Patients....Who Are You?

Traditional Chinese Medical (TCM) practitioners look at the entire person when a patient arrives for treatment.  Our initial intake forms include questions that pertain to past medical history, familial medical history, current medical conditions, and lifestyle (drugs, alcohol, spiritual, emotional, sexual, exercise, etc) habits to understand who the patient is.  I was well trained to ask many questions of my patients and, quite often, some answers that initially do not seem of importance to them evolve into pertinent cluesfor treatment.  I recently read and recommend Dr. Benjamin Carson's book, Think Big.  Dr. Carson is chief of neurological surgery at Johns Hopkins, in Baltimore, MD.  Dr. Carson is an extremely intelligent, gifted and personable surgeon; but he is also a renaissance man - he has read more poetry, prose, philosophy, theology and sciences than most.  He is a humble man and proud of his accomplishments coming from a very underprivileged background.  Dr. Carson  speaks in his book about 'knowing who your patient is'.  I am a kindred spirit of this underlying philosophy.  A patient isn't a number, nor is the patient a statistic.  A patient is a human being who comes to my office seeking help for a health condition.  A patient places his or her well being and life in my hands with the trust that I will do everything possible to heal them.  This is a great responsibility and not to be taken lightly.   I believe that the more I know about my patients, the better I can serve them.  Acquainting myself with who they are, where they live, their relationships, professions, dietary habits - all these attributes contribute to a positive bilateral rapport with the individual and better trust in me, because they understand that the time I spend to know them better makes them special.  I become their 'family doctor' - old school style.  I will ask a patient the same set of questions I might have asked them two weeks prior during treatment.  Very often, they will remember something that is a valuable clue or insight into treating their condition. 

Case Study to Make a Point:  Patient X was referred to my office by her dental surgeon.  She arrived at my office with a chief complaint of chronic TMJ.  This patient was grinding her teeth and had bitten through two night guards within a month.  Her jaw was sore and offset from the constant nocturnal grinding.  During examination and inquiry, the patient presented with rapid and wiry pulses.  Her tongue was red and the tip was pointed (Heart heat in TCM).  I noted that the patient was inappropriately attired for a middle-aged woman.  She dressed more like a doll (frills, banana curls, bows) than a mature woman.  Excessive adornment on all extremities including the toes; she 'jingled' whenever she moved.   She laughed excessively for no reason (we note this in Traditional Chinese Medicine as a disturbance of the Shen or Spirit - a psycho/emotional disturbance).  Everything in her life was 'wonderful', according to this patient.  So, why the constant nocturnal grinding of the teeth?  She had no explanation.  She stated she had no stress at work, her home life was ideal, she was happily married and money was not an issue.  I treated the patient for her immediate complaint of jaw pain, but also addressed the psycho/emotional signs that were visible.  The patient was calmer and experienced great relief of her jaw pain immediately after treatment.  I suggested one treatment weekly for 4 weeks with a re-evaluation during week 4.  The following session (week 2), the patient presented with the same jaw pain.  She stated that the pain had subsided for 3 days and then returned Saturday morning when she woke up.  The evening prior, she had been grinding her teeth all night long.  Again, I asked the same questions:  Stress at work?  Anxiety? Rumination?  What could be causing this grinding?  I inquired about her schedule during the days between treatment and return of the pain.  Did she have dinner?  What did she eat?  Did she speak with someone who might have upset her?  Did she have nightmares?  All answers were negative.  Typically, this type of patient will speak of some stress or anxiety in their life that leads to nocturnal grinding.  This was a bit baffling.  So, again, I treated her for the pain and the psycho/emotional.  During this session, she laughed less and was less excessively giddy. This was a sign of the heart/mind calming down.  She made an appointment for a third session.  The third week, she arrived with the same story - she felt wonderful after treatment and, again...Saturday morning, she woke up with severe jaw pain.  I asked the patient what she did from Friday to Saturday morning.  She said she did the same routine every week - fish dinner home Friday night and working in her garden on Saturday morning...nothing more. She said they had no children, so weekends were 'nice and quiet'.   Date night with her fabulous husband was always Saturday evening.  Still perplexed by this return of the jaw pain, I decided to enlist a different point prescription for treatment.  To reach one of the points, I asked her to remove a charm bracelet she always wore around her left ankle.  When she removed the charm bracelet, I noticed a wide and deep scar near the acupuncture point I wished to needle.  I double-checked her medical history for any past surgeries to the ankle, as I did not recall her speaking of any surgeries.  There was nothing listed.  I asked the patient to please tell me how she received the scar.  Her smile faded, the giddiness fled.  Her response was that many years prior, she had one of the first legal abortions.  The father (her husband of over 30 years) and she were both young and could not afford to have the child.  They opted for abortion.  They were both from very traditional and religious backgrounds and this was a very emotional and traumatic experience for them.  During the procedure, the surgeon accidentally perforated her uterus.  She received over 6 pints of blood, given through the spot in her ankle where the scar is situated.  She had a hysterectomy as a result.  I asked the patient if Saturday evenings was the evening when she and her husband had sexual relations.  The answer was 'yes'.  I asked her if she had sexual anxiety and we spent some time speaking about how therapy could better serve her.  I recommended a good psychotherapist for her to speak about her past experience and sexual anxiety.  Approximately 6 months later, I received an email from the patient.  She no longer was grinding her teeth and, with proper therapy, she had come to terms with her experience.  She thanked me for helping her realize her pain, anxiety and for guiding her to the proper therapy for what ailed her.
The take home message here is this:  if you have a physician who really wants to know who you are, you are most likely in good hands.  If your physician spends all of 10 minutes with you and needs to look at your chart for your name or the reason for your visit - well, it's time to find a different physician.  You're not just a name or a number....you are a patient.  So, when I ask you 'who are you?', it's because I care.  Trust and rapport with your family doctor is a 'must' when it comes to healthcare!

Sloan-Kettering Hospital Study States Acupuncture Works

Here's Your Healthy Tip of the Day:  A study conducted by Memorial Sloan-Kettering Hospital states that acupuncture works for many pathologies, particularly pain management.  I have been trained and certified by Sloan-Kettering to treat cancer patients who are considered special needs.  Read this article and if you haven't already tried acupucnture, call or email my office today to schedule a session.
http://www.nydailynews.com/life-style/health/sloan-kettering-study-acupuncture-works-chronic-pain-article-1.1156095?localLinksEnabled=false

What To Do If You Experience A Subluxation Of Your Patella

Thursday, while exercising, I was doing some 180 degree jumps, when my upper body turned but my right leg didn't.  Ouch!  Subluxation of the patella (kneecap).  My patella was skewered upward and to the right of where it normally should be.  So, I telephoned a colleague and hobbled over to her office and had my patella gently coaxed back into position and was taped up.  I slowly made my way back to my office where I used low level laser and some gentle needling techniques on the affected leg.  By Sunday, I was hitting golf balls and able to squat down...95% better and without pain.

Here's Your Healthy Tip of the Day:  If you experience a subluxation of your patella, do what I did for myself...call Duffy and Bracken on Maiden Lane here in Manhattan.  Tell them I sent you and have the knee cap put back where it's supposed to be.  Then get yourself into my office for low level laser and gentle acupuncture.  You too, will be able to get back out on the golf course 2 days later and hit balls; 4 days later, you'll be back to your regular exercise regime.  Take it from me...been there, done this one too!
Kelley Mondesire'  917-701-7582
Duffy & Bracken 212-402-5430

It's a Long Weekend, So Stay Focused On Your Goals

MLK Day is this coming Monday and we've arrived at the first long weekend since the big holidays...oh boy!  A whole 2 weeks!

Here's Your Healthy Tip of the Day:  Stay focused on your health and wellness goals this weekend.  The 4 day respite is no excuse to go off your health and wellness program - you've only been at it for two weeks, after all.  The office will be closed Monday for the holiday, so stay tu;ned for Tuesday and more fun blogging!

Holiday Health Tips

Quite often, people tell me how they will skip breakfast and lunch during the holidays because they are going out to another dinner party.  Skipping meals is not only counterproductive to maintaining a healthy weight and blood sugar during the holidays, but it is detrimental to your immune system.  The nutrients we get from our everyday fruits, vegetables, whole grains, and protein shakes is what makes for a healthy immune system.  If you do not eat a normal breakfast and lunch, you will be famished by dinnertime and overindulge.  You will also be compromsing your immune system and if you become ill, that will be the end of the partying for you!

Here's Your Healthy Tip of the Day:  Don't be a Dummy!  During this holiday season, start every day with a healthy breakfast, segway into a sensible lunch; later on, at those holiday dinner parties, you won't be famished - you'll eat sensibly and your immune system will thank you for it!

Gift Certificates Available

Here's Your Healthy Tip of the Day:  gift certificates make holiday giving easier and more meaningful.  Give the gift of health and wellness to that someone special.  Call or email the office today.  917-701-7582   k@kmondesire.com    Gift certificates can be mailed directly to the recipient  or sent directly to you.

Your Hips Grow As You Age

Here it is.....The Journal of Orthopaedic Research (5.3.2011) just published a finding that the pelvis widens by 1 inch from the ages of 20 to 80.  The width of the 4th lumbar vertebra increases with age as well.  This occurred in both men and women.

Here's Your Healthy Tip of the Day:  It's inevitable...the dreaded spread!!!! So, do something today to help keep your waist and hips as slim as possible, so when that 1 inch naturally comes on, it won't be as devastating!  Try P90X today; it's made a difference in my life, so why not make a difference in yours?
here's the site: https://extranet.securefreedom.com/MillionDollarBody/csShopping/ShoppingCart_Detail.asp?PriceID=93429&Cat=Fitness%20ProgramBest%20Sellers&AddToCart=
 

Where Are You NOW?

It's week 5 of P90X; this morning, I asked my workout partner if it would be o.k. if I just stayed in bed and watched him workout...not as many calories burned, but at least I'd burn 5.  Less than 1 minute later, I was out of bed and getting ready to do our biceps/back/abs day.  90 minutes later, I was glad I got out of bed, really happy to have a motivated partner for the days when I just don't feel like getting out of bed to exercise, and even happier when my clients and neighbors comment on how good I'm looking lately.

Here's Your Healthy Tip of the Day:  Wherever you might be in your wellness/exercise program, you're bound to have days when you just don't feel like doing it...motivate yourself or make certain your workout buddy will push you to do the right thing.  You'll feel better  and look better in the long run.  If you aren't enrolled in a wellness program yet....what are you waiting for?  Life is short, spring and summer here in Manhattan is even shorter.  Get going today!  Call or email my office and find out how YOU can look and feel your best!

Acupuncture is Highly Effective in the Treatment of Seasonal Allergic Rhinitis

Seasonal allergic rhinitis occurs at the same time each year when certain trees, foliage and flowers are in bloom. This is the most common and prevalent type of allergy I see in my clinic. Symptoms typically include itchy burning eyes, greenish yellow nasal discharge, stuffy and/or runny nose, headaches, shortness of breath, itchy and dry skin, insomnia and general irritability. Sounds familiar? Did you know that approximately 10 to 20 percent of the general populace suffers from allergic rhinitis? The estimated health care cost is between $4.5 and $7.7 billion per year in the United States.1 This does not take into account days missed from the workplace or school.  In China, this type of pathology is considered to be ‘wind heat’ and has been successful treated with the combination of acupuncture and herbal formulas for centuries.
In 2004, Allergy published the results of a double blind clinical trial testing the efficacy of acupuncture and Chinese herbal formulas. The test concluded that this combination of treatment modalities was very effective for the relief of the symptoms of seasonal allergic rhinitis.
The subjects of this clinical trial experienced relief in their eyes and nose, performed more physical activity, and enjoyed a much improved psychological condition.  Ideally, it is wise to begin addressing seasonal rhinitis one or two months before a person is historically affected. Early treatment results in little or no symptoms throughout the season. There are many different herbal formulas (pill form) that I incorporated into a patient’s treatment plan. Treatments vary from week to week because the person’s condition improves after every acupuncture session. In general, for the person suffering from chronic rhinitis for years will visit my office twice weekly for the first several weeks, then once weekly as their condition improves. As the immune system is tonified, the patient’s overall health condition improves and is then put onto a maintenance plan of once visit every 3 to 4 weeks.

References
1. Management of Allergic Rhinitis in the Working-Age Population. Summary, Evidence Report/Technology Assessment: Number 67. AHRQ Publication No. 03-E013, February 2003. Agency for Healthcare Research and Quality, Rockville, MD. www.ahrq.gov/clinic/epcsums/rhinworksum.htm.
2. Brinkhaus R, Hummelsberger J, Kohnen R, et al. Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. Allergy 2004;59:953-960.
3. Deadman P. The treatment of allergic rhinitis by acupuncture. J Chin Med 1991;36:25-27.
4. Maciocia G. The Practice of Chinese Medicine. The Treatment of Diseases with Acupuncture and Chinese Herbs. London: Churchill Livingstone, 1994.

Gluten and Histamine Allergies and Alcoholic Beverages

Gluten Intolerance
Because the gluten-free commercial market has grown so much, many manufacturers make alcoholic beverages that are free from wheat and barley. Microbrews have been available in some markets for five years or more, and Anheuser-Busch recently rolled out Redbridge Beer, a sorghum-based beer that is the first gluten-free beer to be sold nationally. Some other common beers - including Budweiser and Coors Light - are wheat-free but not gluten-free, though always check labels, as ingredients may change.
Common alcoholic beverages that are naturally gluten-free include wine, sake, and most brandies. Most liqueurs and some wine coolers are gluten-free as well, but it's advisable to check labels or manufacturer websites for these, since there are exceptions.
Histamine Intolerance
Many foods, including aged cheese and red wine, are high in histamine, the same chemical involved in a number of allergic reactions in the body. Two enzymes, diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT), bind to histamine in food and metabolize it in the body. In some individuals, however, these enzymes don't work properly due to genetic disorders or gastrointestinal diseases. This can cause a variety of histamine intolerance symptoms, including the so-called "red wine headache." (There is some evidence for histamine being associated with migraines.)
While red wine is especially high in histamines, all alcoholic beverages are histamine-rich. Antihistamines are somewhat useful in treating histamine intolerance symptoms when they occur, but the best treatment for histamine intolerance is a histamine-free - and, therefore, alcohol-free - diet. Other histamine-rich foods include cured meats, spinach, tomatoes, and fermented foods like kefir.

Here's Your Healthy Tip of the Day:  Don't know where to purchase gluten-free foods or need help with a histamine-free diet?  Join my wellness program today!  Together, we'll work out the kinks and get you on a solid path to good health!

World Arthritis Day is TODAY

Today is World Arthritis Day.  The aims of World Arthritis Day are:

To raise awareness of arthritis in all its forms among the medical community, people with arthritis and the general public
To influence public policy by making decision-makers aware of the burden of arthritis and the steps which can be taken to ease it
To ensure all people with arthritis and their caregivers are aware of the vast support network available to them.
The Worldarthritisday website is supported and managed by EULAR, the European League Against Rheumatism.

Here's Your Healthy Tip of the Day:  Neither Western nor Chinese Medicine cannot cure osteoarthritis nor rheumatoid arthritis.  But...Traditional Chinese Medicine can alleviate the pain, discomfort, swelling and limited range of motion experienced by both conditions...drug free and without any evil side effects.  So, if you or anyone you know suffers from arthritis, have them contact me.  If they are not in the immediate geographic area, I will try to find them an expert practitioner to help relieve their pain and suffering.

Visceral Adipose Tissue (VAT)...What You Should Know About Deep Fat Tissue

Courtesy of the Mayo Clinic, I thought I'd share an excert they've posted about belly fat....
"Gaining weight in your abdomen does more harm than simply making your waistband too tight. While putting on weight in general can have negative effects on your health, abdominal weight gain is particularly unhealthy. Too much belly fat increases your risk of:

■Heart disease
■Breast cancer
■Diabetes
■Metabolic syndrome
■Gallbladder problems
■High blood pressure
■Colorectal cancer
Researchers also have found that abdominal fat cells aren't just dormant energy waiting to be burned up. The cells are active, producing hormones and other substances that can affect your health. For example, some fat-cell-produced hormones can promote insulin resistance, a precursor to type 2 diabetes; others can produce estrogen after menopause, which may increase your breast cancer risk. Researchers are still sorting out how the excess hormones affect overall health, but they do know that too much visceral fat can disrupt the body's normal hormonal balance."

Here's Your Healthy Tip of the Day:  enroll today in my Wellness Program!  Complete the online questionaire (click on the link) and you will qualify for a FREE initial consultation.  My Wellness Program is custom-designed for each individual...no two patients have the same treatment strategy.  Busy people who don't have the time for office visits can still benefit BIG TIME from online and telephone coaching and receive nutritional supplements and superfoods to their home or office by just the click of a button!  So...get rid of the belly fat today!
http://www.kmondesire.com/whatsnewsthismonth.html

Understanding Hormones Part 5

Did you know that the two most common causes of low hormonal levels are stress and inflammation?

Did you also know that when there are hormonal imbalances in the body, the detoxification process goes more than south and this can mean:  back up of toxins in the body.  This can affect the liver, gallbladder and intestines.  Acne, body odor, and bad breath can occur...all this happens because the waste products and toxins are not being detoxified and excreted and are appearing elsewhere in the body in the most unattractive ways.  Constipation can become a real problem, as well as smelly vaginal secretions.  Infertility, weight gain, weight loss, mood changes, lack of libido are all affected.  You get the picture, right?
Here's Your Healthy Tip of the Day:  So now that you're the expert on hormones and what they're supposed to do for you, get on the stick today and help make happy hormones.  It's pretty easy...get the blood test, come into my office and we'll talk about your levels, enroll yourself into my Wellness Program and in about 12 weeks, you'll be a new you!  I'll get you as fit as a fiddle, and make your hormones get happy!  You'll be relieved of stress, insomnia and those aches and pains as a result of inflamation will dissipate.  We wake up everyday, so we might as well be as healthy and happy while we're here.  Let's get goin'!

5 Simple Rules of Eating Well

1. Eat every 2-3 hours.  Small snacks.  Think 'grazing'.  Grazing on small snacks allows your body to burn more calories throughout the day.
2. Include lean (lowfat) protein in each meal and snack.  This applies to vegetarians as well. 
3. Include vegetables in each meal or snack.  If you just can't stand to eat them, then "Go Fro Greens" in your shakes, smoothies or mixed with water will suffice.
4. Save carb-heavy meals for after exercise.  Rice, potatoes, pasta are better processes within a 3 hour window post-exercise.
5. Include a good balance of healthy fat in your diet.  You need fat (fuel) to burn fat!!  But, GOOD FATS are key here.  Lean protein contains saturated fat  Mixed nuts, olives, and olive oil have monosaturated fats.
Flax seed oil and fish oil, contain polyunsaturated fats.
Here's Your Healthy TIp of the Day:  Variety is the Spice of Life!  Eat well, eat colorfully and if you're confused, contact me and I'll enroll you into my Wellness Program where you'll learn how easy it is to get fit and STAY FIT!