be taken together (we choose one or the other, depending on your needs), and should not be combined with other antidepressants. Use only under the guidance of a knowledgeable and experienced Naturopathic Doctor. 

St. John’s Wort

One of the most commonly used botanical medicines, St. John’s Wort is an excellent treatment for women with PMDD. Acting on the serotonin system in the body, St. John’s Wort can reduce depressive symptoms of PMDD and improve mood. It can be taken all month long, or just during the second half of the menstrual cycle. 

Chaste Berry

Chaste berry (chaste tree, Vitex agnus-castus), which I also discussed in the PMS article, has been found to be effective for PMDD. Chaste berry can reduce anger, irritability, anxiety, mood swings, and physical symptoms associated with PMS and PMDD. My experience is that it can be moderately effective for PMDD, but often additional treatments are needed to help women feel considerably better. 

IV Micronutrient Therapy

One treatment that I offer at the Integrative Health Institute, and have found to drastically improve PMS and PMDD symptoms in women is IV micronutrient therapy (IVMT). IVMT allows us to administer doses of vitamins (like B6, calcium and magnesium) at higher doses than you would be able to take orally. IV therapy also provides an abundance of nutrients necessary for detoxification of hormones – and reducing the hormone burden in the body can greatly improve symptoms of PMDD. Not every woman is a candidate for IVMT, but talk to your Naturopath to find out if you are. 

Bio-Identical Progesterone

While we don’t know exactly what causes PMS and PMDD, one suspect in this mystery is an imbalance of estrogen and progesterone – often called estrogen dominance. When progesterone levels are unstable, or low, and estrogen levels are high, PMS and PMDD depression and mood swings can result. For some women, especially those in their 40s, bio-identical progesterone can be a lifesaver. Your ND will give you a questionnaire to identify a possible progesterone imbalance, and may also recommend hormone testing.

Reclaiming Your Life

My best recommendation to managing PMDD is to work with someone who takes your symptoms seriously, who recognizes the many ways in which PMS and PMDD can influence your quality of life, and who can help you to develop a plan that addresses your unique experience. My approach to PMDD is generally quite bold and proactive – mostly because I don’t want women to suffer unnecessarily. It can take several months to overcome the debilitating symptoms of PMDD – but trust me, they can be overcome.

Select Resources

Comprehensive Gynecology, Seventh Edition. Ed. Lobo R, Gershenson D, Lentz G. 2017; 37, 815-828.

Ferri’s Clinical Advisor. Premenstrual Dysphoric Disorder. Ed. Ferri FF. 2019

Dr. Lisa Watson believes that you don’t have to be perfect to be healthy.  Lisa encourages her patients to take a proactive approach to their health – taking meaningful steps towards achieving their goals for balanced and vibrant health.  An expert in women’s health and hormones, Lisa is a passionate advocate for women’s health and strives to educate all the women in her practice on how to achieve lifelong abundant health.  Dr. Watson practices at the Integrative Health Institute in downtown Toronto and writes regularly about women’s health on her website at www.drlisawatson.com

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May 6

Ten Nutrition Hacks for Beginner Runners

When I started running, I had no idea what to eat. So, I just ate it all. With these 10 tips, you can begin to shift your metabolic state and your training results.

1. Start your Nutritional Training now.

Just like you are training your muscles, you are training your brain and body to eat for health. The sooner you start, the sooner your body will thank you.

2. Nutrient-dense foods are key.

Choose nutrient-dense foods over those that are energy dense.

Swap out white sugars for Honey, Maple Syrup, Agave, or Stevia.

3. High quality carbs.

Choose higher quality carbohydrates. Remember, that fruits and veggies count as carbs too.

Swap out white breads, cereals and pastas for higher quality grains such as quinoa, oatmeal, brown rice, peas, carrots, corn, pumpkin, butternut squash, fresh and dried fruit.

  • 15-20 grams of carbohydrate (+protein) = 1⁄2 cup dried beans, lentils, garbanzo beans
  • 15 grams of carbohydrate = a slice of spelt bread, 1/2 cup brown rice, a piece of fruit or 3/4 cup 100% fruit juice
  • 12 grams of dairy carbohydrate = 1 cup of milk or yogurt, 1.5 oz cheese
  • 5 grams of vegetable carbohydrate = 1 cup of leafy vegetables, 1/2 cup chopped veggies, 3/4 cup vegetable juice
4. Prioritize fruits and veggies.

Fruit and vegetables should be high up on your priority list. You should aim to consume at least three fruit and three vegetables per day.

5. Remember protein.

Don’t neglect the protein in your diet – protein is very important for maintaining and building lean muscle mass. Try having some form of protein at every meal. You need just under your body weight in kg’s in grams of protein. For example, a person that weighs 56kg’s would need just under 56 grams of protein. Here is a quick cheat chart to give you an idea of how much you are consuming. Apps like myfitnesspal.com will help you track your macros.

  • 21 grams of protein = 3 ounce serving of lean meat (1 medium pork chop), 1/2 a chicken breast or a small halibut, salmon, cod fillet
  • 7 grams of protein = 1/2 cup of cooked beans, 1 ounce of cheese, 1 egg/2 egg whites, 4 ounces of tofu,2 tablespoons of nut butter
  • 8 grams of protein = one cup of milk or yogurt
  • 3 grams of protein = one serving of whole grain products (a slice of bread)
6. Re-Think fat.

Fats are required for proper brain and hormone support. You can also train your body to burn fats vs the more common carbo load. Ask if Keto or Keto Cycling is the choice for you. Make sure your diet includes these healthy choices: olive oil, olives, coconut oil, coconut milk, coconut shavings, avocado, nuts, seeds and organic feta.

7. Time it Right.

Pre Exercise. Eat every four hours. Skipping meals depletes your body of protein, not fat. Aim to get your work out in 30 minutes after a light snack or two hours after a meal.

8. Time it Right.

Post Exercise. Eat 20-60 minutes post work out.

9. Avoid unnecessary ingredients.

Sports drinks, gels and energy bars are commonly used by runners. In the early stages of training, these are not necessary. Many of them contain extra sugar, carbs as well as ingredients that can upset your tummy. Once your endurance improves, we can chat about health options.

10. Pay attention to your fluid needs.

Dehydration can decrease your performance and lead to headaches which may discourage your progress. Set yourself up for success. Take a glass or metal bottle of water with you to work and training. Just like your protein, aim for your body weight in kg’s.

Dr. Jennifer Tanner, has a broad, evidence-based practice with a focus on sports and performance-based medicine. Being a marathon runner and having been a competitive equestrian, an active lifestyle is important. Dr. Tanner uses a variety of tools including Acupuncture and Clinical Nutrition, putting an emphasis on “food as medicine” and addressing the root causes of inflammation. In conjunction with the Integrative Health team, Dr. Tanner is thrilled to help people achieve an optimal state of health and pursue their performance based health goals!

www.drjennifertannernd.com

@drjennifertannernd

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