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Dr. Suzette Lanzarotta, D.C. 

Practicing medicine is an art and not about business.

In years past, our personal physicians treated us from birth to death. These doctors knew our family history, our health history, pretty much everything about our lives.  These practitioners had no choice but to look at the entirety of an individual’s health and not just a set of symptoms that they could match with a diagnosis in a book. They knew that a complete physical included looking at and correlating how you feel and what you were experiencing with what they find in exam and blood work.  A thorough exam included a good blood work up and a physical and any other diagnostics related to the individual’s condition. I believe this is not only good medicine it is good preventive medicine.

Both time and medicine has moved on.  The family doctor that treated everything from sniffles to cancer is now a system of specialized practitioners that treat only within their specialty.  As the patient and the consumer, we must also change and become our own medical coordinators and advocate.  Understanding and working within that premise here are a few tips on how best to be your own advocate without a medical degree.

Tip 1

Keep copies of everything you have done every year in a single file.  It becomes the record of your past health which can reveal clues to how to stay healthy by comparing results from one year to the next.  

Because I look at labs from year to year, I have recognized serious changes in basic annual screenings that other doctors have not picked up.  It is the comparison from year to year that reveals the valuable data that can be used to diagnose a health issue when put in the right hands.  You can carry your past and present into a specialist and present the whole picture.  

Tip 2

Reading beyond the numbers

Each year, millions of us dutifully head into our primary care provider to get out annual physical.  For most of us we walk away with no actual information on our current health.  The feedback if we get anything at all is, “everything looks great” or “time for cholesterol medication”.  Some practitioners will offer a little dietary feedback, but it is mostly generic and doesn’t actually get us where we want to go, which is usually off the medication and healthy.

My goal is to provide you with the information you need to either ask the right questions at your next appointment or seek the advice you need to address health issues that your annual labs should be helping you prevent.

A recent example of this occurred when a patient of mine with a Leukemia diagnosis delivered her yearly labs following a physical on my desk for review, and I was horrified to see only a CBC with differential. Her MD had only looked at her red and white blood cells.  When we sat down together, I asked when the last time she had had her blood sugar checked, a lipid panel done or her liver enzymes checked, her response was, not for years and certainly not since she was diagnosed with Leukemia. This woman’s health care provider is looking at her through a keyhole.

In years past when we have gone for our annual physical, certain basic exams were performed as a screening process. If anything were out of order we would return for a deeper assessment of that issue, more blood work and a differential diagnostic. Blood tests can be diagnostic in and of themselves for some disorders and for other health issues when correlated with symptoms and more advanced diagnostics, they provide a great tracking device as we return to health. The trend from year to year is fewer and fewer blood tests are performed and ultimately the warning signs of impending disease are being missed.

Before your next physical, have a plan, know what you should be looking at and for, and ask to have the labs run.  You may get the brush off in some cases but even a good basic lab done and then read by a functional medicine practitioner can make a difference in your long-term strategies for health and longevity.

My recommendations for an annual basic screening

• fasting glucose
• lipid panel
• CBC and differential
• Ferritin
• metabolic 14 panel
• liver
• kidney
• thyroid
• Vit D

With this basic panel we have a good cross section of how our blood chemistry is fairing and how the systems of the body are working independently and together.

Tip 3

Know what “Extra” testing to ask for.

Additional testing based on your health history

1.  Do you suspect Thyroid issues or are you taking thyroid medication?

• Add Free T3, Free T4
• Thyroid antibodies.  

2.  Have diabetes?

• Add and A1C
• Fasting insulin level

3.  Have high cholesterol or high Blood Pressure

• Add CRP
• LDL break down

Another frequently told story in my office is the patient, usually female over 30 who has gone year after year and asked for a thyroid screening because she has low body temperature, fatigue, loss of libido, hair thinning, mood swings and cannot seem to lose weight. She believes she has a thyroid issue because she has done her research and she knows she has many of the symptoms. The additional testing is a starting point for Hashimoto’s disorder (an auto-immune thyroid condition).

In this case the practitioner runs a lipid panel to check her cholesterol and a TSH. If the results of the TSH fell into the normal range even if it was borderline high or low, she was dismissed with no thyroid issue and instruction to eat less and exercise more because the test was negative for thyroid.   She may need to work on her health, but what happened to the older, more artful method of practicing medicine and screening a patient with the symptoms of thyroid dysfunction with a little more thorough testing?

These 3 tips are the basics you will need for an annual physical to screen for your current health condition.  If you have other health complaints, be sure to express them–don’t downplay them, and ask what the appropriate testing might be.  If you do not feel you are being heard, or your concerns are being brushed aside, please find another practitioner.  

This is your health, and you may only have one chance to change the course and outcome.  Just because you do not have a medical degree does not mean you don’t know what is going on in your body–after all you do live in it.

This is your health; this is your life. Take charge of it.

By Shaly Vassigh, Licensed Esthetician and Holistic Health Counselor

As a holistic esthetician, working in a wellness center, I would be remiss not to focus on the emotional and spiritual health of our clients in addition to the physical components of wellness. While I am not a mental health counselor, I have noticed that, throughout the pandemic, many individuals have significantly reduced their social interactions (even when socially-distanced options exist).  Even as it is becoming safer to socialize, many people seem to be staying away from one another for a variety of reasons ranging from social anxiety (often resulting from fear of virus spread) to depression (largely due to isolation itself, though a variety of factors are contributing to the rising rates of depression over the last few years). 

It is important to remember how much we need social interaction as human beings! It’s essential to have a buddy to check in with at least once a week. Depression and anxiety can happen gradually over time, and a trusted friend may be one to notice something in either your mood or behavior that you may have missed. Your friend may be that encourager, reminding you to take care of yourself and eat well, or better yet, may be a great walking or hiking buddy – inspiring you to exercise and get your sunshine and Vitamin D.  

Mindset

Staying focused on the positive – with a daily gratitude and goal-setting practice, no matter how small – can help you stay mentally strong during stressful times. 

Practicing Self-awareness:

Begin to notice those thoughts that come up for you on a frequent basis.  Write these specific thoughts in your journal. How many times a day would you estimate you have these thoughts? Research shows that for the majority of us, our habitual thoughts are rooted in negativity and culminate – like a tape in our minds – repeating that same criticism, victimhood, and/or fear-based story – whatever it is!  You’ll likely know it well as you pay greater attention to how often it’s coming up for you.  

The great news is that you don’t have to listen to or believe your negative thoughts. You can choose different thoughts and eventually change your thinking, if you keep challenging those negative thoughts while creating positive ones to replace them.   Louise Hay, often referred to as the Mother of Positive Affirmations, states that our greatest fear is that we are unworthy, unlovable.  We often beat ourselves up, talking to ourselves in ways we would never speak to a good friend.  Rarely do we pause long enough to become an observer, to witness the madness – or meanness – that may be going on within.  When we allow ourselves some space to witness, the process of unhooking ourselves from the spiral is set in motion … our higher self takes the helm and we can begin the practice of reflection and mindful choice.  

Another exercise is to begin a journal titled, 1000 Ways that I am Perfect. This sounds like a huge feat, but honestly, there are thousands of functions in our bodies and lives that work perfectly every single day.  A brief study of biology, including how the body repairs itself, will leave you in awe of how perfect your body truly is.  Write down 5 things a day that you notice about yourself or your life that worked, just perfectly.  For example, I drove perfectly to work today!  I breathed perfectly today (you are still alive, right?)! My leg healed a cut perfectly today! I felt a scratchy throat and my body overcame it perfectly today!  Eventually, you will have 1000 ways that you are perfect! So, when you have a few recurring negative thoughts, balance them out by reflecting on those things that are working, and you will feel much more confident and optimistic. Bravo!

Social Health-It’s More than Just Texting a Friend

As I mentioned, because we have needed to keep a physical distance from others during the pandemic, many people have developed almost a fear or aversion to connecting with others.  It is able to be masked (no pun intended) because we may feel that we are texting friends, so we are being social, or that we are having Zoom meetings with colleagues, so we are being social. But these types of interactions remove much of the human part of the interaction that we thrive on. Being able to pick up on a person’s non-verbal cues about how they are feeling and respond to them is more difficult with these platforms.  There simply aren’t enough emojis to express all of the human emotions, especially during a pandemic!. Fortunately, we gained a ‘“care” emoji during the past year.  One important one that should be invented would be a “holding space” emoji. But in reality, that emotion is better presented in person. Holding space is BEING with a person, listening to their story or feelings, without judgement and with a positive regard. It is hard to feel that someone is holding space for you on a screen or text, but on the phone or in person, it is completely different.  

Our attempt at social interactions during the pandemic may have looked something like this–you are feeling lonely or you miss a friend, so you think “I should call Mary.” But then you remember people don’t call any more and you don’t want to bother them so you decide to send a text. But in the text, you can’t think of what to say to ask how they are doing and get the real answer, and if they asked you,  it would be hard to convey the complexity of your life and feelings in a text, and you don’t want to be a drag, so you end up just not texting.  The same goes for actually getting together–you think about someone that you wanted to get together with, but then you try to plan where you can meet safely in a socially distanced way and Do you need a reservation?  Who is going to watch your kids? That is just one more person in your house that you need to be concerned with exposure. And should the kids wear a mask in their home with a babysitter?  So many things to figure out. So it just seems easier to avoid the get together, avoid the attempt at a phone call, and avoid the text. And longer it goes that you haven’t been in touch, the harder it can be to get in touch again.

Another possible scenario is to send a text that opens dialogue.  Hey, how are you doing? Do you want to grab a coffee sometime and catch up?  I’ve been putting off getting together with all that is happening, but I miss seeing you! Real conversations feed our souls.  I have been fortunate to have been working during the pandemic as an esthetician, and hearing everyone’s stories and struggles has been a healing experience for me to relate to other people’s emotions during all of this.  Being there for others has helped me feel better.  If we say “We are all in this together” we need to make that mean something. We are strong together. 

Even now that many have received the vaccine and COVID cases are decreasing, it is important to overcome this cycle and start to socialize again in a way that is safe for your circumstances. 

Your Emotional Health

The past year has been filled with a lot of emotions. We may float from fear to gratitude, from boredom to creativity, from frustration to finding new ways of coping.  Sometimes watching too much news can make us feel overwhelmed by all the negativity.  The important thing is to find ways to express your emotions safely and not keep them inside. In our wellness center, Dr. G has seen a link between holding (negative) emotions inside and health issues with his patients.   Finding a safe way to communicate your feelings is key.  When that is not possible, journaling is another useful tool.  Some other safe ways to express your emotions include physical activity such as running, jumping on a trampoline, hitting a punching bag, playing a sport, or doing yoga.  You can also convert negative emotions using creativity through gardening or doing art. Watching a sad movie and crying or watching a favorite comedy and laughing are great ways to release and feel emotions.

Having a pet to care for is also a great way to cope emotionally. We rescued a sweet little Shih Tzu during the pandemic, and she has been a lifesaver for our boys as well as Dr. G and I, by forcing us to take walks and get outside.  Speaking of the outdoors, nature has a very soothing effect for us.  Just a few minutes outside listening to birds singing their songs, watching a beautiful sunset, and taking in the sights of trees or cactus with age-old wisdom–all going about their lives and duties regardless of the pandemic–that is therapeutic!

Lastly, when you are feeling upset, angry, or sad about something in your life, helping others can be very impactful at elevating your own emotions.  Volunteering at a food bank, donating to an important cause, or helping a friend or neighbor can help turn around negative emotions. There is a lot of research on how helping others can improve your own level of well-being. There are brain chemicals released when we help others that bring us peace and happiness (for some fun neuroscience, check out  3 Specific Ways That Helping Others Benefits Your Brain | Psychology Today).  Our wellness center did a food drive last year for Chiro Cares day.  My kids were at home at the time and were not getting any social interaction other than our family and online classes. It was apparent that their mood and motivation was very low.  I insisted that they come with me to drop off all the food at the shelter.  I explained to them on the way that even though this is all hard for us, we are fortunate that we have food and a home, because many people do not. They reluctantly came along.  When we got there, I asked around about the center and mentioned that I brought the kids along to gain exposure on ways of helping. Fortunately, the Executive Director picked up on what I was looking for and gave us a tour of the building–where they keep the hygiene bags for the homeless that are lightweight enough for them to carry around, where the food is stacked on the shelves like a store, where clothing is ironed and put out on the racks to help to people in need feel the dignity of wearing clean and ironed clothes. We asked about children volunteering after the pandemic, and she gave us the details. When we left, the kids were pumped up and said they definitely wanted to volunteer as soon as it was safe to. I noticed for quite awhile that they had more of a sense of purpose and that they seemed to overcome their struggles a little easier. 

One would think that seeing other people struggling would make us feel more sad, but when we have the opportunity to help and do so, it actually makes us feel so much more than we did before! 

Your Physical Health

As mentioned several times, getting outdoors for some exercise is a great way to help your physical, mental, emotional, and spiritual health! Many Americans are deficient in Vitamin D, which is obtained from sunshine.  Vitamin D plays a large factor in our immune system.  Of course, with warmer summer weather in Phoenix, this means going out earlier in the mornings or towards sunset when it is cooler. Research shows that outdoor exercise can be as effective as antidepressants for mild depression and anxiety.  Any type of exercise is extremely benefits for overall health and for specific medical conditions. 

Your Spiritual Health

When I studied psychology with a top mood researcher for my undergrad degree, there was a finding that stood out in my mind–people with increased sense of spirituality had significantly better physical and mental health outcomes.  (Spiritual wellbeing and health | Michigan Today (umich.edu)

This may include religion, but can mean having any sense of purpose or belief in the meaning of life.  In either case, taking time to focus on our spiritual health which allows us to look at the bigger picture of life, can be very helpful during challenging times.  

On a spiritual level, daily meditation or prayer is, of course, ideally the best. If you struggle to meditate, there are several apps, such as Calm and Headspace, that have helpful guided meditations and calm music to make it easier for you.  Again, on a spiritual level, there is power in group prayer or meditation.  I was connected with a group of friends that did a 40 day spiritual journey in a text chain. We focused on different spiritual quotes each day and reflected on them together. This significantly helped me to deepen my spiritual growth and motivated me to continue.  It also changed my perspective from viewing the everyday stress from the pandemic to seeing life from a different perspective and shifted my focus to viewing all the wonderful, funny, and interesting things in life.  When we lighten our tight grasp on life, we work towards a more equanimous mind, allowing for more peace. 

It has been one of the most challenging years of our lifetime. With any challenge, we have a choice to use the situation to make ourselves stronger.  We can use this time to reassess our priorities and pave a healthier, more mindful path for our future that brings balance to all aspects of our lives. 

When it comes to dealing with the general aches and pains of daily life, issues surrounding the neck and shoulders are relatively common. According to research, approximately two thirds of the population will experience neck pain during their lives. On top of this, around 10% of all patients suffering with complaints will continue to encounter chronic discomfort.

The neck and shoulder area contains a number of bones, muscles, arteries, veins and nerves, alongside various ligaments and supporting structures. On a daily basis, our necks are consistently relied upon to keep our heads level and aloft as we focus on other tasks and move throughout our lives. Often, we don’t recognize the significance of this until pain starts to make itself known. Unfortunately, you can strain your neck muscles in numerous ways, from hunching over the computer at work, to bad posture at home.

Many existing conditions can lead to pain in the neck and shoulder area. Some of these conditions could be incredibly dangerous, such as major trauma or the signs of a heart attack, whereas other cases are less concerning, such as contusions or strains. In rare circumstances, neck pain can present as a symptom of more significant problems, and it is always important to seek medical care if your issues accompany shooting pains, loss of strength, or numbness.

Damage to the Soft Tissues of the Neck and Shoulders

The most common cause of neck and shoulder pain comes from injury to the soft tissues which can include tendons, muscles, and ligaments within the affected structures. Regularly, these injuries happen as a result of some trauma or sudden damage like whiplash, however, degenerative disc disease in the neck, can cause localized pain, and degenerative arthritis of the neck and spine can pinch nerves, leading to shoulder and neck pain. Less common conditions surrounding the heart, lungs, and spinal cord can also lead to pain in the neck and shoulders, including:

• Bursitis: The bursae in your body are fluid-filled sacs positioned over joints to provide a cushioning effect for the muscles. In some cases, the bursae can become stiff, swollen, and painful after injuries leading to chronic pain.
• Broken collarbone: If you fall with your arm outstretched at an angle, this can cause your collarbone to break – a frequent problem when cyclers fall from their bikes.
• Broken shoulder blade: Generally, injury to the shoulder blade is commonly associated with forceful trauma, and can lead to lasting pain around the neck and shoulder area.
• Heart attacks: Although with a heart attack the primary problem is within the heart itself, the attack can lead to neck or shoulder pain know as “referred” pain.

Whiplash Neck Injury

Whiplash is a neck injury that takes place as a result of a sudden jerking motion forwards or backwards. Generally, whiplash happens because of motor vehicle incidents, but it can occur in other circumstances as well. Regularly, whiplash can stretch across the upper back and neck region, resulting in a significant strain across the supporting muscles, discs, and ligaments.

The effects of whiplash can present in a number of different ways. The most common symptoms generally include dizziness, headache, stiffness, and pain. In general, recovery will depend on the extent of the injury and the person in question, but it can take weeks or months on average.

Usually, the best way to manage whiplash is through anti-inflammatory medication and gentle mobilization exercises. Most doctors recommend that patients continue to pursue their daily activities as normal to facilitate a faster recovery.

Neck Pain Caused by Posture Problems

Consistently poor posture can cause health problems, some of which may last longer than others. Slouching or bad form can lead to neck pain by placing additional strain on the muscles and ligaments around your neck and shoulders. Even standing with your shoulders slouched, or working with your head down for significant periods of time can lead to chronic neck and shoulder pain.

To avoid poor posture pain, try some of the following techniques:

• Be aware of your posture when sitting or standing, and adjust your position where necessary
• Make sure that your workstation is suitably organized to allow you to sit properly
• Frequently change positions and stretch while working
• Try to avoid sleeping on your stomach, as this can overextend your neck
• Exercise frequently for improved posture and muscle tone

Osteoarthritis

Osteoarthritis is one of the most common types of arthritis, and any person of any age can suffer with it. However, because the onset of osteoarthritis is a result of the altered use of joints throughout the body over prolonged periods of time, older individuals typically suffer more regularly.

Osteoarthritis is a chronic condition wherein the cartilage providing cushioning between joints starts to break down, allowing the bones to grind together. People suffering from this issue can experience symptoms of stiffness, muscle weakness, and pain, and the most commonly affected areas include the lower back, hips, knee, and neck. At present, there is no available cure for osteoarthritis, although approximately 27 million people within America suffer from this ailment. However, it is possible to manage the symptoms with regular exercise, as keeping your joints mobile and within their correct alignment is the best way to nurture the health of good cartilage.

Dealing with Neck and Shoulder Pain

There are many different examples of neck and shoulder pain, as well as various different causes. Often, the best way to discover which ailment is affecting you is to speak to a doctor or health professional regarding your symptoms.

In most cases, the treatment of shoulder and neck pain caused by soft tissue problems will include the use of anti-inflammatory medication and pain relievers. However, if the root of the problem is elsewhere, then your doctor will need to pursue different courses of treatment according to your specific needs. For example, in cases where the spinal cord or the roots of nerves have become involved, you may find that a surgical procedure becomes necessary.

Let us know what aggravates your neck and shoulder pain, and whether you’ve found any useful techniques for managing the problem.

Resources:

http://www.patient.co.uk/doctor/neck-pain-cervicalgia-and-torticollis
http://www.medicinenet.com/heart_attack/article.htm
http://backandneck.about.com/od/s/g/softtissue.htm
http://www.medicinenet.com/acute_and_chronic_bursitis/article.htm
http://www.webmd.com/pain-management/tc/referred-shoulder-pain-topic-overview
http://www.mayoclinic.org/diseases-conditions/whiplash/basics/symptoms/con-20033090
http://www.livestrong.com/article/437366-health-problems-from-bad-posture/
http://www.arthritis.org/arthritis-facts/disease-center/osteoarthritis.php

Last Updated on March 20, 2020 by Erchonia

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