APRIL 24, 2012 SLEEP

"If we want to reach a level where we can teach others, we must first learn to listen to others."

Do you listen to others? I know I do, and I really have to--especially when it comes to my patients. I have a tendency of sometimes not listening to loved ones, especially Rick and often my children. I am so overstimulated during the day, that before I engage in personal conversation I have to meditate and slow down my mind. Did you ever call a friend with a problem, but first ask how he/she is doing and 15 minutes later you are still on their issues, but you actually called for yourself? Once you ask someone how he/she is doing - you should tell he/she why you called. Or better yet, do not ask how he/she is doing until you tell he/she why you are calling. We all need to listen more. I cannot teach lifestyle changes to anyone, if I first do not listen to their complaints. I also must ask everyone about their life- do they exercise, do they meditate, do they have a hobby, et al.  As I am fond of saying and have said before in this blog, "Take the cotton out of your ears and place it in your mouth and LISTEN."

Regular restful sleep is one of the most important components for maintaining health. If you have disrupted sleep it does not allow for proper digestion or sufficient time to make new hormones and chemical messengers (neurotransmitters) which are essential to our well being. We need these neurotransmitters to wake up with energy. Do you wake up tired? I used to! No longer.
We do know that inadequate sleep has been proven to decrease work performance, alertness, memory and cognitive function and put stress on your relationships (personal and professional). Lack of sleep decreases your quality of life. Do you want that?
A study has shown that a decrease in sleep by one and half hours will result in a decrease of daytime alertness by 32%. Wow!

A large cohort study of more than 3500 patients ages 35 and over found that the optimal sleep duration of 7 - 8 hours could predict better health outcomes.

There are many remedies for sleep- conventional prescriptions as well as botanical. There are also vitamins/supplements that have been used as remedies to sleep. Some of these supplements include theanine, and sub lingual melatonin. Homeopathic remedies like HEEL- Nerviheel and Neuroxtan (available at http://www.longevitynutritionals.com/ ) are excellent. The Bach remedy called Rescue Remedy is another valuable sleep agent. Herbal Vitality has a tincture called Sleep Formula which is useful. You must find the proper sleeping agent for you if you have difficulty.

I could describe many botanicals used in the Herbal Vitality mixture, but I want to mention two botanicals that I am fond of for sleeping.

One is Passion Flower (Passiflora incarnata). The alkalids and flavinoids in Passion flower are stronger sedatives and relaxants than other botanicals. It has the ability to restore debilitated nerve centers by promoting proper nutrition uptake at  a cellular level. It supports a calming and relaxing effect on the body during times of stress. Every person in New York City needs Passion Flower. The leaves and the vines contain the many alkaloids  as harmaline, harmine etc . There are also lots of bioflavinoids such as quercitin, rutin etc in the plant.  I love history of plants so this is no exception. It was first discovered in Peru in 1569 by a Spanish physician/botanist, Nicolas Monardes. In the 1800's it became popular with the Victorians of England.

The second botanical is Skullcap (Scutellaria lateriflora ) It has a relaxing and calming effect on the body. I like Skullcap because I find it can be used during the day to restore balance to an overworked individual. This is me. I utilize skullcap daily during the work day. I feel rested. It does not put me to sleep, but restore my energy and balance during the day and then I get a better restful sleep at night. This plant is a nervine  and has plenty of flavinoids, ligans, and tannins. The best known flavinoid is appropriately called scutellarin.

Until tomorrow...

SEPTEMBER 18, 2010 PASSION FOR MEDICINE AND FLOWERS

"The most helpful thing we can do for someone is to listen and care; then we need to let go of the outcome."

On a daily basis I am reminded this is the most important aspect of my occupation as a physician. Medicine is not taught in the classroom but at the bedside according to Sir William Osler. When I read the "Quotable Osler" I get inspired. The quote above is Oslerian--if there is such a word! Medicine is my vocation. It is my belief that we do not listen to each other very well. Doctors do not listen to their patients. Patients tell us everything about themselves. Why do I let patients talk about their dreams, families, fears, hopes and their health? Because I care. Today, I try to the best of my ability to listen outside my scope of medicine. I have to take the cotton out of my ears, place it in my mouth and listen. I hope when I do that I can truly listen to the person speaking.

This week I let go of an outcome. I must tell you that I feel weightless. I feel lighter. I feel happier. I have realized that what I have done tirelessly for an effort was the right thing to do. I cannot control people, places and things. I cannot control anyone else's behavior except mine. Have you controlled your behavior in a given situation? What was your role? Do you truly listen to others when they speak?

I do know that medicine is my vocation chosen by above. Some may say it is my calling. I do know that I need an avocation- some intellectual or non intellectual pastime, which serves me to keep in touch with the world of art, science, or of letters. I have countless avocations or hobbies. What are your avocations?
Can plants and flowers be your avocation?


When I think of a sedative plant alternative I always used to think of Valerian. The nervous function is suppressed when it is used appropiately. Sedatives induce sleep. Valerian is widely used in Europe. I used to use it more in my daily practice. I have found that some people get the opposite reaction. Some take valerian and get nervous. This is an idiosyncratic reaction. It does happen more often than not. I have found that those who get active or hyper with valerian have some thyroid imbalance, either overactive or underactive thyroid function. I have seen more hypothyroidism in patients with these idosyncratic reactions.

Hops is another sedative but it is not as strong. I personally do not like the bitter taste of hops. Hops is found in beer. Beer has barley and barley is a gluten grain. For those with gluten sensitivity--Hops would not be the greatest choice for a sedative herb.

So let's discuss Passion Flower. The passion flower or passion vines (Passiflora) are a genus of about 500 species of flowering plants. They are mostly vines, with some being shrubs, and a few species being herbaceous. It is impossible to discuss every species of this plant.

I found it intriguing that many insects and birds have adapted to one or two plant species within the Passiflora Family. For example the sword billed hummingbird will feed on two species of passiflora- one being the Passiflora mixata.

Passiflora incarnata, commonly known as Maypop, Purple passionflower, True passionflower, Wild apricot, and Wild passion vine, is a fast growing perennial vine with climbing or trailing stems. A member of the passionflower genus Passiflora, the Maypop has large, intricate flowers with prominent styles and stamens. One of the hardiest species of passionflower, it is a common wildflower in the southern United States. The Cherokee in the Tennessee area called it ocoee; the Ocoee River and valley are named after this plant, which is the Tennessee State Wildflower. This is the most unique flower I have seen to date. It is 'extraterrestial' or 'maritian like' yet so beatiful.

The stems can be smooth or pubescent; they are long and trailing, possessing many tendrils. Leaves are alternate and palmately 3-lobed, measuring from 6-15 cm. They have two characteristic glands at the base of the blade on the petiole. Flowers have five bluish-white petals. They exhibit a white and purple corona, a structure of fine appendages between the petals and corolla. The large flower is typically arranged in a ring above the petals and sepals. They are pollinated by insects such as bumblebees, and are self-sterile. The flower normally blooms in July.

The fleshy fruit, also in itself called a Maypop, is an oval yellowish berry about the size of a hen egg; it is green at first, but then becomes orange as it matures. .

Traditionally, the fresh or dried whole plant has been used as a herbal medicine to treat nervous anxiety and insomnia. The dried, ground herb is frequently used in Europe by drinking a teaspoon of it in tea. A sedative chewing gum was even produced in Romania in 1978.

In addition to anxiety and insomnia, I have used passion flower in combination with valerian and lemon balm (Melissa offincinalis) to treat restless leg syndrome. Studies have been done using Passion Flower for alcohol and opoid dependence. I use 1/2 to 1 ml of tincture 2 - 3 times a day for patients with anxiety disorders.

Photographs: Both are Avocations

Until tomorrow...