Transcription of Patient-Centered Wellness #146
Dr. Lisa: This is Dr. Lisa Belisle, and you are listening to the ‘Dr. Lisa Radio Hour and Podcast’, show #146, ‘Patient-Centered Wellness’, airing for the first time on Sunday, June 29th, 2014. Patient-centered wellness is considered the wave of the future, but it is also deeply rooted in the past and in healing tradition such as acupuncture, osteopathic manipulation and naturopathic medicine.
Today, we speak with two physicians who are integrating these traditions into their practices, and helping patients create their own wellness path. Join our conversations with Dr. Ralph Thieme, Dr. Richard Maurer, and Dr. Maurer’s long-time patient and writer, Patty Hagge, and learn more about their unique approaches to patient-centered care. Thank you for joining us.
As I’ve mentioned on the show before, one of the most important things to physicians and healthcare practitioners really is the relationship with their teachers. One of the most important things to me has been my relationship with my teachers, so I’m always pleased to have people in the studio that I respect greatly as practitioners in the field, but also as my teachers. Today, we have with us Dr. Ralph Thieme who is an osteopathic doctor who practices in Falmouth.
Dr. Thieme has been a part of the Integrative Medicine Program with the Family Medicine Department at Maine Medical Center and has done a lot of teaching in the community, and not the least of which has occurred with his own patients. Thanks for coming in and talking with me today.
Dr. Ralph: Thank you, Lisa.
Dr. Lisa: Dr. Thieme, you are not what I would call ‘A standard doctor’. I’m trained in Family Medicine, you’re trained in osteopathic medicine, but you also have acupuncture in your background … You’re truly an integrative doctor. Can you tell me a little bit about what you do and how you got there?
Dr. Ralph: I think I’ll start by trying to go into how I got there.
Dr. Lisa: Great.
Dr. Ralph: Actually, I’d have to look at that retrospectively rather than I didn’t make choices to get there. It’s as I arrived, I got to look back and see maybe how I had been formed to fulfill this position. One of the things that … The osteopathic profession I think began in a more rural area than in urban area. I find for myself that that’s a part of my history.
I grew up in a farm in Wisconsin. It was a dairy farm. My father worked very hard. He didn’t have the opportunity to have much education, but he was a very smart, brilliant, respected man. One of the things that happened with his work was is he ended up having a bad back, and it happen to occur when I was the right size.
One of the things that he had me do was walk his back. In retrospect, I found out that I was doing one of the oldest forms of treatment that has been recorded oftentimes by children or women. I did that.
He was very respected by his neighbors, and because most farmers would rather not spend money, if they had a problem with their cows, they would call my dad first. If he couldn’t advise them, then they would call the vet. There were times where I would help him deliver calves. When I did that, he would have me take a hold of the ropes that he attached on the calf, and he would vert the calf within the uterus and position it so it could come out, but by then, the cows were usually exhausted. He would help me put a little bit attention on the ropes to actually help pull the calf.
In the process, I had to develop a very gentle, mindful touch, which again made me in retrospect think he was training me to be a good osteopath, and of course, he didn’t know that but life just happened. I went through a period where I thought I might be a teacher, and then I thought I might be a doctor, and then I decided that I didn’t want to be a doctor because what I saw didn’t inspire me, so I withdrew from premed and had all of these credits. I thought, “I’ll get a degree in pharmacy”, and I did.
In the process, I happen to do an externship at a VA hospital that had a visiting physician from the UK. This was back in the ’70s, right around the time that Nixon went to China, so there wasn’t really acupuncture at all around yet. I had the opportunity to see a physician do acupuncture in the VA hospital because he came from Great Britain. It really intrigued me.
Then, I continued my training and got my degree in pharmacy. Didn’t practice it even though I have great respect for pharmacists. I still do. Then, I think because of my own inner search, I ended up getting some graduate work both in counseling and in psychology. In the process, I really felt like I needed to be able to also touch people.
By a set of odd circumstances, I ended up having someone recommend to me that I ought to train to become an acupuncturist. As soon as they said it, I felt like a jolt of lightning or a light bulb go on inside of my mind, and I knew I was supposed to do that. That happened. That piece of information came to me on a Sunday in Hawaii.
On Monday, I searched the three schools in Hawaii for acupuncture and the first two didn’t fit. That afternoon at four o’clock roughly, I walked into the third school, and there was this older, kind of frumpy Chinese lady siting there who I thought might be the secretary for the school. I approached her with a question about acupuncture and schooling to her.
She started asking me questions and we started going back and forth for a few minutes. I was curious why she asked me so many questions. Finally, she said, “You very lucky.” That was roughly the phrase she used. She said, “We have a class that starts tonight at six o’clock. Your paperwork can catch up. You come tonight.”
I began that night, and I had really been in Hawaii just a short period of time. One of the members in the class was a Vietnamese monk. He introduced himself to me at a break and asked where I was staying. I told him I had just arrived in the past week and I was staying in a hotel. He said, “That was no good.” He invited me to come and live at the temple.
I’ve always had that part of my personality was important to me also, and so, although I was not a … I am a Buddhist or I’m not a Buddhist, I mean, there are like all the religions or none of them. I spent almost two years there as the live-in carpenter who also had to sit in meditation every day. That took me through acupuncture.
Then, the year after I graduated, I was doing a house call. In Hawaii, if you’ve ever been there, there are many rainbows. I was in this one little valley and I gave a treatment. Inside, they had the shades [drawn 00:11:20]. It was dimly lit.
When I arrived, it was sunny, and when I was inside, it rained. I didn’t know that. When I came out, it was brilliantly sunny again. I proceeded to carry off with my table and my supplies and didn’t realize it had rained and it was slippery and I fell down a flight of stairs. I jokingly acknowledged my guardian angel for standing there with their foot out, because I needed that fall to injure myself because it helped me with the help of a friend who gave me advice. I went to see my first osteopath.
After doing that, I headed off to osteopathic medical school. It was mostly things happened almost to me more than I chose anything. I just followed my curiosity and my passion.
Dr. Lisa: It’s a big plane ride between Hawaii and Maine.
Dr. Ralph: Yes.
Dr. Lisa: How did you end up here?
Dr. Ralph: This osteopath who treated me, as I was getting treated, I asked him if there were still osteopathic schools because I was unfamiliar with them. He informed me that there were. In our discussion, he said that, “If you want a recommendation, I’ll write you one.” He happened to be a very well-known, a national figure in my profession, and he was a great family of manipulative osteopaths, the ones that do the traditional things with their hands to their patients even though he is a general practitioner.
After he said that, I queried the American Osteopathic Association and applied. I applied only to the osteopathic schools. I went around the country and interviewed at everyone that had asked me for an interview. I had all these acceptances and I didn’t know where to go. I was back in Hawaii trying to decide when I got one last invitation for an interview. I questioned about going or not.
With the help of friends, they convinced me I should be thorough, so I flew to Maine. When I drove down the road that leads you to the University of New England College of Osteopathic Medicine, when I drove down that road, I knew that that was where I supposed to go to school. It was a beautiful late April, early May day, sun was shining, I could see the river and I could see the ocean, and it just felt like the spot, so I ended up going to school there. That’s what brought me to Maine.
Dr. Lisa: It seems as though what you’re telling me is you really came to trust yourself and trust the information that you were being given. This seems to fit in very nicely with how you work with patients and how you help them heal.
Dr. Ralph: I think you give me credit for more awareness than I have, but yes. I think I really do trust something. I think it’s an internal thing that I trust much more than I trust the external world. If I feel called to go and do something, I will do it even if it doesn’t make very good sense to some other people.
Dr. Lisa: I think it’s fair to say that when you were first doing acupuncture and osteopathic medicine within the traditional medical community, it wasn’t as widely accepted as it is now.
Dr. Ralph: That’s true. I was challenged a lot at that time, partly because I think it was something other people were unfamiliar with and it was threating to them. I was also internally challenged because I didn’t know another osteopath and another acupuncturist because I was trained in acupuncture first, and most physicians go about it the other way.
I think our training is literally almost like layers within the temple of our brain, and so my base layer was acupuncture and osteopathy got layered on top of that, and it took me a while. Then, the other part that I think was really, really helpful to me, it interestingly came from a medical doctor, Janet Travell who wrote the book on trigger Points and myofascial pain, because her book is so beautifully written from a muscular point of view and a myofascial point of view, that it gave me the anatomical detail that my mind needed to justify the meridians that I had been taught in acupuncture, and all of a sudden, it all clicked, and then it became …
I’m like a kid in the candy store. I’m still having a great deal of fun because I’m trying to put it together. It’s this huge, wonderful internal process in my patients and in me, as well as within our culture because they think their culture is trying to put it together too.
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Dr. Lisa: For people who listen to the radio show, we’ve had some conversations about acupuncture, and in some part, it’s because I’ve practiced acupuncture myself, prodded along by you. I’ll give you credit because when I came back …
Dr. Ralph: Thank you.
Dr. Lisa: … from my acupuncture training, I said, “Dr. Thieme, I don’t think I know enough to practice acupuncture. I feel really worried about this. Can I follow you around? Can you teach me some more?” You said, “You know everything you need to know. What you need to do is practice now.”
Dr. Ralph: Yes.
Dr. Lisa: People who are listening I think have some idea about acupuncture. Maybe you could explain it a little bit more for others who haven’t been long-time listeners.
Dr. Ralph: First of all, acupuncture is part of a medical system oriental medicine. I know for instance that when I was a student and I was doing rotations, I happen to train for one month in Tempe, Arizona and I was doing pediatrics. Of course, by the end of the month, I had quite a few viral illnesses because I was exposed to all these sick kids, and I would go to this nearby Vietnamese restaurant, and when I went there, I would order something to eat.
One day, the lady who is the wife of the couple that owned the restaurant shook her head and said, “That wasn’t a good choice.” I understood what she was saying and I let her order my meal. That really struck me because I thought, “How did she know more than I knew?” It was because she had all the cultural training that took her to that. It led me to really try to review in my mind all this data that I was taught in school, but to make it to come in place, something that my pap who was a farmer or the neighbor down the street already knew, like people know rhubarb is important in spring time because it’s like the spring cleansing thing that tastes so good.
My grandmother knew that, so that’s like integrative medicine, making it simple and something that’s very accessible for every single patient because we all know it already. Oriental medicine thousands of years ago, it’s lost in time. We don’t know when it began. They mapped out emotions and how they affect our body. It’s visible. You can see the way people sit and how they look in their face, and you can tell what their emotions are. We all know that already. They mapped it out so you could actually use that systematically, and they showed the rivers or channels on your body, how that emotion flows, and how you could start regulating it individually.
For most of us, we need someone who might be able to point it out to us so we can do it. We need teachers, and a doctor is first and foremost a teacher, not a prescriber, not a diagnostician. They’re a teacher. I am so struck with my patients that they might come to me and I’ll say to them, “So, you’ve had x-rays. What did the x-ray revealed to you?” They’ll say, “I’m not sure.” I’ll be confused by that because how did they not get that information?
They’ll say, “I have arthritis,” and I’ll say, “Where?” They won’t know the exact level, and they wouldn’t know the implications of that level. I think that that’s … I think as doctors or as acupuncturists, we don’t always realize how lucky we are with our education, so we don’t actually take the time to bring them up to speed so to speak.
We do that with our medical students but we need to do that with our patients. It is so delightful to see in a person’s face understanding and now, they can deal with this painful issue because they know what it means and they feel reassured and acknowledged, and then we can do something with it to teach people how to manage it and understand it and transform it inside themselves.
Dr. Lisa: Yes.
Dr. Ralph: One of the things they talked about also in acupuncture would be the various herbs that could benefit and the various nutritional components. I’ve wrestled with that because over the years, I’ve read the literature that said some of these formulations are tainted, and so we’ve now have better formulations I hope. I’ve also thought about it from the standpoint of like the local food idea. Should we be doing formulas that come out of China, or should we be doing formulas that came from the American-Indians, and how can we construct for my patient who happens to be living in Maine and might be a lobsterman, how can I help him construct the herbs, the nutrients, the exercise program, the self-awareness that will help him to use the structure that we got from oriental medicine, and the structure we have from our own American medical system to rebuild their life in a way that they’re better able to live with what problems they have and maybe correct them?
I think their system is big. It involved sticking in needles to active these channels. They also involve manipulation or massage to activate the channels. They talk about mindfulness, they talk about exercise programs and the nutrition. I think there are other things that they don’t talk about as clearly, but they would also obviously recommend avoiding things that are destructive to your system. I think all of that is pretty well laid out in oriental medicine, and it becomes a perfect adjunct corollary to American medicine and osteopathy, because osteopathy has that hands-on flavor to being a doctor in this country.
Dr. Lisa: Describe briefly what osteopathy is.
Dr. Ralph: It was created by an MD who was a physician and a surgeon. He just lost his family. His children died, and he felt like he needed to develop a different approach. He studied the structure of the human body and dove into anatomy in a very detailed way.
At a time when bonesetters did exist in Europe, it may influenced him here in the States. He really worked hard to develop a way of using his hands to touch people in a beneficial way. I think the important word rather than manipulation just refers to manos which is the hand, so we use this hands. I like the word ‘Touch’ because I think it carries the layers of my words and my touch you emotionally or thoughtfully or in your body, so when he taught …
He taught how to touch people in a way that could adjust their structure and help them to develop better health. In oriental medicine and in osteopathic medicine, we really understand a little bit about the different points or regions in the body, and how those points or regions can influence our inner organs and how they’re functioning. There are some points in the upper front of your chest that if you mindfully breathe up near your clavicle, it’s very relaxing, but it also helps irate your lungs. Those are lung points in oriental medicine, but they’re also points that we might use to touch or manipulate in osteopathic medicine to help people’s lungs to work better, as well as to release some of the tension that gives us anterior chest pain or a neck pain or headaches.
Osteopathic medicine deals with how our structure and our function works together, and it also recognizes how our mind and our body are interacting, and it also posists the idea that we have a spiritual component, whatever that might be. It brought up the idea that we function in the integrated whole, which I think is significant because I think one of the directions that I’ve had the opportunity by working together with Dr. Craig Schneider at Maine Medical Center in the Integrative Medicine Program the idea that were integrated in many layers, and I think that oriental medicine, osteopathic medicine and integrative medicine are these three well-fitting components that I’ve had the opportunity to study and I continue to try to play with and enjoy and work with.
Dr. Lisa: What you’re describing is something that I believe people are craving. I believe that patients are craving it, I believe that physicians are craving it … I think many people who went into medicine really did go into medicine because they wanted to become teachers, and because the touch was important, and the way that medicine has sort of a pendulum has swung is a way from having the time to do that. In the 15-minute visit, it’s hard to even have enough time to talk to someone. Never mind, help, teach them, help them understand, and then, the physical exam, just the examination without even touching to heal. The examination gets lost as well.
I’m sensing that the pendulum is swinging back and this craving is bringing us back to a place of really practicing us physicians and being I guess involved in our healing as patients in a way that is consistent with what you’ve described.
Dr. Ralph: I think that the patients are driving it. That’s been the last … quite a lengthy period of time, decades I believe where they really have been seeking more and more what … it originally was called ‘Alternative providers’ and then ‘Complimentary providers’, and now, they’re looking for integration of it.
Dr. Lisa: Dr. Thieme, how can people find out about your practice and the work that you’re doing in Falmouth?
Dr. Ralph: I could give you the name of our practice and our telephone number, and they could look it up on the internet even though I’ve not done that, so I have no idea what’s there. I do have patients who come in and say that I’m listed under the wrong address and I have multiple addresses, so I don’t know how the system works.
The name of our practice is ‘Falmouth Osteopathy & Acupuncture’. We’re located in Falmouth, 6 Fundy Road. I am pleased that I have a couple of colleagues that work with me there. One is Dr. Joy Palmer who’s a DO who taught, and Virginia, and graduated from the University of New England, and Dr. Elizabeth Strawbridge who went through the Maine Medical Center. Integrative Medicine Program is their part-time. She also practices in Maine Medical Center’s hospital doing integrative medicine and acupuncture there, so I have some very gifted people that I work with there.
Maybe I should give you our telephone number. It’s 207-781-6560.
Dr. Lisa: We had Dr. Strawbridge on the radio show last year, so listeners may remember Dr. Strawbridge. If not, you can always go to the podcast and learn more about the work that she’s doing. It’s really been a pleasure to catch up with you and to hear what you are doing these days and to hear a little bit more about what got you here. I’m sure the people who are listening enjoyed understanding what makes you the kind of doctor that you are and knowing that there are doctors like you out there who are practicing medicine in a very patient-centered way.
Thank you for coming in and thank you for the work that you do, and thank you for being my teacher.
Dr. Ralph: Thanks for the opportunity to spend this time with you and to see you once again.
Dr. Lisa: As a physician and a small business owner, I rely on Marci Booth from Booth Maine to help me with my own business and to help me live my own life fully. Here are a few thoughts from Marci.
Marci: When was the last time you took a break from what you were doing, from the work that was piled up on your desk and just looked up? I know that during the course of my days, I often forget to take a moment or two to just breathe, look up at the sky and dream, terrible that I have to remind myself to breathe, but when I do, I feel energized because in those moments, I’m able to let go of the daily grind and think more about what I want to accomplish, how I want my business to grow. Sometimes, those are the “Ah-huh” moments. If we all took a few moments out each day to stop what we are doing and dream a little about our business futures, not only would we feel a great sense of calm, but we may come to realize that these dreams can in fact come true.
I’m Marci Booth. Let’s talk about the changes you need, ‘Boothmaine.com’.
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Dr. Lisa: Today, we have with us on the show an individual that I’ve known for a very long time. In fact, we did a writing workshop I believe in 2006 together, and then I interviewed him in one of our very early shows, I think show number two. This is Dr. Richard Maurer. I’m so proud and pleased to be interviewing him and talking about his book, ‘The Blood Code’ today because I feel like I’ve known him from early on in this whole thing.
Dr. Richard Maurer practices integrative medicine in Portland, Maine and helps people resolve metabolic conditions such as pre and type 2 diabetes, hypothyroidism, heart disease risk and weight gain. He strives to help people catch and reverse metabolic conditions as early as possible heralded by symptoms like restless leg syndrome, high triglycerides, migraines and fatigue. He is the author of ‘The Blood Code’.
Congratulations and thanks for coming in.
Dr. Richard: Thank you, Lisa. It’s a pleasure.
Dr. Lisa: The other individual we have with us is Patty Hagge. Patty is a client of Dr. Richard Maurer and is also the writer and residence of ‘The Telling Room’. She has master’s degrees in social work and creative writing, three children and two grandchildren. She lives on Munjoy Hill.
Thank you for coming in.
Patty: You’re welcome. Thanks.
Dr. Lisa: We actually have had your husband on our show not so long ago, Cyrus Hagge.
Patty: Yes you have. Yes.
Dr. Lisa: I’m excited about this book, and I’m excited for you, Richard because I know that you’ve been working on this for a while. I’m excited about this book also because as a primary care doctor, I spend a lot of time with patients that I know need to make alterations in their diets. This book gives us some hard evidence that tells us what direction these alterations need to take and that’s new and different. This isn’t something that people have been talking about.
Dr. Richard: Right. Right. After practicing 20 years, I had followed so many different diets over that time. If I go before that, I was a child born in the ‘60s. Growing up in the ‘70s, my mother at some point read Adelle Davis, and all of a sudden, we started eating brewer’s yeast smoothies with a raw egg and a banana for breakfast.
I’ve been affected by the natural health movement throughout my life. It was no surprise in naturopathic medical school in the late ‘80s, early ‘90s that I pursued what I thought was the right diet. I was a vegetarian and it seems like the right thing to do, I had seven grain cereal … If anyone needed to know that there’s more than five grains, there are seven grains. There’s even nine-grain cereal.
I was eating what … Boy, the American Heart Association would say was a fabulously healthy diet. My first year of medical school was one of the sickest years of my life. I got chickenpox again, I threw my muscles out all the time, I developed allergies, I had a skin infection that was bizarre … It was not a healthy time in my life. I was very thin so people would think, “You must be so healthy,” but something wasn’t right.
It took me many years to really figure it out. Part of this work is a little bit of my experience, but it’s also framed in 25 years of naturopathic natural health practice, a medical practice that emphasizes really getting to the root of the problem and finding a dietary or nutritional or the exercise approach to really resolving and removing the underlying cause of an illness. I think that’s what steered ‘The Blood Code’. I think that’s what has really helped me successfully watch people reverse type 2 diabetes and no longer have it.
It’s not like they’re treating it or managing it, it’s not there anymore as long as they’re eating and living in accordance with their blood test results and some of what I wrote about in the book. It’s a fun time for me to break the shackles of what is a healthy diet. This book is not about what a healthy diet is, and I don’t go around preaching to people what they should or shouldn’t eat. I will say that I’m not a vegetarian anymore. That was a terrible, terrible diet for me and would have probably caused more illness early in my life.
Knowing I’m eating truly right for me and I can back that up with hard evidence on blood test to panels on myself and I can do this as well on hundreds of patients over the past years is rewarding. I hope this book can bring it to people who can bring it to their doctors or bring it to people who can bring it to their families and re-empower themselves to figure out what that right diet is.
Dr. Lisa: We’re going to talk about that, because I know people are going to be very interested as to what your approach has been. I want to find out from Patty why you thought that you needed to do something different in your own health, in your own wellness situation.
Patty: In 2009, my son was a teenager, he was diagnosed with severe sleep apnea. The doctor turned to me and he said, “It’s totally genetic. Who has it, you or your husband?” My husband and I both said, “It’s me.” I had to have a sleep study and I have a sleep study. I didn’t have severe, I had actually mild sleep apnea.
The doctor said, “Yes. You lose 10 pounds. You’d be fine, 10, 15 pounds, you’d be fine. Don’t worry about it.” I tried to lose weight and I could not lose weight, and I couldn’t. I couldn’t figure it out. I had seen Dr. Maurer off and on for years. I said, “Okay. Help me figure this out.” He said, “Okay. This is what you need to do. You need to go get …”
This is 2009. He said, “Go get a glucometer and take your blood sugar several times a day before you eaten, after you’ve eaten, in between and keep a journal and come back and see me in a couple of months.” Nothing else had indicated that I had any insulin resistance at all, like my primary care physician hadn’t even mentioned it.
Anyway, we came back and he looked at the stuff. He said, “Yes. This is what’s going on. You have insulin resistance.” What he actually said to me was … He said, “This is what you have to do. You have to change your diet. You have to take out some of the carbs and replace some of the carbs with fats instead of carbs.” I said, “Okay. I have no idea how to do that,” but I eventually figured it out. Trial and error, and I kept on testing my glucose levels and kept on going back to him saying, “Okay. How does this look?” until we figured out what exactly how to tweak my diet.
Now, if you took my blood work, you looked at my blood work, I do not look pre-diabetic at all. I look like a pretty healthy person.
Dr. Lisa: Are you feeling better?
Patty: Yes. Yes. Yes, I feel great. I mean, I have to work at it. I can’t give up. I have to stay on my diet. I have to exercise every single day. I have to keep going. Yes. Yes, I feel much better.
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Dr. Lisa: There has been some association between animal proteins and increased inflammation, and maybe not in everyone. You’re looking at me as though you’re going to tell me that’s just not true. Was that not true?
Dr. Richard: As a rule, that is not true.
Dr. Lisa: Okay.
Dr. Richard: Even some of the early studies, what was happening is the association error of science. We pool a bunch of surveys from Greater Framingham, Massachusetts and that’s called the ‘Framingham Study’, an ongoing study and we’re in the second generation of Framingham participants. You pool all those people in the mid ‘80s, and you find that the highest quintile about the …
If you’re in the top 20% of meat eaters, you had a little more heart disease and you had perhaps more inflammatory conditions than the lowest 20% of meat eaters. It made sense for someone to jump up and say, “Ah-huh. It’s meat that’s causing this.” What that is is a hindsight association. That was when a lot of these errors began, some of these survey studies, when you control for vegetable intake.
Say the highest 20% are typically the people that ate no vegetables. This was a McMuffin for breakfast, this was a roast beef and fries for lunch, and it was a pepperoni pizza for dinner. Say we change them, we say, “All right. Let’s take people that ate no less than four servings of vegetables a day, now take the highest 20% of meat eaters and the lowest 20%.” All those associations disappear.
Vegetables do seem to be a great equalizer. If you’re trying to wrap your fats and proteins in bread and fried oil, there’s going to be a problem. That’s the inflammatory diet. We want to point our fingers to the one thing in that meal, and a number of people have wanted to claim that it’s the meat or it’s the animal-based protein. Again, the evidence doesn’t support it. When you control for the other variables, it’s not an issue.
That’s certainly coming to light now as we saw ‘The New York Times’, Mark Bittman’s work and a number of investigative journalists that don’t quite have the same bias. They haven’t published something that they’re trying to protect, so we have a much more open expose of what the research really shows. To demonize meat and to demonize saturated fat, the emperor wears no clothes. It turns out these foods are not harmful to our body, perhaps how they were eaten in those survey studies was harmful.
Processed meat and fried oils, these are a problem for our health, and a whole foods diet also means that the skin is still on the chicken. We can bring those saturated fats and those animal-based proteins served with plenty of vegetables. I think I eat far more … I know I eat far more vegetables than I ever did as a vegetarian.
Dr. Lisa: Let’s talk about ‘The Blood Code’, because what I found most interesting as I was reading this book was that your lab tests are … they’re not new and different. They’re pretty straight forward. You just have a slightly more extensive panel than I think what most primary care doctors are offering right now in their offices. You talk about getting a cholesterol panel, you talk about getting a Vitamin D level which a lot of doctors are starting to do now, but you actually talk about also looking more into the thyroid, so not just doing a straight forward TSH which is a standard test, but also doing more test than that, and you talk about doing a ferritin level. You just go a little bit deeper but nothing wacky.
Dr. Richard: Thank you for that. It’s very true. I mean, I think there have been books that have tried to claim some proprietary test or tried to make one test. An esoteric test have more meaning than it should ever have. These are very straight forward tests, to look at a hemoglobin A1c. This is a very common test used to manage people with diabetes. I’m just asking people to do it before they have diabetes.
Running a serum insulin test is probably one of the tests I’m most passionate about. A baseline fasting serum insulin, this test provides a wealth of information and that with the glucose can really help me map whether someone is or isn’t insulin resistant and how severe it is or isn’t. Just that serum insulin on a fasting test is tremendously useful.
I shiver when I see people put on medications that raise their insulin level before anyone ever measured where their underlying baseline insulin was. I think it’s a very simple metric and provides a wealth of information. As far as cost, our local lab here, this test only costs about $28, so I’m never far from a lot of information. The information is accessible and affordable.
There’s a movement right now where it’s relatively recent. The federal government has made a statement that people have the right to receive their blood test results directly from the lab that orders them. This is part of a federal mandate to the labs, and the labs are thrilled with this. This way, the results go to the doctor and to the patient, as long as the patient requests it.
A number of other states will allow people to go and pay cash for test panels. This drives the cost to be even more affordable. I think the movement will be for people to be able to go to a local pharmacy or any local draw station, and for a relatively affordable cash price be able to get a panel of blood tests, and then see if that can steer them whether they can pivot off of those results to better navigate their diet and fitness habits.
To me, it’s very self-empowering. It’s an incredibly optimistic message that people can learn this and really better understand themselves and act on it. I think our doctors, as doctors, we need to facilitate that partnership and really put the power back in the person who needs to make these diet and fitness changes.
Dr. Lisa: Is that true, Patty? How did this all … Working with Dr. Maurer and knowing your labs, how did this make you feel compared to maybe your past experience with … I don’t want to say primary care doctors, I don’t want to blame anybody, but how did your relationship with Richard, Dr. Maurer … how did that change when you had your own information in front of you and he was explaining it and you really understood it more thoroughly?
Patty: I sought out Dr. Maurer in the beginning because I am that kind of person anyway that wanted to take more control of my life and didn’t want to have somebody else figuring things out for me. He always believed in test and talking about the tests and seeing how your blood work was going, and I feel like this really isn’t that new of a thing that you’ve been doing.
No. Numbers don’t really stay in my head, but it felt very real. This piece of paper explains what’s going on. “Look, and let’s compare it to last year.” I mean, I’ve seen him so long, he has a lot of these papers. I mean, we can see over time if something is shifting and I can say, “Okay.”
For instance, recently, my blood work looked good. One little thing was getting a little high and also, we haven’t talked about the calipers but the skin caliper thing, I had … In last … I don’t know, maybe a year, I started gaining weight again, and the little skin caliper said that I was collecting fat a little bit more. He said, “Okay. You have to start working out more,” and he started this fitness thing. It’s all like … It’s just very clear like, “This is what’s going on,” and if you do X, Y and Z, you can keep your blood work good and healthy and strong.
It’s very clear. It feels very clear, and then I feel like I can experiment within that. Like, “Okay. What is it that I really need?” I need to eat a little bit of protein, but mostly vegetables like he said, like, “I get it. I need to exercise every single day and every other day has to be with weights.” It does make me … I’m totally in control and I get to make decisions and I know what I need, so it does. It feels good and I feel like he’s supporting me, and when something happens like I feel like, “Wait. Why am I randomly gaining weight?”, we can look at the blood work and we can tweak it and figure it out.
It’s great. I like that way of working. It makes sense to me.
Dr. Lisa: The skin caliper measurement is an important part of what you’re suggesting, Richard because the skin caliper, anybody who’s listening doesn’t know, you take a fold of skin and you put it in between sort of a pinching instrument, and it doesn’t’ really hurt, and you just find out how big this fold the skin is. It’s very basic, very straight forward, not expensive … Sometimes, it can be a little humbling, but it’s not a hard test, but it does give you a good baseline.
It does tell you, “My upper body is in need of some conditioning”, and it helps with this.
Dr. Richard: Right. It’s another simple, inexpensive metric to steer people towards diet or fitness changes. For less than $20, you can get an extremely accurate caliper. With a little practice, you can do it on a buddy, you can do at some points on yourself. You won’t be able to do all four because one of them is on your back.
I’ve used calipers for 20 years in my practice. The simple little rules that I state in the book, in ‘The Blood Code’, if the triceps are measuring higher than right above the hip bone, then there probably needs to be more exercise. This is a deconditioned state. Some people with hypothyroid will start to move in this direction because on a day off of exercise, people with hypothyroid will go even more metabolically asleep. They’ll slow down even more.
If people have a higher measurement at the hip, it means they really need to do a more ambitious attempt at reducing their carbohydrate intake. Really, to steer people towards dietary changes or exercises changes, the caliper is a simple measurement to help me do that. If someone is even, it may be a little 50/50, where diet and exercise really are both emphasized the same.
Dr. Lisa: I’m very excited about the book. I’m very excited about the opportunities that this presents for people and the possibility of partnership with their doctor if that’s the way they choose to utilize it or even if they just choose to read it on their own. It sounds like Patty, you’ve had a great experience in terms of partnership and understanding your own body better.
Patty: Yes.
Dr. Lisa: How do people find out about your book, ‘The Blood Code’, Dr. Maurer?
Dr. Richard: People can go to ‘Thebloodcode.com’. That’s a website and a real resource for people to sign up for an ongoing newsletter, to utilize some of the posts that the other people in ‘The Blood Code’ community are bringing to light, things that they’ve tried in their life that have been successful or not, and building that conversation and that community really helps again I think reinforce the empowering message that type 2 diabetes is not something we treat, it’s something we can make no longer exist if we live in accordance with it. It’s changed my perspective and I think the ongoing conversation at the website and in the book will really help people see their bodies in a more optimistic light.
Dr. Lisa: I appreciate you both coming in and speaking with us today. I encourage people to go to your website and read the book, ‘The Blood Code’. We have been speaking with Patty Hagge, a client of Dr. Richard Maurer who is also the writer and residence of ‘The Telling Room’, and with Dr. Richard Maurer who’s the author of ‘The Blood Code’. Thanks so much for coming in.
Patty: Thanks for having us.
Dr. Richard: Thank you, Lisa. It’s a pleasure.
Dr. Lisa: You have been listening to the ‘Dr. Lisa Radio Hour and Podcast’ show number 146, ‘Patient-Centered Wellness’. Our guests have included Dr. Ralph Thieme, Dr. Richard Maurer and Patty Hagge.
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This is Dr. Lisa Belisle. I hope that you have enjoyed our ‘Patient-Centered Wellness’ show. Thank you for allowing me to be a part of your day. May you have a bountiful life.
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Dr. Lisa Belisle is a physician trained in family and preventative medicine, acupuncture and public health. She offers medical care and acupuncture at Brunswick Family Medicine. Read more about her integrative approach to wellness in ‘Maine Magazine’.
The ‘Dr. Lisa Radio Hour and Podcast’ is recorded in the studio of ‘Maine Magazine’ at 75 Market Street Portland, Maine. Our executive producers are Kevin Thomas, Susan Grisanti and Dr. Lisa Belisle. Our assistant producer is Leanne Ouimet. Audio production and original music by John C. McCain. Our online producer is Kelly Clinton.
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