The Tale of the Contaminated Pool

My family and I just had a wonderful camping week at the beach. The sun, swimming, tiki bar (what what?), and nights by the wonderful campfire with extended family were all relaxing and rejuvenating.

We reflected on the the fact that the only things we took away from camping were wonderful memories, big smiles, sun-kissed skin, and a better understanding of a need for personal space.

“Well,” we thought. “That one day was weird when we had to leave the pool because it had been contaminated.” We had just thought some kid (even though “it” happens, amirite?ūü§£) had pooed, which is awful in and of itself. But what it turns out to be, oh, is much worse.

Resuming daily activities Monday morning is when I quickly realized that sunsational vibes were not the only thing we brought home with us.

Phone rings: 10:00am

“Hi, Mrs. Wright…….little #2 has HEAD LICE and needs to be picked up immediately”

<Screech screech screech horror movie noise>

Those who really know me understand that I have an incredible visceral repulsion and hair-trigger panic button when it comes  to flying insects and now also to tiny creatures you can barely see that latch on for dear life and suck your bodily juices for sustenance.(Is that too graphic?)

I panic. BIGTIME. We’ve never had lice in our house before!

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It’s coming from INSIDE THE HOUSEEEEEEEEEEE

I immediately stop my work and go to get her, all the while assuming I am going to pick her up and she’s going to be covered in these horrible blood thirsty pests.

A little History with my bug hysteria can be explained in the flea “epidemic” of 2015 when my dog had two fleas. I assumed the whole house had been taken over and went a little nuts and replaced all our carpets and our couch, bought a Dyson cordless and vacuumed six times a day. Totally normal behavior…

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So, I vow to go immediately home, burn all clothes, shoes, beds, pillows, couches, carpets.

“That won’t be enough. The whole house will have to go up in flames. BURN IT DOWN”

So instead of going back down the road of epidemic, I reassure myself that I should assess the situation first, then react. High fives for rational thought.

Restoring my wits, I remember the thousands of other parents/kids/humans that have dealt with this issue in the past. And I got a lovely suggestion from our daycare provider (who was an angel and bagged two to educate me since this was our first time dealing with it) for a service we have here in Virginia called “The Nit Fairy”¬† They searched for, treated, checked me and my daughter and scheduled a follow up with us! I paid for it….$300 to be exact…but the peace of mind that someone did a thorough job in finding them and treating them while teaching me what to do step by step feels priceless to me. Hopefully y’all have this in your area as well! It’s worth the search.

Now…..the aftermath. As soon as my son and husband get home, they are checked and treated. I use the OTC RID lice treatment on both, and vacuum and spray all carseat heads, and regular seats, seat belts, bike helmets with the home spray included in the kit.

Now, we wait….

24 Hour Report: So far so good. All have been checked several times with combing twice.  Bug and egg free for today.

1)Mental itching and feeling of bugs all over level: expert.

2)Shampoo game: on point

3)House cleaning status: laundry done, things bagged and tagged, brushes/toys/ shoes drowned for two hours and counting.

What Do I Do Now?

I am not going to lie to you, looking through photos to show you what one of these things looks like made me throw up in my mouth.

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HOWEVER! For the sake of me never wanting YOU to have to question “what the heck do I do?” upon the words “Mommy/Daddy, my head itches.” arriving at your door, here is a guide on what to do:

Step one: Saddle up, you’re riding this suck fest for two weeks plus.

The average lice egg takes up to a week to hatch. Meaning, if you don’t get the nits (lice eggs) out, you’ll have a brand new harvest in a weeks time. You’ll have to go through the WHOLE rigamaroll again if they go unnoticed.

Get a treatment kit either OTC, call for a prescription from your pediatrician on what they recommend, or go to a place like I did that treats you there. To decide, think about how you feel about chemical OTC treatments versus using an oil based solution such as a blend of Rosemary and Tea Tree Oil in a carrier Olive Oil.

Step Two: Treat yo’self and your WHOLE FAMILY

Get enough kits for your whole crew. Even if you don’t SEE anything on them, chances are there at least one. After you treat, wait seven days and treat again.

********Always follow the FULL instructions on how to treat in the pamphlet. Better yet, call your doctor and ask them!***********

This Comb is pretty legit as a replacement for the normal comb! Not necessary, but made me feel like I was doing more to alleviate my irrational tiny bug abhorrence.

Step Three: Housekeeping Diligence

The second most important step is to be violently and insanely diligent with cleaning up anything that anyone treated has touched in the last two days before finding the, gulp, infestation.

Wash: All clothes, sheets, pillow cases, hats, princess dresses, gloves, blenders, miniature schnauzer-doodles, goldfish… I don’t care ….WHATEVER THE KID(s) or y’all HAVE TOUCHED, wash it in 130 degree water. High heat for 20 minutes and roast the little things.

Dry Clean: Anything you cannot wash at 130 degrees and put on HIGH heat in dryer for at least 20-45 minutes, should be dry cleaned. Comforters, pillows, dragon pillows, fort roofs, fort sides, fort anything.

Bag: Anything else such as toys, tiaras, magic wands, and seal it for FOUR weeks in a bag and shake it like a polaroid picture when you take it out before use.

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Vaccuum: Everything. Everywhere. All the time. Carpets, floors, couches, mattresses, headrests and car seats, your desk, headboards on bed. Just get an iRobot and call it a day.

Step Four: Pete and Repeat.

You know the old joke, “Pete and Repeat were on a boat. Pete fell off, who was left?” Yup…..basically you can clean and wash and vacuum for as long as you want. But everyone needs to be checked daily until you see no more lice or nits. Up to two weeks after last treatment. If you still see lice or nits after the two treatments, get your butt to a doctor cause you’ve got a superbug.

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You could also just shave your head if you want. Believe me, in my initial freak out mode I told the day care provider that I was going home to shave everyone’s head. I mean, why not?

Please Share what has worked for you and your family to rid yourself of these evil effers that can hold their breath for TWO HOURS under water. Unless you say Powdered Sugar is delicious and the lice hate the sugar. (name that movie??) download (8).jpeg

<Kristy mumbles “holding their breath for two f$%king hours?” BLEEECCCHHHH¬†>

Hope this helps you not to freak out like I did. Do as I say, not as I do:)

48 hour report: One sluggish bug found……Repeating steps above….AGAIN.

Godspeed good soldiers…

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Dr. Annie Answers: A Parent‚Äôs Intuition

Many of the things that people have said they appreciate about me as a doctor are the direct result of advice from one of my best mentors. One thing – trusting a parent’s intuition – has literally saved the lives of multiple patients of mine, and now hopefully, also that of my nephew. He’s in the womb below, while I was also preggers with baby #2.

As a resident, I remember feeling so lost in the beginning about offering advice on things like breastfeeding or colicky babies or a kid with a weird rash. I had been around lots of kids, sure, but I had never been pregnant, had never tried to breastfed a baby, or to get a fussy toddler to take medicine.

I, for sure, gave some asinine advice in those early days and more than once had patients laugh in my face (sorry pregnant patient who I tried to tell to work on her core strength for third trimester back pain!!). What Dr. Pippitt told me was, “Of course you don’t know their kid better than they do, but you do know medicine better than most of them.” Her advice now seems so obvious – let parents be the experts on their own kids. This applies to people being the expert on their own bodies also, but I’ve found we misinterpret ourselves more than parents do their kids…. so paying attention to what parents think is even more important IMHO.

Since then, I, of course, have become a mom twice over. I know tons more practical advice and can be quite a bit more helpful in treatment strategies. But! I still know that every parent is the expert on their own kid. My bottom line advice for when to have something checked out, followed up on, checked out again is always “if you, as the parent, are still worried or feel something’s not right”.

The validity of this was recently driven home in a tragic way. My sister, back in March, called me on FaceTime to show me a lump on her 3 year old kid’s neck. I took one look at it and thought, “that’s not normal”. My sister and her wife agreed and took him in to their pediatrician right away. The doc told them it was nothing to worry about. But… they were still worried when it didn’t go away. They saw ENT who also said it was nothing. But… they were still worried. Finally at 2 month follow up, it was bigger, not smaller. A few weeks later an MRI and biopsy had confirmed it was Hodgkin Lymphoma, an extremely rare, but very treatable diagnosis in someone his age.

Their intuition was right on, and had they not followed up despite being told it was nothing, it could have been caught at a later and more dangerous stage.

So, the next time you find yourself with that, “something’s not right” feeling, go ahead and get checked. This goes for your own body too, of course. Make sure the provider you see is able to make you feel confident that your fear can be ruled out before you go. This doesn’t mean they will do every test imaginable every time – sometimes we can take a look at something and tell you with high level of certainty, “you don’t need to worry”. We did go to school for a long time to learn that medical side of things, after all. But, if your care provider doesn’t listen to or respect your knowledge about your own kid or your own body, find a new one.

Dr. Annie is a married mother of 2, aunt of dozens of other amazing kids and family doctor in the Sacramento Area.

Ps. If you want to support my sister & her family, you can find them on Caringbridge.com under starlinglynnalesker

Dr. Annie Answers: Getting Pregnant

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It’s kinda crazy to me that a lot of us spend so much of our lives worrying about NOT getting pregnant and then you go straight from that to worrying about getting pregnant. This, like many issues addressed here, can be influenced by many personal health issues. Talk about it with YOUR doctor. I’m just here to give some basic info. This advice also is less applicable if you’re using a sperm donor or other fertility treatments for any reason, but some of it still applies.

So you think you want to get pregnant…

Number 1: Start a prenatal vitamin. *Ideally* you’re already taking one if you are of childbearing age (aka teens through 40s). If not, start NOW. You should be on a prenatal vitamin at least 3 months, and ideally 1 year before you conceive. What if you’re already trying to conceive? Start now. Better today than next week. Just, the sooner the better.

Which prenatal vitamin is right for me? There are lots of brands, gummy options, drinkable options, etc… to choose from. Find one that you can tolerate taking. The basics it needs to have are 400-1000mcg of folate, 27mg iron, 1000 units vitamin D, and 100mcg iodine. If your diet does not have a lot of healthy omega oils, also get a 1000mg daily DHA/EPA supplement. I personally use Honest company prenatal and DHA.

Talk to your health care provider about any medications you’re taking and if they are safe while trying to conceive. Make sure any chronic health issues such as thyroid problems, diabetes, or high blood pressure have been checked and are in good control. Plan ahead for these!

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This depends a little on what you were using. You CAN get pregnant the month (or week) you stop any form of birth control. So don’t stop using anything unless you are A-OK with being pregnant right away. That being said, hormonal birth control is more likely to have a “wash-out” period where you don’t ovulate regularly and are less likely to conceive. DepoProvera, oral pills (especially if you’re skipping periods), the patch, the nuva-ring and Nexplanon/Implanon all have a 3-6 month expected wash-out. I have seen it take up to a year with Depo. IUDs are less likely to have wash-out, but we wouldn’t be surprised if it took 3 months or so.

So, let’s say you want to get pregnant “sometime in 2019”. Easy. Go off birth control after you have that New Year’s blow-out party. What if you have a more specific window? You can plan to go off birth control 3-6 months in advance of that window, but use condoms to prevent pregnancy until then. Know that condoms are only 85% effective at best and you could still get pregnant earlier than you think. So, if, for example it would be devastating to get pregnant in February (calculate due date from theoretical conception date out here), don’t stop birth control until after that.

How to get pregnant….

SO, um, there are of course some basics here I’m assuming everyone knows about human reproduction. If you’re confused on the what goes where, may I refer you back to wikipedia under “birds and bees”. If you’re not in a relationship where sperm is readily available or you can’t have intercourse for any reason – see a fertility specialist about how to get that all going.

If those exceptions above don’t apply to you… the most reliable way to get pregnant is also the simplest. Have unprotected intercourse every other day from right after your bleeding stops until you start bleeding again. Every. Other. Day. Not every 3 days. Not twice a day (but good for you if this is your issue!). This gives you optimal semen volume and you will never miss your fertile window because it lasts 2-4 days. Boom.

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Now we get to the people who are absolutely opposed to having sex every other day. For some couples, that’s not sustainable over the several months it can take to get pregnant. That’s totally fine! If that’s the case, I usually recommend the Glow Ovulation, Period Tracker App. This lets you track cervical mucus, basal body temperature, ovulation sticks and pregnancy tests, sexy time and everything else about your cycle. Take at least 1 month to track everything while still using condoms so you get some understanding of your cycle.

Then, go for that fertile window! Again, sex every other day or daily.¬†What kind of sex? Pretty much whatever. Position doesn’t matter. Ideally, the person trying to conceive should have an orgasm during or after (though there isn’t evidence that this is necessary, it has little down side!). And if you’re gonna use lube, use this lubricant. Chill out for 5-10 minutes after sperm gets in there then go about your business.

Did you say cervical mucus? Sounds so gross, but is actually the easiest way to check if you are fertile. Just look at the TP after you wipe when you go pee. When you’re approaching fertility and fertile, you’ll notice a clear discharge like egg white. When this is super gooey/stretchy – that’s peak fertility. More nitty gritty¬†here.

How long is this going to take?

If you’re under age 35 it is normal to take up to 1 year to get pregnant depending on your health and the health of your partner. Most couples will get pregnant within 3-6 months. If you’re over 35, the timing gets a little more pressured because fertility starts to decline significantly around age 37. In this case, we would usually only give you 6 months before further testing. If you’ve already been trying to conceive for that long – go see your doc.

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Photo cred: FionaMargoPhotography.com

Final note: Don’t sabotage your efforts.

If you’re in the exciting phase of ‘trying to conceive’, don’t do things that are going to stress you out and make it harder or threaten an early pregnancy. Ask your health care provider if any medications you’re taking are safe. Don’t go binge drinking. Don’t smoke marijuana. Don’t smoke anything for that matter. Have your sperm provider avoid hot-tubs, tight underwear and long bike rides. Eat lots of healthy fruits and vegetables and proteins and fats (first trimester is ROUGH ya’ll, you will need those nutrients stocked up). Exercise regularly. Avoid over the counter medicines other than tylenol and tums without asking your healthcare provider. And… enjoy the ride!

ps. Make sure you follow us for an update on my own adventure trying to conceive baby #3 coming soon ūüėÄ

94

Dr. Annie is a family physician and married mom of 2 in the Sacramento Area.

Dr. Annie Answers: Kid Vitamin Basics

Mother’s Day is this weekend which has me thinking about all the things moms have to worry about… one of the most common being the nutrition and health of our precious little ones. Almost every day at my clinic, I get some sort of question about vitamins – What’s safe? What’s necessary? Where do I get good ones? The answer, of course, varies by your particular health needs and should be discussed with your own medical provider. A few things are pretty generalizable though and I’ll delve into them here by age. This post is about kiddos – coming up next will be an adult version, so make sure you FOLLOW US to get that update!

Breastfed Babies, Birth through 12 months: 400 units Vitamin DScreen Shot 2018-03-09 at 2.08.17 PM

Vitamin D is needed for all babies who are breastfed half or more of their milk intake. I nearly always recommend¬†Baby Ddrops¬†for those who can afford the $10/month averaged cost. These are concentrated drops so, instead of getting your tiny baby to choke down a whole milliliter of vitamin D like the generic ones at the pharmacy, you only have to put 1 drop on your clean finger and put on baby’s tongue before a feeding. If your baby is formula fed, no vitamins needed, they’re already in there – see below for details.

Breastfed Babies, 4 months through 12 months: Add 6-11mg Iron

Iron is recommended for breast-fed babies after the first 3 months of life. Mom’s iron from the womb keeps them going up until that 4 month mark.

Sidenote….¬†One of the potential benefits of delayed cord clamping at birth is increasing baby’s iron stores for that first 3-4 month period (great review on this by Dr. Raju et al¬†here.) . This is, of course, an important thing to discuss with your own pregnancy care provider, but worth considering for this and other benefits if there is no reason¬†not to do it.

From ~4 months through the rest of the first year, baby will start eating more and more ‘real’ foods which can supply some iron, but usually not enough. The recommended amount by the American Academy of Pediatrics for babies 7-12 months is 11mg per day. For reference, you’d have to get your baby to eat 2 cups of cooked spinach to get that much – not gonna happen.

Option 1: at this age, stop Vitamin D supplement and change to multivitamin. Poly-vi-sol with iron is the go-to recommendation for most health care providers. However, my daughters both projectile vomited it, so we had to use alternatives. Other options are Zarbees Baby Multivitamin with Iron  and Honest Company makes an easy-to-give vitamin powder: Link here. pexels-photo-533360.jpeg

Option 2: continue with Ddrops and give iron-only supplement like this one or give a serving of iron-enriched cereal daily. I personally, along with a growing number of pediatric care providers, recommend the former along with introducing iron-rich foods such as pureed meats, dark leafy vegetables, beets and beans before cereals as part of a healthier early diet. Baby cereals don’t otherwise have much in the way of nutrition or “taste education” for that little one. (References¬†here in AAP News¬†and¬†here from NIH)

Formula-fed Babies up to 1 year

Breast-milk is best for moms and babies that can do it in all aspects except these 2 vitamins. Formula comes conveniently stocked with both Vitamin D and Iron so you don’t have to worry about the supplements. Certainly not a reason to choose it over breastmilk, but a nice side-benefit if it ends up being the right option for you. I usually recommend¬†Baby’s Only Organic Formula¬†or¬†Plum Organics Grow Well Formula. Screen Shot 2018-05-07 at 5.58.09 PMThey are well tolerated (review here), have the right amount of all important nutrients and both come out to roughly $1/ounce (compare to Similac Advance Non-GMO at $1.25/ounce). They are also organic and free of corn syrup solids and chemical additives – which, when you’re talking about the ENTIRE nutrition of your tiny rapidly growing baby is important. AND!! You can get them both on auto-ship from Amazon so no leaving the house – bonus!

After 1 year: Vitamin D 400-1000 Units Daily +/- others…pexels-photo-61129.jpeg

This now depends on how picky of an eater your kid has become. If you have that amazing, adventurous eater who loves a variety of meats, fruits, and vegetables and drinks 2+ cups of milk per day, multivitamins are unnecessary. If your child doesn’t get 400-1000 units Vitamin D from fortified milk and other foods, they will need a vitamin D supplement again. Why? What about kids before the advent of vitamins?? Well, kids were outside ALL DAY without sunscreen back then. We now know better and protect their skin – the downside of which is low vitamin D.

If you do have a picky eater¬† – even if you’re not sure how picky is picky – a multivitamin can fill in the gaps. Again, the above mentioned Zarbee’s and Honest options are great as is¬†Renzo’s Picky Eater Multi. If they’re getting extra of some of those vitamins, they will pee them out.

Hang on…. I hear a question coming out of the Ether….

“Dr. Annie, are the examples you listed above the only good options?? What about Flintstone’s vitamins or Olli Chewables?” Of course those aren’t the only vitamin brand options. If you want to check out others, just read the fine print on the label on the back and make sure they have the right amounts of the recommended vitamins.

Wait…. another one coming in…. “What about probiotics??” I’m so glad you asked! YES probiotics are so important from infancy through the rest of life – so important I’m going to write a separate post all about it ;^)

94 Dr. Annie is a family physician, wife and mom of 2 picky eaters In the Sacramento Area.

Dr. Annie Answers: Good fat, bad fat

 

In case you clicked on this post thinking it had to do with body shapes or positive body image – that’s not the fat I’m talking about here. Although, I do fully believe that there is a wide range of healthy body shapes out there and that no person should feel shame about theirs. I digress…

What I’m actually writing about here is the fat we eat. Unless you’ve been living under a rock for the last decade, you should be at least a bit aware that ‘trans fats’ are BAD and ‘omega-3 oils’ are GOOD. I’m going to both give you a bit more detail and also simplify it at the same time. **As¬†always, this blog post is meant to give you information and not as personal medical advice since I am not your personal doctor. **

For decades, people with high blood pressure, high cholesterol, diabetes or obesity have¬†been told to follow a “healthy low-fat diet”. That is an oxymoron. It turns out, that exact advice has been a huge driving force in the EPIDEMIC rise in all of the above conditions.¬† We are just now starting to get a grip on the actual data and the conclusion is undeniable: a diet very high in healthy fats and very low in carbohydrates can prevent and¬†reverse that damage. There are a tiny handful of people with specific health conditions in which they have to limit fat intake. You are probably not one of them.

Good fats go into your body and provide steady energy, a vehicle to transport important nutrients and hormones around, and keep your blood vessels and nerves healthy. Bad fats get in there and gum up the machinery, clog those arteries and often carry harmful things in with them. Your body needs a LOT of those good fats, probably more than you think.

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I have to admit, I too was a skeptic for a time. Enter Whole30 diet in which you eat only vegetables, fruits, meats (SO much meat), nuts, seeds and eggs for 30 days and NO grains, legumes, dairy, sweeteners of ANY kind, alcohol, soy or chemical additives. You aren’t supposed to track calories but I was curious – on average I was eating about 100-120 grams of fat per DAY, lots of it saturated. And you know what? I lost 15 pounds and 2 pant sizes and felt like a freaking super-hero by the end. Depression better, sleep better, skin better, energy better. It just works.

So, how is one to navigate this?? There are a few simple rules.

  1. No reduced-fat versions of foods.
  2. Not all fats are created equal, increase the good, limit the bad
  3. If something is high-fat, try to choose the highest-quality.

Want a little more detail? Read on, my friend!

Rule 1: Choose the full-fat version

“Whaaaaaaaaat?”, You say. Not even low-fat yogurt?? No. We are evolved to like the taste of fat. When fat is removed from foods, food manufacturers have to replace it with something – both for the volume lost and also for the flavor. The answer in most cases is carbs/sugar and salt – both of which have a huge body of evidence to show they are harmful. Diabetes, obesity, hypertension, and multiple cancers included in the ‘harm’.

Moreover, when you have less fat, you have to eat more to feel satisfied because of the way hunger signals translate from stomach to brain. That big old bolus of sugar/carbs you ate instead causes an insulin spike that stores away fat in your body (no thank you extra stored fat!) and then crashes into hunger soon after. Higher fat foods, however cause almost no insulin spike. Check out the difference:

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Insulin over time after eating pure carbohydrate vs pure protein vs pure fat.

So, does this mean I can eat bacon and eggs for breakfast, a steak with butter on it for lunch and breatwurst wrapped in more bacon for dinner as part of this healthy low-carb, high fat diet? Um, no. (though there are some interesting studies in which people did just that…). Most people would still say your diet should include plenty of non-starchy plants (aka not potatoes, corn, peas or carrots). Half or more of your plate should be vegetables like broccoli, cauliflower, greens, bok-choy, asparagus….. or sometimes fruits like so:

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Rule 2: Know Good vs Bad fats

So which are which? Nuts, seeds and fruits tend to have healthy fats and should be the largest source of your fats. Newsflash: corn (aka Canola), soy, cottonseed, palm fruit and peanut oils do NOT fall in this category. Coconuts, tree nuts, sunflower seeds are great for eating and their oils for cooking.

And, yes, I said fruits. Avocados and olives are fruits with hella good fat content (California joke).¬†Good fats can also come from fatty fish such as salmon, tuna and trout – or for the more adventurous palate, sardines and mackerel. Good quality meats and dairy can also be a great source – more on what “good quality” means below. If you have to buy the cheap cuts – limit these a bit.

The worst fats are the ones humans have done something ‘advanced’ to that alters them. Ask yourself: Is it is a processed ‘food product’ like margarine or Doritos? Bad. Did the animal or plant it came from have it’s natural lifestyle disrupted for mass production? Bad. Did it come from a lab – aka trans fats and hydrogenated oils? SO SO BAD.¬† Avoid, avoid, avoid. Also, avoid heating liquid oils (canola, olive, avocado, etc..) to high heat as this can create carcinogens (cancer-causers). Better to use coconut, ghee (butter), or animal fat.

Rule 3: Choose High Quality Fats

Some of you might be thinking at this point… is this what that Atkins Diet was saying? Yes and no. The Atkins Diet skims over the high-quality vs low-quality fat delineation and just says: increase fat, lower carbs. This is a good step in the right direction. However, the quality of the fat also matters, and I’ll tell you why.

Most things that we put into our bodies can be categorized in one of 2 ways – fat soluble or water soluble. In a huge simplification, that means that it can get through your gut and into the rest of your body by ‘riding’ on a fat or with water. Vitamin D, for example, is fat-soluble. So you want to take it after eating some fat. Vitamin C, however, is water soluble so can be taken with just water. This also goes for nasty stuff you don’t want in there. Many chemical pesticides, growth hormones, antibiotics and even heavy metals like mercury are concentrated in fats. Furthermore, the good fat to bad fat ratios change dramatically when we take an animal and feed it an ‘unnatural’ diet.

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Happy, healthy cows.

If a cow is fed grass, as nature intended, the fat profile in those rib-eye steaks and that delicious milk is WAY healthier than if they are corn fed. Not only that, because that corn-fed cow was on a diet it’s body wasn’t made for, they are loaded up with hormones and antibiotics which ride on in to your system with that fat. Note: organic doesn’t mean grass fed, but is still better than non-organic.

Where your budget allows, buy these top quality fats. Organic olive oil and avocado oil are cheaper at Costco. Search out the deals on grass-fed beef. Then cook it in some organic ghee and top off with organic Bechamel served with some broccoli roasted in coconut oil. Then tell me how “deprived” you feel on this diet ūüėȬ† It’s really not as hard as you think!

Take home point: Eat LOTS of fat, don’t worry about how much but do worry about what kind. Choose organic plant oils and aim for organic/free range animal products.

Resources:

There is a lot of emerging information about this (finally!!), here are some ways to learn more:

 

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Dr. Annie is a family physician, wife and mom of 2 girls in the Sacramento Area who, yes, cooks everything in butter.

Dr. Annie Answers: Open Letter to my Patients

Dear patients,

There are things you say to me on a daily basis that I wish I could make nationwide public service announcements about in the midst of prime-time TV. We are early in our blog-adventure, but I’m just gonna put these out there in the hopes that someday they’ll be shared widely (as a close second option to a televised career).

Things you don’t need to apologize for

In my opinion, women apologize out of habit for WAY too much sh&* anyway (I’m guilty too), and I get a fair amount of apologies from men too, but these? Let them leave your mind.

  1. Women of the world, I could not care less if your legs are shaved. Not a bit. Not at all. Nor do other doctors. Unless you’re seeing a gynecologist, the rest of us also see men – know what? Men NEVER say, “sorry, I didn’t shave my [insert any body part, ever]”, when they come in to get checked out. You have enough to worry about and apologize for – let this one go.
  2. Same goes for your choice of pubic hair management. There’s a whole large part of the population that wouldn’t ever consider waxing/shaving/electrolysis and you know what? We feel fine about caring for them too.
  3. While we’re here – no apologizing for menstruating!! We have seen blood before. Menstrual blood. Body blood. Birthing blood. All the bloods. It doesn’t phase us a bit – or else we would have chosen another profession.
  4. If you cry in the office, it’s because you need help and you do NOT need to apologize for those tears, ever. If you cry, it’s because you felt comfortable enough with me as a provider that you could open up about what is REALLY bothering you – whether physical, mental or emotional. That is one of the greatest gifts to a primary care provider. That is our goal. No apologies for that.
  5. Having ear wax. We all do. We can clean it out. Don’t use q-tips to clean it, they only make it worse. (But if you do¬†have to use a q-tip,¬†always lubricate it with olive oil or vaseline!)

 

Exercise and diet

I’m gonna post in detail about this later. The bottom line here is: you can get an excellent workout in 12 minutes with high intensity interval training. And almost no one should ever be on a low-fat diet*. The low-fat diet trend was WRONG. It is BAD for you. Fat does not lead to high cholesterol or heart disease if it’s the right kind of fat. Know what does? Sugar. What’s worse for you: Bacon or Skittles?? I bet some people would guess the Bacon. Wrong.

A picture is worth 1000 words

If you have a rash that comes and goes – take a picture! If your kid is walking funny but only sometimes – video it! Take notes of what’s going on and bring them. Your recollections and descriptions may or may not be useful, but those are.

Agenda-setting

A list of all your questions is so helpful for organizing what to get to. However, you should know that depending on where your provider works, they may have NO choice in how long your appointment is. Many institutions do not allow us longer than 15 or 20 minutes total – that includes the 5 minutes it takes you to check in and have vital signs done. So, while we for sure¬†want¬†to fix everything (trust me, that’s why we picked this job!), we just don’t have time. We may have to choose some things for now and some for later. Insurance also regulates now what can be done at a “Physical” or “Wellness visit” and most will not let us address ‘problems’, ONLY ‘preventive care’ at those appointments. It is not our choice. We can’t “change the coding”, or we could lose our licenses. Talk to your lawmakers about this!!!

Share, learn, love.

-Dr. Annie

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