New Year’s resolutions are an age-old tradition that can help boost motivation for creating new, or refreshing stalled, health habits. Maybe this year, you commited (again!) to losing extra weight, getting more sleep, upping your exercise routine or cultivating a meditation practice. Yet despite your good intentions, you find yourself losing sight of your goals or making excuses not to follow through when life gets busy.  You are not alone.  According to the US News & World Report, roughly 80% of New Years resolutions fail by mid-February.  So how can we truly increase the likelihood of sticking to our resolutions and making the changes we need to feel more vital and healthy?

Dr. Meghan Kemnec has insights based on her experience working with hundreds of patients wanting to make behavior changes to improve their health.  Here are Dr. Kemnec’s key strategies to making your wellness resolutions stick all year long:

Get clear on your “WHY”. General goals like “losing weight” or “learning to meditate” do not get to the root of your motivation for change. Instead of simply stating the outcome you want, dig deeper to find the emotional reason you want it. For example, you may want to lose weight so you have more energy to play and have fun with your kids. You would like to learn to meditate in order to feel less anxiety and more confidence in social situations. Focus on the emotions behind the behavioral goal and you will be more likely to stick to your resolutions.

Recruit a friend, family member or partner to support and keep you accountable to your goals. It’s easier to brush off or procrastinate our resolutions when we aren’t being held accountable. Having a support system is often the missing piece you need to keep pushing on when you start to make excuses or want to give up. Find someone in your life who will cheer you on and keep you inspired to reach your goals now matter what. And you can rely on your health practitioner to keep you on track as well!

Boost motivation and energy with food and supplements. What we eat affects our mood, energy and motivation and will often make the difference when it comes to reaching our health goals. Take the time to eat meals that include colorful fruits and veggies like bell peppers, kale, carrots and berries for vitamins and phytonutrients and nourishing, healthy fats like wild salmon and avocado for omega-3’s, to keep sustained energy and focus. You can also supplement with a high quality B-complex for extra mood, energy and immune support.  

Uplift with some daily sunshine!  During these darker and more cloudy winter months, it’s common to feel less motivated and even a little blue. A quick way to combat that feeling and boost your mood is to get outdoors in the sunlight. All it takes is 15-20 minutes to feel a lift in your mood and energy, so go for a brisk walk outside at lunch time or sit outside in the sunshine during a break in your day. And if you find it challenging to get outdoors, taking a quality Vitamin D supplement (preferably with K2) may also enhance your energy and mood to keep you on track with your health goals!

Dr. Kemnec and the Peninsula Integrative team encourage you to follow these suggestions to help you refresh your motivation and keep you inspired throughout the year!

Uncategorized

Many of our patients are new to telemedicine. Here’s how it works!?

This guide is meant to help you make the most of your telemedicine visit and to answer some frequently asked questions about telehealth.

 

Scheduling Your Telemedicine Appointment:

You can schedule your visit three different ways:

  1. Schedule your visit by visiting the “Appointments” tab of our website.
  2. Call our office at 650-485-2758.
  3. Email Front Desk within Charm or office@peninsulaintegrative.com.

Preparing for Your Zoom Video Telemedicine Appointment:

  1. New Patients: Fill out all questionnaires online within the Charm patient portal. You can also upload and share recent lab results with your doctor ahead of your visit.
  2. Check your email confirmation for instructions on downloading the zoom app to your phone or computer.
  3. Download the Zoom app at least 10 minutes before your visit. If you are prone to technical challenges, you are welcome to enlist our office staff to help you try out Zoom ahead of your appointment.

Starting Your Telemedicine Appointment:

  1. Click the link (from your confirmation email or text) for your doctor’s Zoom meeting room 2-5 minutes before your scheduled visit time
  2. Your doctor will admit you from the virtual waiting room once it is time for your visit.
  3. Don’t forget to share video and audio with your doctor. Zoom will prompt you to select these options automatically.

During Your Telemedicine Appointment:

Just as we would in an office visit, your doctor will review your current symptoms, lab results, and relevant history.

Your doctor will perform any physical exam that can be done remotely, including a visual inspection of skin, a blood pressure check, or recording your own temperature, depending on the tools you have at home.

Your doctor will explain additional labs that should be performed to help with diagnosis. If this is your first visit, your doctor may defer extensive supplement, lifestyle, or medication recommendations until they are able to determine the complete picture. During a follow up visit, expect your doctor to make detailed recommendations to address symptoms and their underlying causes.

Your treatment plan will be reviewed with you at the end of your visit and will be sent to you in the Charm portal.

Lab orders will be created in the Charm portal and shared with you under Lab Order or Documents. Blood work orders can be printed at home or shared directly with the lab if you have included your insurance information in the Charm patient portal. Lab kits from third party labs will be shipped directly to your home.

Your doctor will enter all supplements recommended into our online dispensary, Fullscript, for you to process orders on your own or you can get them from our office. If you prefer to have our front desk ship supplements to you, this will be arranged at check-out.

Following Your Telemedicine Appointment:

Our front desk staff will call you to process your check-out and schedule your follow-up visit. They will review any lab processing questions and can help to arrange shipment and processing of supplement and prescription orders.

Your superbill, which has detailed codes for insurance, will be processed within 2 days of your visit and can be submitted to insurance for reimbursement, depending on your insurance plan.

You may as always check-in with your doctor via Charm messenger if you need clarification of your plan, labs, or prescriptions.

FAQs

What is telemedicine?

Telemedicine is the delivery of health care services and health care related information using equipment that can allow for communication between patients and healthcare providers and even healthcare providers exchanging information to provide better access to healthcare services. This work is done using technology over the phone or internet, using home or cell phones and tablets or computers.

Why Should I use Telemedicine?

Visiting the office is not always easy or convenient, especially during a viral pandemic. The purpose of telemedicine is to improve the opportunity to get healthcare quickly from the safety and comfort of your desired location.

What are the benefits of telemedicine?

The benefit of telemedicine is less waiting and travel time, less time away from work, and increased comfort and security. Examples of telemedicine include a video chat for mental health care, evaluation of a sick child by video, or taking a picture of a skin problem and sending it to your doctor for an assessment.

Is telemedicine safe?

Telemedicine is a safe and an effective way to extend the delivery of health care. It may not be appropriate for ALL clinical situations and a medical professional can help you determine if telemedicine is appropriate.

Guidelines also exist for telemedicine to ensure safety and quality. Clinicians are held to the same standards of care through a telemedicine visit as an in-person visit. Similarly, the same standards for privacy and confidentiality for an in-person visit apply to telemedicine. For more information, click here.

Zoom is a HIPAA-compliant platform. However, at the time of this pandemic, privacy guidelines are being relaxed to allow for access to telemedicine if needed via Facetime or Skype. We still recommend a HIPAA-compliant platform when possible.

Do health plans pay for telemedicine services?

?Health plans, including Medicare and Medicaid, are covering a wide variety of healthcare services available through telemedicine. To find out if your health plan covers telemedicine services, please contact your health plan. You may learn more about telemedicine by visiting http://www.americantelemed.org/about/telehealth-faqs-

Expanded coverage for telehealth is currently being promised due to the COVID-19 pandemic. We still encourage you to check with your insurance provider.

Reference: http://www.wsha.org/wp-content/uploads/Frequently-Asked-Questions-about-Telehealth-for-Patients-June2017.pdf

Uncategorized

By Dr. Meghan Kemnec, ND

February 27, 2020

COVID-19, or Coronavirus, is a virus that is likely to spread into communities in the coming weeks in the US, with the first confirmed case of unknown origin diagnosed in Northern California just yesterday. It is important to note that most people with Coronavirus exposure recover after experiencing only mild flu symptoms.

This article details some of what you can do to prepare your families to maintain health and reduce discomfort in case of a pandemic.

Healthcare Professionals, Epidemiologists, and CDC representatives are recommending the following:

  • Frequent hand washing. As always during a flu season, we should wash our hands very regularly and especially before eating.
  • Wear a mask if you are ill or expect to be in close contact with those that could be ill. A recent study has shown that a surgical mask is just as effective as the N95 respirator for preventing the spread of flu. If you can’t find the N95 mask now due to high demand, a surgical mask and good hand washing technique should be protective.

What to Do to Prepare at Home:?

  • Make a back-up plan for school and day care in case of closures.
  • Talk to your employer about the possibility of working remotely in case of a large epidemic.
  • Consider stocking up on essential supplies like food and medicines in case of a disruption to supply lines. Experts advise keeping a 30 day supply of non-perishable food items as well as any daily medicines on hand in case of store closures or interrupted supply from China.

How to prepare your immune system to prevent catching a stronger case of flu or coronavirus:

As of now no vaccine is available for this coronavirus, but we can take regular precautions with supplements, healthy diet, and sufficient sleep.

Diet and lifestyle guidance:

  • Eat soups and meals cooked with garlic. The lectin content is naturally antiviral.
  • Focus on healthy, well-balanced meals that incorporate fruit, vegetables, and protein.
  • Drink water! Hydration is key to maintaining robust immune function.
  • Getting sufficient sleep, at least 7-8 hours is also advised to allow for cellular repair and immune competence.

Recommended supplements for immune support generally include Vitamins C and D.

  • Most adults can safely take 1,000 to 3,000 mg of Vitamin C daily in divided doses and 2,000 to 4,000 IU Vitamin D to strengthen immunity against a virus.Children might take as much as half these doses for prevention. Talk to your doctor about the doses that are right for you and your family.
  • Herbal therapies that are often both effective against viral infection and safe for children and adults include elderberry, echinacea, garlic, and stinging nettle.
  • Additional supplements like higher dose vitamin A, licorice, skullcap, and zinc may also be effective against this year’s Coronavirus.

Talk to your naturopathic doctor about safe doses of these herbs and nutrients, especially if you are pregnant or breastfeeding.

Symptoms of this virus include: fever, cough, and shortness of breath, and may develop within 2 and 14 days of exposure.

If you are sick and suspect coronavirus due to exposure risk, please stay home and away from those who are not ill. If you need medical care, contact your doctor for a telemedicine visit, or if your condition is serious with high fever that won’t come down with OTC remedies, head to an urgent care wearing a mask, and let them know you suspect the virus. If you are having difficulty breathing, call 911 and let them know you suspect the virus.

At risk populations:

Young children who participate in school or day care situations seem to be at a lower risk in general of serious effects like pneumonia from this Coronavirus, as they are commonly exposed to other coronaviruses on a regular basis and, therefore, have strong immunity to COVID-19.

Pregnant women are at slightly higher risk for complications due to reduction of immune competence during pregnancy, but no studies exist yet on any negative effect for baby.

Adults older than 30 may have a less effective immune response to coronavirus, with smokers over 70 being at the highest risk for complications related to lung damage.

Severity and prevalence of COVID-19 as of Feb 27, 2020

80% of people infected seem to experience mild symptoms. There is currently about a 2% mortality rate.

There are currently over 80,000 cases internationally, most in China, with new cases in China falling and International incidence rising. Italy has over 600 cases, and the US has between 14 and 15 cases now, with 445 people tested and 8,000 under monitoring.

References:

https://jamanetwork.com/journals/jama/fullarticle/2749214

https://www.datapunk.net/covid19/antivirals.pl

https://www.cdc.gov/media/releases/2020/s0226-Covid-19-spread.html

https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html

https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html

Functional Medicine, Holistic Nutrition, Immune Systems

With a surge in recent advertising of gluten and dairy free foods, so many people are now wondering about food allergies. They wonder if they have food allergies, and if they too should be avoiding certain foods to improve their health. This can be a confusing topic, and this article is designed to help you understand the difference between allergic food reaction and food sensitivity or intolerance and whether you might benefit from food sensitivity testing.

To answer this question, it is helpful to understand a little about our IgA, IgE, and IgG immune responses. IgA, IgE and IgE refer to immunoglobulins, or antibodies. These antibodies are part of our immune system, and are produced in response to things we come in contact with on a daily basis. Our bodies make antibodies to foreign substances like bacteria and viral cells, but can also respond to foods, dust, dander, and pollen. Antibodies help the body mount an immune system response (‘fight’) against foreign invaders.

IgA and IgG reactions are known as delayed response reactions, that include food sensitivities, where IgE responses are immediate and are considered a true food allergy. IgA and IgG reactions may not happen immediately, but can take hours to days to show up in your skin or intestines, and cause symptoms related to inflammation like headaches, fatigue, brain fog, or joint pain. People with food intolerance may experience digestive upset like nausea, constipation, or diarrhea, or skin itching and rashes including conditions like eczema and psoriasis.

IgE Reactions

IgE immediate hypersensitivity reactions are characterized by the hives, and throat swelling that accompany anaphylactic reactions some people experience when exposed to certain foods. Other symptoms can include wheezing, coughing, a runny nose, vomiting, swelling of the lips or tongue, tearing or redness of the eyes, or even a weak pulse and loss of consciousness. Common foods that trigger IgE reactions are peanuts, shellfish, egg, dairy products, soy, tree nuts, wheat and fish.

IgA Reactions

IgA immunoglobulins are present in our mucus membranes and helps us fight bacteria and viruses. IgA increases in response to foods when the foods we eat cause inflammation, and in response to stress, disease, or alcohol.

IgG Reactions

An IgG reaction to food proteins suggests tolerance related to immune cell reaction. Repeated exposure, inflammation, and immune reactivity contribute to sensitivity and high IgG in response to food proteins.

Testing for Food Allergy and Sensitivities

We test for IgE allergic reactions with skin prick or patch testing as well as blood testing to know what foods and other allergens must be avoided and when an Epi-pen is an appropriate prescription.

While you can test IgG and IgA for rood reaction, this is not diagnostic of hypersensitivity or allergy, but sensitivity and intolerance, as well as inflammation. While blood testing is available for food sensitivity reactions, these tests are controversial as the results are commonly not reproducible and are not as reliable as elimination diets for uncovering food sensitivity.

What About Celiac Disease?

If it seems like everyone has a gluten intolerance these days, you may find you are just gluten sensitive through IgA and IgG testing. If you are not diagnosed with celiac disease, you may be gluten sensitive and not gluten intolerant. Those who truly have an allergy to gluten have celiac disease, which is caused by an autoimmune response to proteins found in wheat and some other grains, and harms the cells of your small intestine. Testing for celiac disease is done with a blood sample looking for more specific immune reaction to gluten and gliadin and confirmed with a biopsy of the small intestine. For more information about wheat allergy vs. celiac disease please see the article Should Your Child Avoid Gluten?

Why would you consider testing for IgA and IgG food sensitivities if the tests are not 100% reliable?

  • You like to see laboratory data with recommendations for how to proceed.
  • Your friend or family member did the testing and it helped them to feel better.
  • An elimination diet may not work for you for one of these reasons:
    • They are time consuming and can take months to go through the process of eliminating and then challenging foods.
    • You have a picky/growing kid who already avoids some foods. You don?t want to restrict calories, or risk food aversion, or tension that can go along with an elimination diet.
    • You are busy, enjoy eating out, or don’t have time to cook, and have limited time for the shopping and meal planning that is required to follow a restricted.

If food sensitivity testing seems like it might be a good fit for you, or if you prefer to try an elimination challenge diet to address your symptoms, see one of our doctors to help you navigate the world of food reactions.

Functional Medicine, Holistic Nutrition, Immune Systems

Looking for a naturopathic approach to treating your child’s headache? First make sure to rule out the common causes of headaches, and take a trip to their doctor if necessary. Next, figure out your child’s headache triggers. Finally, check out some excellent natural remedies for headaches. Combined this approach can be very effective for treating common headaches in kids.

Common causes of headaches in kids

Common causes of headache are dehydration, illness, especially fever and stomach bugs, allergies, and stress. Kids may often experience headaches related to constipation. The cause of a headache should be evaluated by a trained professional. If your child frequently experiences headaches, is having their very first headache, or is under 5 years old, you should see your child’s physician. Headaches related to head trauma, neck pain or stiffness, or with rapid onset and worsening warrant a trip to your pediatrician or the ER. As always, the information contained in this post is not intended to take the place of care from your pediatrician.

Some great natural headache remedies are homeopathics and topical essential oils, but before we get into that let’s address the basics.

First: Keep a diary

Keeping a daily headache diary can be a great way to figure out possible triggers. Write down (or have your child write down) each time they get a headache. Write a log of all the foods they have eaten, amount of water or fluids consumed, supplements or medications taken, and anything else that may have affected the headache. Triggers can include foods (like those listed under ‘Migraines’), artificial colorings, flavorings, carrageenan, or preservatives. Other triggers can be things like social stress (e.g., the night before a big test), too much TV/screen time, lack of exercise, poor posture, and many others.

Foundations of Health

Food and water are a great place to start.

  • Hydration: Many of us are so busy that we forget to drink water, and kids are especially prone to forgetting to take a break and drink. How much water do kids need? A good general rule for hydration is half their weight (pounds) in ounces of water.
  • Food: Teenagers and picky kids commonly skip breakfast, and all kids may be susceptible to headache from low blood sugar.

Homeopathic Remedies

Two homeopathic remedies that commonly are effective in treating headache are Natrum-muriaticum 6c and Belladonna 6c. If you have on hand, give 5-6 pellets, under the tongue. Wait 15 minutes and re-dose if no relief, switch to the other remedy.

How to choose a homeopathic remedy for your child’s headache:

  • Belladonna 6c is indicated when the headache is accompanied by signs of illness like high fever and congestion. Always follow guidance from your doctor to address fevers over 104F.
  • Nat-mur 6c is indicated when headaches are brought on from sun exposure, or along with menses, and with migraine.
  • Chamomila 6c is indicated if the child is exceptionally fussy
  • Sulphur 6c is indicated if your child is sensitive the heat or sun

Essential Oils

Essential oils like peppermint and lavender can be great for headaches related to stress. These should always be applied with a carrier oil such as olive or coconut oil for dilution and never given internally. Dilute one to two drops of essential oil in 2 tablespoons of carrier oil and gently massage into temples or at base of neck. When purchasing essential oils, look for organic oils that are unadulterated. Remember that inappropriate use of essential oils can lead to seizures in kids, so use carefully.

Migraines

Children and teens with migraines may complain of light sensitivity, nausea, and dizziness. Once you have consulted a doctor for proper diagnosis, you could try the following dietary changes. B vitamins may help with symptom control and are found in foods like leafy greens and bananas. Avoidance of likely trigger foods including aged cheeses, nuts, vinegar, soy, citrus, and chocolate may help to avoid onset.

Functional Medicine, Holistic Nutrition, Integrative Pediatrics