We Must Speak Up; We Must Speak OUT

Posted on June 16, 2020 by Masina Wright ND

I add my voice to the growing number of health care professionals and medical societies condemning the newest human rights violation by the Trump administration against our transgender community. The urgency of this issue is paramount! To deny health care rights during a global pandemic is both inhumane and absurd. Our trans patients and colleagues are already vulnerable due to the health disparities inherent in our system and biases from healthcare practitioners. Not only are out trans patients affected but all patients who fall under any part of our QUEER community in the past, present or future are at risk, making it even more difficult to be open and honest wit our health care providers.

Gender based and transphobic violence includes racism, murder and hate crime. It disproportionately affects black trans lives, especially black trans women. In the midst of the Black Lives Matter uprising and Covid19 the reversal of transgender health protections puts an immediate threat to black trans patients, and all trans BIPOC patients who identify as gender neutral or non-binary.

This recent action should be met with a call to arms from all medical professionals, including attending physicians, resident, medical students, nurses, APPs and staff. We must to do our best to provide trauma-based compassionate medicine and NEVER deny care for transgender patients nor any LGBTQ patients. The personal views of providers in any setting (outpatient, clinic, hospital or otherwise) must not be allowed to interfere with the right to health care. The recent COVID pop-up hospital in a Brooklyn park that denied transgender and LGBT care is an atrocious example of what the Trump administration is suggesting here.

There is a dearth of education for healthcare professionals from the earliest academic levels. Health disparities, intersectional oppression, and implicit biases of language, systems and structures have to be called out and addressed to stop this cycle of ignorance. Silence is clearly violence, and we cannot in good faith stay silent and allow conservative politicians to sacrifice health protection in the names of transphobia and racism – not now or ever again.

Kaiser Kabir OMS4 Lincoln Memorial University
Masina Wright, DO PGY1 University of New Mexico Hospital, Internal Medicine

A Pandemic wasn’t the Plan: Part 2 – Anxiety/Herbal Rx 04/04/2020

Posted on April 4, 2020 by Masina Wright ND

I went to my local Co-op today, which is one of the only places that doesnt feel totally overwhelming to shop, and every single person had a mask on. This is the new norma I spent the week pretty anxious about the contagion and infectious side of COVID19. I had two of my patients get ruled out for the virus mid-treatment this week AND the contagion aspect seemed really important for those around me I come in contact with, not only myself. What do I need to do to not be a vector of spread? We now only wear scrubs to the hospital not work clothes, and I take my shoes off at my door. Are you freaked out about the contagious side of it? This is a real phobia for some people, and it at the root of many OCD compulsions. I feel for all the germ-phobes out there! My only advice is therapy therapy therapy. There are also one or two antidepressants that help with OCD if you are really noticing an uptick in this in your every day. Ask your PCP if they can help. If you dont have one, this is a great time to get one! Many health providers are accepting new patients, and their clinics or your local community center can help you get the health coverage you need.

Medicine really needs to start valuing mental health as equal to primary and specialty medical care in insurance reimbursements and coverage. SO much suffering comes from the mind. And teeth! Dental coverage too! I promised a blog on botanical medicine and viral illness. I am not up to date on the most current treatments and theories in the natural medicine world anymore. The Naturopathic News and Review publication is a great resource for cutting edge evidence from practicing ND’s.

Most of my botanical training is american traditional eclectic western botanicals, and the knowledge dates back to folk traditions, native medicine, midwifery, and turn of the century medicine. In this vein, there is a wealth of knowledge about foundational immune support and antivirals vs antibacterials and antifungals. If you are interested in this kind of care, most ND’s and herbalists are doing telephone and online appointments and shipping our medicine. Look under your Naturopathic Medicine State Association and see who is available in your area for personalized medicine.

Chinese botanical medicine also has a fantastic apothecary of immune supporting botanicals as well as support for basically every system. Their pharmacopeia is rich and complex with over 5000 herbs with specific indications and formulas. Many TCM Doctors and Acupuncturists are also herbalists and sell custom blended teas as part of their practice. Consider reaching out to someone locally for this as well with a phone or video appointment.

Herbal Medicine for COVID19 falls into prevention by strengthening and prevention by antimicrobial actions. Prevention by strengthening herbs are used when you are not sick. They tonify and strengthen the body, increasing reserves that can be called on if illness occurs. The following is a list of such herbs:

nettles
astragalus
alfalfa
borage
siberian and american ginsengs
ashwahaganda
cordyceps and other nourishing mushroooms (use sparingly)

Nettles are best made as a herbal tea and drank clear and often. They can also be eaten in soups, cakes, and stir fried although this is easier in some parts of the country than others.

Astragalus is a sweet root and is best as a broth, or a tablet taken 3 tablets in morning and night. This is a key ingredient in “change of season soup” from the TCM formulary for immune strengthening as well. Borage, Siberian and American ginsengs and ashwahaganda are adrenal tonics that boost immunity by decreasing inflammation and increasing resilience. I like borage tincture 1 tsp daily, ginsengs as tinctures or pills (they don’t taste great), and ashwganda as a standardized tablet or capsule. Ashwaganda means something close to “horse piss” Ive been told, and it is named after the strength and passion of a horse as this is what it embues. These should be discontinued at the first sign of a sniffle or other illness. Then switch to active antimicrobial prevention. Taking these while sick can sometimes strengthen the pathogen rather than the host.

Antimicrobials: These are divided by their functionality.

Use these herbs as a prevention; it is best to preserve the antibacterials for signs of actual infection. Like Rx antibiotics nature’s antibacterials have strong actions and their use needs to be preserved for proper indication

A selection of commonly used antivirals includes:

alium cepa (onion)
allium sativa (garlic)
echinacea – only in the first 24 hours of infection
elderberry- usually used as a syrup that is very safe for all ages (watch for honey under 1yo) and for pregnancy –has some possible conflicting evidence for COVID19 infection, make your own informed consent to use.
monolauren (from coconut oil)
euphrasia (eyebright) – for viral conjunctavitis and eye symptoms
cats claw

A selection of my fave antibacterials include:

goldenseal – for inflamed mucus membranes and purulent discharges
berberis – for anything that looks or feels “infected” including GI issues
echinacea – one of the only botanicals proven against strep species. Use a glycerite form of the tincture and squirt it directly onto an inflamed throat. The glycerite is sweet and is safe for children and elders.
cats claw – used for Lyme infection
onion and garlic, oregano and thyme – in cooking! use liberally!

Antifungals are also important for chronic immune system depletion often manifested as thick brittle toenails or fingernails, frequent yeast infections, sinusitis and chronic belly issues. They are less relevent for this pandemic other than to sustain and support long term immune and lung health. My go-to antifungals include:

monolauren (from coconut oil) 300mg 2 times/ day
pau d’arco tincture or tea – 2 tsp or cups per day
tea tree oil – topical
caprylic acid – at least 2 caps daily
garlic
* a note on essential oils

I personally took a bottle of astragalus tablets 2 2twice-ish daily and now I am switching to Monolauren daily for 3 months with vitamin C and cats claw tincture daily for at least the next 3-4 weeks for intensive antiviral support. I am also taking ashwaganda as an energy tonic to support my stress levels during this unusual time to be working in medicine, and a probiotic. For my personalized medicine I have an herbal thyroid support formula alongside my Armor thyroid medication as I have Hashimotos thyroiditis. Finally, I drink homemade nettle tea or lavender/ chamomile tea and am doing the best I can to get cooked or fresh greens most days.

My training in essential oils is only for primarily olfactory/ inhaled, diffused in water or skin products. I was not trained in “by mouth” use of essential oils such as promoted by DoTerra or other EO companies so I cannot recommend tfor or against these by mouth. I do like topical and diffused use of these medicinal substances and find myself drawn to tee trea, eucalyptus and lavender, cypress, pine as my primary antimicrobial nature scents for baths, lotions, soaps and diffusion. Many flower essential oils have beneficial effects on the mind/ mental health as CN1 is a cranial nerve. There is a long tradition of use for cosmetic use as well.

Best of luck out there friendly readers. How we as humans conduct ourselves in these pandemic times can illustrate where we need to work on ourselves and where we shine bright. This is an excellent time for insight, awareness and evolution. Its also a perfect time for devolution and hopelessness. Reach out and find the resources you need or ask a friend to listen awhile: many providers are providing sliding scale or free servicesand telemedicine is blooming. The world is small with the internet. Kindness can be found in bugs on a sidewalk or a smiling eyes from 6 feet. If nothing else is true, it is that we are in this together.

Rheumatology: Pain, Joints, and Autoimmunity

Posted on May 13, 2019 by Masina Wright ND

I just finished my final elective of medical school. I chose Rheumatology because I have such a strong genetic tendency towards this class of diseases, and because it was something I felt under-educated about heading into Internal Medicine.

Rheum itself means “a watery fluid that collects in or drips from the nose or eyes.” Whereas rheumatism is “any disease marked by inflammation and pain in the joints, muscles, or fibrous tissue, especially rheumatoid arthritis” according to online dictionaries. Clearly these two do not match up? Although perhaps one could argue it is the “watery fluid” of the joints that is attacked by immune system dysregulation in most of these conditions, resulting in pain, inflammation and joint destruction. Most of these conditions are also multisystemic, affecting the heart, lungs, kidneys, eyes, skin and more. The umbrella of rheumatology is large: conditions I saw in clinic included rheumatoid arthritis, lupus, scleroderma, psoriatic arthritis, polymyositis and dermatomyositis, pseudogout, gout, and polymyalgia rheumatica. There are of course more that I did not witness.

A large part of patient management involves managing and regulating pain. Opioids are now recognized as crutches inhibiting recovery for many people with long term pain rather than panaceas. Dr Clauw, a pain specialist from Michigan explains this way better than I could, and also addresses several prescription and over the counter medications as well as lifestyle management techniques for living your best life with chronic pain. Watch this YouTube video now, or listen to it while you drive: https://youtu.be/B0EhNajqkdU

One conversation that came up several times was the use of topicals for pain. Many folks cannot take ibuprofen for pain due to stomach or kidney disease, or are already on long term therapy with prescription strength NSAIDS and still have pain. Voltarin, a topical NSAID was prescribed regularly, specifically for osteoarthritic pain at the base of the thumb with good success.

Many patients use CBD preparations for consistent pain reduction. Some people call cannabiboids “opioid sparing medications” as people can reduce the amount of narcotics needed on a daily basis with the concurrent use of CBD products. The doctors I was working with did not specifically endorse nor did they advise against medical marijuana as Maine is a state where purchase and possession is legal with certification. However, they did support individuals trying topical marijuana preparations of their own initiative for pain management.

The biochemistry of cannabinoids is super interesting if you are into psychoneuroimmunology. This recent article from Naturopathic Doctor News and Review does a pretty good job of outlining the basics of CBD oil as well as some of its politics in reference to mental health. Its use in pain management is multifactoral. There are two main cannabinoid receptors in the human body both of which are relevant to rheumatology and management of chronic inflammatory, neuropathic and mechanical pain. CB1 receptors are found throughout the brain and body and are responsible for most of the psychotropic effects; they are also found on osteocytes (bone) and chondrocytes (cartilage). CB2 receptors are primarily on immune cells as well as osteo and chondrocytes. The underlying physiology is complex and still being researched extensively but one thing is clear: cannabis-based medications are effecting in reducing chronic pain via their effect on the the endocannabinoid system in humans and altering pain chemical signalling.

As aggressive autoimmune diseases, most of these conditions require sophisticated, high end medications to manage their progression. I saw many cases of men and women who had life changing benefits from DMARDS, or Disease Modifying AntiRheumatic Drugs. My main take home point from this rotation was if one of my patient is newly diagnosed with one of these conditions, REFER! to a rheumatologist as the medications are advanced and specific. My great-grandmother was bed-bound by 40yo with rheumatoid arthritis and she did not have the benefits of science to treat her disease progression. Even tho I am also a Naturopathic Doctor, I have respect for the powerful efficacy of these medications and do believe they improve and maintain quality of life in potentially destructive conditions like these.

On the other hand, medications alone are often not enough to manage and maintain the best health possible. The 2017 textbook I was given for the elective had a small section at the back for complementary and alternative therapies that have good evidence for rheumatology.

Vitamin C is an essential component of cartilage and collagen. Supplementation reduced progression of joint and cartilage destruction over time. My Note: Vitamin C is naturally occurring in high levels in many raw fruits and vegetables. This is a great reason to eat fresh raw foods as part of your every day diet with any kind of inflammation or joint disease.
Vitamin D is for more than strong bones; it is also a hormone that effects immune health. Countries that have less sunlight year round have higher occurrences of autoimmune disease. Get outside 20 minutes daily minimum all year round, and supplement vitamin D every winter. Have your blood levels tested every fall to ensure optimal levels of this hormone and nutrient.
Fish Oil has known anti-inflammatory properties in its EPA component and many brain benefits in its DHA. This rich omega 3 essential fat is best eaten as a meal at least 3 times per week – a tin of sardines, mackerel or herring has way more nutritional value than a couple of fish oil pills and costs so much less. Any seafood will contain fish oil – the littler the fish, the higher the benefit when it comes to these healthy oils. If you do go for the fish oil pills know that you get what you pay for. Evidence shows you need about 3000mg of fish oil via pills daily for benefit, or at least 450 mg DHA and 750mg EPA. I like Nordic Naturals Brand for best quality and efficacy if you are going to go the pill route. For tinned fish, there are lots of brands, but this is my fave and it’s easy to find in regular grocery stores.
Omega 3 oil is also available in vegetarian form as flax seed oil or marine algae oils.

The evidence for a specific kind of diet for autoimmune disease is variable. Dr Jackson referenced the Mediterranean Diet as the best foundational nutritional plan for Lupus specifically. This makes sense as it is a low inflammatory, high fruit, fiber and vegetable diet with known benefits for heart health and longevity.

Many people choose to go paleo, or follow the whole 30 autoimmune diet plan. Phoenix Helix is a podcast dedicated to autoimmune health and paleo nutrition. During my rotation I listened to a great episode with Dr. Aly Cohen, an integrative rheumatologist who spoke on scleroderma and integrative medical management. In addition to reviewing some specific suggestions for scleroderma, Dr. Cohen spoke on the importance of reducing processed food chemicals, pesticides and additives and choosing clean drinking water, not from plastic bottles. As she said, over 90,000 chemicals have been introduced to the ecosystem and therefore the human body in less than 100 years. Autoimmune disease is linked to this toxic burden and inability to process the chemicals. Find out more about her work @thesmarthuman on Twitter and Facebook.

Three weeks of rheumatology clinic was only enough to learn the basics of diagnosis and management, and gave me great respect for my fellow Rheumatologicial internists. Each of the conditions under the Rheumatology umbrella have advanced immune dysregulation and multisystemic consequences with potentially dire outcomes. Fortunately, pharmacology has a class of exceptional medications that work quite well, especially when paired with nutritional initiatives and long term pain management strategies that focus on quality of life. I am grateful to Dr. Stanhope and Dr. Jackson at Central Maine Medical Center Rheumatology Associates for letting me ask too many questions while they were trying to write notes during their busy clinic days – and for the freedom to enjoy afternoon sunshine on my last medical school rotation!

Gluten Free Living

Posted on September 23, 2015 by Masina Wright ND

How to Eat Gluten Free

Gluten Free is the new Vegetarian – almost every grocery store now has gluten free breads and products in their freezer sections, and crackers and baking mixes in the aisles. Websites abound on not only celiac disease resources (a disease caused by severe gluten allergy) but also on gluten sensitivity, a mlder form of systemic immune response to the gluten molecules. It is easy to find gluten free recipes, resources, and restaurants in almost any geographical area.

So, what is all the hype? The bottom line is that gluten sensitivity begins with the immune system of the digestive tract becoming hypersensitive to gluten proteins like gliadin. The body creates antibodies to the sequence of amino acids, which enter the bloodstream and travel throughout the body. Whenever these antibodies see that same sequence (which is repeated as a small part of many tissues of the body exposed to blood i.e. thyroid, joints, brain, lungs, skin) they attack that tissue as if it was gluten. This creates “auto” or “self” antibodies, which are then produced in greater and greater numbers causing symptoms in a diverse set of body systems.

Therefore, gluten has been linked to autoimmune diseases such as lupus, rheumatoid arthritis, Hashimotos thyroid disease and multiple sclerosis. These are end stage conditions that develop years after smaller warning signals such as headaches, digestive disturbance, asthma, allergies, psoriasis, alopecia, insomnia and various “undiagnosible” ailments. Eliminating the offending foods or doing tests to assess your body’s immune response is the only way to assess if food is an underlying factor in your ill health.

Gluten is a protein that is found in the following Grains:

Wheat
Rye
Barley
Kamut
Spelt
Oats is technically gluten free but very often contaminated in manufacturing.

Therefore, people with a gluten sensitivity or allergy cannot eat any of these grains, or products that contain them such as soy sauce, gravy, doritos or other gluten based products. Oats are technically not a gluten containing grain, but should be avoided unless it states “gluten free” on the package.

Non Gluten Grains which are safe for gluten allergies & sensitivities include:

amaranth: highly nutritious, tiny seeds available whole or as a
rice: including brown and white rice, Arborio, basmati and rice flour
corn: including cornmeal, cornstarch and corn flour
millet: small seeds, eaten whole or combined with other gluten-free flours
quinoa: small seeds that can be eaten whole, as a hot cereal or ground into flour
buckwheat: used whole, cracked or ground into flour
oats: gluten free oats and oat bran
tapioca: made from cassava root, often combine with gluten-free flours
teff: very small black grain, contains symbiotic yeast
arrowroot: a starch used as a thickener, superior to cornstarch, blends well with gluten-free flours

Potatoes, sweet potatoes, squash, and other starchy vegetables can also be enjoyed by those who are gluten free.

For more information on gluten allergy, see http://www.thedr.com./store.html and order Unlocking The Mysteries of Wheat and Gluten Intolerance for yourself. Dr. Tom DC offers eloquent and thorough evidence based information on why it is worth at least trying gluten free living for one month and then reassess.

Many people have a wheat sensitivity or allergy, but can tolerate other gluten grains like spelt and kamut. Some people with a wheat, but not gluten sensitivity will later develop a gluten sensitivity. Corn, potato, dairy and/or soy sensitivities are also common in people with gluten sensitivities. For this reason, it is best to start food eliminations by eliminating all of the above products, and slowly reintroducing each gluten grain as well as corn, potatoes, and soy separately to judge your individual reactions.

AVOID FOR GLUTEN -FREE SHOPPING:

look for labels that say – wheat (or whole wheat) flour, wheat germ, bran, farina, graham flour, semolina, gluten, modified food starch, wheat starch, vegetable starch, vegetable gum
Pastas – spaghetti, vermicelli, macaroni….. buy rice pasta, corn pasta, or some of the newer legume (bean) based pastas. Must say “gluten free”
Soups – commercially canned – read labels for “flour” or wheat
Desserts – most contain wheat – so read labels carefully
Cereals and breads – as with desserts – read labels carefully
It’s probably best to go to health food store in order to find alternatives. Most breads, bagels, wraps, pizza doughs, etc are kept in the freezer sections
For persons allergic to wheat, but not to gluten, you can use flour substitutes such as spelt or kamut (these are the most similar to wheat); rye, oats and barley can also be eaten.

TIPS FOR A GLUTEN-FREE DIET:

focus on protein, vegetables, fruits, and healthy fats like avocado
Lots of delicious gluten free options abound: Tray various pasta, breads, crackers, etc until you find what your taste buds prefer.
Avoid any food that contains wheat, barley, rye, oats – as well as spelt and kamut. Also, remember that gluten can be found in most processed foods, including soups, sauces, gravies, and of course in breads, cereals, and desserts.
40% of people allergic to gluten are also allergic to soy and/or corn – which are often found in “gluten-free” breads, etc.
READ LABELS on everything the first few months to find hidden sources of gluten.

Eating Out and Travelling:

Most cream based soups and chowders are made with a gluten base. Boone’s in Portland has a gluten free chowder, bisque, crab cakes etc if you are craving those.

It is pretty easy being gluten free in restaurants once you get the hang of it. Focus on protein and vegetables, fancy salads and avoid gravies, pasta, gnocchi and sandwiches. If you are craving a burger, ordering it without the bun is pretty standard in today’s low carb world. Steak and arugula salad is always a good choice.

Sadly, fried treats are out the window like calamari, fried clams, fish and chips… once it gets battered it is almost always a wheat base. French fries are also often battered. Best to ask ahead of time instead of getting a delicious plate of inedible fries. Frontier restaurant in Brunswick has delicious GF fish and chips, and rice flour calamari. Not cheap but delicious!

Fish options and mussels or raw oysters rarely have gluten unless they are fried or pan fried. Eating fish at home with rice and salad is a great nutritious option too.

Some places have gluten free sandwich bread but most places don’t. In a pinch on the road, subway will make a “chopped salad” which is basically a sub in lettuce/salad. Planning your food and having fruit, yogurts, nuts & seeds or trail mix, protein bars, and even leftovers or sandwiches on GF bread you make yourself before you leave become important while travelling.

What else? Gluten free breads and crackers abound. I personally like Millet breads the best – available in Whole Foods GF freezer section. Rice breads tend to be very dense and gummy, but are easy to find. Mary’s Gone Crackers are a great GF crackers, followed by Nut Thins and Glutino brand. Glutino also makes a great pretzel. Rice cakes can have a bad reputation but are a quick tasty snack and great vehicle for dips, cheese, avocado and almond butter.

Sweets: Lots of gluten free cookies and treats are available! Any ice cream or candy without “cookie dough” or brownies or cones is usually GF. Many coffee places have at least one GF option. Flourless chocolate torte, chocolate mousse, crème brule or pannacotta are restaurant dessert options that are usually safe.

Namaste company also makes a “Perfect Flour” gluten free mix of flours that you can buy and use with any recipe. Makes cookies really easy!! They also have a great pancake mix if you love pancakes.

Tips for substituting wheat flour:

do not be concerned if batter appear thinner than wheat batters, this is common
add 1/2 tsp baking powder per cup of substitute flour; add just before cooking because it loses its potency when mixed with liquid and allowed to sit
refrigerating dough 1/2 hour helps improve texture
do not bake anything thicker than 4 inches
when baking, lower the temperature a little
baking time is usually longer, especially if egg or milk is eliminated from the recipe
experiment with your options – buy small quantities from a bulk food store and make half recipes first

For thickening, the following quantities equal 1tbsp of wheat flour:

*Arrowroot 1 tbsp = 2 tbsp wheat flour

*Corn starch 1 tbsp

*Potato flour/starch 1/2 tbsp

*Rice flour 1/2 tbsp

*Tapioca flour 1/2 tbsp – my favorite

The Lost Art

Posted on June 7, 2014 by Masina Wright ND

I am sick in an invisible way that people cant really see, and I don’t really feel – much. I can take a pill and make it mostly unnoticeable. Except for the fact that my hair falls out in handfuls with a certain kind of stress…

I consider myself an expert in self-care. And yet, I can hardly find the time to do the “little” things that I know could help. Like, nettle hair rinses, getting at least 8 hours of sleep every night, taking my fish oil, and eating more protein. Instead, I keep myself too busy and dull myself with things that make me feel better for a few hours, but never in the long run. I have fallen into the mindlessness of modern health care where I want a pill to do the work of healing for me. Dammit!

We all have levels of health maintenance we are willing to do on a regular basis. Vitamins, exercise, water, organics, therapy, whatever. We each have a certain degree of self care required to maintain the status quo of daily function. But, what happens when that balance is tipped and we need to actually recover from an illness, injury, or accident?

I offer you an invitation to step off the rat wheel of everyday living, and create a luminal space for healing. A luminal space is an anthropology term that refers to a period of time “outside of time” – a step out of everyday living. Some health crisis force this through body fluid effluvia that ties one to the bathroom, or physical disability that prevents mobility. Too often we are able to power through a cold, or anxiety attack or injury and do not engage in the art of self care to allow actual healing. This is what snowballs into chronic illness / disease or chronic pain.

I have been “sick” for at least 9 months, but I haven’t made more than a few half-hearted efforts to engage in deep self care. I have taken lots of prescriptions and had lots of blood tests, but is that truly healing medicine? I finally broke my baby toe last week, and have been suddenly forced to slow down by immobility. I am doing hydrotherapy, making castor oil packs, cooking and eating good food, meditating, saying no to social engagements I don’t deeply want to do, and getting sleep. These are some of the cornerstones of deep self care.

It is very difficult to give ones self approval to close the door on society and expectations and family, and friends, and chores, and domestic duties, and distractions, and choose to do something solely for the self instead. We are culturally programmed to take care of business, pleasure, family, kids, dogs, and our homes before we take care of the inner self. If you are sick, at any level, you will heal faster, and better if you take the time to practice deep medicine by taking the time to take care of your self.

I am here to help you do that. And, I give myself permission to offer that same wisdom and practice for my self. The pills and the maintenance are not enough. We must engage the luminal, lost art of deep self care for complete health and healing.

Mediterranean Adventure II

Posted on April 4, 2013 by Masina Wright ND

We were concerned that traveling Gluten Free would be tough. And not even just gluten free – I can’t eat potato or corn, and my sweetheart can’t have rice. So, we were both headed abroad knowing that food choices could be tough. We had the good fortune of staying with family, so for most of the journey we had a kitchen and fridge to stock with staples we could rely on. For me – mostly eggs, rice cakes, delicious olive paste, incredible fresh green olives. For my sweetheart – she had the bonus of finding gluten free bread, plus corn cakes, jam, and yogurt. Then we shared fruit, veggies and local cheeses. She brought her own corn pasta, and I had no trouble finding rice pasta as needed in the local “Veritas” (organic) market for family dinners. We even found quinoa! Local markets and/or supermarkets also had lovely fresh meats, fish and produce for family dinners. We both brought some snack bars (Kits Organics for her and Luna Protein for me) as well as trail mixes. Of course, there were also lots of delicious treats we could both have. Europe has an impressive array of yogurts, puddings, and other cold delights in small jars. (Less ice cream though, in the freezer sections.)

Overall, food turned out to be less of a problem than we feared. When going out, my sweetheart was invariably able to get “patatas bravas,” a local dish of fried potato with a yummy spicy mayonnaise. Tapas (or pinxtos as they are called in San Sebastian) were harder for me to navigate, so often I just didn’t. Dinners out were easier – I could almost always find some delicious fish or chicken and vegetable options in the Menu del Dia – a 10-15 Euro daily menu with 3 courses and wine and coffee included. As my sweetheart is more sensitive to gluten and cant get away with any exposure, she usually stuck to Ensalada Mixta (salad, tuna, olives, and hardboiled eggs) with a potato side dish. All in all, it worked out well. We weren’t able to sample the breadth of Spanish gourmet cuisine, but we still had some flavorful dishes and local delicacies.

As a Naturopathic Doctor, I was constantly assessing the Mediterranean Diet and to see how the classic reputation of the region matched the real fare. As I suspected, there was plenty of bread, cheese, sugar, and packaged foods available as in the Standard American Diet (SAD.) There were a few noticeable differences though that may account for some of Europe’s lower body weights and improved life expectancy. First, there was no bacon. Yes, “bacin” was on some menus, but it was peameal-style bacon, pan-fried and not the true “bacon” of North American fame. Second, beef was rare to see on a menu or in the supermarkets, and was quite expensive. This made sense as we drove across the country, as there were very few cows. European terrain is not made for grazing the way Texas is.

Finally, and perhaps most impressive to me was the rest stops for food along highways. Each one was set up like a classy buffet restaurant, complete with chefs behind the food casing presenting grilled vegetables, roasted chicken, and a wide arrays of sandwiches, jambon, fruit and cheese choices. There were mini bottles of wine and cans of beer at every register, as if instead of being on a roadtrip one was intentionally stopping at that location for a meal. And stop everyone did, even for coffee. The American in me was shocked that people were literally getting perfect little iced espressos and walking to sit down and drink it before they got back on the road. We are such a to go culture! The contrast was very strong, and was I think the best illustration of the differences between our SAD diet culture and that of the Mediterranean. They sit down and savor a meal, a coffee, and a moment in time. It’s a lifestyle, a way of thinking, and a paradigm. We eat on the go, “para llavales”. We Rush, wolfing down food, eating mindlessly as we multitask and gulping down our beverages while we push on ahead. And we pack on the pounds and generate chronic disease as we go along, coercing our nervous systems into simultaneously digesting and running at the same time.

I am still filtering through layers of impressions, photos and reflecting on the whole experience of world travel. I highly recommend Spain to anyone – Barcelona is the second most popular tourist destination in the world, and well worth the hype. Traveling gluten free was not a problem; we were able to find great local resources and food options, especially for a food adventurist. For those who can eat gluten, there is an incredible world of tapas out there just waiting your arrival! But do yourself a favor – eat like you have all the time in the world.

Resolving an Arthritis Flare – for My Dad

Posted on October 30, 2012 by Masina Wright ND

Chronic inflammation can cycle into snowballs of pain that catch us off guard. For those with a familial tendency towards rheumatism, arthritis can become quite severe. Joint inflammation usually takes the autoimmune form of rheumatoid arthritis or the inflammatory/ immune joint presentation of osteoarthritis.

It takes time and patience and a good amount of work to manage an acute pain flare. We want a recipe for success to include a small pill and minimal work. Unfortunately, this is rarely the case. To follow is a recipe for treatment of an acute, immediate or aggressive flare up of arthritis/tendon inflammation or bursitis that may be causing moderate to extreme pain and inhibiting mobility.

1.You will need to rest as much as possible for 7-10 days. Plan to stay home and lay low whenever possible. Stand up every 2-3 hours (except while sleeping) for 10-20 minutes of stretching and gentle exercises. Walking in nature, Pilates, physiotherapy, gentle yoga, or Wii Fit balance exercises good choices to support rehabilitation.

Plan your life accordingly. You may need to work from home if possible, and reschedule activities. This is necessary to address the pain. It is likely your pain and inflammatory levels will be up to 50% resolved by the tenth day of treatment.

2. Take a daily bath if you have access, soaking the affected joints for up to 45 minutes. Use Epsom magnesium bath salts with 10-15 drops of lavender essential oil or a bath salt of your choice. Follow with 20 minutes of icing the affected joint. If you don’t have a bath, use a hot shower and/or hot towels or a heating pad and ice after a shower.

This plan will not cure your arthritis. This does not replace the need for surgery if you have a fracture or true tear like a labrum or rotator cuff. Do not discontinue scheduled plans prescribed by your physicians and specialists.

3. Start an Anti-Inflammatory Diet. This is best continued until joint replacement is successful; however, it is crucial during the initial rest window. Studies have proven that nutrition is directly linked with inflammation. By eliminating foods known to increase systemic inflammation, you can reduce your own inflammatory load. This allows your body to begin healing. You can google one, find a local holistic nutritionist for guidance, or a local ND. The anti-inflammatory diet eliminates gluten, beef, tomatoes, potatoes, eggplant, peppers, peanuts, soy, oranges, and often dairy. What else can you eat? So many things! Fish, apples, pears, chicken, rice, legumes, nuts, seeds, quinoa, pork, lamb, oats, berries, greens, beets, carrots… the list is endless!

4. The Medicine. Zyflamend- 3 capsules morning and nighttimes daily. This is a modern formulation of 6-10 botanicals to treat inflammation, joint pain and rheumatism using herbal medicine. New Chapter has combined these into an effective and well researched formula called “Zyflamend.” http://www.newchapter.com/zyflamend The PM version also contains a small amount of relaxing herbs which are helpful for supporting a restful attitude during your healing. You may continue this for up to one year’s duration before a break is needed. This product is safe to take with most narcotic and non-narcotic pain medication including Vicodin, Oxycodone, Ibuprofen, Tylenol 3 and Ibuprofen. However, do not drive while taking the nighttime formulation.

5. Nordic Naturals Omega Joint Plus – 3 capsules daily with food. This is a premium joint care formula containing 1500mg of glucosamine sulphate as well as anti-inflammatory levels of EPA and DHA. The product is expensive at ~$50/bottle for one month supply however, it is worth it. Switch to this product during your first month of resolution treatment for best results, and hold your other fish oil or glucosamine supplements. http://www.nordicnaturals.com/en/Products/Product_Details/514/?ProdID=1548

During your 7-10 day acute healing time, you can take your other supplements as well, or take a supplement vacation and focus on the above products only to streamline your protocol.

This is the skeleton treatment plan. This is a great place to start If you do not get the results you are looking for or have trouble adhering to the program, consider seeing a ND in your area. In addition to the above protocol, continue to take your medications for heart, kidney, lung or other medical health conditions. Specific neutraceuticals to address sleep, anxiety, digestion, or other issues may also be prescribed in a consultation. Classical homeopathy is also extremely useful in complex cases. It is safe with complicated pharmaceutical treatments and provides lasting results.

Your pain is a sign that something is wrong, Respecting the pain by changing your every day lifestyle can provide insight into the pathology. Physiotherapy, Osteopathic medicine, Acupuncturem Chiropractic, Craniosacral therapy and other physical medicine treatments are essential to rebalancing pain as well. Z

Side Note; If you drink More than 2 drinks a night, NSAIDS like ibuprofen, celecoxib, Alleve, and other antiinflammatories are not safe for more than 7 days of use for pain. If you have heart failure, either preserved or reduced ejection fraction these medications can damage your heart and kidneys. Seek appropriate treatment from your primary care doctor or orthopedist and disclose your daily alcohol intake as this could lead to life threatening stomach or esophageal bleeding. If you have marooon or black poop, or vomit what looks like coffee grounds, go to your ER immediately,

Pain is a message, Increasing pain means something is worsening. Listen to your pain by doing the above lifestyle changes. If you do not find improvement, follow the resource branches of care with primary care, orthopaedics, rheumatology, psychiatry and physical medicine to get to the root of the cause. Your bones will thank you for it,

Nutrition to Strengthen Liver Yin

Posted on October 27, 2011 by Masina Wright ND

Modern culture is Yang obsessed. We go-go-go, we seek sun, we burn the candle at both ends, we exercise vigorously, and we love stimulants. It is a rare bird that has enough quiet, meditative alone time, in a dim or dark environment. This is the Yin state – nourishing, moistening, dark, and quiet – Yin builds what Yang wears down.

Every organ of the body has a Yin and a Yang aspect. Some organs (Spleen, Liver, Heart, and Lung for example) are naturally more Yin in Nature. Other organs (Stomach, Gall Bladder, Small Intestine and Large Intestine for example) are more Yang in nature. These “natures” were determined by the functions each organ enact as well as more energetic attributes. Supporting the natural state of each organ will optimize health, and promote healthy functioning.

Much is said about detoxifying the Liver, and reducing its Yang (brought on by alcohol, drugs and stimulants) but what happens when you actually have deficient Liver Yin that needs to be nourished? Stripping an already deficient organ will create further disharmony that will eventually manifest as pathology.

A diagnosis of Liver Yin deficiency means that this aspect of the Liver organ network is compromised. The Liver not only detoxifies, it has many other (building) jobs including cholesterol metabolism, vitamin storage, bile production, and blood reservoir. Blood is a Yin substance (all fluids are yin) and many B12 and iron anemias can be diagnosed early on as a Liver Yin deficiency by a trained Acupuncturist. Thin brittle nails, anemia, sallow skin, easy bruising, hair loss, blurred vision, tinnitus, dizziness, infertility and some tremors are all associated with a Liver Yin deficiency diagnosis.

Nutrition is one of the best ways to support and recover Liver Yin. A diet that is nutrient rich and nourishing is essential, as is sitting down to relax while you eat and chewing thoroughly to savor flavors. The diet should also include plenty of fluids, especially in the form of soups. Meals consist of 40% easily digested complex carbohydrates like whole grains and starchy root vegetables. Another 40% of the diet is cooked vegetables. Proteins comprise 10-20% of the diet, with a focus on high quality organic or grass fed sources. Healthy fats fill the other remaining 5-10%.

Below is a list of recommended foods to nourish Liver Yin. Do not limit your nutritional intake to only these foods. Instead follow the guidelines above of the optimum ratios of carbohydrates, vegetables and proteins, and add the recommended foods from the list below within your meals. Where ever possible choose organically grown foods to avoid genetically modified ingredients.

Foods to Nourish Liver Yin Deficiency

Zucchini, squash, potatoes, sweet potatoes, string beans, beets,

Mushrooms including wood ears & tremella,

Tomatoes, spinach, carrots, parsley,

Molasses

Apples, banana, mulberries, mango, coconut, peaches, lychee fruit, melons,

Grapes, raisins, cherries, plums

Olive oil, flaxseed oil, almond oil

Vegemite, kelp, spirulina, wheatgrass

Oats, rice, millet, barley

Adzuki beans, black beans, mung beans

Organic cow, goat and sheep yogurt

Tempeh, tofu, miso

Nuts & seeds, black sesame seeds (great as a condiment!)

Eggs

Pork, chicken, Chinese black boned chicken, duck

Mackerel, sardines, oysters, mussels, clams

Cuttlefish, squid, perch, eel

Foods to Restrict or Avoid

Chilies, cinnamon, garlic, ginger, onions, shallots, leeks, basil, cloves, wasabi

Coffee, black tea

Vinegar, pickles

Lamb, shrimp, veal

Citrus fruits

Cigarettes, alcohol

Recreational stimulants

Activities that build whole-body Yin nourishment are also encouraged while working specifically on Liver Yin. Rest more. Read. Spend some quiet, alone contemplative time in a cool, dark room with a candle lit (taking a bath is a nice way to do this.) Exercises like Tai Chi and Yoga are more Yin building than Yang in nature. Drink warm water and lemon. Get extra sleep. Breathe.

References:

Clinical Handbook Of Internal Medicine, Vol. 2. MacLean & Lyttleton. University of Western Sydney: Australia. 2002.

Chinese Dietary Therapy. Liu, J. Churchill Livingston: Edinburgh. 1995.

The Healing Cuisine of China. Zhao & Ellis. Healing Arts Press: Vermont. 1998.

An interesting theoretical write up: http://www.indiadivine.org/audarya/ayurveda-health-wellbeing/997986-liver-yin-deficiency-patterns-derived-patterns.html

Its Not You. Its Your Food!

Posted on May 25, 2011 by Masina Wright ND

Chances are, you are having some kind of allergic response to the foods you are eating. For some people this manifests as weight gain, puffiness, or bloating. For others its drippy nose, itchy mouth and red eyes. Someone else manifests their allergic response as constipation or diarrhea, and someone else has creaky sore knees and chronic urinary tract infections. How can one set of reactions have so many manifestations? Because we are all different types of people with different genetic and systemic vulnerabilities. Our immune systems are also unique, and respond individually to stress.

70% of our immune system is in our guts. It is our digestive immune systems job to separate out food from bacteria and parasites and viruses and other “non-self” things that we ingest. However, with age, or over-medication, or stress, or a whole host of other complicating factors our digestive immune system can become imbalanced and start to identify foods as “enemies.” Then, every time that food is eaten, we mount an immune attack against it! Creating inflammation, swelling, mucus production – a whole mini-battle scene in your gut. When this happens daily, it starts to affect the organs involved and creates local damage, which impairs intestinal integrity. Then, little particles of inflammation leak into the bloodstream and negatively affect distant organs. Thus, the “personalized” food sensitivity effects of bladder, respiratory, joint, brain or other system dysfunction.

Most common allergenic foods:

Dairy, wheat, soy, corn, eggs, chocolate, oranges (citrus), seafood (especially shellfish), additives/preservatives, tomatoes, potatoes, strawberries, peanuts, almonds.
Hereditary factors do set up susceptibility, as allergies appear to run in families. For example, if both parents have an allergy/intolerance, then there is a 67% chance that the offspring will be allergic. Therefore, be extra careful when introducing these foods to babies.

Common physical and symptomatic signs of food allergy:

Dark circles under the eyes, puffiness under the eyes, chronic swollen glands, runny nose/nasal drip
Canker sores, celiac disease, chronic diarrhea, constipation, gas, gastritis, heart burn/acid reflux, IBS, ulcerative colitis, gallstones
Chronic infections, frequent ear infections
Bed-wetting, chronic bladder infections, kidney disorders
Asthma, chronic bronchitis, wheezing, itchy nose or throat, sinusitis
Acne, eczema, hives, itching, skin rash, red (burning) ears
Bursitis, joint pain, low back pain, arthritis and arthritic disorders
Arrhythmia, edema, fatigue,
Headache, migraines
Hyperactivity, anxiety, depression, inability to concentrate, insomnia, irritability, mental confusion, seizures

Diagnosis:

Identifying the foods your system is reacting to is important. It can be so varied – wheat for one person, salmon and sesame seeds for another! By identifying the problematic foods, you can also “know your devil.” Even if you still choose to eat the food occasionally, at least you can predict the response and manage it as needed. Knowing the problem often makes the symptoms more bearable!

There are many ways to identify food sensitivities. As a Naturopathic Doctor, I use blood work for people with multiple system involvement or complicated medical histories. The test starts at $269 for 95 foods, and increases for additional foods or for candida antigen identification. The hypoallergenic dietary method is an excellent detoxification diet. It is a great method of self diagnosis for people who have one or two symptoms that may be related to food sensitivities. It is also a fantastic weight loss diet, and I often use it for that reason alone!

Hypoallergenic Diet: Food elimination and subsequent reintroduction
Bloodwork: IgG testing using bloodspot analysis
Applied kinesiology (AK): Muscle testing for strength/weakness in the presence of the food being tested
Vega / Intero Food Test: A biofeedback-like software program based on AK that tests your bodies electrical responses to foods.

I personally am not trained in AK food testing, and have not found a practitioner in Maine who does the Vega style testing.

To minimize immune reactivity & enhance your immune system:

Identify and eliminate the foods that you are reacting to.
Increase the variety in your diet and rotate foods – do not get stuck eating the same ingredients or foods every day.
Eat organic foods! Especially those fruits and vegetables that can’t be peeled and animal products – milk, yoghurt, eggs and meat.
Minimize tuna, swordfish, farmed salmon and other large fish known to have heavy metal contamination.
Don’t drink tap water! Use a filter or switch to reverse osmosis-treated water to eliminate fluoride, chlorine, and other chemicals that are present.
Supplement with antioxidants: vitamins A, C, E, zinc and selenium.
Once or twice a year take a course of probiotics (especially if you have just completed a course of antibiotics) – these are the good bacteria that your intestines and your immune system need to function optimally. You need a probiotic that provides both Lactobacillus and Bifidus bacteria.
Don’t suppress stomach acid production with heart burn-relief aids – instead, identify the triggers and eliminate them. You need that acid to act as a barrier against bacteria, viruses and fungi in our environment.

Recognizing that you probably have food sensitivities, and diagnosing them appropriately is the first step towards feeling (and looking) better. Depending on your age, and how long you have had your symptoms, you may also need to do some digestive system repair. This is a four staged series of treatments that clean up your sites of inflammation, heal your gut lining, and recalibrate your immune systems reactivity. You will be amazed at how fantastic everything starts to feel once all the little chronic health problems disappear!

The Wright Doctor

Modern Medicine, Old Fashioned Care

Category Archives: Autoimmune