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Travelogues and Writing Binges

Hi, all! Most of you know I’m starting a 6 month sabbatical in a few weeks to hopefully make some good progress on my book about Integrative Medicine, but I wanted to finally be brave and also tell you about my new blog I started a couple of weeks ago. I’ve written poetry forever, but I rarely shared any with anyone until this past year, and really not until the past 6 months… and since I sometimes write about meditation and also personal stories, I thought it would be best to have a separate site– I’ll write my personal things on that one ( poetsandragons.blogspot.com ) and leave this one for book updates and essays about health and the environment. That way you can choose which side you’d like to subscribe to. And if you like my personal stuff, you will also be able to follow me as I travel and if you’re around, drop me a line and we’ll have tea! It’s still new and I’m still editing the last few posts, but it’s a start, and comments are welcomed!
Much love, Andrea
:)

ADHD

Yesterday, while catching up on medical concerns with a patient before we started her Osteopathic session, I said “oh, yes, I tried that too” to convey understanding about what she was telling me regarding her experience with ADHD. She had been wondering whether to try a new treatment, and she stopped short. She was so surprised, and asked me, “Wait, you have this?” And I said, well, not the hyperactivity symptoms, but yes, I’ve been dealing with it since I was a teenager. It seemed to help her trust what I had to say about effective treatments and medication options, so I thought maybe it would be helpful to write about too.

Typical of many girls with mild attention-deficit symptoms, my main issues growing up were becoming bored and fidgety or even combative after only a few minutes of something I wasn’t extremely interested in, forgetting to do things like homework while doing adequately in school (so as to not raise any red flags learning-wise), getting in trouble over and over in class for falling out of my chair or daydreaming or talking, having major depressive symptoms with serious irritability and quickly becoming frustrated, and being able to ‘hyper-focus’ for hours on end on something I was truly interested in (in my case it was usually books or video games).

It wasn’t until around age 12 that I realized one day playing my game-boy, that my body was hurting all over laying cramped on the couch playing, and I didn’t want to eat dinner because I’d just ‘won’ and the game had automatically started over at a harder level… I was willing to be in pain and not sleep or eat in order to keep playing. I felt so angry about everything (mostly at my mother insisting that I pause the game- which turned off automatically after 10 minutes on pause so I rushed through eating), especially at any attempt to get my attention- I was so intent that didn’t hear anyone unless they were touching my shoulder at which point I would jump and yell at them- that a lightbulb went off: I didn’t like myself like that. I decided to put the games above my tallest bookshelf and not play them again.

Somehow I got through college (with an unimpressive GPA from taking so many classes and not being able to complete the entire curriculum for any one of them), but afterwards I was lost. I didn’t know how to do anything but be in school, even at the sliding-through level I generally took, and I was dealing with emotional trauma I hadn’t had help processing yet, so my mother paid for me to go to therapy while I looked into going to grad school. I took Effexor (venlafaxine), which is a combination SNRI (serotonin and norepinephrine) receptor blocker. In those three months, my mother and I didn’t fight once. (A miracle, honestly, given our violent and frightening history.) I studied for the MCAT, albeit cursorily, by skimming the entire Kaplan book in 3 days, seated at my desk, without music or food as with my previous study habits. And then, at the end of the summer, the relationship I was in went through a rough patch, and I stopped my medication cold turkey. (NEVER do that, by the way. Withdrawals are absolutely horrific.) Fighting with my mother commenced shortly afterwards, and I was told to either pay rent or leave, so I left the next morning, and decided that I’d try to find ways to deal with my sensitivities and attention issues without medication if I could.

The next chapter of my life really began after a year of working in a restaurant, using alcohol to calm myself down in order to be social, and playing video games until 3am most nights, when I somehow was accepted into medical school. I went through two video games there, one each year I lived in Kansas City, until realizing after one 8 hour bout wherein I ate an entire box of Better Cheddar crackers and drank only 20oz of Mountain Dew that day, that again, this was not the way I wished to live. My ban on video games resumed. I finally learned to study, even though it was with enormous amounts of caffeine, and also tried a few other anti-depressants and stimulant medications, but every one either gave me untenable gastrointestinal side effects or caused such nausea and anorexia that I would stop after 2-3 days. Personally, with no medical evidence for this, I blame the withdrawal-induced traumatic brain pathway I gave myself, and assume my gut-brain connection just decided it had had enough of me messing with it.

Now, I never had the major issues or severe symptoms that some of my patients have experienced, but it was enough of a problem that when I was semi-officially diagnosed (I didn’t want it on my medical record, so my psychiatrist at the time just spoke with me about it at length), it was actually a relief to know I wasn’t simply ‘lazy’ or ‘lacking motivation’ as I’d been told when I was younger. As for the sometimes frightening hypersensitivity to sound and busy environments I had experienced since I was about 6 years old, my psychiatrist attributed those issues to the same group of symptoms, and gave me a ‘good’ reason to leave environments that were difficult for me to handle and to take time to myself when I was overwhelmed.

Fast forward through residency, where the stress of losing my mother, 100-hour work weeks, and the fear of causing harm to patients seemed stimulating enough to force me to learn what I needed to become a good physician… then to today, and my current way of living. I’ll share the things I’ve learned, many of them in the last 5 years, that help me accomplish necessary tasks, and allow me to be creative and passionate without letting me forget about responsibilities I’ve taken on. I don’t do every one of these perfectly, but these are definitely the most helpful non-medical ADHD symptom modifiers I’ve found.

* I meditate every day. As my ‘Insight Timer’ on my phone records, I’ve missed 3 days in the last 400. And I felt it when I did! Nothing has given me more insight or helped me more in my own life, and nothing has allowed more healing. I recommend developing a personal regular practice of some kind very highly, no matter what your experience level or belief system.
* I take on only as much as I truly can handle- Some days that isn’t much, and as an introvert, I need a lot of time to recharge between activities. If I don’t take the time I need, or if I stack my schedule too high, I get sick, depressed, frustrated, and am ineffective at work.
* I haven’t had a TV since I was 19, and only watch with my housemates when I truly have no responsibilities and can waste a few hours, and really enjoy what is available. Otherwise I keep a Netflix queue and only watch when I can truly take time off.
* I am not allowed to play video games, and if I try one that makes me think about it after I put it down, or if it causes me to miss something someone around me said, it’s over.
* I go to bed at 10pm and get up as early as I can- my favorite time is 5:55am. I need a lot of sleep to recharge, to allow my overstimulated brain to ‘file’ important things and get rid of things I don’t need, and to make sure I am well-rested and alert so when I need to focus during the day I am able to without medications or caffeine.
*  As much as possible, I eat whole foods without chemical additives and avoid refined sugars (including agave, hfcs, brown rice syrup, coconut sugar, and crystalline fructose… there are probably more…). Some people may benefit from avoiding flour also, and some may benefit from avoiding dairy. Personally I love home made sourdough bread and grass-fed whole milk for the omega 3s, but that’s my personal preference.
* I don’t try to multi-task anymore. It’s not possible anyway, and it’s not worth the frustration and disappointment when I fail.
* I write everything down in pen, keep an online office schedule also so I have to cross-reference and don’t forget something, and I make lots of hand-written lists, but re-write them when many things are crossed off or too many new things have been messily added. I do not use my phone calendar or reminders (I am on the internet too much anyway, and writing with my hand allows me to remember photographically much better than typing), and when I leave myself a voice note or need to write a note in my phone, I transfer it to a word document as soon as I can or put it in my written paper calendar, or I act on it right away.
* Most of all, I am as understanding and realistic as I can be about myself. I keep what matters to me in the forefront of my mind, and stop to reevaluate as needed. I am comfortable being wrong, and work daily on being flexible while sticking to what is important to me.

I hope that was a little helpful, and if nothing else, sometimes it helps to know that doctors are regular humans too. The people I look up to most are those that have had to work with something that was not easy and found ways on their journey to be even more bright, loving, and compassionate. In my case, I hope to use my experiences to help others if possible, and at the very least, to learn to be more peaceful and kind to myself.

Top 5 Food Tips Ever

In honor of Dave Letterman retiring… I thought I’d do a list of the top 5 food priorities for optimal health:

1. Eat fewer oxidized fats– using low heat cooking for oils/fats of all kinds (boiling, braising, poaching) most of the time keeps free radical load down and saves your arteries from damage from outside sources (the two main sources are internal: infection and stress- so minimize those two too!)

2. Eat top quality fats (which means top quality proteins along with them)– small amounts of grass fed beef and dairy, antibiotic free and grass/bug fed chicken and eggs, wild sustainable fish, free range animal meat in general, and pesticide-free organic vegetable and whole grain fats are best to keep your nervous system, hormone processes (=metabolism), and immune system healthy and stable.

3. Eat mostly plants– make sure they are pesticide free for bee health and overall ecosystem health, and fertilized mostly by animals if possible for soil and water health… permaculture, sustainable and organic farming are top priorities!

4. Keep your food miles low– know your local sustainable farmers and buy local as much as you possibly can… keep your community, your soil, your water, and yourself healthy with a smaller carbon footprint.

5. Enjoy your food– eat slowly and chew well, learn to choose and cook delicious healthy food, and eat with people you feel nourished by as well… avoid screens and intense conversation and always make time to sit (not driving) to eat.

fresh tomatoes from the market (last fall actually…) :)

A New Tactic

Hi everyone! It’s been a while, definitely lots of changes coming soon! In the meantime, here’s a not-new idea… I’ve decided that since my blog isn’t getting many reads except for a voluminous amount of spam commenters, I would see what would happen if I just wrote about things that mattered to me, sort of like a regular blog… Opinions are such fun, and changeable, and elicit such reactions from people, I thought maybe an interesting discussion could get started better this way, and maybe I could learn more about what all of you think too…

Today I was listening to NPR on my way into work, and the familiar topic was: why extremely rich mostly (all?) white bankers haven’t been prosecuted at all when they stole money from millions of less fortunate people and caused the financial crisis, while (as an example) non-white people are sent to jail for having ‘open containers’ at a rate 24xs more than whites in the particular instance they sited.

Yes, statistics can say anything, and those two examples are far from seriously comparable, but a great point that was made during the discussion reminded me of a major issue that is always on doctors’ minds– in malpractice cases the judges are never, to my knowledge, practicing physicians, and if health care providers are called to jury duty they are usually classified as having a ‘conflict of interest’ or some such in that they’d be too biased towards the doctor in question. Now I’m not speaking about individual actual malpractice cases, but speaking of the following as a general rule that I think should apply to all court cases: Everyone should have a right to a trial by a jury of their actual peers AND a judge that has firsthand knowledge of their cultural background and life concerns, whether experienced in their own families, friends, or in clear direct experience of the people/groups in question.

While discussing the particular instance of open container laws, the program mentioned that most judges in inner city courts are from suburbs or the surrounding states of Delaware or Connecticut, which have a very different population and cultural composition than inner cities. It stands to reason that the defendants in those cases may have a larger-than-average bias against them during trial… so my question is, how can we change the system (or actually, implement the rights that are supposedly already written in) to improve understanding and representation in court cases to improve equality and justice for all?

My initial answer is to require judges to be picked from the communities they are to judge. And that juries should be made up of one’s actual peers. So, for instance, if I were to be taken to court for something, I would hope there would be at least one doctor on the panel, maybe two, hopefully near my age, practicing actively in similar specialties to mine (meaning some sort of primary care, as I’d think a plastic surgeon might have very little in common with my day-to-day life), and perhaps also one or two people with graduate degrees, and some people from the midwest who’d moved to wherever I was, as well as maybe a meditator or two. I realize that’s wishful thinking in general, but it illustrates my point– how can we expect a ruling to be fair if those judging have no idea where the person being judged is coming from? Unless our entire justice system and culture is suddenly changed to one of more openness and understanding, it seems that changing jury and judge profiles might be the fastest way to more effectively foster true justice.

Thoughts?

Blueberry Soup with Ice Cream!! (kidding: Purple Carrot Soup with Sour Cream = much better :))

Sustainable Health Nutshell: Cook and Eat more of your own food, especially when you get it locally… it’s crazy delicious and easier on our Earth!

Ok, it’s been a while, lots going on, but I wanted to share this recipe as it was so good… Excuse the picture- I almost ate it all before I remembered to take one for you all!

sooooooo yummy!

1. Rough chop an onion, a few garlic cloves and a medium portobello mushroom.

2. Warm some olive oil with turmeric, fennel, cumin, coriander, black pepper, marjoram, and thyme till the spices just start to sizzle.

3. Sautee the veggies, adding occasional splashes of water when the sizzling sound gets too high pitched (= too high of a temp for olive oil- the water keeps it from oxidizing (which causes artery damage and inflammation when you eat oxidized oils) at higher than 212 degrees).

 4. While the onions are softening and the mushroom gives up its water, chop 2 good sized purple carrots, (or one purple and one red) and peel and chop a good sized sweet potato (not a yam if you want the taste and color to be purple and neutrally sweet–a sweet potato is beige outside and off-white inside, a yam is reddish outside and orange inside). Mix a bouillon cube if you like into a glass measuring cup of hot water and let it dissolve. (I only had salt-free vegan cubes on hand and was feeling lazy, but I usually try to use organic ones without palm oil and with less salt, or I forego it and just use more spices!)
5. Add the broth or water and carrots and sweet potatoes (and I had leftover broccoli stems I peeled and chopped and added in at the same time) so all veggies are covered. Bring it back to a boil then lower the flame and put the lid on so the veggies soften.
6. When it’s ready, use an immersion blender (or, “blendy-stick” as I lovingly call mine) and mix until there are still some veggie chunks but the soup is mostly a uniform saucy consistency. While it’s still hot, you can add in a green of your choice- I used arugula, chopped up the tops of a farmers’ market $1 bunch, but the second day I added a ton of cilantro, so you can pick, but I do suggest choosing one (arugula is sweet-bitter, cilantro is sour-bitter, spinach is sweet-astringent) so whichever you’re in the mood for), and if you use something like chard, sautee the stems in with the onion and garlic, and chop the leaves a bit more and let it boil a minute or so to break down the fibers so the texture of the soup isn’t odd.
7. To serve, add a dollop of sour cream and go to town. It might need a sprinkle of salt if you used a salt-free broth, but the sour cream usually takes care of that. If you’re dairy-free, add a squeeze of lemon or lime juice to brighten it up a bit.
Enjoy! Let me know what variations you come up with! xoxo