A Running Doc’s Life: Making Progess…One Day at a Time!

Slowly but surely, with a lot of help from Sarah, I continue to keep making progress as I continue to recover from the last few weeks. My workout now is walking 1 mile a day, at a 20 min mile pace. A far cry from what I usually do, but I am literally starting over. I am glad I have the opportunity to start over.

It was easier to get motivated even to go walk a week ago. The bike trails were all clear, the grass was clear of snow. It was great to get back outside and enjoy Spring for once! But even that had to change!

Getting 25 inches of snow will put a change in the routine of walking outside. At least I have a treadmill at home!

The treadmill is ok, as long as the TV is on, or I can listen to music. But, nothing compares to being outside. Hopefully this recent snow won’t last very long, as we all can get back outside again.

I guess overall it is no different when it came to exercising prior to having this recent illness. I am just at totally different levels of achievement at this time compared to previous. But it really is not any different. There is always some degree of discomfort. That is not always a bad thing. If things really hurt trying, nobody would do it. But, in order to keep progressing forward, there are always little obstacles in the way. Work, responsibilities…time. It still boils down to excuses. Time to decide what is more important to you, and to also ask yourself what are you going to do about it? Are you going to sit back and take it easy, or work for something you want to achieve? It truly comes down to choice…and are you willing to take a chance? No more excuses. The world is already full of excuses. Take control, and be the one in charge!

Spend time with friends. We have no idea when one of us may not be in the picture anymore! And remember, if you are trying, and moving, progress is still progress!

You never know what you have the potential to achieve until you try. Unless you try, you will never know. Never give up on yourself. If you truly can’t count on yourself, then who can you count on?

Never, ever forget this! When you move forward, you will continue to move forward. Keep moving everybody!

Dr. Dan

Consecutive Exercise Day…new streak: Day #15

Easter Baskets the Healthy Way!

Easter Basket with Easter Eggs --- Image by © Royalty-Free/Corbis

Do you have your Easter baskets all ready for the little (or big) kids in your life? Easter baskets are usually filled with all kinds of goodies and I like to think of them being just as exciting as getting your Christmas stocking! My family has all kinds of funny stories about the big search for finding our Easter baskets and of course what we find inside is even more exciting! The candy aisles at the store are filled with all kinds of goodies, but let us not forget that there are plenty of other non-junk food options to fill your Easter baskets with. Here are some ideas for you:

  • Sidewalk chalk
  • Color Dotz by Crayola (color your bath water with them!)
  • Books
  • Coloring books
  • Stuffed animals
  • Sunglasses
  • Shoes
  • Socks
  • Hair accessories for girls
  • Mini cars or planes for boys
  • Nail polish
  • Gift certificate to the movies or iTunes
  • Magazine subscription
  • Jump rope
  • Yo-yo
  • Pencils, crayons, markers

Kelsey Raml, MS, RD, LN

Meal Replacements: Good or Bad?

I often get asked about meal replacements such as Boost, Atkins, Slim Fast, Ideal Protein, etc. Are they good?  Should I use them? What kind? etc…

The Academy of Nutrition and Dietetics does approve the use of meal replacements for weight loss efforts: “Several studies comparing isocaloric diets have shown an equivalent or greater weight loss efficacy with structured meal replacement plans, compared to reduced calorie diet treatments. One or two daily vitamin- and mineral-fortified meal replacements, supplemented with self-selected meals and snacks, may be a successful weight loss and weight maintenance strategy for overweight and obese adults who have difficulty with self-selection of food and portion control.” (http://www.andeal.org/topic.cfm?cat=2886&conclusion_statement_id=250237&highlight=meal%20replacements&home=1).

The key words are one or two replacements/day, not your whole day and paired up with a well-balanced, calorie reduced diet. I typically recommend the use of these for the meal when the individual is on the run the most. Sometimes you are rushed in the morning to get to work or school and don’t have time for breakfast, in this case, a meal replacement may be a good idea…or maybe it’s lunch as you only get a short break and a meal replacement might fit in well here. The biggest thing to remember is you are drinking your meal, not eating it. Some people are truly satisfied this way and others are not. Personally, I do not use meal replacements because I know I need to “eat” my food to be satisfied rather than “drink” them…when I drink something, I feel like I still need to eat thus a meal replacement would only add more calories! Another reason why I don’t do meal replacements is I prefer real food. I would rather eat whole food than drink a supplement….but that’s just me. 🙂 One more thing to consider is they are typically around 150-200 calories. This may not be enough for a meal, so you may consider adding a piece of fruit, salad, or yogurt to it to give you a little more substance.

Meal replacements do have a place in our society for helping people manage their weight, but there are many kinds so it’s important to check out the ingredients, nutrients, and prices. If you notice a really long ingredient list, there is more “stuff” added to the product and then you need to consider if you really need all of that extra “stuff.” Some ingredients can affect your body in certain ways, so you may need to check with your physician, pharmacist, or dietitian to ensure it is safe to consume. Costs also makes a difference. You have to remember that these companies are trying to make money off of you, so consider cost and value when you make your selection.  In addition, it’s important to consider that a well balanced, portion controlled, healthy meal of real food can be cheaper than some supplement drinks! If you have any specific questions regarding choices, selections, or even disease states and the use of these, don’t hesitate to contact me. I’m here to help you as your credible and reliable nutrition information source!
-Kelsey Raml, MS, RD, LN

A Running Doc’s Life: How My Life Changed Overnight!

Well, I have now been home for over a week, and am starting to make progress. My weight dropped to a max of 14 # loss, and is now leveling out. I can finally start eating, but not everything I want yet. I could not eat anything for 5 days, and then after that it was just toast and bananas. It started out Sunday March 24. 5AM. I just had gotten up to go to the bathroom. No changes. Heading to the sink, when all of a sudden it felt like I got hit in the right side with a baseball bat, and fell to the ground. Then the vomiting started. The pain eased up following this, but then the next 3 hours it kept coming in waves, and more frequent. We were to go run with the run club at 7AM, and I told Sarah to go. I thought I just came down with the flu. She had her phone with her, and at 7:40 I called, and told her to come home to take me to the ER. I could not take the pain anymore. We made our way in, and had labs, CT scan of my abdomen, thinking then it was my appendix. The ER doctor came in to tell us my appendix was fine, but I infarcted my right kidney. That means the blood flow was cut off to the kidney by a clot, and it looked already at that point that I had lost 90% of my right kidney. Next thing is we are in the ambulance to SF (Fast!) to the vascular surgeon at Avera Heart Hospital. We do not have a vascular surgeon in Watertown. This surgeon literally met me in the garage of the hospital as they were taking me out of the back, and telling me all of the ramifications of this, and if there was going to be a chance of saving anything of my kidney, we need to go to the cath lab now and try to remove the clot. Away we went! He was able to remove some of the clot, and then I had a “clot buster” infused through my femoral artery for the next 27 hours, having to lay flat on my back and not move at all! That was beyond word description. I hope to never have to do that again.

This was the picture at the beginning with the clot in my right kidney. Not a lot of blood was flowing through.

This was my kidney after 27 hours of the “clot buster” TPA. I had improved blood flow quite a bit. It helped. I don’t know yet how much it helped…time will tell. But for now I have something of a functioning right kidney.

So how did this happen? All that time I had laying flat on my back helped bring it to light. We had gone to Jamaica the 3rd week in February, so we had a long flight. Also, I was wearing a night splint for my right foot to help with my plantar fasciitis. Well, between the 2, it was enough immobility for me to create a clot with in my right leg. I had pain for a few days after we returned, but no swelling. Usually there is swelling with a clot. At any rate, I thought it was muscle, and kept running, biking, swimming…all of my usual daily things. So, several tests later, they found I had a clot in my leg, and also a defect in my heart called a Patent Foramen Ovale: PFO. It was present since birth, but no issues…until now. What happens with the PFO is you can have what is referred to as a “paradoxical embolus”. The blood clot moved up from my leg, to my heart, and from there is very common to go to the lungs, and you have a pulmonary embolus. If you have a PFO, the clot moves from one chamber, the right atrium, through to the left atrium, and back out through the arterial system…to lodge somewhere else. By far and away the most common is presentable by having a stroke–up to 75% of the time. In my case, going to the kidney, it occurs 1% of the time. 1%!!! I guess I feel lucky. I have 2 kidneys, but only one head. This could have resulted in far more significant problems. But now the PFO had to be fixed, or it would keep happening!

They have a device that they deploy into the defect of my heart to fill the gap of this PFO. This is what it looks like.

This is what is looks like in a diagram of the heart closing the PFO. Thank God for modern medicine. This device going through the femoral vein in my leg to my heart first began undergoing trials for use in 2012. If this would have happened prior to then, I would have had my chest opened up in order to fix it. Now it was an hour procedure, and if everything went well, home the next day!

This is how it looks in me! It worked! Other than getting rid of the nausea and vomiting, and trying to gain strength, it was a matter of time for it to heal. I am currently on multiple meds, including multiple blood thinners for awhile. I can walk, but no aerobic activity for minimum of a month, but have been told once this all heals up, I can run marathons again if I want too! What am I going to be able to do running with no hole in my heart anymore? I am learning to be on the other side…the patient side. It is very humbling!

I appreciated all of the texts, emails, notes, cards while gone. Jill and Tim Makepeace had these cupcakes delivered. Sarah and the kids loved them, and I saved one for me later to have, but just could not eat anything with the nausea and vomiting. The nurses taking care of me got to enjoy the rest, so then they kept an even closer eye on me after that! My consecutive streak came to an end, but I started a new one. It started off last Sunday walking 1/4 of a mile…1/4 of a mile!!! This after biking 30 miles and running 3 miles the day prior to all of this happening. I am now up to 1 mile walking, which I will hold for awhile. It wipes me out. I have had time to reflect on the good things in my life, what truly is important to me, and how lucky I really was! I am here! Keep moving everybody!

Dr. Dan

Consecutive Exercise Day of my next streak: Day 8

Diet Choices and Inflammation

Inflammation is an important part of our immune system’s response to injury and infection. It is our bodies way of signaling the immune system to defend, heal, or repair itself against possible infection or bacteria. Without inflammation as a physiological response, our body would not heal properly, and many conditions would be deadly.

That being said, if our inflammatory process goes on longer than needed or if it occurs in unnecessary places, inflammation suddenly becomes an issue. Chronic inflammation has been linked to the development of numerous diseases and health conditions.

Chronic, low-grade inflammation often does not have symptoms according to Mayo Clinic, but there are labs that can be ran to determine if inflammation is present. Besides looking at blood test results, your diet and lifestyle habits can contribute to your bodies inflammation. It’s important to maintain a healthy lifestyle to keep inflammation in check.

Starches, Fruits, Vegetables

  • Choose whole-grain starches, fresh whole fruits and vegetables.
  • Consume a variety of colorful fruits and vegetables.
  • Limit refined starches (white versions) and added sugars (white or brown sugar, soda, energy drinks).

Meats

  • Limit high-fat red meat such as prime rib, bacon and sausage, as well as processed meats (ex: bologna, salami and hot dogs). These are higher in saturated fat, which if consumed in excess can increase inflammation.
  • Choose skinless poultry, fish, eggs, legumes.

Fat

  • Limit saturated fat. This includes butter, whole milk, cheese, high-fat red meat and skin on poultry. Our bodies only require a small amount so excess intake will increase inflammatory risk.
  • Be very cautious or avoid trans-fat altogether (ex: prepackaged baked goods, flavored coffee creams).
  • Choose monounsaturated and omega-3 fats, these are thought to neutralize inflammation. Found in olive oil, avocados and nuts.
  • Omega-3 fatty acids are found in salmon and tuna, walnuts, and ground flaxseed. Omega-3 is an essential fat that our bodies cannot make. We must obtain it from dietary sources or supplements.

Other suggestions

  • Flavor food with spices and herbs that have antioxidant properties such as garlic, green herbs, ginger, and turmeric.
  • Moderation in all areas, excess of any food (even if it has anti-inflammatory properties) is not a good thing.

An exact and strict diet plan for a patient with chronic inflammation is still lacking but we do know general healthy eating suggestions that help produce anti-inflammatory results over time. The suggestions above will come as no surprise, as it is information we have all heard numerous times. The key is to adapt these suggestions into your daily lifestyle.

Kaitlyn Tusha, BS, SDSU Dietetic Intern

References:

https://www.johnshopkinshealthreview.com/issues/spring-summer-2016/articles/understanding-inflammation

https://www.livescience.com/52344-inflammation.html

https://www.todaysdietitian.com/newarchives/020314p44.shtml

https://www.todaysdietitian.com/newarchives/020911p36.shtml

Celery Juicing Health Benefits: Fact or Fiction

Image result for celery juice
Photo from: https://www.meghantelpner.com/blog/celery-juice/

Many people have noticed that one of the latest nutrition “trends” has been juicing and consuming beverages that claim to boost gut health, detoxify the body, and fill your body with tons of vitamins and minerals. Most recently, celery juicing has become a popular topic of discussion on social media and other news outlets. Some celery juicers have claimed that drinking this magic drink has cured them of mental health problems, infertility, and eczema. However, as a Registered Dietitian we are taught to look to the science based evidence to understand if the topic is a healthful practice or not.  

After a search in the current scientific literature on celery juicing we can conclude there is not enough information to prove that celery juice lives up to all the claims. Majority of the studies have been done on mice and not human subjects. There needs to be more research regarding celery juice impact on human health.

Luckily, there are still benefits to consuming celery. By eating fresh celery provides a source of vitamin K, vitamin C, potassium, folate, manganese, and much more. It has a high percentage of water which can help prevent dehydration. Celery is also a great source of fiber, but only in its whole form. By juicing the celery stalks, you are stripping the celery of all its fiber. Despite these benefits, there have not been large human studies done using celery juice as a treatment for chronic conditions.

One claim is that celery contains phytochemicals and antioxidants associated with reducing inflammation to possibly reduce autoimmune symptoms and disease risk. Nonetheless, so do lots of other vegetables, fruits, and herbs. Compounds called flavonoids are in celery stalks but there are lots of other foods with the same level of or even more flavonoids. If you were to puree 1 pound of any vegetable or fruit, you would get similar potential “superfood” nutrient levels. There’s nothing particularly special about celery other than it’s a vegetable, and most all need to be eating more veggies.

As a registered dietitian counseling a patient who is or wants to try celery juicing I would tell the patient that celery juice is not harmful for most people, but check with your doctor if you take statins, blood pressure medicine, or blood thinning medication as there is always a risk of nutrient-drug interactions.

Kaitlyn Tusha, BS, Dietetic Intern