JULY 31, 2011 A GAY OLD TIME

"Eventually, everyone sits down to a banquet of circumstances." - Robert Louis Stevenson

Each of us have a bowl of berries which can serve as the desert for the banquet of food. This banquet sometimes gets to be too much. The banquet is overwhelming so each of us starts to separate the meat from the vegetables from the sweet potatoes. Even our separation does not spare the mixing of all categories. This is your own banquet of CIRCUMSTANCES.

We will have to deal with this banquet at one time or another. I believe it is inevitable. The banquet of circumstances can be your relationship with your family, your own personal relationship with another individual or your relationship with work. Maybe it is even your relationship with your own self. This 'banquet' happens for a reason. It is time to look at your own 'house'. Does your house need cleaning or does your body needing cleansing?

When was your last banquet of circumstances? Did you work it out? Or was it brushed under the rug? The banquet of circumstances I sat down to last weekend was absolutely enjoyable. I was surrounded by love, friendship, bees and needlepoint amphibians. In addition to caring for my bees I had the pleasurable of the company of my friend, Bessie at the Arts Project of Cherry Grove Annual Art Show. It was Bessie's first show and a hit for contacts, camaraderie and sales. She makes her own lampshades. I displayed needlepoint frames, pillows, knitted scarfs, hats and neck warmers. Gotta love that little frog!

Circumstances did happen during the 80's and 90's The first wave of patients dying of AIDS, the epidemic that we all feared during that time. I was in my 20's. I first came to Fire Island Pines in 1976, and every summer from 1978 - 1982 . I was visiting my cousin, Anthony who had a house there. He was an artist/illustrator for Highlight Magazine. I was introduced to the finest cultured gay men. Some of these men were the same who had been present during Stone Wall. One by one these men started dying. I left for medical school in 1982. By the time I returned in the summer of 1983, many more had more died, including my cousin, Anthony Rao.

We are in trouble once again.

As a health care contributor to Instinct Magazine (www.instinctmagazine.com) I have the pleasure of reading this nationwide magazine before it hits the news stands every month. This month is a sobering experience. A 21 city survey finds one in 5 men having sex with another man are HIV positive. This will become the second peak of this thirty year old epidemic.

You may ask how is this possible? Why is this happening? There are newer drugs on the market. I remember working in London at the old St. Stephens Hospital where men had to go 'underground' to get AZT as it was not available in London at that time. I find it utterly sad that more than 8,000 people are today on waiting lists for tapped out state programs providing life saving HIV medications. How could this happen in 2011?

Here are the numbers. 8,153 men who have sex with other men were surveyed in 21 cities.

- 19% of these men were HIV positive

-28% of these HIV positive men are black

-18% of these HIV positive men are Hispanic

-16% of these HIV positive men are white

Most alarming is 44% estimated number of these men are unaware of their infection.

You would think that prevention is the key. It is! The government view of sexuality of gay men should be celebrated and not viewed as an obstacle or 'different'. I do not how to put it, but I hope same-same marriage in New York State will help alleviate these escalating numbers. You must read the first ever safe-sex book by Richard Berkowitz called How to Have Sex in an Epidemic. If you want a look back, watch his 2009 documentary entitled Sex Positive. New campaign ads are finally focusing on minority groups and young gay teenagers/young adults with their accepting father/mother. There is a group that goes unnoticed. This is the supposedly heterosexual man who likes to have occasional sex with men. These are men on the DL (down low). Where are the campaigns for these DL men?

Promiscuity is still here. We have to realize it. We are sexual beings... some with a larger appetite than others. Some have sex addiction. There needs to be more open talk- lets get down and dirty and tell the schools, other doctors and religious organizations about the reality. This is not going away. I am open and frank with my gay patients. I want to know how they are practicing safe sex. I also want to know what these gay patients are doing for this second wave of the AIDS epidemic. Get involved! Do not be one of those statistics.

Until tomorrow...

JULY 30, 2011 COLTSFOOT AND COUGH

"As far as your self-control goes, as far goes your freedom." Maria Ebner Von Eschenbach

When self control and self esteem are intact, you will experience greater freedom. Freedom from what? Freedom to be your own self. Freedom to be the person you always wanted to be. When you boost your self-esteem through a hobby you develop a new freedom. You have reached another level in your life. This new hobby whether watercolor painting, puzzles, lego building, bee keeping, knitting, pottery and even butterfly watching starts you on a path of self control and self awareness. These lead to acceptance.

How often do you get a cough? Is it due to bronchitis, a respiratory allergen, environmental toxicity or 2nd hand smoke? It could be congestion from bacteria or virus that is causing the congestion of your lungs. We treat too many individuals with antibiotics who in actuality do not need these prescriptions. If you remove the infection, the physician has to find the underlying problem. The physician needs to be an investigator. The physician needs to be Sherlock Holmes.

The physician needs to practice and do a more through bedside examination. One factor the physician should discuss is the dietary lifestyle. The physician should be asking about dairy ingestion as this leads to mucous production which then can lead to infection or congestion. It is essential for the patient to have a diet low in mucous forming foods. Inherently there is nothing wrong with mucous , but excess is always a problem. Foods which are mucous producing are the following:

1. Dairy - includes goat and yogurt

2. Gluten grains - B, R, O, W - barley, rye oats and wheat; excluded is steel cut oatmeal

3. Starchy root vegetables as potatoes, turnips

Replace #1-3 above with fruits and vegetables that are high in antioxidants and low in sugar. For example this would be a diet rich in all berries and green leafy vegetables.

I would rather treat a cough with herbal remedies. It is easy for me to use ginger or elderberry cough syrup which are commercially available. As an herbalist I have my favorite cough remedies. I do love Elderberry. There is one remedy that I have seen other herbalists use with success. It has a pleasing taste to the patient too. I feel this is just as important as the efficacy. No patient will take an herbal mixture that causes them to gag. However I will tell you that the worst tasting herbs have major potential for efficacy and healing.

The cough remedy are equal parts of the following:

1. Coltsfoot - SEE PHOTOGRAPH ABOVE; Do not think coltsfoot is dandelion IT IS NOT

2. Mullein - Remember this is used in earaches

3. Liquorice

You can take the above tea every 3 hours if time permits or minimum of 3 cups per day.

My grandfather (Poppy - born July 30, 1901 would have been 110 years old today) never had a cough. It wasn't due to herbs above, but instead from his consumption of an allium species- garlic.

Until tomorrow...

JULY 29, 2011 BUTTERFLY WATCHING

"Creativity is a flower that praise brings to bloom. But discouragement often nips in the bud." - Alex Osborn

There are some hobbies that involve insects. Ant Farming as well as Bee Keeping can teach humans a thing or two about living in a community. Both of these insects (ants are bees without wings as far as I am concerned) survive and proliferate based on a highly efficient system.

What about Butterfly watching? You can observe the metamorphosis of a caterpillar into a butterfly. I would not recommend collecting butterflies and framing them at this time. I know this was a hobby for many children when they were young. I never wanted to do this hobby as I felt very bad killing a butterfly and framing them. I know there are certain stores that sell framed butterflies. Since there are many butterflies being endangered due to pesticides and environmental changes, I would rather observe and record data as a method of studying butterflies.

Find a flower that is frequently visited by butterflies. There are several types of Butterfly Bushes. There are many in Fire Island, but the number of butterflies visiting has diminished greatly. I can recall that I saw many more in the 1980 and 1990's than I see today.

The first photograph (taken by 7song) is a Skipper. I do not know if it is the endangered Dotted Skipper. There are many endangered species of butterflies in North America. If it is truly a Dotted skipper (Hesperia attalus) then it is considered endangered in many states, as far south as Alabama and as north as New Jersey. The host plants for this butterfly include the Switchgrass and Fall Witchgrass. Interesting to me is the fact that the butterfly is becoming endangered... or is it the plant?

Butterflies, like bees collect nectar. Although butterflies do not make honey, they do pollinate plants like bees, bats, and moths do. I found it fascinating that there is one species of butterfly that is considered a federal endangered species. This is Saint Francis Satyr (Neonympha mitchelli francisci). Although there is no photograph of this butterfly I would suggest looking it up. It is endangered as the plant hosts are destroyed by beavers.

I would like to find out more about butterflies. I am in awe of my former mentor, 7song, who not only is in love with plants, but also insects. I could easily see why he is interested in insects. It was the next natural progression for him from plants and herbs. For me it is the Honey bee.

Suggested reading: Bringing Nature Home

Photographs 1- 3: 7song

Photograph 4: Paul Fratellone

Until tomorrow...

JULY 28, 2011 BENEFITS OF LYCOPERSICON ESCULENTUM

"The real measure of our wealth is our worth if we lost all of our money." Anonymous

The benefits of Lycopersicon esculentum go beyond the growing and handing out to friends and family in paper bags. I am talking about the Tomato.

As I have always said I learn from patients. One of my patients happens to also be a staff nurse for many years. Her name is Joan. Joan and I met while I was the Medical Director of the Atkins Center for Complimentary Medicine. Joan is an avid reader as well as an excellent nurse. She brought me a small article in the AARP magazine entitled 'Vine-Ripened Wonder'.

We all know it is summer when we see the ripe tomatoes growing on the vine, or begin receiving tomatoes from an avid gardener/friend/family member in a brown paper bag. The article discussed the benefits of the primary nutrient in tomatoes called lycopene. Lycopene has been studied extensively for its role for prostate health. The Herbal Clip from the American Botanical Council has published several articles on the benefits for prostate health beginning in 1996. In 2004 there was another article on prostate health and lycopene. The New York Times had an article in 1995 entitled 'Tomatoes Found to reduce risk of Cancer". We do know that diets high in antioxidants such as lycopene can reduce incidence and improve outcomes of benign prostate hyperplasia, prostatitis and prostate cancer.

The article talked about reductions in LDLs (also known as bad cholesterol) when using lycopene. So Joan's question about LDL prompted me to read a little more last night. The Vine-Ripened Wonder AARP article referred to a study from Japan indicating that tomatoes prevent heart attacks by reducing LDL. I had to find this study.

I did find the Japanese study, published in 2007. The article by Silaste ML et al,"Tomato juice decreases LDL cholesterol levels and increases LDL resistance to oxidation" was published in the British Journal of Nutrition. It is not a common journal. The authors of this study did conclude that a high daily dietary intake of tomato including ketchup and tomato juice is associated with a lower level of LDL and lower total cholesterol.

But there is a problem. The AARP article also discuss another antioxidant besides lycopene that is also important. It is called 9-0x0 octadecadienoic (I dare you to pronounce this nutrient). It states it is another Japanese study. It is not from the 2007 study. I cannot find the study that mentions this other antioxidant.

More is to be revealed.

Then should I assume that the Italians have less cholesterol and LDL than the French?

Until tomorrow...

JULY 27, 2011 DHEA AND TESTOSTERONE

"That which we do not confront in ourselves we will meet as fate." - Carl Jung

You would hope as we get older that we have been confronted with most issues. It has been stated by Jung , if not confronted we will meet as fate. What does that mean? I am not a psychologist, but I do believe that the psycho-social issues of most patients affect the medical issues. In regard to 'meet as fate', maybe he means the patient demise or death. I cannot imagine anything that I have not confronted since I became sober. I have dealt with my fears . As far as 'all my fears' I cannot say I am 100% perfect. I know from clinical experience that many patients avoid confronting some specific fears.

As we discuss human growth hormone, I must discuss testosterone. It is 90% androgen in the male body. Remember that females also have some testosterone. High testosterone is associated with increased aggression. It is not the total testosterone that is associated with sexual arousal, but the free testosterone. It is also the low free testosterone that is associated with risk of heart disease. It was once thought that is was the total testosterone, BUT it is not. The sex hormone binding globulin (SHB G) controls levels of free testosterone. On men over 45 years old (that's me) the ability of SHBG to bind to testosterone increases by about 40%. Decline in sexual arousal or even libido is associated with increased binding and resulting in less free testosterone. Many prescription medications and alcohol causes testosterone to bind.

The next hormone that I consider is the parent hormone DHEA. (Dehydroepiandrosterone). This hormone is the most abundant in women and is the precursor to the androgens and estrogens. The normal levels for men are 400-500 mcg/dl and in women the normal levels are 350 - 430 mcg/dl. Unfortunately levels decline after 30. These levels are low in adrenal insufficiency (stress on the body) and in diabetes. It can be replaced, and you can purchase over the counter in most vitamin stores. I caution those who may decide to take it without the advice of a health care practitioner. It will help but you do not want to have much greater than normal levels. Studies have shown that DHEA does not support the commercial use in women, yet it is sold . Again I caution anyone to take DHEA especially women as it can exert its adverse effects causing too many hormones to be produced. Excess hormones are associated with cancer.

Until tomorrow...

JULY 26, 2011 YOUR OWN IMMUNE HEALTH

"If I were to begin life again, I should want it just as it was; ONLY I would open my eyes a little more." - Jules Renard

I think I would keep my eyes wide open. Reflecting back, I have trusted too many individuals, I was aware of certain circumstances, and not only were my eyes shut, but my mouth was too. As circumstances would have it, I was an enabler to the circumstances that happened in my life pre and post sobriety. The difference is I can now accept this. I have gone from awareness to acknowledgment to acceptance. I do not blame others for my mistakes as I once did. I can say honestly and wholeheartedly, I blame myself. This is life. I am one of those people who have learned from their mistakes. It was a hard lesson to learn, but I did. I wouldn't want to have changed anything...well, maybe some things, but I clearly would want to open up my eyes more...

In addition to cardiovascular health, we all could do better with our own immune health. Many of the chronic medical conditions are linked to how well our immune system is functioning. The chronic conditions such as Arthritis, Inflammatory Bowel Disease, Alzheimer's, Parkinson's, have a direct connection to all aspects of our life including dietary lifestyle, exercise and other lifestyles. Why do you think cancer and auto immune disease increase with age?

These increase because for the years preceding you have had a poor dietary lifestyle.

You ate too many refined carbohydrates, processed foods with dyes, less water and increased alcohol consumption. I often wonder when I see men my age (51) why do they still drink, smoke, use drugs and have unprotected sex? Are these men on a suicide mission?

I feel every person should take the following to promote a healthy immune system.

1. Probiotics - these are the good bacteria. Yogurt is NOT the answer

2. Vitamin D3 - sun can give you enough (without sunblock for 10 minutes 3 times a week, but you need healthy small intestines/colon)

3. Green Tea- you cannot drink what is needed. It cannot hurt to drink green tea but studies indicate 24 + cups of green tea per day.

4. Greens - we ALL need more greens each day. Greens contain antioxidants, B vitamins and much more. If you cannot eat 2-3 servings of greens per day as food, then purchase a Green Powder. (check out www.longevitynutritionals.com for their greens, reds, purples and orange powders)

The list could be endless especially when discussing antioxidants. I could write a separate list of the right herbs to take like ginger, tumeric, green tea, bacopa and rhodiola.

The real question is, "Do you want to change your dietary lifestyle?" I cannot make anyone change. Individuals who are sick and tired of being sick and tired might consider changing. If you aren't one of those individuals maybe you are fearful of change. Are you fearful of change?

Change is good.

Until tomorrow...

JULY 25 , 2011 WHERE HAVE THE YEARS GONE..AM I AGING ?

"Children are gifts; if we accept them." - Kathleen Turner Crilly

I was a child once. I was a gift to my parents. If you have children they are gifts. If you do not have children, consider you nieces and nephews as gifts. You own pet at this time might be your child. That pet is a gift from the universe. Some of us had parents who didn't know that children were gifts, and some of had parents who treated us as gifts. I can say I had parents who treated my brother and I as if we were gifts. Was my childhood perfect? It was as perfect as I can remember , but I know today there is no perfection. Our parents did the best they knew how to do.

This is how I view the past. I do not blame my parents for anything. Perhaps maybe it wasn't the right time to have children, but they did. Is there ever a perfect time to have children? I do not know, but I do know if you wait until the exact moment you will have another reason not to have children. Whether it is the financial situation or the world problems, you never know when it is the right time. Every one has a different circumstance. I cannot speak for every one's childhood. I can only speak from my own experience. I know that despite the many differences I have with my son and daughter, they are always gifts to me. I am sure at different times, both of my children view it differently. But I know GOD chose me to be a father. I did my best to raise them properly. I can say, now and today, I did this to the best of my ability. No more no less.

As the children get older, I realize that I am getting older and going through the natural process of aging. I can compare this to rusting. Inside of rusting from the outside in, we are all rusting from the inside out. This 'rusting' is caused by the free radical damage. We all get free radials by eating the wrong foods, the exposure to the environmental toxins and not drinking enough water.

Most of us are taking in the wrong fuel for our foods. We all eat to many processed foods and refined carbohydrates. The main prevention for aging is eating right. Cancer, heart disease and many other diseases and health issues related to aging are all linked to free radical damage.

Did you ever think of this concept? Do you realize you might be eating the wrong foods and not drinking enough of water? We all need water. If we continue to abuse the planet we all will age even more quickly. We will experience more rusting. To neutralize the free radical damage and thus the aging process you might need to take some antioxidants. I feel if you eat better, you might not need these antioxidants because many antioxidants are found in food. Which foods, you might ask?

All the green vegetables and alkaline fruits as all berries are a start. In case you want a list of some antioxidants I suggest some of the following below. I would not take all of them as you can start with 2 of the list. Ask a health care professional.

1. Coenzyme Q 10

2. Alpha lipoic acid

3. Resveratrol

4. Grape seed extract

5. Pycnogenal

6. Green tea - an herb

7. Tumeric- an herb

8. Ginkgo biloba - an herb

9. Ginger - an herb

10. Lycopene

11. Lutein

12. Vitamins C and E

13. N -acetyl cysteine - precursor to gluthathione

14. omega 3 oils

This is just the beginning..

Until tomorrow...

JULY 24, 2011 FIVE IMPORTANT AMINO ACIDS

"Spiritual awakening means we have zest for life and accept our imperfections"

Do you have a zest for life? I certainly do. It didn't come naturally. Or maybe it did and I ignored it. Maybe I let 'life' get in the way. Maybe I let my addictions get in the way. The latter seems more probable. I have no perfection. Sure I strived for perfection, but I have to come to realize-- or actually was taught by 12 step elders that there is no such thing as perfection. There is only progress. I am aware and acknowledge my imperfections. But that is not enough. I have come to ACCEPT my imperfections. It makes life easier. I can now breathe since I realize I am not perfect. No one is perfect. Not even YOU!

Do you want to stay young, healthy, virile and beautiful? Well who doesn't. There is this new over the counter (OTC) product....Well actually that is what most OTC products claim when discussing youth, beauty and aging. There are many products that are supposedly reported to stimulate the production of Human Growth Hormone (HGH). Go to any vitamin and/or supplement store and count the number of products that claim to stimulate HGH. There are too many to count. The product may contain multiple amino acids such as arginine, glutamine, isoleucine, leucine, glycine, lysine, ornithine and even valine. There are about five amino acids that have some relevance to healthy aging and sexual expression as well as assistance in maintaining sex hormone levels. I am not going to discuss testosterone and DHEA at this time.

I want to focus on amino acids. There are 20 twenty essential amino acids. I remember their structures from Biochemistry. I used to have a mnemonic for the twenty. I am sure there are new ones for today's pre-med or medical students.

Arginine is a useful amino acid. It acts as a vasodilator thus opening blood vessels. It has been considered the natural 'viagra' (or levitra or cialis) because like these pharmaceuticals, it increases the production of nitric oxide. Arginine is found in greens, beets, carrots, leeks and alfalfa. If you have an old exposure to Herpes I or II, these foods can aggravate outbreaks. Arginine is also found in chocolate and nuts, so both should be contraindicated if you have herpes. Not to digress but use 2,000mg/day of lysine if you have herpes lesions.

Glutamine is an essential amino acid I use often to rebuild and restore the small intestine villi. You can take powdered glutamine in higher than usual doses for IBS (irritable bowel) symptoms. I usually prescribe 5-10 grams/day. You can find glutamine in fruits and vegetables such as paw paw fruit, Brussels sprouts, dandelion greens, and other leafy greens including beet greens. All of these are so healthy. Besides rebuilding and restoring the 'gut', glutamine is essential for insulin balance, maintaining HGH levels, and anemia prevention.

Another amino acid essential for muscle and cartilage as well as sex hormone balance is Glycine.

Glycine is found in fruits, vegetables and herbs. I love all of the following sources of glycine: figs, pomegranate, garlic and raspberries.

As men, our production of semen gets less and less as we age. I have found that the amino acid, Histidine is great for semen production and well as inner membrane lubrication. Not only is histidine great for semen production, but for release at orgasm. There is less semen at orgasm or ejaculation as we age. Not good for your partner. Histidine is highest in raw sunflower seeds. This is a great snack, but make sure you do not have diverticulosis (out pocketing of the large intestine) as these seeds can lead to diverticulitis (inflammation of the large colon pockets). This disease entity can lead to abdominal pain, colon perforation and severe infection requiring hospitalization and antibiotics. In addition to the sunflower seeds, you can also get histidine from all Allium species (onion, garlic and relatives), endive, cucumber, pomegranate, apple, pineapple, beets and celery. It is also present in horseradish (which I do not like).

We all need the amino acid, Isoleucine for the master gland of the body, the pituitary gland. The pituitary gland produces HGH (from the anterior lobe of the pituitary). The anterior lobe also produces prolactin. You can get your natural sources of isoleucine if you are ingesting nuts, coconut, olives and the delicious avocados. You can also get it from paw paw fruit.

So good natural sources of these amino acids are available. You must eat well in order to have a healthy HGH level.

The roles of human growth hormone...

Until tomorrow...

JULY 23, 2011 SHE HAS MORNING SICKNESS

"Beginning TODAY, treat everyone you meet as if they will be dead by midnight. Give to them all the care, kindness, and understanding you can muster and do it with NO thought of any reward. Your life will never be the same again." - Og Mandino

You might have seen this quote before but like me forgot who wrote it. It was Augustine 'Og' Mandino II. Mr Mandino died at age 72 in September 1996. He was a bombardier during WWII, an insurance salesman, a divorced father, and author of The Greatest Salesman in the World. This book contained the 'time tested wisdom of the ancients distilled into ten simple scrolls'. You MUST read this book. The ten scrolls in this book yield peace, serenity and love. Sure there are some Christian overtones, but for me, being a 12 step program member I have no fear or doubt when reading them.

Reading Scroll I- Today I begin a new life is exactly how I wish I had started life. I eventually did but it took some years. I do not regret nor forget the past. I just DO NOT dwell on the past. This book, his first, is still in print as are 15 more of his 19 books. I would say he was an accomplished author. Being a movie star buff I was also excited to learn that his co pilot during WWII was none other than Captain James Stewart.

He even shares his birthday, December 12 with Francis Albert Sinatra. Now, how did I remember that!

The quote above is precious. It stirs sadness, happiness, guilt and anger in me. What does it stir in you? Would I treat people differently if I knew today was their last day on Earth? Would you treat people differently? I can only wonder and try it for one 24 hour period in my life to know the answer.

The other day I saw a young pregnant female about her dietary concerns. She did discuss her morning sickness as she was only 2 months pregnant. I feel that morning sickness is multi factorial. I am not an Ob/Gyn physician although during my clinical clerkships in London I delivered more than 100 babies. It was exciting and thrilling. About 5 years ago, Rick and I had the opportunity to watch a delivery in Spain with a friend. It took me back to my medical school days. For Rick it was his first real delivery. I remember that day if it were yesterday. He had tears in his eyes.

Back to morning sickness...with the hormone elevation during pregnancy I feel the fluctuation in sugar and blood pressure changes cause the morning sickness. So I did discuss the importance of eating regularly and consuming more protein than refined carbohydrates during pregnancy. You must have read about sugar cravings for ice cream during pregnancy. Not the wisest choice but I am sure it helps the anxiety and nerves.

I still do not get the pickle craving!

The medical term for morning sickness is Nausea and Vomiting of Pregnancy (NVP). This is the allopathic or conventional definition. If there is extreme, unrelenting vomiting the condition is then called Hyperemesis Gravidarum.

This patient had tried the conventional antihistamines with little relief. Her physician suggested steroids is the vomiting got worse. She asked me about other choices of treatment.

This is one of the many times I learn from patient questions. I knew ginger (Zingiber officinale)

had been studied with at least 5 trials from 2001-2005. I personally use peppermint when I feel nauseous, but that can be a trigger for some individuals.

So what did I do. I started to study, research and read about botanicals used for 'morning sickness.' I was relieved to find that there are many botanicals that can be used. From reading books authored by Tori Hudson, Tierona Lowdog, Victoria Maizes and Aviva Romm, I can now safely suggest some botanicals. I would still advise less sugars and avoiding hypoglycemia with several small protein meals. I would always encourage fluid intake. I do know that Charlotte from 'Sex in the City' sought acupuncture treatment for vomiting when she was pregnant on the show. There are promising studies on acupuncture and acupressure.

My botanical conclusions are a tea infusion of Meadowsweet, Chamomille and Black Horehound. I have never used the digestive bitter, Black horehound ( Ballota nigra) but it was mentioned in all of my readings. I might substitute the Meadowsweet for Ginger as ginger is a better anti emetic (anti vomiting agent) than Meadowsweet. You can even use horehound in motion sickness which is a great suggestion.

Until tomorrow...

Hint: For those with motion sickness carry a tincture of Black Horehound with you

JULY 22, 2011 BEE-HAVE

"There is no secret to balance. You just have to feel the waves." Frank Herbert

Most of us could use more balance in our lives. Life is not without a little roughness. The roughness could be described as a roller coaster or riding the waves. I do not want to think of the waves like Fire Island waves as in the last two weeks because they have been treacherous. But life can be balanced. Find the serenity and peace in your life. When do you find it the most peace and serenity? In order to feel serene we all must go through the process.

The process of your progress may be slow or fast. I favor a slow process of the progress I am making to better understand what I have learned. Someone told me early in my recovery, "I wish you a slow recovery." At first I was outraged and angered that someone would wish me a slow recovery. In retrospect I understand and I am delighted that I did have a slow recovery. It allowed me to focus on my own wellness. The understanding of my own well-being has allowed me to mature. It has allowed me to be connected to the world. It allows me to be peaceful and serene even among my

BEES...

I mind my own 'bees-ness. 'This means I 'bee-have.' The thrill of handling our bees is beyond reproach. Bees have fascinated me since I read a Scientific American article when I was about 12 or 13 yrs old. I even wrote a paper on bees while at Mark Twain Middle School. Although I read many books, I have been concentrating lately on Bee books. I have just finished Hive Management by Richard Bonney. I got my bees late this year, but according to this beekeeper's guide, I should begin the year with a late winter hive inspection and end it by 'putting the bees to bed'. This year I will at least get my honey bees to sleep sometime in Autumn.

I enjoyed what I read about his visual inspection of the overall well-being of the hive. I want to be the perfect beekeeper, but I do know that is impossible. Mr. Bonney was a state apiary instructor as well as a beekeeper so as I am reading I get two perspectives on being a beekeeper.

I do not think my honeybees will swarm this season, but you never know.

It is not necessary to open the hive every weekend I am in Fire Island. This weekend, Todd, Rick and I did not find the queen. At first I was alarmed but we saw larvae in the honey comb cells. This was reassuring that our queen must have taken flight to get 'some drone-queen action'.

The poor drone dies after giving her his sperm. What a sacrifice! Can you imagine a human male dying every time he gives his sperm to his beloved female? Let's not even entertain the same sex male relationship exchange!

I added some wild flower honey to the top super to help my little girl workers with feeding and nurturing the larvae and young. This weekend I will open only the top to see if the honey jar is empty. I will not open the whole hive as we did in the above photos. This weekend will only be external inspection.

I will observe the worker guards in the front of the hive. I changed the entrance to a smaller one as I want to protect my 'girls' from predators. If the hive is flourishing and there is intense nectar flow, there will be less guarding according to Bonney. I haven't seen foraging workers in my garden and on my flowers but my neighbors say have no fear as honey bees are foraging in their gardens. Yeah! I would love to put a radio device on one of the forager workers and follow them by satellite.

Even some bees can become loafers or couch/hive potatoes. I have learned that when the hive entrance has a number of those loafers it can indicate many things. First the weather could be so hot that some do not want to take flight. This has been a problem and will be this weekend as well. The other reason is no place to store honey. In our case, that cannot be true as there were empty frames. I even have read that bees can enter a different hive after foraging, but this would be highly unlikely since as far as I know, we have the only bee hive.

I am sure this happens on large bee farms. That lonely bee would be regarded as a trespasser or interloper and thrown out.

I am in awe of this complex bee society. So simple yet so complex. Can humans learn from bees?

Until tomorrow...

Photograph credit: Rick Byrd

JULY 21, 2011 NO LONGER SLEEPLESS IN NYC

"The world is not to be put in order; the world is order, incarnate. It is for us to harmonize with this order." -Henry Miller

Life on life's terms is what Miller is saying. We live in a stressful world. It is our job not to take the world on alone. If you need to get involved, do your part. Make it a simple part. Take care of yourself first, so you will be able to take care of others. We all need to fit in. Do not try that hard to fit in. Breathe, meditate and pray. Get yourself a mantra to repeat every day. When I first learned of mantras , I couldn't help but think of the movie, " What's Love Got to Do With It" about Tina and Ike Turner starring Anegla Bassett as Tina. Finally when Tina gets the courage and determination to leave the abusive relationship, she meditates and recites mantras. This changed her whole life and outcome.

Do you want to change your life? Do you want to harmonize with the order?

Stress can cause Insomnia. I should know. I believe I am an insomniac. I have been this way as long as I can remember. My mind never used to shut off. This lack of sleep started during my college years, perpetuated in medical school and rocketed during the long long internship/residency hours when there was no restriction of the amount of hours we worked. Today, there are strict rules in medical residency programs. I can recall working 48 hours + consecutive. So who wouldn't turn to caffeine et al?

At one time or another we all have a sleepless night. Those nights for me are long gone. The stress of the day or anxiety about the next few days (that is called projection) can keep us awake at night. The pharmaceutical industry has made it too easy. We have one sleep medication after another. Lunesta, Ambien, and Clonezepam are just a few. Some of these are habit forming and can become addictive. Most of these medications are now controlled allowing only a 30 day supply without refills. Of course I have seen patients even buy these medications of the Internet. Who knows what you are obtaining from the Internet!

Do you have a sleepless, restless night once in a while? Of course I do, too, but I now have tools to help me. These tools are breathing exercises, meditation and prayer. I stopped counting sheep a long time ago. If sleepless nights continue, the whole body eventually becomes affected.There are many useful and powerful herbal hypnotics that aid in a restful night sleep. At one time or another I have discussed various herbs as the

California Poppy, Valerian, Hops and Passion Flower. The combination of Passion Flower and Valerian as tea has worked the best for myself and my patients. Equal parts of each herb drunk as a tea before bedtime is ideal. I also have used the nervine relaxant, Chamomile. I have never used Red Clover for sleep. I have tried a herbal infused bath with lavender and lime blossom.

Recently I have been using a homeopathic remedy by HEEL. Rick cannot believe it is me sleeping so soundly.

He has seen me toss and turn and wake up countless times. I am referred to as Shamu, the whale-- not due to weight naturally but the flips I perform while tossing and turning. The product is called NEUREXAN. The bottle reads for temporary relief of

-sleeplessness

-overactive mind

-restless sleep

That's me, but not any longer. It is a homeopathic remedy containing passiflora incarnata, avena sativa and zincum valerianicum. I use 3 -4 dissolve tablets under my tongue.

It is available at Longevity Nutritionals ( http://www.longevitynutritionals.com/ ) . I even performed a technological feat by downloading the App onto my blackberry from their website.

Until tomorrow...

Happy Birthday Mom - July 21, 1929 - June 10, 1982. Miss you.

Happy Birthday Nancy Mom - July 21, 19??

Bottom photograph: Hand made needlepoint of a California Yellow Poppy. Made into a pillow. Given as a gift to Alyssa Fratellone

JULY 20, 2011 ADVENTURE OF THE MOUTH

"We can choose to create of our lives an accident or an adventure." Anonymous

So we all have this choice! Is your life path an accident or an adventure? It all depends on how you view your life. Do you view it with a positive or negative attitude? The above photos exude adventure - fun, best friends and a refreshing hobby. For me personally, life is full of adventure. I only build upon this adventure. Every day is a new adventure; a new beginning. My life has not been an accident. I used to feel that my life was an accident... or rather I created an unsteady life. Today, life is good. Is it perfect? No it is not. Is it better than in the past? Yes it is. Am I happy? Yes. I am grateful for today? I am more grateful for my life than ever before in my adult life. It is unbelievable hoe the lyrics of a Rogers and Hammerstein musical can lift your spirits. While Rick and I were enthralled to see our 'little' friend, Marina on the stage we were taken back to our childhoods. I never knew the lyrics from 'My Favorite Things' included a ' bee sting' It is portrayed NOT as a favorite thing and that is the way I felt when I was a child. Now that is different. I couldn't help but think of my mother while watching the play. Listen to the lyrics of ' Climb Every Mountain' It brought tears to my eyes.

Last week I had two patients with dental complaints. Their complaints were about their gums hurting. The health of the mouth can affect the whole body. The inflammation in the mouth, especially in the gums is linked to inflammation in the heart. This is determined by a simple serum (blood) test: the C reactive protein (specifically the high sensitive CRP).

Digestion begins in the mouth. Typically when a patient has a dental problem, a dentist should be consulted. The most common dental problem I see is gingivitis. This is the inflammation of the gums. This can be caused by lack of oral hygiene (brush plus use a water pick or dental floss) or an inappropriate diet. The use of refined carbohydrates is linked to poor dental hygiene, especially gingivitis. 'Itis' in medicine means inflammation. There are herbal antibiotics that I have used for gingivitis. These are Echinacea, Myrrh and Eucalyptus. Myrrh is mentioned in James Duke's Medicinal Plants of the Bible

"My beloved put his hand to the latch, and my heart was thrilled within me. I arose to open to my beloved; and my hands dripped with myrrh, my fingers upon the handles of the bolt." - Song of Solomon 5:4-5 (RSV)

The King James version mentions lock instead of bolt.

I recommend equal parts of myrrh and echinacea. I ask the patient to put 1/2 dropperful of each in their water pik and use every day. Both of these herbs are excellent as anti-infective herbs. Both will soothe the gums. I will tell you now that the taste is not pleasant. I have found the worst tasting herbs are the most effective. Another example of an unpleasant herbs are the bitters and chaparral, but the more unpleasant , the better the effectiveness. Perhaps add one drop of either peppermint oil or calendula oil to ease the taste in the mouth.

Until tomorrow...

Photograph credit: Rick Byrd and bee photo, Jen.

JULY 19, 2011 BEST FRIENDS

"My life is my teaching" - Mahatma Gandhi

I could ask for a better G.O.D. chosen profession than medicine. I am a teacher. I love to teach. I am teaching everyday of my life by healing individuals. I love to assist individuals in reaching their goals in life. The first lesson is a lifestyle change that involves exercise and better eating habits. I couldn't have found a better quote to qualify what I do in life. I learn something new every day. I find this refreshing.

During past summer months when I volunteered my medical services I was always confronted with individuals getting earaches. Have you ever had an earache? Was it caused by swimming?

I usually prescribe Mullein oil. One of my patients is Spencer, our King Charles Cavalier. This breed of dog is friendly, affectionate and great with children. Both Rick and I have had many breeds between us. We both agree that the King Charles is unique, or maybe it is just that Spencer is special. I do think that a good way to get to know your dog better (besides spending time with him/her) is to find out about the history of their breed. The history of King Charles Cavaliers dates back to King Charles I and II. In the United States this breed became popular in the 1920's with Roswell Eldridge. Although he never lived to see the dream, there finally was a King Charles Kennel Club started in 1928.

Sure humans get ear infections and so do dogs. The usual treatment for a physician is to write an Rx (prescription) for antibiotics. The most common is amoxicillin. Kids especially get this pink liquid antibiotic from their pediatrician. I prefer mullein oil.

Upon reading I have discovered another plant, named Pennywort. There are many herbs that are given this name, so I need to more work on this species. The stem goes down from the center of this round leaf so you cannot miss it when you see it. Crush the leaves and collect the juice. You now have pennywort juice. Put some drops of this special juice in the affected ear.

The next ear infection I get whether in an individual or in Spencer I will use Pennywort. I have added Chamomile and Yarrow to the Mullein Oil for Spencer, too. 40% of all Cavaliers get ear inflammation. Among Cavaliers it is called Primary Secretory Otitis Media (PSOM). Among pet owners like ourselves it is called glue ear. This is a highly viscous mucous plug. It has been postulated that hearing loss develops in Cavaliers and it is progressive. I do not think this is from the glue ear, but rather a degeneration of the auditory nerve.

I do believe that most dogs with floppy ears have ear problems.

3rd photograph: Spencer

4th photograph: Max, a Shuzon (breed Shitzu and Brichon)

Photographs: Rick Byrd

Until tomorrow...

JULY 18, 2011 I. B. S.

" Our ability to relax into life reflects our willingness to trust." --Anonymous

I am finally able to relax into life. Most days. I am sure the meditation and prayer play a role in this process. I am also aware that my hobbies and self esteem are involved. The hustle and bustle of this metropolitan city is sometimes not that relaxing. It does create some stress. I am finally beginning to trust my own instincts. I know these are good instincts. I go with my 'gut feeling' and intuition. In the past my 'gut feeling' was not to be trusted. Today I trust myself. I might not necessarily trust everyone around me, but even that is getting better.

Do you relax into life? Do you trust yourself?

The inability to relax can sometimes affect your digestion. Maybe you have a nervous stomach or an irritable bowel. There are studies that IBS can sometimes be associated with anxiety and depression. I always ask patients, "Do you have bloating , flatulence, changes in bowel habits and burping?" Health care professionals as patients are challenging. I know I am a challenge to my conventional colleagues as I do not want to take medications all the time. Last week I was seeing an acupunturist. She was a 41 year old white female who has had bloating for several years. She also has a history of vomiting. She said that her last boyfriend left her due to bad breath in the morning. She does not drink coffee or smoke cigarettes. She has seen a top gastroenterologist who suggesting she stop drinking any milk products. She did this for 10 days, felt better, but felt she couldn't commit to stopping dairy.

I tested her for food allergies. She had a severe gluten, dairy and yeast sensitivity. We discussed the many food options she can have. Rather than tell her what she can't have I told her what she can have.

After one week she felt better, but still had not eliminated all the necessary foods that she was allergic to. I had given her glutamine (an amino to heal the 'gut') and probiotics (the good bacteria).

I decided to make her an herbal tea mixture to ease her abdominal discomfort, bloating and gas. All of these symptoms had improved, but were still bothersome.

I wanted to blend herbs with different properties . So I did --

1. Nepetea cataria (catnip) - acts as a carminative

2. Foeniculum vulgaris (fennell) - acts as a carminative

3. Maticaria recutita (chamomille) acts as a nervine

4. Salvia officinalis (sage)- acts as an astringent

5. Metha x piperita (peppermint) - acts as an antispasmodic

Within days you will find some relief. Take equal parts if used as a tea or can use as tinctures to add to a cup of chamomile tea.

Until tomorrow....

JULY 17, 2011 VISITING ZOOS AS A HOBBY

"Some people haven't yet found themselves. But the self is not something one finds; it is something one creates." - Thomas Szasz

I do not know how to tell you to create yourself. You do not find yourself. You go out in the world and create yourself. You instinctually know and will be driven to your life purpose. No matter what your life purpose is, I do know one thing.

I know/flowers/herbs, animals, especially bees.

Find a connection with nature!!

What is your most special childhood memory? Was it visiting a zoo for the first time or was it Barnum and Bailey's Greatest Show on Earth-The Circus? There are many memories to choose from, but going to the Bronx Zoo was a highlight for me. The Bronx Zoo is the largest metropolitan zoo in the United States covering 265 acres. The facility known then as the Bronx Zoological Park, opened its doors on November 8th, 1899.

I cannot recall if my parents took us to the zoo in 1967 or if I visited with Yonkers PS 4 on a field trip. I was in awe of the animals, especially the gorillas, chimpanzees and the giraffe. I think it is unfair to pick my favorite animal as I loved all the animals in the Reptile House too. In 2010, the Bronx Zoo became a home to 4,000 animals of 650 species, many of which are endangered or threatened.

I didn't visit the smaller (5 acre) NY Metropolitan Zoo in Central Park until I was in my medical residency in New York City. The Central Park Zoo began in 1860 making it the first zoo to open in New York. Just a menagerie of animals, at that time it was called the '1934 Zoo' or the 'Robert Moses Zoo.' If you haven't visited this zoo you probably read about in high school if you read the 1951 J D Salinger novel Catcher in the Rye.

I have made a point of visiting as many zoos as I can when I travel. I have been to the Washington DC Zoo, Philadelphia Zoo and the San Diego Zoo. I have not visited the Franklin Zoo in Boston yet, but I have a reason to visit this zoo in particular. My son is currently doing his pre-veterinarian internship at this zoo. He is working with the Gorillas. I am also excited about visiting Boise Zoo in Idaho soon. I can add another zoo to my zoo visiting hobby. The next logical question for me is to ask is, "Are there bee zoos?" There are observational bee hives at San Diego Zoo, Houston Zoo (Woodland Park Zoo) and Honolulu Zoo. There are three states as far as I know that do not have zoos. These are Vermont, New Hampshire and Wyoming.

Photos:

Top: Polar Bear at the Central Park Zoo NYC

Next: Bronx Zoo

Next: Observational Bee Hive

Bottom:Okie at Franklin Zoo; his birthday was last week
(Photo credit: Gregory Fratellone)

Until tomorrow...

JULY 16, 2011 HERBAL MEDICINES FOR THOSE MENOPAUSAL YEARS

"Things are being worked out as quickly as possible for your highest good."

Why rush life? It is not on your terms. Most of us want what we want when we want! This is the addict in all of us. It is better to receive when it is the right time. I am not talking about purchased gifts, but subtle gifts such as the ability to relax, feel peace and serenity and the compassion to love. I have come to realize that nothing happens on my time. It is my Higher Power's time. I cannot nor do I want to control anything any longer. I surrendered a long time ago. I do slip into the 'want it when I want it mode' at times, but I know now to pray and meditate when this happens. If I get into one of those moods, I know there is some underlying issue or issues that must be recognized . After I recognize these issues I must accept these issues. Once I have accepted these issues then I will take action if necessary.

Some females use natural hormonal replacement therapy for menopausal symptoms and healthier bones. NHRT is not the only option. It is an option but there is a risk for cancer. I am careful about who I write hormonal therapy for. These women need hormoe testing by blood or saliva, a mammogram and PAP prior to starting NHRT. I do not encourage thermography as a breast screening versus mammogram and/or ultrasound. I have seen 3 women with normal thermograms who had undiagnosed breast cancer found on a breast ultrasound.

I would like to see more gynecologists use herbal therapies for treatment of women issues. There are great conferences and books on Botanical medicine for Women's Health. The goal is to ease the transition from having hormones at higher levels to having much lower levels of hormones. The herbal treatments are to relieve bothersome symptoms like hot flashes, insomnia and depression. They also help with your bones, prevention and treatment of pelvic laxity, vaginal dryness, reduced libido and incontinence.

Did you ever think that plants can have so many functions? Probably not, but they do.

The goal is to combine nourishing herbs as well as herbs to support the liver and the adrenals. The adrenals are on top of the kidneys. These glands are so important. During times of stress especially in menopause, the adrenals are working overtime. You do not want your adrenal glands to become fatigued. So I recommend supporting the adrenal glands with an herbal adaptogen. Herbs that have estrogenic properties (phytoestrogens) can reduce the risk of Brest Cancer, prevent osteoporosis, high blood pressure and heart disease.

Menopause is a natural transition. In my humble opinion, it is not a disease. It is natural process of aging.

So I recommend and use nourishing herbal infusions of the following herbs. Each of these herbs has benefits for different symptoms in menopause such as insomnia, anxiety, hot flashes, osteoarthritis, depression, and palpitations.

Here goes...

1. Black Cohosh (Actaea racemosa)

2. Blue vervain - (Verbena officinalis)

3. Chaste tree - (Vitex agnus castus)

4. Goldenseal (Hydrastis canadensis)

5. Green milky oat (Avena sativa)

6. Passionflower - (Passiflora incarnata)

7. Sage (Saliva officinalis)

Photos: Top: Goldenseal

Middle: Oat straw

Bottom: Verbena

You can't help but love plants and flowers!

Until tomorrow...

JULY 15, 2011 TINY TINY GALLSTONES

"A right handling of ill health is a major factor in breaking down separateness and a sense of aloneness and isolation; that is why the effects of bad health, when rightly handled, lead to a sweetening of the disposition and a broadening of the sympathies. Sharing and a sense of general participation has to be learnt the hard way." - Alice Bailey

Physicians need to handle patients with more care and understanding. Despite the changing medical times, patients need to be guided. Conversation between doctor and patient is a must. The patient might have to lead the questioning. Simply taking a pill and a test is not always the answer. Keep in mind that as people get older they need more time to think about what has been said. Perhaps some physicians are not getting the message. There is a convincing argument for the value of herbal medicine in the modern world. Anyone can read and learn about herbal medicine to get a better understanding about these alternatives.

Each of us has a relationship with nature to develop. You might be a long way off. I was at one time in my life. Then the light went on. All the properties of plants as food and remedies have been nearly obliterated by industrial processing. Also many of us have removed the natural world from our lives. Plants provide the most effective foods, and each plant contains a wide range of phytochemicals (pharmacological constituents) that every leading pharmaceutical company envies. Pharmaceutical companies want what plants have. These companies are part of the rising health costs in this country. Many of these healing plants have a long history of healing diseases over many centuries. Try to be more grounded with Mother Earth.

I am confronted with using herbs on a daily basis. Here is a great example of how I used herbs in a 48 year old female who had multiple small gallstones. She had known she had gallstones for a long time. Her diet was fair. She avoided fatty foods, drank less alcohol than usual and tried to the best of her ability to avoid refined carbohydrates. In the 5 years since her diagnosis she had one mild gallbladder attack (cholecystitis- inflammation of the gall bladder). She did not want surgery even if it was laparoscopic.

The cause of gallstones is unclear. Treatment plans usually involve dissolving the stones, or at least reducing them in size so they can be passed spontaneously. Some tried turpentine oil. This proved unsuccessful. Conventionally, bile acids can reduce and dissolve gallstones with fair success. The drawback to this is that it is a 2 year treatment plan. There are other acids like chenodeoxycholic acid which also provide success.

I knew I could use a combination of herbs to slowly dissolve the stones without the bile acids. It might take time, but I would rather use this approach. I explained the risks and benefits of all methods to reduce or eliminate stones without surgery. I had to think of herbs with alkaloids as well as some digestive herbs. I rarely use herbs as single agents. I love that many herbs have more than one action.

A mixture of the following was used:

1. Marshmellow root 2 parts

2. Fringetree Bark 1 part

3. Goldenseal 1 part

4. Balmony 1 part

5. Boldo 1 part

Drink this as a tea three times a day. When the patient called and said she was fine and passing small stones, I was elated. She had run out of Golden Seal which is an easier herb to obtain, but I changed it to Barberry (which has berberine ) and also added 1 part Meadowsweet. I love Meadowsweet.

When she started to get anxious I utilized a homeopathic remedy by HEEL called Nerviheel as well as Chamomile tea.

Photos: Second Photo: Boldo (Peumus boldus) from Chile

Fourth Photo: Fringebark Tree

Fire Island Bee Correction

Photo credit: Rick Byrd

Photo: Rick Byrd and Todd Erickson (Bee keepers/Bee Hive Installers)

Until tomorrow