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 My staff is amazed by patients who call the office requesting a script refill at 11 am, and then call the office at 11:20am from the pharmacy complaining that they have not received refill authorization yet. We want immediate response to request for services. The idea of immediate gratification has permeated the service industry, but do you really want to apply a FedEx mentality to your medical services?
Think about what has to be done to safely refill your medications. The receptionist answers the phone and transfers you to the nurse. After the information is gathered, the chart is reviewed. The nurse determines that this medication is on your list, and assures that you have no allergies or interactions that would make continued treatment unsafe. She confirms that you have been evaluated by the doctor in a reasonable amount of time since your last refill, and that blood tests assessing your liver and kidney’s tolerance of the medication are up-to-date. Finally, the doctor reviews your chart and authorizes the refill. The chart returns to the nurse, who prepares the refill for the patient.
This process occurs while the doctor and her nurse are seeing patients and managing urgent messages from really sick people who need acute care. It also occurs while the doctor is hopefully putting down their notes, looking up from their computer screen, and spending a few precious minutes really listening to the troubles and needs of the patient in front of them. Or when the patient asks the classic “doorknob question”, the question they’ve been saving for the entire visit about the medical situation closest to their heart, just as the doctor puts her hand on the doorknob to exit the room. When the doctor releases the doorknob and returns to her seat, she’s guaranteeing a wait for the next patient. But she’s also guaranteeing that the patient in front of her will get her deepest concerns addressed.
When you are asking your doctor’s staff to hustle through a refill authorization, which part of the process would you like them to exclude for you? Would you like them to overlook a review of your drug allergies and intolerances? Would you wish the doctor to quit sympathizing with the patient in the exam room and rush the refill authorization? What looks like a simple and straightforward request is actually a multi-step process in place to assure patient safety is met at every interaction. Please give your doctor a little extra notice when requesting a refill, so that both of you can be assured that safety and good care is delivered along with your medication.
 Plant- based eating is easy, until 5pm. I sat down to many dinners with potato and veggie and the famous empty spot where the meat should be, and I felt deprived and defeated. I wonder if that is why the solution for Mark Bittman, food writer for the NYTimes and author of Food Matters adopted “vegan after six”, shedding 15 pounds in one month and approaching his ideal body weight within four months. But it may be easier than you think to get dinner lean and healthy.
The 3-3-3 plan for three weeks was devised by Neal Barnard, MD, to help you still enjoy familiar foods while modifying your diet. The premise is that folks cycle through about ten meals. I used to think I ate a wonderful varied diet with plenty of interesting new recipes, but when I thought about it, I did only eat about 10 different meals. If you change the composition of those ten meals, by the end of the month, you’ve made the critical difference. Imagine the difference at the end of the year – or ten years.
Continue reading 3 3 3 Plan to Modify Your Diet
By Nava Atlas; VegKitchen.com
I’ll always have a pleasant association with this classic Indonesian salad platter, as it was the first meal I had on my first trip to Paris. Served with plenty of rice, the salad (which always combines raw and lightly cooked vegetables) made for a filling and memorable meal. Though easy to enough to make as an everyday meal, it’s also festive enough to serve to company or to make as a vegan potluck dish. Here’s my Americanized, but still very tasty, interpretation. Photo by Jillian of Bitchin’ Vegan Kitchen.
Look for peanut satay sauce in the Asian foods section of well-stocked supermarkets. You can also substitute Peanut Sauce for the Coconut-Peanut Dressing. This makes for a lively meal served with a simple rice dish or a soup. See ideas for accompaniments following the recipe.
Serves: 4 to 6
- 2 to 3 ounces mixed baby greens
- 1 cup green sprouts, like baby pea shoots or broccoli sprouts
- 4 ounces slender green beans, tips trimmed (see note)
- 1/2 medium head cauliflower, cut into bite-sized pieces
- 1 cup baby carrots (thick ones cut in half lengthwise)
- 3 medium tomatoes, diced, or 1/2 pint cherry tomatoes
- Two 8-ounce packages Thai-style or smoked baked tofu
Coconut-Peanut Dressing:
- One 8-ounce jar peanut satay sauce
- 1/2 cup light coconut milk
- Juice of 1 lime
- 1/2 teaspoon red or green Thai curry paste, more or less to taste,
- dissolved in a little hot water
- 2 teaspoons brown rice syrup, agave nectar, or maple syrup
- Spread the greens on a large serving platter, then sprinkle the sprouts over them.
Place the green beans, cauliflower, and carrots side by side, without mixing, in a wide skillet with about 1/4 inch depth of water. Cover and steam for 3 to 4 minutes, or until all are tender-crisp. Remove each type of vegetable separately with a slotted spoon, transfer to a colander, and refresh under cool water. Transfer to a small plate Repeat with each vegetable.
Arrange the green beans, cauliflower, and carrots in separate mounds on the greens, leaving room to add the tomatoes and tofu. Arrange those on the greens as well, between the cooked vegetables.
Combine the ingredients for the dressing in a small mixing bowl and whisk together until completely combined.
To serve, let everyone scoop the vegetables, tofu, and greens onto individual plates, then pass around the dressing for everyone to use as desired.
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 More and more data keeps pouring in, supporting the fact that vegetarianism is the optimum diet. 1,011 participants in the Adventist Health Study-2 were compared in measurements of triglycerides, blood sugar, BMI, waist circumference, and blood pressure in a recent study published in Diabetes Care.
The risk factors above were found in the lowest percentage among vegetarians (25.2%), followed by semi-vegetarians (37.6%), and highest among non-vegetarians (39.7%).
These percentage differences may seem small, but remember that having just three of the five risk factors above clinches the diagnosis for metabolic syndrome. Patients diagnosed with metabolic syndrome have 16 times increased risk of stroke and heart attack over normal people. It’s hard to imagine the power of fruits and vegetables, whole grains and beans to protect us from dreaded diseases.
Number One Daughter and I were arguing recently about the presence of a small amount of meat in the diet, and whether or not it contributes to the develop of disease. This data also illustrates that maintenance of a small amount of animal flesh (semi-vegetarian) contributes to the persistence of risk factors at the same rate as meat eaters. Better to knock it out altogether. Let’s look forward to aggravating the children well into our nineties.
 Anyone thinking about converting to a plant based diet, but thinks their guy would never allow it? Is your guy standing in front of the grill right now? Are you a guy, talking about how real men eat meat, and vegetables are what your food eats? I’m going to hit you where it counts. Right between the legs.
Eating a meat based diet results in high exposures to animal protein, which is linked to prostate cancer. Then the gland gets scooped out. Whammo. Not very manly.
There’s a ton of estrogens in animal muscle, and lots of fat marbled into the muscle that creates even more estrogen when it breaks down in the small intestine and liver. All those hormones create havoc in the body’s hormonal systems, leading to modified levels of sex hormone binding globulin and altered hormone ratios in the blood. More estrogen, less testosterone. Zowie.
The fat in lean meat accounts for 20% of the total calories, meaning that 1/5 of every forkful of meat eaten is fat. The fat lines the blood vessels that travel to important organs, and a small drop in radius of a vessel results in a big decrease in that vessel’s ability to deliver blood to its’ target. Try inhaling through a straw. Wowzers.
Still love to grill, and looking for something crazy delicious that is low fat, animal free, plant based but doesn’t taste like cardboard? Grill a portabello mushroom that has marinated in Italian dressing for a few hours. Serve it on a whole wheat bun with some A1 sauce, lettuce, tomato and onion. Put some grilled asparagus and taters on that plate and eat like royalty.
Enjoy a great dinner and a long happy sex life.
 by Nava Atlas
Vegkitchen.com
This is a salad I often make for company. It’s so pretty, yet incredibly easy to prepare. It was inspired by a salad I had while traveling in Tel Aviv a few years ago. Adapted from Vegan Express.
Serves: 6 or more
- 1 large sweet potato
- 4 medium white potatoes,
preferably Yukon Gold or red-skinned
- 1/2 cup vinaigrette (homemade or store-bought)
- Salt and freshly ground pepper to taste
- 4 ounces (or as desired) mixed baby greens
- 1 cup (1/2 pint) cherry or grape tomatoes, halved
- 1 medium avocado, peeled and diced
- Toasted pumpkin seeds for topping
Microwave the sweet potato and white potatoes separately until done but still nice and firm. Plunge into a bowl of cold water when done.
When the potatoes are cool enough to handle, peel and cut into dice. Combine in a mixing bowl with vinaigrette; season with salt and pepper.
Line a large serving platter with the greens. Mound the potato mixture in the center.
Scatter the tomatoes and avocado around the perimeter of the salad. Top the potato mixture with a sprinkling of pumpkin seeds. Serve at once; pass around additional vinaigrette as desired.
 Insulin-like Growth Factor is getting a lot of press lately. While insulin is secreted from the pancreas, IGF is secreted directly from the walls of the first part of the small intestine. The secretion of insulin is closely tied to the release of IGF during eating. When we eat foods, insulin is secreted to facilitate the transport of the sugar in the food into the cells. In addition to insulin, the hormone insulin-like growth factor is secreted. IGF stimulates the growth of cells. This makes sense, because when the human is eating, there is sugar and protein available to grow cells. Sugar nourishes tissues and makes them grow faster. The problem is, IGF promotes the growth and division of rapidly dividing cells. When you are little, all cells are dividing rapidly. When you are a grownup, the only cells dividing rapidly are cancer cells and fat cells.
Today, we know that the peaks of insulin and the secretion of IGF stimulate not only the growth of cancer cells, but also their capacity to invade neighboring tissues (Journal of Cancer Research and Clinical Oncology, 1999 and Cancer Research 1997). Researchers have shown that lower levels of IGF suppresses cancer growth, which spawned a new class of chemotherapy that specifically reduces IGF levels in the blood.
We don’t have to wait for new medications to reduce our cancer risks. Research shows that reducing or eliminating sugar and white flour from the diet has a dramatic and rapid impact on levels on insulin and IGF in the blood. Also, cow’s milk is a great source of IGF. Cow’s milk is intended to grow a baby calf very rapidly. It is loaded with IGF. To make matters worse, the use of bovine growth hormone to stimulate milk production increases the concentration of IGF in cow’s milk even further. When we process the milk into hard or spreadable cheeses, we further concentrate the fats, hormones and pesticides. That’s why dairy and bakery are such nono’s for cancer survivors.
Further exploration into the links between sugar and cancer can be found in the recent 60 Minutes episode posted last week. Choose an apple or pear for your lunchtime snack instead of a little cake, and live a lot longer for it.
 Repost, originally posted Nov. 2010.
My patients are frequently surprised when they develop diabetes a few years after their diagnosis of high blood pressure or elevated cholesterol. That’s a lot of bad luck concentrated on one person. They want to know why all this is happening to them, and increasingly they want to know what they can do to stop the bad news. I’d like to tell them the story ends with the diagnosis of diabetes, but as I’ve said, I’m trying hard to tell the truth. That’s not all they have to look forward to.
Nine doctors published a consensus report on June 16 in CA: A Cancer Journal for Clinicians about the association of various cancers and diabetes. After reviewing epidemiological data from reliable sources, they determined the risk of liver, pancreas or endometrial cancer is about doubled in the setting of a diagnosis of diabetes, while there is a 1.2- to 1.5-fold increased risk of colon/rectal, breast or bladder cancer. Mortality from cancer may also be higher in diabetics.
It’s proposed that all of these diseases that plague people who eat the American diet can be considered one disease, the disease of affluence. When folks living the good life eat a diet rich in luxury proteins, dairy and processed foods, you see increases in heart disease, cancer, diabetes and obesity. Osteoporosis and Alzheimer’s disease also increase in frequency with exposure to the western diet. The cars and desk jobs that we love aren’t doing us any favors either. And people who maintain a healthy body weight through portion controlled western diets can still anticipate an increased risk of these diseases.
These cancer specialists considered dietary modifications in one paragraph, but spent the majority of the paper considering the impact of underlying biologic mechanisms or possible drug interactions. Maybe the doctors are hoping that elucidating the biologic mechanisms will spur future research into the next great cancer remedy. But if the American diet is proven to be the best diet at growing cancer, promoting obesity, and spreading illness, then why are we still eating it? Seeing photos of people in third world countries eating meager portions of grains and beans makes me feel so lucky to live comfortably in America. Turns out the impoverished, who are feasting on whole grains and green leafy vegetables are getting the upper hand. At least in the case of diseases of affluence, lucky them.
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