Skin tears are a common problem for the elderly as skin thins and becomes more fragile. Any shearing, friction, or blunt trauma can result in very significant injuries to the skin. Even a simple injury can cause significant tears: bumping into furniture, falls, pets, or even removing a band aid.
 
Factors that increase chances of a skin tear include thinning outer layer of the skin, loss of the under layer of skin, and drier skin. Also the elasticity of the skin decreases as we age, making it more prone to injury. Some risk factors can’t be changed, such as age or immobility, but there are some things you can do to minimize your risk of having one of these very uncomfortable injuries.
 
How to Prevent Skin Tears

• Wear long sleeves, long pants, or knee high socks.
• Consider shin guards if repeated tears to shins
• Evaluate environment for potential areas of risk, such as sharp corners on furniture,
• Remove scatter rugs
• Make sure lighting is adequate
• Ensure good nutrition to support skin health – especially protein
• Good hydration to prevent skin dryness
• Use a good quality hypoallergenic lotion daily to keep skin moist
• Keep fingernails and toenails trimmed short
• Avoid adhesive products whenever possible
• Remove band aids carefully

 
Skin tears are equivalent to a burn, are prone to infection, and take a long time to heal. Treatment can take weeks to months, depending on the size and severity. Prevention of this serious injury can save a lot of suffering and expense. Take a little time to take care of your skin!
 
To your health-
Tracy

Hippocrates made this observation over 2000 years ago and it is even more true today. While some simply view the gut as a tube that processes food and eliminates; there are so many things going on from ‘point A to ‘point B’ that it can really boggle the mind.

Studies show 30-40% of clinic visits are gut related, or 105 million visits per year in the US. That’s a lot of gut problems.

Some of the things that can get off track in the gut include:

·         Poor digestion – this one is huge! Starting in the mouth with thorough chewing of food before swallowing, digestion is critical. The acid in our stomach is critical for breaking down food into small blocks that can be used as fuel and absorb the nutrients. A very common complaint is heart burn and the first thing people reach for is an acid blocking medication. This is often the exact opposite of what is needed. Did you know that 60% of people age 60 have little or no stomach acid? Supporting the digestion process with something as simple as apple cider vinegar before meals can make a big difference. Not everyone likes vinegar straight up, so you can mix it with an ounce or two of water and add a bit of honey or stevia to make it taste better, if you like. And when you get a flare of heartburn – reach for apple cider vinegar rather than the Tums or Prilosec first. You may find it works better!

·         Good bacteria – did you know that we have 10 times as many good bacteria in our gut and on our body as we have cells in our body? Good bacteria is responsible for so many different things: making vitamins, managing the immune system, even affecting our weight. Eating a diet heavy in sugar and processed foods can decrease the good bacteria and leave us open for other problems. The good stuff thrives on vegetables and naturally fermented foods like good quality yogurt, homemade sauerkraut (like grandma made, not the the heat processed variety), kefir, and others. Feed those good bacteria to keep your gut balanced and you may find constipation and bloating improve, along with your general health. Another option is a high quality probiotic to get the ball rolling. Dosing varies from 15 billion units (yes, billion!) for the general population and much higher for those with more serious gut issues.

·         Leaky gut – is the common term for intestinal permeability. This is a condition where the lining of the gut becomes irritated and will allow larger proteins from food to get into the blood stream. When this happens, the immune system is alerted and causes inflammation or, even worse, autoimmune diseases.

Hippocrates was a smart guy! Many diseases do start in the gut and that is why I am passionate about gut health. It really is the foundation to health. 

The Health Fair is coming in just 2 weeks and I thought it might be helpful to give a few tips on how to get the most out of your labwork. I’ll list a few of my favorites and some that you can bypass

·         Blood chemistry profile - is very useful to get a lot of information on the health of your liver, kidneys, blood sugar, electrolytes and lipid panel (cholesterol and others). This is a foundational test that everyone over 35 should get on a yearly basis. You can have abnormalities and not notice any symptoms. At $35 this is a bargain!

·         Hemogram - is great to check for anemia or as a first test in idenitifying iron overload (which I do see more of in this region). Any other blood abnormalities such as low white blood cells or clotting cells (platelets) are also included. This is another very useful test!

·         Vitamin D level – please put this one on your list.  It is typically low in this northern part of the country and can cause immune problems (remember last winter when you caught every viral thigh floating around?), including cancer, heart disease, general fatigue and body aches. If you have ever talked about vitamin D with me, you know I’m the ‘Vitamin D queen’ – I’ve encouraged this for years and seen many people feel dramatically better when the level is optimal. At $40, this is extremely reasonable and one of the ‘must haves’. CRP – a marker of inflammation is helpful for heart health as well as other low grade inflammation. This is important as inflammation is now identified as the basis of many chronic diseases, not just heart health.

·         Hemoglobn A1C – is great to look at your average blood sugar over the past 3 months, as opposed to the one in the chemistry panel, which is a snapshot of the blood sugar at the time of the test. Essential for diabetics and very useful for anyone that is interested in monitoring their blood sugar.  You can take steps to improve it before you become diabetic.

·         Hormone levels - are helpful if you are not using topical hormone replacement. But these are not the best if you are using creams, gels, or patches.

Now a few tests that I don’t recommend:

·         Thyroid panel – this is a group of tests that have very limited use in the work up of thyroid disorders. There are better tests to evaluate the function of your thyroid – I use the free T4 and free T3, which are more accurate, along with several others. Save your money on these.

·         Celiac test - is an ok screening for this disorder but please note that it is not very accurate. There are many negative results reported when the patient does in fact have Celiac. There is also a ‘non-Celiac gluten sensitivity’, which does not show up on these tests at all.  If you have concerns about this, give me a call.

This is a great time to take advantage of the very good pricing on your lab tests. I hope this is useful for you in choosing the appropriate ones for you.

Adrenal fatigue is a collection of signs and symptoms, or a syndrome, that comes when the adrenal glands are not functioning properly. This can be either too much cortisol (the stress hormone) or too little. You really need the cortisol levels to follow a nice curve throughout the day and decrease in the evening to allow you to go to sleep. When cortisol is out of balance, it affects all other hormones: thyroid, estrogen, progesterone, testosterone, and others, which causes other problems

I struggled with this in the past when I had too much on my plate and started having problems with sleep. Every night I was up for hours, waiting for my brain to settle down and allow me to sleep. My days were a struggle to get through, because the fatigue was so profound. It was during this time that I realized I needed to look at things a bit differently and learned to rebalance my adrenals.

Some of the classic symptoms are:

You feel tired for no reason

You have trouble getting up in the morning, even if you have enough sleep

You feel more alert after 6 pm than you do all day

You are run down or over whelmed

You have problems recovering from stressors or an illness.

You crave salty or sweet foods

You have chronic fatigue

You have body aches

You have lightheadedness

You have low blood pressure

If any of these symptoms sound like you, there is help. We can support your adrenals and help you feel like you have your life back again. 

Over the past several months, there have been a number of questions about Mountain Sage Holistic Clinic and the services we provide. Here are the most frequently asked questions and answers.

1.       Can you write prescriptions if I need them?

Absolutely! As a family nurse practitioner I am licensed as an independent clinician, which means I order lab tests, x-rays, other imaging and diagnostic tests, along with any necessary medications. This makes Mountain Sage Holistic Clinic a full service clinic for managing your health concerns.

2.       Do you take insurance or Medicare/Medicaid?

At this time we are not contracted with insurances, Medicare, or Medicaid. BUT we do provide the documentation required by those payors for you to submit to your insurance. While we can’t guarantee that they will reimburse because the policies vary. Many people have fairly high deductible plans and find that this type of service will be applied to the deductible or be reimbursed according to your policy.

3.       Do you have any payment plans?

It is very important to us that our services are available to everyone. With that, we are open to working out a payment plan to suit individual needs.

4. Do you manage bio-identical hormones?

Yes, we do manage bio-identical hormones. Hormone replacement therapy is very useful for many men and women struggling with hormonal issues. There are synthetic versions of hormones and bio-identical versions – which means the medications match the hormones that are naturally made in the body. The bio-identical versions are also very customizable, the dose can be adjusted to each person’s needs. The synthetic versions have fixed doses and are not customizable.

5. What types of health issues do you see managed at MSHC?

Any type of chronic condition like: diabetes, chronic fatigue, stomach and bowel issues, adrenal fatigue, thyroid problems to name a few. Also health promotion, disease prevention, and wellness visits are a important part of staying healthy.

6. Do you do labs?

Many of the labs that are needed can be done through MSHC as we have the kits available to complete the collection. These kits are then completed in the privacy of your home or at MSHC. Occasionally blood work needs to be drawn from a standard lab and at this time those can be ordered and completed at the lab of your choice. In the future we plan to have this available in house.

7. Do you have a FaceBook page?

Yes, we do! On it you will find updates and links to the articles posted in the Roundup along with other interesting wellness info.

Please feel free to email me with any non-medical questions or concerns that you may have through the Contact Us page. We are always interested in hearing about your interests, needs, or how we can serve the community better. For appointments call 455-2807 Monday-Friday and Saturday until noon. The Complementary 15-minute Wellness Strategy Sessions are still available to see if the Holistic approach is right for you.

Have a blessed Christmas and Hanukah! Enjoy you time with family and friends during this Holiday season!

Be well-
Tracy

Living at this northern latitude can create some challenges in maintaining good health. The snow, cold and increasingly darker days can prompt us, like the bears, to go into hibernation mode. Unfortunately, we can’t sleep through the winter and need to find ways to emerge mentally healthy in the spring. Winter Blues or Seasonal Affective Disorder can really have a significant effect on some people, 1 out of 7 people struggle with this issue. Those who have WB or SAD tend to sleep more, have an increased appetite (especially for carbohydrates), be irritable, gain weight, have increased body aches, and may have trouble with interpersonal relationships. There are some simple ways to manage this:

1. Get some sunlight early in the morning. This helps to set the body clock and studies have shown that 20-30 minutes of sunlight in the morning supports the neurotransmitters (dopamine and serotonin) that regulate our mood. This works best if you can get out within an hour of waking, but any time of the day is better than none.

2. If daylight is difficult to obtain, try a daylight lamp. This should be 5000 - 10,000 lux brightness rating. Verilux makes several models that have full spectrum light. You can use it for 30 minutes while enjoying that first cup of coffee in the morning.

3. Vitamin D supplement. This is the sunshine vitamin and it really does help to lift your mood, as well as decrease aches and pains. Not to mention the wonderful effects for your immune system! (This is one of my top 3 supplements.) It’s best to get a level done since most people really do need a significant amount, but a reasonable starting point is 2000 units daily.

4. Get some exercise. I know for a lot of people ‘exercise’ is a four-letter word, but even 2 walks during the day, for 15 minutes each can make a big difference. There was an interesting study that took 2 groups of people with mild to moderate depression symptoms and compared prescription medications with daily walking of 30 minutes and the benefits were exactly the same – but no drug side effects for the walking group!

5. Eat protein 2-3 times a day. Meat, fish, chicken, eggs, or plant-based are all good sources. This is not a huge amount; just the size of your palm is plenty. This helps decrease the carb-craving we can get in the winter and avoids the ‘winter weight’ that is so common – which can give you the blues when your jeans don’t fit!

6. Plan to do some activities that you enjoy, especially helpful if you get together with people you enjoy. Just spending time in pleasurable activities can do wonders for your mood. (Maybe that’s why we see so many babies born in Sept and Oct!) Any type of activity helps increase endorphins – the ‘I feel good’ brain chemicals.

7. Please also watch for signs of your mood worsening. Score yourself on these 2 questions over the past 2 weeks, how often have you been bothered by any of these symptoms:

1) Little interest or pleasure in doing things 
2) Feeling down, depressed or hopeless.

Not at all=0, Several days=1, More than half the days=2, Nearly every day=3. If you score 3 points or more, you may want to discuss your situation with your provider for other strategies.

Be well-
Tracy

Symptoms of a cold and influenza can overlap and be confusing at times. I thought it might be helpful to have a comparison of the symptoms along with some red flags.

Symptom                                 Cold                                     Influenza

Fever, Chills                              Rare                                     Common, 100-103 (kids)
Stuffy Nose                               Common                             Occasionally
Sore throat                               Common                             Common
Muscle pains                            Mild                                      Severe
Headache                                 Not usually                          Can be severe
Sneezing, watery eyes             Yes                                        Rare
Cough                                        Mild to Moderate               Can be severe, but dry


Also note influenza is different than the stomach flu; with that you have the nausea, vomiting, and diarrhea – not the cough and body aches.

As you can see the main differences are the fever, headache, muscle or body aches and the cough with influenza are all much more severe than with a cold. People generally feel very ill with influenza, ‘hit by a truck’ is often used to describe it.

Both illnesses are spread through the air by sneezing or coughing – please cover your mouth using the inside of your elbow to prevent touching something after you’ve coughed into your hand. Symptoms usually start suddenly for influenza.  You are most contagious during the first 24-48 hours of symptoms and continue to be contagious until you are fever-free for 24 hours.

Things to watch for include: increased difficulty breathing, shortness of breath, wheezing. Both are viral illnesses, but the concern with influenza is the possibility of pneumonia developing. This is not typical with younger adults but we do want to really watch the following groups:  > 65 years, children < 2 years, pregnant women, anyone with chronic lung disease, diabetes, heart disease, or immunosuppressed individuals as they are at risk for having complications.

What can you do? The best thing for any viral illness is rest! We have a tendency to push through illnesses and go to work, school, church etc. anyway. There is discussion on the overtreatment of fevers; their purpose really is to fight infections and so letting a fever ride that is <101 is really reasonable in otherwise healthy individuals. Actually, it can be helpful to induce a fever at the onset of an illness by; layering up the covers, taking a hot bath, or (if you are lucky enough to have access) take a sauna.  (Please be sure this is appropriate for you before embarking on this – not for pregnant women, etc. check with your provider if you are unsure.) For fever management ibuprofen or Tylenol are readily available.

Next, is fluids, fluids, fluids and I don’t mean Coke or Red Bull.  Water or tea with lemon and honey are good.

Then my favorite – chicken soup!! Did you know somebody actually did a study and grandma was right; chicken soup is good for you!

Be well-

Tracy