A Pill for Libido. Really?

As an internist who sees hundreds of women in the second half of life, I am all too familiar with women’s waning libidos.  Having gone through menopause myself, I have personally experienced the power that changing hormones have on many psychological and bodily functions that the younger me took for granted.  As an integrative physician, I am always searching for causes of symptoms and for natural and integrative ways to treat and heal them.  Our society sees a waning libido as a pathological symptom.  Viewing our aging bodies as pathological is where our problem truly lies.

Our collective maturity level in America can truly be seen as ‘adolescent’.  We are a society with many compulsions.  We seek fast ways to manipulate the body, to manage symptoms, and to regain youth. We want pills as substitutes for inner work, diets for rapid weight loss, and shots to stop menstruation considered inconvenient by many.  We are addicted to an ideology that has proven not to work over the past three decades.  Somehow, we are unable to make the shift to a more mature way of thinking.  Industries that support these compulsions make a lot of money.  The money itself becomes an incentive to keep the compulsions in place.

We have promoted the ‘anti-aging’ ideology for nearly 3 decades. We have yet to find a way to turn back the clock.  We are fearful of aging because we lack respect for process, and have not created a way to mark and consecrate our life stages from a place of reverence. Our society normalizes this. Mother Nature, in all of Her wisdom, marches on in time.  It is about time we find a way to gracefully honor the rhythms of the natural order of life and learn how not to resist aging due to our adolescent fear.

A woman’s libido has many facets that influence it – hormonal, psychological, emotional, and spiritual. Hormones have powerful effects on the biological nature of sexual desire.  When we are young and fertile, our hormone surges are aligned with the zeal to procreate.  In other words, the desire for sex is aligned with Nature. This is a powerful force that underlies our libidos when we are young.  As we age our hormones change, and we are less able to procreate - and Nature is less supportive of our libidos.  Women in their mid-40s complain about their waning libido, their changing body, and mostly their newly discovered need for balance.  They feel depleted after half a life of caring for others.  Energetic depletion, alongside changing biology creates less desire for sex. There is a greater desire for more intimacy, spiritual and emotional fulfillment, and the restoration of balance in both a woman’s body and life.

By our 50’s, most of us have experienced enough pain and difficulties to last us a lifetime.  These experiences are meant to serve as catalysts for inner growth and self-discovery. In midlife we must move out of the compulsion to ‘please the world’ and into an inner place of authentic connection.  We must learn how to be true to ourselves.  For us to find meaning and not feel victimized by our past requires hard work and a desire to seek.  The process of seeking itself deepens our ability to be intimate and fulfilled. In my medical practice, I find that women, who are committed to ‘seeking’ as they age, feel more fulfilled with intimacy, rather than the sex act alone. They are able to more readily accept their changing bodies. Sexual pleasure to them feels different, in some ways more fulfilling, even though their libidos may not be as heightened as in youth. The irony is that they are the ones who feel more sexual fulfillment than those who continue on the treadmill defined by the collective, with expectations of eternal youth.

Because our society has glorified youth and the sex act in favor of aging and intimacy, as we age, society expects us to perform both physically and sexually similar to when we were young, but with limited success.  Our aging bodies have different needs: the need for a pure diet, exercise, work/life balance, attention to inner process, and - one that we have not yet normalized in our society - a search for meaning. The spiritual aspects of ourselves call to us more powerfully and with greater zeal as we age.  Our physical bodies also require more attention.  Continuing the unhealthy diet of our younger years, does not nourish our changing bodies, and many of the lifestyle choices that have gained traction do not support our emotional or physical bodies.  This level of self-awareness needs to be paramount as we age if we desire to achieve a state of true health, which should no longer be defined by a ‘hard body’ or a ‘boundless sex life’.

For men, Viagra and Cialis do not fulfill these needs.  The ability to hold an erection for a longer time is not an adequate substitute for health, meaning, or intimacy.

Our society is struggling with the choices it has collectively made.  Frankly, our collective ideology is in contrast to the laws of Nature.  In other words, it goes against the laws of Nature.  Due to the decades of traction behind our unnatural ways of life, we continue to pump out pills as substitutes for what is missing at deeper levels of our being. The woman’s libido pill Addyi will not be able to offer what women consider as sexual fulfillment – namely:  intimacy, meaning, and a renewed relationship with themselves and their partners. The risk of life-threatening side effects alone is not worth taking a libido pill.

As we age and seek deeper levels of meaning, biology (not surprisingly) follows suit.  Not necessarily with the same intensity as it did during youth, but our aging physical bodies respond to emotional and spiritual depth differently than when we were young.  The zeal to live from depth is what Nature supports as we age, in favor of the zeal to procreate as in youth.

At this time we do not need yet another pill with more side effect casualties left at the altar of our flawed ideology.  We need to reframe our collective consciousness and normalize the necessity for healthy aging as defined by physical, emotional, and spiritual health.  This is a much more powerful way for us to live and will go much further in our level of fulfillment, both sexually and spiritually, than any pill can ever offer.

The Hope of Transforming Health Care

In the words of Martin Luther King Jr., “Of all forms of inequality, injustice in healthcare is the most shocking and inhumane.”

My past few articles have been on the unhealthy infrastructure in health care today and how it adversely affects patients as well as physicians, nurses and those who work within it to serve.

Over the past few weeks, I have seen an inordinate number of patients who are hurting because of the way they are treated by administrative practices within this system.  The patterns of conditioning through ‘learned helplessness’ are pervasive and worsening as the systems continue to compete with each other for market share out of greed. 

We all comprise their ‘market’.  What they forget is that money is not a substitute for care.  Care is a choice born of intent.  But when physicians and nurses are ‘boiling frogs’, they are unable to provide the care they intended to offer.  Their care cannot be limited to a 15 minute office visit done under pressure.  When physicians take longer to problem solve, they are reprimanded and punished as it reduces revenue and threatens quarterly profits. 

A ‘boiling frog’ is a frog who is heated in water till it dies.  The teaching point is - because the torture is started in cold water and heat is applied slowly, the frog does not realize it is being boiled alive.  Its senses are sensitized to greater levels of heat.  As morbid as this analogy is, this is used to describe how people adapt to abuse.  This is no different in health care. 

Today’s physicians are no longer seen as healers.  On the contrary, they are viewed as tools that serve health care administration in all its extractive methods, merely generators of revenue, likened to Pavlov’s dog.  Today’s physicians have lost heart and meaning.  The mandates that grind them down demoralize and wound them in deep ways. 

I left corporate health care 15 years ago when this behavior was escalating.  I was unable to live under patriarchal rules.  Today, this treatment is being normalized by ‘the powers that be’.  For me, this is unacceptable.  For others, adapting is their only hope. 

It is important to lift the veil, to view the shadow beneath the blanket of illusion projected in marketing ads, with terms like ‘health’ and ‘care’.  We must wake up to what is really happening.  This is a system that purports to serve.   It offers neither health nor care. 

When patients wake up and demand authentic care, and physicians gain the courage to speak their truth, transformation will be the inevitable outcome. 

“Health care needs to be examined from the inside out, from the top down and the bottom up. There must not be any stone left unturned. When physicians analyze the current system in ways in which they were trained to analyze the body, they will be able to identify the pathology that keeps it sick. They will have to reach deep inside and stand in the face of criticism and rejection, with courage and heart to transform their system that has lost its soul.”

                                                    ~Becoming Real, 2011, by Rose Kumar M.D.

Health care is in crises.  In Southeast Wisconsin, both patients and physicians are struggling to make sense of the lack of consciousness that has taken over the health care system.  Morale is at an all-time low. 

I implore you all to awaken to what the reality of today’s health care system.  Nothing can transform without holding the light to it, including the shadow.  It is the only way to transform this system into one that actually serves the mission of its vocation.  When a critical mass of conscious consumer’s expects real care, the system will be forced to deliver what is expected.   

 I believe this is the only hope we have to transform health care.  This is also how it will ultimately recover its soul.

The Intention Behind The Ommani Center

How does one adapt to being uprooted and unearthed?  The human spirit strives to survive, to continually move towards its destiny to carve out a course that reclaims ones sense of meaning.  My mother is a person who experienced this.  At the age of 10, her parents were killed in the India-Pakistan partition, leaving her orphaned and terrified.  As life presented her with gateways, she was able to walk through some, and not others, due to the fears resulting from the acts of violence she had experienced that had been imprinted upon her.  She engaged her courage as she grew large at the wounded places and carved a course for her life that offered her meaning and purpose.  Over the history of the human race, millions like her have been left with varying levels of paralysis in our world with little emotional context. The context with which the unknown was encountered for them was through the experience of terrifying loss.
We may think that our generation is protected from this level of loss, that it is from a more distant time, but this is far from the truth. Our world has been warring for decades, leaving casualties of violence and encounters with the terrifying unknown embedded in our collective psyches.  We are living in a virtual reality.  We have learned to cover up our feeling function and learned to deny our deep emotions with creature comforts, with superficial solutions, none of which endure.  Eventually we must stand naked before ourselves, confront our gateways and step into our largeness, reclaiming what was taken from us and redirect our course consciously into the unknown.  This is what midlife expects of us.  In the areas my mother was unable to choose, due to her circumstances, I must.  Where she could not reclaim, I must.  We, the children of the last generation, now in midlife, must find the courage to engage our consciousness in the areas where we become stuck, and live  from our superficial yet familiar cultural framework and believe in the potential of our souls.  To redefine health from this context is our sacred task.  This is how REAL Health Care can be accessed.
The Ommani Center for Integrative Medicine was born from my strong intention to create a context for health that is deeper than just the physical level.  Health is more than just symptom management through integrative methods.  As important and vital as this is, it does not access true health or healing.  Being conscious of how and where one lives and relates to life from may be the more important and deeper context that determines one’s state of true health.  This can and must be evoked.
If those that killed my grandparents and irrevocably changed the course of my mother’s life had this level of consciousness and asked the important and REAL questions, needless suffering could have been averted.  We cannot go back in time and change history.  We can, however grow strong at the places where we have been wounded.  We can use our wounds to acknowledge our humanness and engage our courage to grow in consciousness and health.  We must engage our wounds in order to offer ourselves a larger context for empowerment, reclamation and ultimately for healing.  This will uncover a deeper sense of meaning in our lives.
A Health Care System that can hold this level of space from a context such as this, inclusive of modern technological advances with high-standard –of –care, is what we all deserve.  It is a place where meaning is restored.  Cultivating and supporting a system like this is sacred work.  For me, it is a vocation.  Where my vocation aligned with my mother’s biography is where I found meaning and an opportunity to create a larger context in the form of The Ommani Center where true health and meaning could be accessed that was inclusive of my love of medicine and my devotion to high quality health care.
If we want a system that cares and offers us more than what our current system offers, this needs to be our collective work.  Together, we must  support and expect health care to be REAL for us so it can  address our REAL needs and ask the REAL questions of us, questions that we can live out in our destinies from a place of health and meaning.  I encourage all of you to expect this from our Health Care System.  Our expectations of what is REAL will truly change our world for the better.

Midlife as a Gateway to Authenticity

Are you a midlife woman who doesn't understand what is happening to your body and your mind?
Have you told your doctor how you’re feeling and were dismissed with medications or hormone replacement therapy?

Do you feel overwhelmed by the volume of information available about managing midlife and peri-menopause?

I am not only a practicing internist but a midlife woman.  I have been helping midlife women for over two decades with their menopausal symptoms and have gained significant personal insight about how little support is currently available for us.

During my forties I noticed my body and energy level change. I began to feel tired and heavy.  I also felt restless and had trouble sleeping through the night.  I looked for answers to these symptoms in my medical books and journal articles. I even went to my gynecologist to understand why I was feeling this way.  All she had for me were prescription drugs and hormone replacement therapy.  She told me that this is peri-menopause and that I have entered this category in midlife.  “It’s downhill from here” she said.  My visit was a huge disappointment.  As a scientist and a problem solver, I was determined to understand why I was having these symptoms and what I could do to restore my sense of health and well-being.

I found a lot written on this subject.  What I read though was theoretical but not practical and it did not address the deeper aspects of what I was looking for.  Why did my soul feel restless?  Why did I feel emotional ‘heaviness’?  Why was my body changing in this way and why were issues resurfacing that I thought were solved?  I was forty-two when I began to feel this way. I was an intelligent and a dynamic woman who had lived a very healthy lifestyle.  I had also created a successful medical practice and on the surface,  appeared to be at the top of my game.  Deep inside, I felt empty and disconnected.  My marriage felt deeply unsupportive and I found myself less able to tolerate the disrespectful ways I was being treated.  It was as if I was not able to compromise myself in order to adapt anymore.   My tolerance for the superficial was receding.  I found myself being more reactive and angry.

What I discovered was that hormonal shifts in my body that were normal during this stage of life brought with them emotional and soul shifts that were offering me an opportunity to take a look at my life from a deeper perspective.  Since I was conditioned to pathologize this, it engendered a deep fear of aging and degeneration. It was anything but.

This time in a woman’s life holds immense transformational power.  When a woman arrives at this gateway, her hormones shift, recalibrating her identity.  She is meant to question who she has pretended to be and move her deep into her soul and her authentic self.  Our society deems this a ‘midlife crisis’.  I like to think of this as the alchemical process of becoming real.   Women need to learn how to take care of themselves through this gateway and beyond.  They need to learn how to use the framework of transformation to connect with their intrinsic power and truth.  At this juncture, women are in need of balance at all levels of their body, mind, emotions and soul.  Many have lived unbalanced lives up to this point, neglecting to take care of ourselves.  As their bodies change they are called to heal their self-neglect.

I would like to offer some simple solutions to support your midlife transformation:

1. Work with a physician who can help you balance your hormones, not replace them.  Bio-identical hormones are much safer alternatives to synthetic ones.  They can quickly restore your feeling of well-being when used correctly in small doses.  Most women are in need only of natural progesterone to balance the estrogen to progesterone ratio.  Taking estrogen in even natural form can aggravate many symptoms of the menopausal transition.  This needs to be customized by your physician to suit your biology and your sense of well-being.  There is no "cookie cutter" way to balance hormones.

2. Acupuncture can make a significant difference in your well-being particularly if you are having a difficult time with menopausal symptoms such as hot flashes and night sweats.

3. Have your thyroid levels checked.  Make sure your physician orders a thyroid panel to give her/him a better understanding of the status of your thyroid as it can become sluggish during midlife.  Make sure you have free T3 levels checked.  These commonly decrease in midlife resulting in weight gain, fatigue and foggy thinking.  Replacing your free T3 and normalizing your TSH to a value between 1 and 2 will make a big difference in your sense of well-being.  Moreover, low free T3 levels have been correlated to an increase in all cause mortality.

4. Clean up your diet.  Change your diet to one that is mostly organic and plant based.  A plant based Mediterranean diet has been shown to significantly lower the risk of heart disease, diabetes and cancer, three of the most common diseases in the U.S. that present in midlife and beyond.

5. Begin taking a therapeutic grade omega-3 supplement and vitamin D.  These will decrease inflammation and strengthen your immune system, reducing the risk of disease.

6. Make aerobic exercise a priority.  At least 20 minutes of exercise, 6 days a week is needed to decrease the impact of physiological stress and restore cardiac health.

7. Incorporate massage therapy, yoga and meditation in your life as ways to heal stress and bring you closer in contact with your authentic self.

8. Work with a psychotherapist to gain a better understanding of your real needs and desires and to dismantle the parts of you that no longer serve your life.  Many feel that they can do this alone and with the help of friends, but it is much more effective and efficient to engage a professional who is objective and can clearly mirror what you need to work on to connect to your authenticity.

9. Make a commitment to be true to yourself and seek for a deeper sense of meaning every day.  Stop compromising your real needs to be liked or accepted.  This is one of the hardest patterns for women to break.  Garner the courage to be true to yourself.  You will earn the respect of many around you.

I invite you to reframe midlife from a time of crisis to one of transformation.  The best years of your life are yet to come.  Grace them as a seeker with deeper meaning and understanding  so you can experience the power and sacredness of your authentic self and most of all experience a deeper sense of meaning now and for the rest of your life.

The Ommani Center – A New Model for Healthcare

Rachel Remen M.D. is a physician and mentor who inspired me 23 years ago. An article about her current work, Medicine’s Search for Meaning was recently published in The New York Times. It made me reflect on where I started as a young physician, and where I have arrived today as a physician who holds a vision of a healed health care system in my heart. I was a fledgling 3rd year resident in Internal Medicine at Stanford when I attended the talk that Rachel gave on ‘patient-centered’ medicine. I sat on the steps in the auditorium, listened to her and wept. My heart has remained open wide since that day at Stanford and I have pursued a path of LOVE and DEVOTION for my patients and it has been my hope for health care ever since.

As stories of entrepreneurs go, mine has been lined with challenges as well as immense creativity. I weaved in and out of corporate medicine after residency and left it forever in 1998 when I was told that “wellness is a conflict of interest for health care” and “preventive medicine does not generate hospital dollars”.
I suddenly realized that the business model that corporate health care serves is exclusively a financial one. The dollar is what is served, not health, healing or patient care. Physicians are merely assembly line workers who generate money for the health care systems quarterly profits. My heart continually breaks for my colleagues who work in a corporate model that serves administrators and policies, not patients.

Let me tell you something about what a doctor’s heart is like. As I talk about mine, I can assure you that many doctors entered their profession with similar stories and experiences and were seeking the grace in their work that fulfilled their passion to heal.

When I was little, I remember the first inklings of how I knew I wanted to serve in this capacity. When I was around people, I felt a deep ache in my heart. I didn't understand what this was for a long time. I knew I was always searching for why people got sick and how they could get well. I think I came into the world this way in addition to being raised around the scientific inquiry of my parents who are brilliant scientists. Because I loved science so much, I voraciously read everything I could get my hands on to help guide my understanding. Nothing was as fulfilling for my soul as seeking answers to difficult questions. I knew I had to spend every day of my life in this numinous place. Going to medical school felt like a natural extension of my passion for learning within the healing model available in our society. To be immersed in it and to be able to feel the joy that accompanied complicated problem solving was nothing short of bliss. When I was on the wards during my clinical rotations, that old familiar ache in my heart from childhood resurfaced. I now recognized it as LOVE. This strong and deep feeling, this ache, this love that I discovered I had for my patients has never stopped flowing.

I feel privileged and honored every time I am with them, ever since the first patient I ever saw. She privileged me as a medical student, to study her condition and honored me with her patience during my very green inquiry. Since that very first day, my patients have made it possible for me to explore answers with them. The closest I came to this with colleagues was with nurses during night shifts on call. I watched their dedication and devotion – a Florence Nightingale energy that held their patients in their hearts embrace. I followed them on the wards to learn how to balance intellect with love and to this day, owe my deep learning to them. They
mentored me on how to hold space and how to stay real in times that were stressful, during life and death, illness and health.

When Rachel Remen spoke of patient-centered care in her talk at Stanford, I was just getting ready to graduate from residency and enter my medical destiny track. That day, was the beginning of the rest of my career. It was as if it all came together inside of me and I received an ‘initiation’ of sorts into practicing medicine to honor the soul of my sacred vocation.

After I completed my training, I worked in corporate health care. No such feeling was present in that system. The numinous was unreachable. In fact, if my patients needed time and attention, I was penalized. I soon realized that I was now a worker on the assembly line, towing the party line and making money for administration that served the dollar, not the soul of medicine. After 7 years of experiencing this heartless model, I left it forever. Without a degree in business or any experience in running a medical practice, I took a leap of faith and designed The Ommani Center for Integrative Medicine – a place where I could practice medicine from that same sacred place that unfolded my path through medical school and residency, initiating me in this sacred vocation of science and healing.

Today, my intention for creating this Center permeates its presence. Despite my lack of confidence in running a business, I discovered that in addition to loving it, I was also a fierce advocate for patients. The Ommani Center was born as an answer to what I felt is missing in health care- my love for my patients and for being able to practice with heart and meaning without compromising the scientific method or patient safety.
The Ommani Center is a unique health care model. I created it with a mindset for sustainability, both from a financial and environmental context. The architecture was designed to give the feeling of ‘flow’. The paint used on the walls, the water and teas served, cleaning products and even the soap we use to wash hands and cotton gowns are all environmentally friendly. We recycle everything we can and are fiscally responsible in how we manage overhead and even where we refer patients for lab and diagnostic tests. I believe that we all have a responsibility to keep health care costs down. It takes extra work, time and energy for all. On my end, I pay extra to have my medical assistants enter lab and diagnostic data (into electronic medical records) performed at labs that cost my patients significantly less compared to hospital based tests. I would rather pay the $6000 – 7000 per year for staff time to save hundreds of thousands in health care costs. We must all do our part to transform health care. We cannot underestimate the power of one.

As a physician, I knew I would be sacrificing financial security to do what felt ethically correct for me. My moral compass came at a financial price. As a response to this, I shifted from a profit mindset to a sustainability one. The Ommani Center's sustainable business model has proven to be solid for more than a decade. Since 2001, it has sat gently on the earth, served patients with heart and meaning and kept its carbon footprint light.

Meanwhile, my colleagues in corporate health care, struggle to adapt to endless policies that micromanage them and restrictions that make it nearly impossible for them to practice from heart. Corporate health care is an experiment gone awry. In my least optimistic moments, I gain solace in knowing that The Ommani Center, a sacred health care model that stands in the heart of Pewaukee,Wisconsin is poised to be replicated in communities across America where patients and physicians are hungry to access sustainable, cost and therapeutically effective health care. This is my contribution to restoring the soul of medicine and for bringing meaning back into physicians’ lives who have sacrificed so much to heal others and are less than able to in the corporate system today.

When I see them working under emotionally abusive conditions in the current system, I feel an unbearable pain in my heart. I want them to know that it is now possible to practice with heart and soul and to serve patients rather than policies and administrators. The Ommani Center is like a lighthouse for health care. As it grows and expands in the near future, it will become a haven for physicians looking to restore their souls and reclaim their hearts as they follow the golden thread of their purpose for choosing their sacred craft.
I have come a long way since that threshold day on the steps of the Stanford auditorium. The vision in my heart that was ignited there continues to burn bright and is brighter each day as my beloved patients add their light to it.

Let us create the new model for health care together. Let us all remain true to its sacred purpose and mission so we can finally gain access to health and healing.

http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/?smid=fb-share&_r=1

The Power of Bearing Witness

I have been seeing a patient, who I will call Ann, for 10 years.  She is a therapist who is a gentle and sensitive soul.  I can only imagine the gentle yet powerful space she is able to hold for her clients.  As she bears witness to the many facets of their lives, they have a powerful witness to their process.  They have her love, guidance, expertise and strong arms that hold them through their journeys. They are fortunate to have her in their lives.  With the space she holds they know they are not alone.

I saw Ann the other day when she needed me to bear witness to her process.  She had to hold space for a mother who had lost her daughter.  She was not sure what to say to this mother to help her pain.  It rattled her to her core.

As I sat with her and held space for her, all I could do is bear witness to her process. I told her that the most powerful gift she could give the grieving mother was her presence.  Bearing witness is a gift we can offer each other at any time.  In a world that is moving at warp speed, it is easy to forget that we matter.  Since we don’t live in communities like we once did that marked our passages and witnessed our lives, it is common to spend our milestones alone.  Once they pass, people get occupied again with their busyness and forget that we are in process.  When a person experiences a loss, the process through grief takes time.  It is important for them to be supported through its different stages.

Bearing witness is a sacred act.  It even changes the one who bears witness.  It deepens and fortifies one's soul.  It makes one trustworthy.

As a person’s grief transforms and shifts through its various stages, one gains access to the inner endurance that lives within.  The vacuum that is left in one's life is somehow filled with memories and a deeper level of wisdom.  This is an alchemical process.  The pain of loss never goes away, but it changes  form and also changes the greiver in profound ways. Without bearing witness, one could never experience the power of  Soul in process.

Many of us feel alone in our process.  This is not good for our health. We feel isolated. We may feel that our process is a burden on others.  Isolation is one of the most profound stressors on Earth.  Being witnessed, on the other hand, makes us feel like we matter.  Mattering is good for our health.  It makes our life worth living.

Mattering is a form of LOVE.

As a physician, I feel that bearing witness is the most sacred part of what I do each day.  Holding space and bearing witness to sometimes unbearable suffering deepens my heart and fortifies my soul.  It makes my patients feel that they matter, that their pain and suffering matters.  To be asked to bear witness for another is a profound honor.  Life presents us with so many ways to bear witness to each other every day. We must embrace these opportunities for loving.

Like Ann who will be changed forever by her witnessing, we must hold our strong arms around each other with open hearts. As Ann bears witness to a grieving mother, I bear witness to Ann.  Somehow, I feel that my arms are around her and this mother, all at the same time.  My heart is open to holding space for all of this.  For me it is a great honor and a blessing.

Making another feel like they matter also makes my life matter.  Isn't this ultimately what we are on Earth to experience? For me, this is one of the greatest forms of LOVE.

Modeling Healthy Eating for our Kids

When I ask my patients to change their diets to healthier, plant based ones, many tell me that they will be met with resistance from their children.  Isn't the role of a parent to raise their children with healthy imprinting?  Ultimately, it is our role as parents to teach our children what is best for their health, to model it for them and to provide our children with nourishment at all levels.

Children do not come equipped with accurate information in these areas.  They rely on us to guide them, which we must, despite their resistance.

When I was pregnant with my daughter 23 years ago, I realized that what I ate impacted her health, not just mine.  A 'light bulb' went off in my brain that was based in common sense. I stepped onto an organic path that was based on the premise of Food as Medicine. It made a lot of sense and since then, there is a monumental amount of scientific data that supports it.  I have never swayed from this path.  As a matter of fact, I have moved more deeply onto it. I am happy to say that both my children are imprinted with the premise that Food is Medicine!

Twenty three years ago, our food supply was not as contaminated and genetically modified foods were not commonplace.  They are today, and it takes more work and consciousness to make sure our family's are safe when it comes to what we feed them. This is one of the greatest acts of LOVE that we can show.  Its benefits will last our children a lifetime.

For parents who have young children, the link below has some superb recommendations.

http://www.takepart.com/photos/kitchen-chores-kids/elementary-school-kindergarten--2nd-grade?cmpid=foodinc-fb

How to Get a Good Night's Sleep

Sleep is essential for health.  The lack of sleep stresses the adrenals and reduces vitality. It causes an acceleration of the aging process.  The three most powerful ways to promote health and slow down aging are:
1. A plant based wholesome diet rich in antioxidants
2. 6 – 8 hours of sleep per night
3. Regular aerobic exercise (at least 20 minutes 5 to 6 times per week)

Studies show that 8 hours of sleep per night are needed to produce enough melatonin and healthy neurotrasmitters to maintain health. Hormonal changes in women in midlife, particularly a reduction in progesterone can disrupt the sleep cycle. The lack of sleep has become a chronic problem of our time.  The stress of our fast paced life and constant busyness, coupled with fast food, brain stimulation with computers, texting and television, all contribute to insomnia and disturbed sleep.  The brain has a hard time shutting off and resting at the end of the day with all the over-stimulation it experiences.  The brain needs energy to function and needs a good 8 hours of sleep to replenish its circuits before another day of activity begins.  Deep breathing and meditation help immensely but most people do not take the time to do this.  Doing 10 minutes of abdominal breathing every night, or alternate nostril breathing (Pranayama), relaxes the brain enough to allow for its rest and rejeuvination.
The regular intake of alcohol, inflammatory fast foods (nutrient poor), caffeine and regular tv or computer use have an additive effect in overstimulating the brain.  I advise my patients who have difficulty sleeping when they first come to see me, to eliminate or minimize alcohol and wheat,  increase their intake of whole, plant based foods, omega -3 and exercise.  With these changes, the vast majority begin sleeping better.  Not watching television or using the computer before bed also helps as the glare from the screens has deleterious effects on brain activity before bed.

Supplements:

1. Magnesium 250 mg before bed.

2. Lavender oil pills, Lavela, which have shown similar efficacy as prescription sleep aids (available at The Ommani Center)

3. Melatonin 5mg.  No more than 5mg should be used as a sleep aid, only on an as needed basis as melatonin is a hormone.  Any hormone taken by mouth regularly will suppress the production of the body’s natural hormone production.  It has been shown to help people that work night shift as melatonin production is reduced with lack of darkness during night hours (even a night light in the bedroom at night will reduce the brains production of melatonin).  A decrease in melatonin production by the body has been correlated with increase in the incidence of cancer. The data on melatonin supplementation is mixed and this should not be taken on a long term basis as a sleep aid until conclusive evidence demonstrates its safety.

4. Valerian is an herb that is commonly used for insomnia.  The data on its effectiveness and my experience of it with my patients remains mixed.

5. Omega-3 Fish oil. Omega 3 and the amino acid tryptophan together increase serotonin in the brain.  Seratonin is a precursor to melatonin which aids in sleep.  Salmon, sardines, oily cold water fish and eggs all increase serotonin in the brain.  Make sure your omega-3 supplement is of pharmaceutical grade, mercury free, micro-distilled and supplies at least 300 mg of DHA and 300 mg of EPA per capsule.  2 to 3 capsules per day are needed for a therapeutic effect.

6. Bio-identical progesterone is extremely effective to restore sleep in midlife women whose hormones are out of balance.  This must be done with the aid of a physician skilled in hormone balancing, who also monitors blood levels of hormones to ensure safety.


Foods:

Bananas, almonds, warm milk, cherries, decaf green tea, oatmeal, salmon, cold water fish and eggs are all recommended to enhance sleep.

I always tell my patients to try eliminating the unhealthy foods and behaviors they are engaged in for a few weeks and then resume them.  See what happens.  Experimenting in this way releases the pressure that they may feel of ‘being deprived.’  Instead, they approach this experiment with curiosity and take cues from their body instead of my directive.  The majority of patients who have approached it in this way have successfully resumed a healthy sleep pattern.

Complementary Medicine:

1. Acupuncture is a very successful modality in restoring sleep patterns.

2. Massage relaxes the muscles and produces serotonin in the brain and body.

It takes time to develop an unhealthy sleep pattern so it takes some time to develop a healthy one.  Food takes time to restructure the cells and re-calibrate the good chemicals in the brain and body that promote health.

Food is Medicine.  It is not a quick fix.  It is however a lasting one.  Supplements are just that – supplements to our diet and lifestyle, not substitutes for healthy food and exercise.

Nature has everything within it we need to support our health.  If we live a balanced life from its basic principles, we can minimize disease and maximize our body’s regenerative potential.  The good news is that we always have a choice to do this.  The fun of trying healthy behaviors and see how our body responds. This is the basic premise of any scientific study.  We can do our own study and learn from our body’s wisdom at any time.

The choice is always ours.

http://www.elephantjournal.com/2013/03/5-ways-to-get-old-fast/

http://www.yogajournal.com/practice/220

http://www.tatianasadak.com/userfiles/2607091/file/LavelaBrochureFull.pdf

http://www.ncbi.nlm.nih.gov/pubmed/16162447

http://www.cbn.com/health/naturalhealth/drsears_depression.aspx

http://www.ommanicenter.com/bookstore - Becoming Real by Rose Kumar M.D.

http://www.ommanicenter.com/womens-health

Food As Medicine - Musings from a Foodie Physician

Over the years as a physician and a foodie, I have conducted my own scientific experiments on the effects of food on health.  Of course my primary subjects in this study have been my family and my pets!
I’m happy to say that all the experiments have been a glorious success, from healing my stepson’s asthma to curing sinus infections, colds and ophthalmic migraines to healing my dog Jazmine’s Lyme arthritis to a level where she can go for walks, spar with her buddy Boosie (a 2 year old Chiweiner who is full of energy).  I am happy to say that I can see the ‘puppy look’ in her eyes again at age 13.

Having been raised by two scientists (my parents) who are also foodies and amazing cooks, I grew up in a home where the smell of roasting spices and bubbling lentils were a common Sunday afternoon sensation.  If I scraped my knee, my mom would make a turmeric poultice to heal it, if I came down with a cold, fennel and ginger tea resolved it.  A cup of over-boiling chai was ever present as an afternoon elixir after a hard day at school – luxurious tea time during hot Indian afternoons that I cherished and a memory that will forever be held in my heart.  This was my original imprint – Food is Medicine.

It still is and will be as long as we are on Earth.

One of the only places that this is not a truth is in the traditional medical system.  Here we are in 2013 with hundreds of thousands of studies on the power of food to heal almost every ailment on Earth, but Corporate Medicine in its endless quest for pharmaceutical management has lost its common sense. For some reason, it is unable to wrap its brain around the concept of – Food is Medicine.

In this blog, I want to share what I love to do most (second to being a mom to my beautiful grown children and pets and spending glorious and cherished time with my family, friends and patients) – cook, smell, create, grow, experiment and live on the wild side with food – all kinds of food – herbs, spices, soups, stews, curry’s and concoctions that will heal colds to high cholesterol and heart disease.

I will share what I've learned from my ancestral roots and all the travels where I have explored different tastes and sensory pleasures with unique foods.  I have also witnessed my patients heal hundreds of ailments over two decades with foods that I will share as we explore the beautiful and medicinal qualities of food together.

Are You a 'Sensitive' ?

They are termed 'sensitives' - people that feel to the depth that the 'norm' doesn't.  They tend to be pathologized by others for their depth of feeling and also tend to pathologize themselves for it as feeling deeply is not acceptable in our society.  They have difficulty being around crowds, injustice, violence, and loud sensory stimulation.  They feel the collective energy deep in their souls.  They are deeply empathic.  I am a sensitive.  Are you?
The title of the link claims that we are 'too' sensitive.  I disagree with this.  Our world is not sensitive enough.  Maybe that is why the state of the world is in chaos and disarray.  Maybe if more of us 'sensitives' set the tone for the world, it would be a more peaceful place where art and beauty are valued more than they presently are.

http://www.rebellesociety.com/2013/05/06/6-sweet-survival-tips-for-super-sensitive-souls/

http://www.elephantjournal.com/2012/02/ten-ways-to-find-out-if-you-are-too-sensitive/

The Dark Side of Healthcare

Most people don’t realize what it is like to maintain a private practice in today’s health care climate.  I applaud and honor any physician who has the courage and audacity to do so.  As a private practitioner myself, I know and love the challenges of growing and maintaining a medical practice.  I know what it takes to swim upstream and settle for a fraction of what employed physicians get paid.  The trade-off they make is a large salary with little to no freedom to work from the soul.  They work for a system that is heartless and expects them to meet quarterly projections.  Many physicians feel trapped by the organizational limitations placed upon them, but have difficulty leaving to work independently.

It would be accurate to say that private practitioners belong to a sacred tribe, one that is preserving the heart and soul of Medicine.  I have experienced being an employed physician long enough to know that the heart and soul of medicine are absent in corporate health care.  After 6 years of practicing in that setting, I left that system and have never looked back.  I remember the immense initial adjustment this took. I had to rearrange my definition of success and put meaning in the forefront.  I remember feeling the tension between the financial freedom that being an employed physician offered versus the financial stresses of being in private practice. I also remembered the tension between what the ‘system’ expected of me –patient numbers- and my longing to be able to truly connect with my patients – a sense of meaning.  I opted for the latter, sacrificing the former.  The payoff was priceless.  15 years later, I can’t imagine working any other way.  My life is simple and sustainable.  My medical practice also operates from a model of sustainability.  Most importantly, I don’t work for the medical system’s financial projections.  I work to serve my patients, the vocation of medicine and the health of my community.

Two decades ago, our medical system embodied the scientific method, valued the doctor-patient relationship and practiced from soul.  Today, money and profit is what health care is serving.  Neither health nor care is its goal.  It is a ‘sick care’ system that manages symptoms in the ‘name of health care’.  The scientific method has fallen by the wayside.  Health care today has become a ‘closed system’ where even scientific evidence of harm is sidestepped in the name of profit.  Preventive medicine is a conflict of interest for this model.  Symptom management does not involve patient education, lifestyle change, patient responsibility or healing.  It involves using prescription drugs to manage symptoms.

Today’s health care consumer is waking up to the reality of this dark side of health care.  When people experience the lack of care from their physician who practices under pressure within a corporate health care system, they look elsewhere for a doctor who can take the time to problem solve with them.  Many people want more than what the current distortion of healthcare is offering. They want to learn what made them sick, how to heal, how to stay healthy and how to live consciously.  This is what patients, the consumers of health care, deserve.

One of the biggest crises in America today is the contamination of our food supply by the food industry.  We are all discovering that the large corporations running our food industry are no different than the pharmaceutical industry.  Our food supply is contaminated with hybridized plants, chemicals, pesticides and additives. If food is medicine, eating these foods is making us sick.  The incidence of food related illnesses in our country has skyrocketed.  The medical systems answer to this is pharmaceutical management.  Today’s medical paradigm still does not see the connection between food and health.  One broken system supports another.

The solution to this seemingly insurmountable problem is already underway.  A critical mass of people is formed and demanding change.  They are simplifying their diets.  They are eliminating chemicals and processed foods from their grocery lists.  They are eating clean, organic and local foods. They are living more in harmony with nature.  They are making choices to promote health.  They are discovering that many of their diseases are diseases of lifestyle; that the body is more resilient and regenerative than they have been led to believe.

Healing and transformation require work.  As adults, we must recognize that our choices will determine the kind of world in which our children will live.  We must do the good and hard work of creating a shift in our current societal paradigm.  Society and all of its systems are currently broken.  They have gotten so far off course that the lack of soul is palpable within them.  But I and many others, who refuse to compromise health and meaning in favor of money, are changing the organizational sickness by serving what is important and real.  I encourage all of you to see through the illusion of our health care system, demand the kind of care that you rightfully deserve and do the hard work required to restore the soul of our world by making personal choices for health and healing without compromise.  It is the only solution for correcting our collective course and restoring wholeness to our personal and collective lives.

As Margaret Meade said, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”

We are those people.  This is our time.

The Need to Transform the Existing System of Healthcare

There is a movement underfoot in our country that is provocative and exposing. Our shadow is up and it is unraveling itself in all of our institutions. When I left the medical system at age 36, I did so because the corporate intent that I was expected to enable – sick care, felt ‘unethical’ to me. Sick care was not what I was trained to serve. It was not what my heart and soul went into medicine for. But it was required of me by the medical system to generate profit. I was required to keep people sick in order to keep my job.

Deep inside, I knew I was a problem solver. This is what I loved about Internal Medicine. I wanted to uncover the causes of symptoms and ease suffering by working with people to figure out the causes for their illness and how to tap into it to find solutions with them. If our premise is that life is full of precision, then we should be able to figure out the purpose and meaning behind our symptoms and suffering. Our suffering can also help us become real. It has an alchemical effect on our ego that strips it from being ‘all knowing’ to becoming a student of life.

I love medicine. It excites me and it stimulates my thinking at many levels. As physicians, we need to use our knowledge from a context that serves the vocation of medicine.  We also need to use it responsibly and humanistically. This is what we have lost and must regain in health care today. We must open the currently closed system of medicine while maintaining a high standard-of-care. An open system grows and evolves.  A closed system stays stagnant and is based in fear.  Today’s health care system uses fear to keep patients coming.  Its revenue depends on this.

An open system will of medicine is cost effective and patient centered. Its context examines what is wrong but also “what is right about what is wrong”. When we explore symptoms and illness from this framework, we can heal our patients at causal levels. We can use the pathological model within the larger context of a healing model, seeing pathology as a symptom rather than an end.

This context is transforming medicine and evoking health at The Ommani Center for Integrative Medicine. This is a prototype of an ‘open system’.  This was a way I could make medicine REAL and restore and reclaim its SOUL. Becoming Real is the calling of our time. This is our collective path. This can transform our medical system and restore it to what it was originally intended to be.  This will involve physicians who are open to working from this context and patients who expect it.

Midlife as Alchemy

What is Midlife? What is Menopause? What is at stake?
What is our Conditioned-Self?  What is our Authentic-Self? How do they differ?
In my 22 year history as a physician who has worked with thousands of brave and courageous men and women with stories of wounding, suffering and healing, I can say that I have been able to identify the differences between these selves and the intrinsic power that emerges when one leaves the Conditioned for the Authentic Self.  The Conditioned-self is who you were told you SHOULD BE. The Authentic-Self is WHO YOU ARE.   For the first half of our lives, the Authentic-Self is buried beneath the Conditioned.  In the second half, we must re-emerge Authentic.
There is a powerful shift that occurs in midlife when our physiology and soul intersect at this gateway to make room for the REAL to emerge.  This creates a felt space between the Conditioned and Authentic selves.  The traction of the conditioned one pulls at us, urging us to behave from familiarity based in FEAR.  All the ‘shoulds’ fear us into staying stuck.  Fear is the feeling that adapts us in the first half of our lives.  We adapt to be accepted.  Adaptation conditions us. It creates a shell around our Authentic –self that waits patiently for us to awaken.  We learn to withhold our truth; we say ‘yes’ when we want to say ‘NO’. We over-ride our true feelings to be accepted and loved.  For decades we live this way.  We construct our lives from choices that emerge through our conditioning.  We become part of society’s ‘herd’.   We normalize this identity and close our eyes.
When we turn 40, something changes.  A soft whisper fleets through our body and mind, suddenly with no warning.  Sometimes we don’t really hear it, sometimes we try not to.  It beckons us to awaken, to bring LIGHT to our choices.  It says, ‘Who are you really?’  This frightens us.  If we don’t listen, it moves in deeper, rises stronger – as fire, as density -anxiety, depression –in our bellies, pulling us in.  We begin to sweat, to hot-flash; we awaken at 3 am with minds racing and fear coursing in this unknown place.  In the middle of the dark rises a whisper of comfort, the voice of our Soul pulling us in – to connect, to open, to awaken and deliver us finally to our Voice and our Truth.
If we do not listen, it may call to us as cancer, divorce, tragedy, devastation, that forces us inward to evaluate, deconstruct and  make ourselves new.
All this sorting and sifting, transforming and reinventing – THIS is midlife.
This is menopause.
This is not a sickness or a  deficiency. This is NOT a pathology.
This can NOT be medicated away.
This is HERE to stay and it will offer us the fire of alchemy into which we must step to make ourselves WHOLE.
The voice of the Authentic-Self will rise from ashes of the conditioned one as adaptations fall into the fire to be transformed.  If we willingly lean into this, our voice will emerge – FINALLY- the TRUE voice we will use to heal the world.
We will spread our wings and fly out from this fire into life again with wisdom and an inner eye that can never be closed.