APRIL 8, 2011 ORIGAMI MAGIC

"Character - the willingness to accept responsibility for one's own life- is the source from which self respect springs." Joan Didion

If I listen to these words carefully and read them slowly, I can conclude that I must have some character. I have accepted the responsibility for my own life- my bad and good actions. I have made amends. I have held no resentments and anger...recently. I say recently because I am human. It is by accepting responsibility for my own life that I have gained my own self-respect. It just sprang out. I saw it clearly.

I saw its imperfections. But I saw the progress I have made over the years.

A simple task as a HOBBY has more than helped make me the man I am today!

Origami is like magic. With a series of folds a two dimensional paper is finally transformed into an elaborate three dimensional structure. The best part of starting this hobby is that you CAN DO IT.

Origami, from ori meaning "folding", and kami meaning "paper". Kami changes to gami due to rendaku. Origami is the traditional Japanese art of paper folding which started in the 17th century AD and was popularized in the mid-1900s. It has since evolved into a modern art form. The goal of this art is to transform a flat sheet of material into a finished sculpture through folding and sculpting techniques and as such the use of cuts or glue are not considered to be origami. The number of basic origami folds is small, but they can be combined in a variety of ways to make intricate designs. The most well known origami model is probably the Japanese paper crane. In general, these designs begin with a square sheet of paper whose sides may be different colors or prints. Traditional Japanese origami practiced since the Edo era (1603–1867), has often been less strict about these conventions, sometimes cutting the paper or using non-square shapes to start with.

I was fascinated to learn that what I thought was of Japanese origin was in fact not. It is 1st century Chinese. It was brought to Japan in 500 C.E. by the Buddhist monks and quickly integrated into the Japanese lifestyle.

So how did it get to the US? Master Yoshizawa Akira, who wrote children's books had some origami designs. Akira brought her work to the US with help of Samuel Randlett. A New Yorker named Lillian Oppenheimer saw Akira's work and became hooked on the designs- especially one of a bird. She started to practice and mastered the technique. It would figure that a New Yorker would get involved.

She founded the Origami Center of America in 1980.

Get started with origami paper and a website. I prefer http://www.paperfolding.com/ or http://www.origami-usa.org/

If you like books as much as I do, I suggest an old step by step origami instruction guide called Complete Origami: An A - Z of Facts and Folds by Eric Kenneway 1987. I am sure if you check out http://www.amazon.com/ and search for new books on origami you will find plenty.

Until tomorrow...

APRIL 7, 2011 THE BIG E.D. or NOT SO BIG

"Time is a flowing river. Happy are those who allow themselves to be carried, unresisting with the current. They float through easy days. They live, unquestioning, in the moment."
-Christopher Morley

This certainly doesn't sound like a description of salmon swimming upstream. But in a way it does. I felt like a salmon and I wasted time in my active days. Today I do not waste time. I live each day to the fullest. I sometimes think if I am not busy I am wasting time. I have to slow the process down. I feel I should be doing something at every minute- whether knitting, stitching, reading, writing or meditating. How ridiculous is that! Life moves to the unseen drummer so it doesn't matter if I go fast or slow. I am happy just being in the moment. When meditating I am taken to that river and I float, feeling the cool water on my back and the sun beating on my chest. It feels serene. This meditative feeling allows me to get through my days. It allows me to educate patients and also learn from patients. I lead a grateful life. Do you lead a grateful life ?

Impotence. What a scary word. The newest terminology is Erectile Dysfunction (ED). It does sound somewhat classy. Not many men want to admit to this. I must admit that since Viagra, Levitra and Cialis have been on television more, it has opened the bedroom door for discussion. So I thought why not here. It is estimated that 20-35 million men suffer with Erectile Dysfunction. It is defined as the inability to achieve or maintain an erection. The two categories of ED are physiological and psychological. Which do you think has the highest percentage- psychological or physiological? Physiological has 80-90% while psychological is only 10-20%. Easy to tell the difference. If a man has an erection during sleep or in the morning upon awakening, it is NOT physiological.

The most common causes of a physiological condition are:
1. Heart disease
2. Hypertension (high blood pressure)
3. Diabetes
4. Atherosclerosis
5. Thyroid disease
6. Kidney disease
7. Peyronie's disease - curvature of the penis due to atherosclerosis of the penile arterial vessels
8. Neurodegenerative diseases
9. History of prostate cancer
10.Lack of testosterone

What is always forgotten as a cause are the types of medications the individual is on and the recreational drug use. Prescription medications include those for high blood pressure (especially beta blockers) and anti-depressants such as Zoloft, Celexa, Paxil. The most common recreational drugs that may cause ED are alcohol, marijuana and cocaine.

For psychological impotence, there can be many factors. These include grief, depression, sexual abuse, guilt and chronic stress. By far the most common cause is being in an unhappy, unfulfilled relationship. I can do some therapy with the patient if he feels comfortable. I am a great listener. I think years of sobriety and the advice of taking the cotton out of my ears and putting it into my mouth helped a lot.

First came Viagra, followed by Levitra, then 36 hour Cialis and NOW the daily 5 mg Cialis so you are ready at all times. As Virginia Slims used to say, "You've came a long way, baby!" All these medications work by releasing nitric oxide, a vasodilator that allows blood to rush to the penile vessels. If the man is taking nitroglycerin he should not even attempt to take any of those 3 drugs.

There are herbal alternatives:
1. An old medication for high blood pressure called Yohimbe can be used for ED If you use the tincture(1:5) 15 drops twice a day, or 5-6 mg tablets three times a day.

2. Yin Yang Huo (Epimedium spp) - This is used in traditional Chinese medicine (TCM). You men have heard of this . It is sold in the USA as Horny Goat Weed. Dose: Tincure (1:5) 1.5-2.5 ml twice a day. I advise as a tea: 1 tsp of the herb, seep for 20 minutes and drink 4 oz twice a day

3. Xian Mao Root (Curculigo orchiodes )- I find this TCM herb to be the most effective. It is difficult to get, although it can be obtained in Chinatown, NYC. Tincture (1:5) 1/2 to 1 ml twice a day.

Other herbs used are Fresh Oat, Ashwaganda, Damiana, Ginkgo, Asian Ginseng, and Morinda Root. I use a formula from Herbal Vitality called Male Libido. Check out www.longevitynutritionals.com for a bottle. If you want a supplement that releases nitric oxide use L-arginine. It must be taken in high doses- somewhere between 6 - 9 grams per day. I would use the powder because it only comes in 500 mg to 1000 mg tablets. I have seen men use up to 15 grams. Since it releases nitric oxide, be careful with your blood pressure. No one wants to be erect as they pass out!

Until tomorrow...

APRIL 6, 2011 ADHD

"I have learned to like myself for the first time and to have some serenity." -Keith Miller

I do not know which came first- liking myself for the first time or serenity. Maybe these came at the same time. I didn't like myself for the longest time. I do not know when that first began. Possibly when I was younger and realized I was different. Liking myself now brings so much peace, love, happiness and serenity to my life that it is contagious. I love life! Was there a time in your life when you didn't love yourself? Was it when your self esteem was lowest? I do know that when I started to increase my self esteem in various ways, I began to like myself. As my self esteem heightened I began to love myself. Tranquility and serenity followed.

Have you ever felt non focused? Did you have difficulty sitting still as a child? I did. I never sat still as a child. My Nanny called me the Jack Rabbit. At times my mother could not handle my brother and I, especially when company was coming over. My mother never hit either of us. When my Uncle Sonny and his family were coming over for Easter one year, my mother was not in the mood for hearing my brother and I fight. What she did might be called child abuse today, but in those days we didn't hear those terms. My mother tied my brother and I to separate wrought iron room dividers. My uncle was horrified when he arrived with his family.

In 1980 ADD (attention deficit disorder) was officially recognized and included in the Psychiatric Diagnostoic Manual - DMS-III classification. Several years later it was renamed ADHD (Atterntion Deficit Hyperactive Disorder). When reading the DMS-III classification, I know I was a child with ADHD. I do not think it hurt me as I got older, but it definitely made me different. I do not actually know if I had an extreme of normal human behavior or actually ADHD. It doesn't matter some 45 years later. I think my ADHD character defects have actually helped me to be where I am today.

Today, I feel many children are classified as ADHD. Today we have many health care practitioners who treat ADHD far better than years ago.

I am the gluten free and/or yeast free doctor when I treat children as well as adults. I do believe in a strict dietary lifestyle change. Until you try this lifestyle change of yeast free, you will never know how it feels not to be bloated and flatulent. In addition some parents have tried the old Feingold Diet. This is a diet with no artificial colors, preservatives and salicylates. This total withdrawal has not been shown to be effective. In some few instances, a gluten free and dairy free dietary lifestyle shows little result. But in my clinical experience I have witnessed drastic changes in a child's personality, irritability and attention by eliminating gluten and dairy.

I do ask parents to use fish oils. There is one problem. Most children hate the taste, so I prefer to use Cormega brand (by Orthomolecular). There are great antioxidants like pycnogenol but many taste horrible. Most things can be hidden in apple or grape juice, however.

I think a multifactorial approach to treating ADHD is most effective. Sometimes there is a role for conventional drug therapy such as Ritalin, Focalin and Strattera. There are many herbal treatments for ADHD, unknown to most conventional physicians. In upcoming blogs I will discuss the multitude of herbal treatments for ADHD.

Until tomorrow...

APRIL 5, 2011 HEPATITIS

"Today, everything WE need shall BE supplied to US."

You do have everything if you have your health. Health, happiness, serenity and peace are always supplied to us if we ask. If you pray,what do you pray for? I pray for tranquility and serenity every day. During my early twenties I lived through a time where your health was not guaranteed due to the 'new' epidemic, HIV/AIDS. I was health conscious then as well as now, so I did protect myself. But even with protection, mishaps do happen. I recall those days where there was no tranquility as every day another friend was sick and eventually no longer with us. Thank God those days are over. I will never forget my friends who died during those 'disco' days of the 1980's. There was no tranquility and serenity then.

Serenity for me is living among nature- the plants, flowers, bees, and trees. It is among the warm weather, the sound of the ocean and the song of a bird.

Find your serenity. I promise you will not be disappointed.

Both hepatitis B and C are viruses that can cause devastating chronic degenerative liver disease. Some of this chronic liver disease can progress to hepatocellular necrosis, liver cancer and liver failure. Hepatitis B (HBV) is spread by sexual contact or by contact with infected blood or other body fluid. About 2 billion individuals world wide have been infected with HBV. More staggering is that 350 million have the chronic form of the disease. Many infected people have no symptoms when diagnosed. There is a vaccine for preventing HBV. As a medical professional I received this vaccine earlier in my career. I think it is important for health care providers to get this vaccine.

Hepatitis C (HVC) is most often treated with interferon and ribavirin. About 40-50% of those with HVC genotype I (the most common genotype) will be cured by interferon as will 70-80% who have HCV genotypes II or III. The treatment is successful but not without side effects. I have many patients who start the treatment and cannot finish the course of injections. I see many individuals with crippling fatigue, depression, muscle pain and weakness over the 12 month treatment program.

There are many herbal treatments available for the treatment of hepatitis but it is most effective to start with a change in dietary lifestyle. I want the infected individual to start an anti-inflammatory diet. This involves consuming less meat and more fruits and vegetables. I want the patient to start juicing green vegetables and a few low sugar fruits in the morning. If the patient does not want to juice, then I suggest using a Green and Red Powder Mix. I have formulated Green/Red/Orange/Purple antioxidant drinks for Longevity Nutritionals. Check out http://www.longevitynutritionals.com/ I know everyone does not like to VitaMix vegetables and fruits. One scoop of either Greens or Reds is easier.

I utilize my bag of supplements for supporting liver function. I utilize many antioxidants, especially vitamin C. I usually recommend this be given intravenously with other antioxidants-- both vitamins and minerals including Vitamin B12, folic acid, zinc, selenium, manganese, calcium, magnesium and copper. N-acetylcysteine (NAC) is hepatoprotective. NAC is the precursor for glutathione which is either administered intravenously or taken in powdered form. SAMe, lactoferrin and alpha-lipoic acid are also recommended to be taken orally.

As far as herbs are concerned, I use the Western Herbs Milk Thistle, Ginkgo, Astragalus and Tumeric. I have seen other Registered Herbologists use Chinese and Indian formulas. There are many herbalists who are more familiar with Chinese Herbal treatments. David Winston, RH utilizes the approach of four treatment protocols. He uses hepatoprotective, hepatosupportive, herbal immunopotentiators and herbs to clear stagnation. The last two categories do involve more of the herbs I am familiar with like Ashwaganda, American Ginseng, and Asian Ginseng. The only two western herbs for stagnation mentioned are Oregon Grape Root, Barberry and Andrographis. The hepatoprotective Chinese herbs are Chai Hu root, Dan Shen root, Yin Chen Hao and many more. In this category I utilize Milk Thistle and Schisandra Berry.

The hepatosupportive herbs to help elimination of waste and maintain normal liver function are Amla fruit (Emblica officinalis), Lycium fruit and Eclipta herb. I have not used these but rely on Burdock, Dandelion and Yellow dock. The best three herbs for hepatoprotection are Milk Thistle (Silybum marianum) Schisandra berry (Schisandra chinensis) and Tumeric (Curcuma longa)

As an RH I have an important tool. As an integrative physician without an understanding of herbs, one knows ONE herb for ONE condition. Today as an integrative physician and RH, I know how to combine herbs with confidence.

Herb use for Hepatitis B and C is far superior to herb use for other conditions. I would like one day for a conventional Hepatologist and/or Gastroenterologist to recommend herbal remedies.

What always needs to be mentioned is that there are NO herbs that are CURATIVE for Hepatitis B and C, but many can help individuals live healthy lives.

Mother nature does have some miraculous plants.

Top photograph: Milk Thistle (love this flower)

Middle photograph: Schisandra berry

Bottom photograph: The largest organ in the body (excluding the skin), the Liver .

Until tomorrow...

APRIL 4, 2011 HERBAL TREATMENTS FOR PSORIASIS

"Create an opening for someone simply by imagining it is possible for them to grow."

-Yehuda Berg

Everyone deserves to grow emotionally and spiritually in this world. If you are spiritual then you must help others out. Simply telling them you meditate and pray is not enough. You must show them how you meditate, and guide them. As a parent we want our children to grow. We also try to protect them from the dangers of this world. As a parent, I have tried to the best of my ability to educate my children. I educated them on addictions as the teenage years approached. Now that seems a lifetime ago as they are in their twenties. As they grow older and mature, I am sometimes afraid of what they will encounter in this world and the future. I pray and meditate for their health and happiness. When I meditate I imagine a place in the world for them so they may grow individually with love and peace. It seems so Pollyana, but it is my wish. What do you wish for loved ones? Have you ever thought to imagine an opening for someone special in your life ?

Psoriasis is more common than you might think. It affects up to 1-2% of the world's population. It is characterized by erythematous, sharply demarcated rounded papules covered by a silvery shiny scale. It cannot be missed on a thorough patient physical. It is generally itchy. I have used many herbal treatments for this condition. Before I begin treatment, a detailed history must be obtained. A careful food history must be acquired by the physician. I really concentrate on this issue as many psoriasis sufferers consume too many carbohydrates, especially gluten (B R O W - barley, rye , oats and wheat) and cow's dairy. I often ask about consumption of alcohol in the form of beer, wine, vodka and other spirits. These spirits are full of yeast. Yeast is another source of problem when you have psoriasis. Other dietary concerns are vinegar products, pickles, cantaloupe, peanuts and dried fruits. After a careful assessment and blood tests for IgG RAST food allergies, I begin treatment. I always ask the patient to take probiotics and L-glutamine in powdered form to start healing the small intestine while the elimination lifestyle is begun.

Foremost, I do recommend a dietary lifestyle change. I also recommend some herbal treatments. I have seen them be successful with the dietary lifestyle changes. Stress is also an underlying problem in patients with psoriasis. I recommend meditation, stress reduction exercises, a hobby and yoga. More than 50% of psoriasis suffers have fingernail involvement. I have even seen this disappear with a careful dietary change.

The two herbs I use are Barberry and Yellow Dock (Rumex crispus)

I do not use these two herbs topically as you might think. I use them as tea or tincture concoctions. Both amplify the livers capability to detoxify. Yellow Dock (Rumex crispus) has a relative, rhubarb. The juice of the wild rhubarb can be used topically if juiced properly. It does burn at first, but the lesions do disappear. Walnut or butternut is similar to rhubarb but only a small amount. Both walnut and butternut in excessive doses can be a severe laxative. I have used Yellowdock topically with some success.

Another less known herb, Golden Smoke (Corydalis spp) can be used for skin conditions that are stress induced like eczema or psoriasis. It actually acts like a cross between a California Poppy and Barberry. I wonder if California Poppy would test positive on a drug screen (urine or blood) for opiates. I do not know the answer to that question. Another herb, Dicentra root is a combination of the above with the addition of Blood Root.

Herbalists say to use those herbs fresh. They can be used for Hives, Urticaria, Eczema, and systemic psoriasis.

Top photograph: Barberry

Bottom photograph: Yellow Dock

Until tomorrow...

APRIL 3, 2011 PASS ME A CUP OF JAVA

"The most important single ingredient in the formula of success is knowing how to get along with people." - Theodore Roosevelt

Success. We all want it at some point in our lives. Who doesn't want to be successful? I used to think being as successful as some of my mentors was what I wanted in life. I used to want my name to a household name. Not any longer. I am happy. I am successful within myself. So far, I have achieved what I wanted in life. I am sure there is more I can do, and I might or I might not do more. There are statements made by doctors on television today that I said more than 10 years ago.

What is the negative attitude towards coffee? I never remove coffee from a patients dietary lifestyle. After all I probably just removed the breads, candy and cow's dairy. Removing coffee might send the patient off the deep end. I might say something if it is more than seven cups a day especially with sugar. Coffee is an herb that has been around for centuries. Has your physician ever mentioned the benefits of coffee to you ?

Coffee has some health benefits. The Harvard School of Public Health found that a group who consumed 6 cups of coffee a day had about a 20% reduced overall mortality compared to those who drank coffee less than once a month. This is for both males and females and the patient population was 120,000. This is a great study. Older studies suggested that an increase in coffee consumption would decrease overall mortality.

So far for those who love coffee-you are safe.

We always think that the caffeine in coffee increases blood pressure but this is clinically insignificant. Studies have revealed no significant blood pressure increases. There is a slight elevation in the lipid panel (total cholesterol, LDLs and triglycerides).

Another cardiac risk factor, HS-CRP (marker of inflammation of the coronary arteries) was once thought to be elevated in heavy coffee drinkers. This has been extensively studied and there is no correlation between high CRP and caffeine, but there seems to be a protective effect.

In the news lately there are the studies indicating that coffee has a protective effect for Parkinson's Disease. There are thirteen studies documenting this fact. The risk was reduced by 30% for every 3 cups of coffee. There are studies citing a protective effect in those patients with Alzheimer's disease. Coffee has also been studied for its anti-diabetic effects. The results are promising. Note that when these studies refer to 6 cups of coffee it is the old measurements. Before we had 8 ounce cups we had 6 ounce cups. So, six 6 ounce cups = 36 oz. Today that is equivalent to 2 - 18 oz. grande cups.

There are some negative effects, but these are expected. Some of these occur for those who exceed their habitual intake. For instance, insomnia and heart palpitations are common as well as tremors and nervous irritability.

I have the ability to drink coffee after a late dinner and still go to sleep. I would recommend decreasing slowly if you want to stop coffee intake. Caffeine is an addictive substance. Starbucks should know after 40 years in the business. It is addictive and you can get withdrawal symptoms, so do it slowly. The withdrawal symptoms may include headache, decreased alertness, drowsiness and decreased energy.

I love the high polyphenol content of coffee. It is like green tea. Who wants to give up the great taste of coffee? It provides anti-inflammatory, antioxidant and neuro-protective benefits to your body.

Have a cup of java on me.

Until tomorrow...

APRIL 2, 2011 THE CANDIDA BLUES

"The soul should always stand ajar, ready to welcome the ecstatic experience." ---Emily Dickinson

Be open, ready, willing and able for a new experience. Narrow mindedness should be avoided--just let go of it! I was once a semi-narrow-minded physician. Over the years that has changed allowing me to better myself and challenge the individuals I assist with lifestyle changes. Have you experienced something new in your life? Ever had a completely 'new ecstatic experience'? This summer I will be experiencing something new. It will be my first time in many years on Fire Island as a civilian without physician volunteer duties. I am looking forward to this. I was a civilian years ago on Fire Island. In reflection, I was not as happy as I could have been. I was a 'new be' to sobriety and relationships. This year Rick and I will experience Fire Island in a different way. We have our honeybees, plants, flowers, herbs and ourselves. To add to that we will have real friends. This makes the serenity, peace and love even more special. Old doors close, and new 'old' doors open or old doors close and completely 'new doors' open... Be open to change. You will definitely benefit!

Changing your dietary lifestyle may not make you ecstatic immediately. But the benefits you and your stomach/intestines will feel will certainly make you happy if you give it a try. Here are some sample questions I might ask you on a visit.

1. Are you bothered by fatigue?

2. Do you feel worse on damp days or in musty moldy areas?

3. Have you had a prolonged course of antibiotics?

4. Are you blue or depressed?

5. Are you bothered by headaches, irritability, or a feeling of being 'spread too thin'?

6. Do some foods disagree with you or trigger symptoms above?

7. Have you been checked by a physician who spent time talking to you?

8. How many doctors have you seen for the same recurring problems?

9. Are you bothered by digestive disorders, bloating, gas, constipation, diarrhea or belching?

10. What kind of diet do you adhere to: high protein, low carb, high fat or high protein, moderate carb, high fat? or high protein, low carb, moderate good fats?

I am not asking these questions because I am nosy, but I want to ascertain the relationship of the common yeast, Candida to any health problems you may have. I am not talking about the yeast in breads and cakes, but a different kind of yeast. Candida normally lives on the dark warm interior membranes of your body in harmony with billions of friendly bacteria. When there is an imbalance of sorts there is a problem. Candida does NOT cause any problems when you have a normal immune system. But when you take antibiotics for pneumonia or a urinary tract infection, it will not only kill the bad bacteria, but many of the millions of friendly bacteria in the small intestines.

Until tomorrow...

A dream come true: As I sit here at the SW Conference of Botanical Medicine in AZ, I am grateful and proud that my badge reads: Patrick Fratellone, MD RH New York, NY