Intermittent Fasting

Intermittent fasting (IF) is a diet methodology involving limiting intake of food into short windows during the day. These short fasts typically provide a window of six or so hours per day that the participant can consume their daily intake of food, but there are many strategies of fasting to fit varied lifestyles and goals. As with any healthy diet, the general mission is reducing overall intake of calories to facilitate weight loss and overall well-being.

So how does the process work?

As we consume food, nutrients are broken down by body’s enzymes in the gastrointestinal system and result in a supply of various molecules in the bloodstream. Carbohydrates and refined grains (flour, rice, etc) break down quickly into sugar, which the cells then utilize for energy. However, unused sugars are quickly converted into fat stores. The key to avoiding this transfer? Exercise and fasting.

Exercise provides a natural use of the body’s glucose as it is released as energy and put to work. Fasting lowers the body’s insulin levels and facilitates a transition to the next source of energy, as sugar is no longer readily available. The source the body turns to is those same fat cells. This evolutionary mechanism of the human body called, gluconeogenesis (or literally “glucose creation”), was a genetic adaptation aimed at providing optimal performance to early humans in times of food shortage.

What is the science behind fasting and how long should you fast?

There are a lot of answers to this one, but we can start by looking strictly at the science. The chart below shows the various stages of the body’s use of insulin and the subsequent transition to using fast stores for energy. (Credit to Idmprogram.com for providing this informative graphic).

1. Feeding – During meals, insulin levels are raised. This allows uptake of glucose into tissues such as the muscle or brain to be used directly for energy. Excess glucose is stored as glycogen in the liver.
2. The post-absorptive phase – 6-24 hours after beginning fasting. Insulin levels start to fall. Breakdown of glycogen releases glucose for energy. Glycogen stores last for roughly 24 hours.
3. Gluconeogenesis – 24 hours to 2 days – The liver manufactures new glucose from amino acids in “gluconeogenesis”. In non-diabetic persons, glucose levels fall but stay within the normal range.
4. Ketosis – 2-3 days after beginning fasting – The low levels of insulin reached during fasting stimulate lipolysis, the breakdown of fat for energy. The storage form of fat, known as triglycerides, is broken into the glycerol backbone and three fatty acid chains. Glycerol is used for gluconeogenesis. Fatty acids may be used for directly for energy by many tissues in the body, but not the brain. Ketone bodies, capable of crossing the blood-brain barrier, are produced from fatty acids for use by the brain. After four days of fasting, approximately 75% of the energy used by the brain is provided by ketones. The two major types of ketones produced are beta hydroxybutyrate and acetoacetate, which can increase over 70-fold during fasting.
5. Protein conservation phase – >5 days – High levels of growth hormone maintain muscle mass and lean tissues. The energy for maintenance of basal metabolism is almost entirely met by the use of free fatty acids and ketones. Increased norepinephrine (adrenalin) levels prevent the decrease in metabolic rate.

The concept of fasting is to lower insulin and allow fat cells to release their stored sugar. This in turn reduces weight as fat cells are depleted. Numerous studies have pointed out the various lengths of time for this insulin drop to occur, but the consensus is it starts to pick up after about 8 hours and accelerates rapidly as you approach and pass the 24-hour mark. Glycogen, or glucose energy stores, lasts around 24 hours before depletion. After this point, almost all energy used is coming from stored fat cells. Absent other health conditions, it is generally safe for the body to endure a fast lasting 24-48 hours, as long as the individual is regularly hydrating with water.

In a recent Harvard study, intermittent fasting was shown to shed weight, reduce blood pressure, cholesterol, and improve blood sugars. Almost all studies performed show that IF is safe and effective. However, it is the timing of the fast and the length that can provide dramatic and sustainable results in weight loss and diabetes prevention. According to Dr. Deborah Wexler, Director of the Massachusetts General Hospital Diabetes Center at Harvard Medical School; “There is evidence to suggest that the circadian rhythm fasting approach, where meals are restricted to an eight to 10-hour period of the daytime, is effective,”

Can you do it?

Most people, when faced with such a proposition, say that they couldn’t imagine going without food for more than 24 hours, or even simply limiting intake to a six-hour window every day.

Personally, I find that a 24 hour fast two or three days per week, is very effective. I find my appetite is suppressed, my energy levels are great, and I experience consistent and sustained weight loss. The best part? I haven’t dramatically changed what I am eating (I try to be healthy of course but it’s not a rule). For those suffering from chronic pain; weight loss, ideal energy levels, and a general avoidance of inflammatory food is even more critical.

The best diet is one that works for you. Make it too hard and you’ll crash and revert, getting rid of any gains and sometimes getting to a worse point than they started with. But with a little training (it’s more brain than body), anyone can implement intermittent or extended fasting with success.

Some closing tips

1. Avoid sugars and refined grains. Instead, eat fruits, vegetables, beans, lentils, whole grains, lean proteins, and healthy fats (a sensible, plant-based, Mediterranean-style diet).
2. Let your body burn fat between meals. Don’t snack. Be active throughout your day. Build muscle tone.
3. Consider a simple form of intermittent fasting. Limit the hours of the day when you eat, and for best effect, make it earlier in the day (between 7 am to 3 pm, or even 10 am to 6 pm, but definitely not in the evening before bed).
4. Avoid snacking or eating at nighttime, all the time.

Sources:

The post Intermittent Fasting and the Importance of Diet in Pain Management appeared first on Restore Medical Partners.

Restore Medical Partners pain interventionists preach the minimum-to-maximum invasiveness scale; where the first step for the patient is always the less invasive therapies and then progressing upwards depending on the results of those therapies. This means starting with smaller steps, milder treatments, and more conservative measures, and gradually working up from there. In the past, this scale didn’t include many steps to speak of, but today that is simply no longer the case.

Physical Therapy & Adjunct Medication

The best long-term answer to any pain symptom or injury is always physical therapy, exercise, and diet. The first step in treating an injury or pain complaint is a well-structured physical therapy regimen designed to provide strengthening and body mechanics to overcome and correct painful symptoms. As with any well-rounded health regimen, regular diet and exercise also play a key role. Simply avoiding inflammatory foods such as high-sugar/corn syrup, excessive trans fats, oils, and carbohydrates, can make significant differences when it comes to pain.

Alongside this, adjunct medications (non-narcotics) play a role at this end of the scale. These medications include Gabapentin, designed to combat neuropathy (nerve pain), as well as anti-inflammatory medications such as Ibuprofen and Naproxen. Natural vitamins such as alpha-lipoic acid and magnesium can be useful supporting players in a healthy regimen to control pain.

Image-Guided Injections

The new-wave of targeted procedures employed by interventional pain specialists have filled the void when the steps above alone have proven inefficient on their own. This category includes epidural steroid injections (for nerve pain), radio-frequency procedures (for arthritic pain), and a host of other minimally-invasive needle-based solutions for chronic pain. Under the hands of skilled interventionalist, most patients can achieve significant results during this phase, and are redirected to step one once pain has been effectively controlled.

Spinal Cord Stimulation

For those who don’t achieve the results from the first two phases of the invasiveness-scale, spinal cord stimulation can provide significant benefit. Spinal cord stimulation or “SCS” technology has become an increasingly effective option in treating chronic pain. This medication-free approach works by providing an extremely small electrical charge in the form of a wave that works to interrupt the body’s pain signals as they are transmitted back to the brain. This interruption of signals helps to reduce pain levels for long-lasting results. Spinal cord stimulation is a rapidly-evolving field and represents the latest in technology designed to combat stubborn chronic pain.

Minimally-Invasive Spine Techniques

After failure of steps one through three, a surgical referral is typically considered. However, this doesn’t mean giving way to an invasive spinal surgery. New options exist to provide patients the benefits of surgical intervention without the issues that sometimes accompany it. Technological advances can now provide patients with decompression of the spine without the need for fusion utilizing small implantable devices that maintain range of motion, provide support, and don’t carry the same risks as open surgery, both during and after the procedure.

With these modalities and cutting-edge technologies available to today’s top pain management specialists, patients now have a plethora of options to consider that can create an environment of appropriate treatment and superior long-term results. If you are seeking better options for your care of the care of a loved one, speak to your doctor, a board-certified pain management specialist at Restore Medical Partners might be the answer you’ve been seeking.

The post The Evolution of Spine Care appeared first on Restore Medical Partners.

Venice, FL, February 22, 2018– Dr. Lindsey Job, Pain Management Physician and owner of Restore Medical Partners, won a finalist Readers’ Choice award for Best Pain Management in Venice.

“It is a wonderful achievement to receive this recognition from the wonderful people of the Venice community and we hope to continue growing and providing our patients the very best pain management to achieve even greater heights. Thank you to all of our community readers for your continued support.”

The 2018 Sarasota Herald Tribune Reader’s Choice Awards were held at the Arts Center in downtown Venice Wednesday Feb, 22, 2018. Winners and finalists were invited to mingle, eat, drink and congratulate each other on their yearly accomplishments.

“The Restore Medical Partners team has been absolutely wonderful from start to finish; Dr. Job and her staff always take great care of me, and their smiling faces make my life a little bit easier. Thank you to everyone in the Restore family!”

Dr. Lindsey Job has always been passionate about Pain Management. Her achievements and training are a reflection of her pursuit of excellence in the treatment of pain syndromes. At Restore Medical Partners, our vision is to restore our patients’ lives, functionality, and get them back to doing the things that make life enjoyable. With our caring staff and quality medical services, we will begin to restore the image of Interventional Pain Management by providing a full range of treatments and services for patients suffering with neck pain, back pain, sciatic nerve pain, failed surgeries and other painful conditions.

# # #

Click HERE to view all results from the 2018 Reader’s Choice Awards.

To schedule a consultation with Restore Medical Partners call 941-375-3006.

The post Dr. Job Receives Finalist Award for Best Pain Management In Venice appeared first on Restore Medical Partners.

FIGHTING AGAINST THE OPIOID EPIDEMIC

No doubt you’ve heard repeatedly about the opioid epidemic sweeping the nation. Just a few short years ago, it would be unthinkable for presidential candidates to be debating the cause and possible policy to combat this kind of rampant abuse. Now the conversation is commonplace. It’s likely that you have been touched by opioid addiction, whether through a loved one or friends of friends. It’s truly a startling public health crisis. Drug overdose is the leading cause of accidental death in the US, with over 64,000 lethal drug overdoses in 2016. Opioid addiction is driving this epidemic, with an estimated two thirds caused directly by opiates. According to the American Academy of Pain Medicine, pain is a significant public health problem that costs society at least $560-$635 billion annually, an amount equal to about $2,000.00 for everyone living in the U.S.*2. For the first time since the 1950’s, life expectancy in the US dropped for two consecutive years. The soaring deaths related to synthetic opioids are playing a tragic role in that. *3. Opioids are truly a complex subject to discuss, and those in the medical field have a particularly challenging task of fighting back.

So what can be done?

The blame for the emergence of the opioid epidemic falls on many shoulders, but there are those that are taking a stand against the rising tide. Comprehensive pain management physician specialists are needed now more than ever to take the reins in caring for these challenging patients, and fighting to ensure that they avoid becoming just another statistic. A major challenge is that many patients, as well as many physicians, don’t know what comprehensive pain management doctors even do!

Pain management has evolved significantly over the past decade, and a wave of technological and innovative advances are pushing the boundaries of what is possible to treat acute, and more critically, chronic pain. No longer is the field dominated by medicine management and the occasional steroid injection. Instead of a last resort, pain management is becoming an earlier step in typical treatment. Minimally invasive procedures and non-opioid adjunct medications have revolutionized the way pain is viewed and treated. Like most fields of medicine in the past quarter-century, pain has undergone a renaissance of sorts, and highly skilled physicians are entering the specialty and changing the game.

The titanic challenge of the opioid crisis requires a well-rounded and progressive approach. Skilled physicians such as Lindsey Job MD and Peter Fernandez MD of Restore Medical Partners in Venice and Sarasota, FL are working towards a paradigm shift in the field; shifting focus to targeted interventional therapies (x-ray guided injections, ablations, etc) and incorporating integrative medicine and physical therapy. Accurate diagnosis and treatment with guided procedures can allow patients to undergo physical therapy, setting them on a road to recovery, and most often, off of addictive opioid medications. With support from their medical teams, Physicians like these are helping to turn the tide in their communities, managing medications appropriately, catching pain early (before patients have become dependent on narcotic medications), and more importantly educating the public on their dangers.

Living with chronic pain can be a truly devastating experience for anyone. And the numbers certainly are scary. But there is a way forward; a responsible and effective way to practice pain management. The public need to know that there are options beyond dangerous opiates, and that you don’t have to live in pain due to fear of being treated with narcotic medications. Only with the correct approach can chronic pain, and the opioid epidemic with it, be contained and resolved. Only with the leadership of these innovative pain management mavericks can we combat this crisis head-on, and save the lives of thousands along the way.

Sources:

Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. DOI: http://dx.doi.org/10.15585/mmwr.mm655051e1

http://www.painmed.org/patientcenter/facts_on_pain.aspx

https://www.scientificamerican.com/article/life-expectancy-in-the-u-s-is-falling-and-drug-overdose-deaths-are-soaring/

Watch ABC7 on Thursday, February 22nd at 7pm to see how Dr. Job and Restore Medical Partners are leading the charge in the fight against the opioid crisis.

The post Opioid Epidemic and Your Pain Management Physician appeared first on Restore Medical Partners.

It turns out, a pretty big one.

Studies have shown that patients who follow a strict vegan or Mediterranean diet experience improvements in pain symptoms. Regular exercise, controlling stress levels, and eating healthy foods all work in unison to reduce inflammation, a primary cause of chronic pain. Inflammation is the body’s immune response to toxins and injuries; a biochemical coagulation reaction that signals to the body that repair is needed. While this inflammatory process is critical to healing, the inflammation itself causes pain, and over time it can trigger chronic diseases such as heart disease, strokes, diabetes, and even depression.

Maintaining healthy cholesterol and insulin levels can keep inflammation at bay, which is especially important as patients age, where natural arthritic degeneration can cause inflammation more regularly. Fibromyalgia, a constant source of frustration for millions of patients nationwide, has also been shown to be eased with a proper anti-inflammatory diet.

While targeted interventional care is sometimes needed, one of the most exciting and easy-to-accomplish approaches to pain management is in your diet. A natural, anti-inflammatory diet helps speed along recovery from injuries and other pain conditions, and is a necessary factor in a well-rounded approach to chronic pain.

Here are three basics to fighting inflammation with your diet;

1. Eat your vegies! 8-9 Servings of vegetables each day. You can alternate several of these servings with fruit instead. Cruciferous vegetables such as Brussels Sprouts, cabbage, broccoli, and cauliflower are particularly helpful in reducing inflammation.
2. Restrict the grains. Dairy, simple carbohydrates, flour, and sugar are particularly bad choices for those in chronic pain as they tend to cause inflammation. When consuming grains, choose whole grains like barley, oats, quinoa, and brown rice over other options, and limit your intake. Olive oil and nuts are also effective inflammation fighters.
3. Avoid red meat: Now I know this one may not be all that popular, but red meat can be a significant trigger for inflammation. Replacing red meat with fish or choosing vegetarian options is always a wise decision. Alternating some red meats with chicken can also help. While chicken isn’t necessarily beneficial, it’s not a trigger of inflammation the way red meat is.

Maintaining a healthy weight, the side effect of good diet and exercise, is the best way to fight arthritis and inflammation. Get a simple exercise routine going, even if it’s only a 30 minute walk 2-3 days a week. That kind of activity can ward off pain and increase overall health and wellbeing. It can also be a time to decompress and de-stress, another major factor in keeping pain levels down.

Sources:

https://www.ncbi.nlm.nih.gov/pubmed/21139128

https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation

For more tips on a healthy diet and low-stress exercise regimen, consult your physician today!

941-375-3006

The post Diet and Pain Management appeared first on Restore Medical Partners.