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The Quest

September 2018

What's New?

Search Bar! 
To help everyone (including myself) find things more easily on my website, I have added a search bar to the home page!

Newsletter Index! 
To help everyone (including myself) find news items, conditions about which I've written, tips, recipes, and other things in The Quest, I have created an index, found on my Newsletters page!

What's Next?

Exclusive Access to My Presentations on YouTube
To help add value to your membership, and to make it easier to learn what I would like to teach you about various subjects, I will soon be creating a members-only YouTube channel!  Then you'll be able to view my presentations anytime you wish!

Calendar

  • Sept 7: TLC "U"-Sleeping Well
  • Sept 8:  WHOLi KaBOWLi! tasting
  • Sept 13: TLC "U" - Nutrition
  • Sept 15: Tour, Q&A Session, and SLIM TLC group visit, WHOLi KaBOWLi! tasting
  • Sept 19: TLC "U" - Weight Mgmt...and more!

Condition Corner

Sinusitis
I can tell we are already getting into allergy and cold/flu season, because I am starting to receive more requests for antibiotics to treat sinusitis.  Many different guidelines have been published by various professional groups that govern antibiotic use in sinusitis, so my job is to combine what I have learned from those guidelines with experience and common sense.  Here is what I have learned: 

  1. "Sinusitis" = Sinus inflammation (which may include pain/pressure and mucus production without being an infection).
  2. The #1 cause of sinusitis is allergies ("allergic rhinosinusitis") = no antibiotics needed.
  3. The #2 cause of sinusitis is viruses = no antibiotics needed.
  4. Even many cases of bacterial sinusitis can be cured without antibiotics (I've done it in myself and also had success in many patients!), by treating it with modalities that help the sinuses open up and drain (e.g., guaifenesin, pseudoephedrine, nasal saline rinse, nasal steroid spray, NSAIDs - like ibuprofen or naproxen - or systemic steroids if safe).
As understandable as it is that many conclude they need antibiotics (sometimes they're right) when they have sinus pain/pressure and mucus production, most cases of "sinusitis," as outlined above, do not need, and should not be treated, with antibiotics.  However...
  1. The more the above modalities have been given a good attempt and failed...
  2. The longer the symptoms have been present...
  3. The more severe the symptoms, i.e., the more disgusting the mucus (dark, thick, green, etc.), the more it is produced throughout the day instead of just waking up with it, the more pain or pressure...
  4. The higher the temperature (exceeding 100.4 °F)...
...the more we need to consider antibiotics!

TLC Tip of the Month

Chronic Insomnia
One out of every ten adults suffers from chronic insomnia,* which can have many consequences - including high blood pressure, depression, weight gain, fatigue, poor memory and concentration, and increased accidents.  One of the most effective therapies for chronic insomnia is Cognitive Behavioral Therapy (CBT), the positive effects of which can be long-lasting!  Our Licensed Professional Counselor, Gale Hartschuh, is trained and experienced in such CBT, along with other techniques that can help.  If you are a chronic insomniac, I strongly recommend booking an appointment with her ASAP!  In addition, see my "Top 10 Steps to a Good Night's Rest" handout for some good tips.

*From www.sleepeducation.org

Nutrition Nugget

Oil is a form of plant waste (similar to sugar and white flour).  Why would we squeeze a nine calorie-per-gram sludge out of a plant and throw away the rest, which contains almost all the micronutrients and fiber?  Oil, no matter the source, is for the outside of the body, for conditioning and moisturizing.  Eat the whole olive, vegetable, coconut, or seed!  Grill, bake, boil, broil, steam, or sous vide!  Sauté in vegetable broth!

Practice Pointer

My job as your PCP is to make sure you have all the necessary preventive care.  If you want to help me help you stay healthy, consider downloading the AHRQ ePSS mobile app.  Then, enter your data and review the "A" and "B" recommendations.

Recipe of the Month

Mix and Match Trail Mix*

Mix (note:  I'm OK with a little salt):
  • 1/2 cup nuts of choice, raw or dry roasted, oil-free (e.g. almonds, Brazil nuts, cashews, peanuts, pecans, pistachios, walnuts)
  • 1/2 cup fruit of choice, dried, oil-free (e.g. apples, banana chips, blueberries, cranberries, cherries, raisins)
  • 1/2 cup seeds of choice, raw or dry roasted, oil-free (e.g. pumpkin seeds, sunflower seeds)
  • 1/2 cup fun extras (optional) (e.g. coconut flakes, dairy-free chocolate chips, dried edamame, pretzels)
*Adapted from the recipe by Rosane Oliveira, DVM, PhD, from the UC Davis Dept. of Integrative Medicine
Copyright © 2018 TLC Family Health, All rights reserved.

TLC Family Health is a Direct Primary Care practice founded by Douglas M. Cluff, M.D. 
"Making Great Primary Care Affordable and Accessible"
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