Amazing Book I am currently reading.....The Virgin Diet

I have had a several months of all work and no writing and have missed blogging.  I have to share with you abou this amazing book I am currently reading. Check out The Virgin Diet at www.jjvirgin.com.

I can tell you that what JJ has written about in this book is EXACTLY what we teach our patients at  Cool Springs Family Medicine www.csfmed.net on a daily basis! Cut out the gluten, dairy, soy, corn, eggs, sugar/yeast, peanuts and you being to see the gut heal and the weight come off. As well as the joint pain, fatigue, foggy headedness, bloating and many other symptoms begin to resolve! Add digestive enzymes, probiotics and eventually IgG good sensitivity testing to the treatment and people begin the journey to health and healing.

As healthcare providers, we have to begin to address the root of the these chronic illnesses we see on a daily basis. And personally I believe that the gut is starting point.  It's true that a week gut equals a weak immune system. The research is abundant on the gut and brain connection.

Looking forward to finishing this book and writing a blog!!  Ask for this book for Christmas...you won't regret it.  A client at the hair salon I was in today overheard me telling my stylist about the book and beginning to clean up her diet...the client asked to see the book (since I had it in my bag for reading under the dryer), when she gave it back she said she felt like it was "written just for her"..... I believe it, and you will too!  I don't know JJ Virgin, and I certainly don't make a penny on promoting her book, but I would hope she would do the same had I written the book and she believed in it as much as I do!

I am finishing this book by the weekend so I can get this next blog written and get the word out to my patients that hear me speak on this daily!!

Happy reading!

Blessings, Dani

Hope for Hashimoto's workshop February 25, 2012

You do not want to miss this workshop on the number one undiagnosed autoimmune disease in the country! I have had great success with using Dr. Haskell's protocal and treatments with my patients. I am honored that he has agreed to speak to our patients and the public concerning this epidemic in the United States.  Come listen to his research and clnical pearls in person on February 25,2011! 

Hope to see you there!  Dani

Using NAC with Trichotillomania

The use of NAC with Trichotillomania: Trichotillomania is a psychiatric condition characterized by repetitive hair puling that produces noticeable hair loss. The preferred treatments and those most studied in the past have been cognitive behavior therapy and SSRIs (Sertraline). Both have shown improvements in patients with a combined CBT and SSRI the most beneficial (2). A recent study in 2009 showed promise with using N-acetylcysteine for the treatment of trichotillomania (1). NAC is a non-essential amino acid that is precursor to glutathione (the “mother” of all antioxidants that mops up free radicals in the brain) in our bodies that appears to restore the extracellular glutamate concentration in the nucleus accumbens. Therefore, offering promise in the reduction of compulsive behavior in patients. NAC is used for acetaminophen toxicity, chronic bronchitis as well as a mucolytic agent by inhalation in Mucomist I use NAC daily in my practice for my Hashimoto’s patients as a precursor for glutathione and to decrease inflammation. I had never used NAC for trichotillomania until recently. I had a patient in her 20’s present with a history of trichotillomania that developed while pregnant two years ago. When she came to see me she had completely plucked her eyebrows and eyelashes out. No prior history whatsoever of trichotillomania. I was at a loss for what to do. On exam she had barely any eyelashes left on top or bottom and a few stray eyebrows. Exam otherwise was completely normal. She explained how plucking felt “good” and there was no pain involved with it. She has no prior psych history. She is unsure what provokes the plucking but was clearly seeking help with stopping this clearly physically scaring condition. A recent article that Dr. Kalb was familiar with discussed the research on using NAC during a double blind placebo controlled study for trichotillomania (1). The study showed that using NAC (1200-2400 mg/d) had led to statistically significant reductions in trichotillomania symptoms. We started her on NAC 1200 mg daily as well as an herbal anxiety control supplement. On her 12-week f/u appointment she reported pain with plucking for the first time and therefore a decreased desire to pluck. Her eyelashes and eyebrows were growing back in as well. She continues to take NAC as well as the herbal anxiety control. 1. Grant JE, Odlaug BL, Kim SW. N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2009 Jul;66(7):756-63. 2. Dougherty DD, Loh R, Jenike MA, Keuthen NJ. Single modality versus dual modality treatment for trichotillomania: sertraline, behavioral therapy, or both? J Clin Psychiatry. 2006 Jul;67(7):1086-92.

The Happiness Hormone: Pregnenolone!

"I have air in my testicles"...and yet another translation situation in Honduras!

Honduras July 14, 2011
“I have air in my testicles”

Today was our last day in the clinic in Duyure. I was blessed to go on a food delivery trip to 6 of the families in the village. That was an amazing experience to be welcomed into the homes of these sweet, sweet people. I had several patients I had seen in the clinic that hugged my neck and one even pulled out of her bra my notes that instructed her to return today for her repeat blood pressure!! It was precious.

My little boy patient with the 544 blood sugar yesterday returned this morning with a fasting BS of 99! I was thrilled….but the reality is that this was just one day with increased insulin….and no way to get the insulin on a regular basis. The reality of his situation and so many others breaks my heart.

The patient that stole my heart today was an 83 year old cowboy that came in with a big sombrero, plaid shirt, jeans and a big buckle on his belt . He came walking in and sat right down and plainly said that “I have air in my testicles”! As he very graphically continued to show me, as if I didn’t know where his testicles were located. I happened to have two observers from the education team in my room at the time that were sitting there with their mouths open, about to laugh out loud! My sweet, sweet MaryLeigh the interpreter, never flinched and continued to ask him the questions I was asking. He flat out stated that “I pee straight, but there is air in my testicles”. We don’t do prostate exams, but I symptomatically treated him for a prostate infection

The next patient had a “bump in her anus” and it hurt to sit on the chair, and had told us that she had not had a bm in 15 days!! On further investigation, she has had a bm recently but there was pain and a “bump”. This is an elderly lady and I was worried there might be a fistula or the very least a large hemorrhoid . She had a tiny, tiny external hemorrhoid. We had no Preparation H or Tucks for her. When she left she hugged my neck and said “Mucho Gracious for looking at my butthole”! Of course Maryleigh translated exactly what was said!! Everyone in the room busted out in laughter!

The clinic was being broken down and myself and another provider were still seeing patients that had waited for 10 hours to be seen. We didn’t turn one patient away during our 4 days.

We haven’t had internet for 2 days in the pasada and I find myself grumbling about it. This morning as I am typing yesterdays events I realized that as I silently grumble about the 1 ½ hour ride each way up/down the mountain, the lack of vegetables, the heat, the critters in our cabin etc, and the lack of internet, that in reality I am nothing but a spoiled baby. I didn’t walk 4 hours to get to the clinic with no water to drink, I have enough money to feed my children, and buy their medicine, a car to drive with air conditioning… and thank God I do, so that I can use my resources to be able to serve others that can’t.

"I feel like a cow"...and other funny translations from Honduras 2011

Honduras 2011
Day 3, July 13, 2011
“ I feel like a cow today”


I cried today for a patient that only has salt wrapped in corn tortillas for food. Her son was in the area beside of us with malnutrition and they were working on getting him a nutrition consult and a delivery of food bags that will feed him for one month. I learned from Meridith the local Missionary with Mission Lazarus that salt wrapped in corn tortillas is the food for the “poorest of the poor”. The salt gives them a feeling of fullness and there fore they can continue to work and do their chores. I was devastated and had to look away to keep from breaking down in front of her.

The other patient today that broke my heart was an 11 year old boy with a blood sugar of 544!! Over 126 is not acceptable with a fasting BS check. He is an insulin dependent diabetic and only has ½ vial of insulin left to use until his doctor appointment in September, 4 hours away!! He doesn’t have strips to check his BS daily due to cost. We have no insulin in our formulary. I went to get Dr. Stephens, Meridith and another provider to assess him. No DKA or dehydration. We are working on getting him insulin, but with his newly increased dose twice daily, his ½ vial will not last long at all. Another story that is very difficult for me to absorb!! My heart broke for the mother as we told her we didn’t have insulin but would do our best to find some in the pharmacy in San Marcos. He is coming back in tomorrow for another check to see if his increased insulin was sufficient. I can’t imagine the pain that these mothers experience daily knowing that they are unable to meet the needs of their sick children. We are so very blessed to be able to pick up our prescription at the local pharmacy and go on our way!

The funny story of the day was when my interpreter was giving me the symptoms of my patient and then all of a sudden with headache, stomach acid, low back pain she says “and she feels like a cow today as well”! I guess my face was frozen and then I burst out laughing! Margaret said she swears that what the patient said, but with further questioning, somehow “I vomited today” was translated into “I feel like a cow today”. A much needed burst of laughter indeed! I told her that I too feel like a cow with all of the carbs that I have been fed since arriving in Honduras!!

I am typing this in the dark, since the power and the internet are down tonight, a nightly occurance apparently. At least I didn’t walk 4 hours each way to get here with nothing but a salt tortilla and no water to drink along the way…..and I complain about no hot water! Looking forward to what tomorrow brings. Keep praying for the people of Duyure, Honduras and our safety each day.

Blessings, Dani

Duyure Honduras: Day 2

Honuras Medical Mission Trip
Day 2: July 12, 2011


We are in Honduras in the rainy season and had a torrential downpour last night that made travel up the mountain today scary for our bus of gringos….but we made it without a hitch! We started a bit earlier today and had 250 scheduled to see.

I had a new translator today and it takes a while to get in sync with each other and find a flow that works for both of us…but we came together quickly and I was thrilled with our day of seeing patients. I saw lots of ringworm on the body and scalp today as well as fungus on the feet (athletes foot). We had a patient with blood sugar of 408 and BP of 160/102 who walked 2 hours to get to the clinic today! I brought Dr. Stephens in on her consult and we are so limited in diabetes medication that we gave her what we had, but are hoping that Mission Lazarus can find her the Metformin that she needs to help bring her diabetes in control….the Honduran diet is not diabetes friendly at all. Therefore speaking to the patient about a low carb high protein diet is not beneficial. They don’t have fresh vegetables like us and have a bean, rice, corn tortilla diet. The teaching is challenging and frustrating as a provider!

My favorite patient today was a little boy whose mom is very concerned because he doesn’t’ seem to “focus” in class and has a hard time getting his homework. She has taken him to several doctors and no one has addressed his issues. She wanted to know if he was “born this way”? He was clearly not focusing on our visit, but when I asked him what he wanted to be when he grew up he told me a “pilot” and wanted to learn his lessons. This is another case of no way to really change his diet, and put lots of good vitamins and minerals in his body as well as get him the help he needs to be able to focus. I felt so sorry for the mother who clearly wants to help her child learn and do well in school.

Of course as we were getting ready to leave the clinic today, we had another downpour and we were all piled in the bus for our 90 minute ride back down the mountain when we got stuck!!! All the men got out, the women went to the back to weigh the bus down (no jokes please)….and 20 minutes later, several wheelbarrows of sand, some wood planks later we take off and then slide sideways and busted the top off the water line and up shot a flow of water that who knows how long it took to turn it off! When we pulled out of the clinic, the men were working frantically to turn off the water from the street! Seems that nothing is easy!! And we slid back down the mountain!

One scorpion on the back of one of our leaders at dinner and a nice thunderstorm later….we are ready for bed and day 3 of this adventure!!