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Ferritin: More Than Iron—A Diagnostic Power Tool

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“Not All in Her Head”: Callie’s Story of Seizures, Strength, and Starting Over

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An Important Reminder From Nurse Nan: Save Your Tick

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Losing your mind or are you sick?

“I Think I’m Losing My Mind”: When Treating Tick-Borne Illness Feels Worse Before It Gets Better

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A Patient’s Story: From Pushing Herself to Be Stronger—To Acceptance

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Good Morning Washington Visits the Kaplan Center! Part 2

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Managing AFib Symptoms

How to Improve AFib Symptoms

Nutrition and other lifestyle modifications can have a meaningful influence on your Afib symptoms.

AFib, atrial fibrillation, is a form of arrhythmia (irregular heartbeat) that involves the upper chambers of the heart (atria). When the upper chambers are out of sync with the bottom chambers (ventricles) a person will experience an irregular heartbeat. AFib is the most common type of arrhythmia, affecting approximately 2.5 million adults in the United States, and unfortunately, that number is expected to rise.

Causes and Symptoms

Within the tissue of the heart, there is an electrical system that controls how the heart pumps. Most commonly, AFib is a result of damage to the heart tissue which may be caused by a condition like high blood pressure, obesity, type 2 diabetes, or an existing heart condition. It may also be caused by infection, aging, or genetics.

Between 10-40% of people with AFib are asymptomatic (“silent AFib”), but those who are symptomatic may experience any of the following:

  • Fluttering heart or palpitations
  • Shortness of breath
  • Fatigue
  • Chest pain
  • Low blood pressure
  • Dizziness

Untreated AFib can lead to an increased risk of blood clots, stroke, and heart failure or may even complicate other health conditions; therefore, it’s extremely important to have a discussion with your provider if you are experiencing symptoms or believe you may have AFib.

Suggested Lifestyle Modifications to Lower Risk of AFib

If you have been diagnosed with Atrial Fibrillation, management may involve medicine or, when necessary, a medical procedure called ablation; however, living a healthy life with AFib will always require lifestyle changes.

Nutrition

Research confirms that a healthy diet can reduce AFib symptoms:

  • A study published in Nutrients in 2022 showed that people who ate a Mediterranean diet had lower rates of AFib. Heavy on nuts, fruits, vegetables, fish, and extra virgin olive oil, the
    Mediterranean diet is rich in phytochemicals, antioxidants, and healthy fats, all of which help lower overall inflammation and keep the immune system strong.
  • Excessive sodium can increase blood pressure, a known trigger for AFib. If you’re accustomed to eating processed, frozen, or take-out foods – all of which are very high in sodium – you’re likely to consume far more than the daily recommended amount of 2300 mg. Modifying your diet by cutting out high-sodium foods will have a profound effect on your overall health.
  • Despite what we’ve learned about the cardio-protective effects of alcohol, patients with AFib will benefit by limiting or omitting alcohol consumption altogether. A 2021 study found that for
    people who have been diagnosed with AFib, even one drink can increase the odds of an episode by twofold; the more alcohol consumed, the greater the risk increased.

Obesity

Obesity is a known risk factor for AFib; the good news is that it can be improved by weight loss. A study in the J American College of Cardiology found that sustained weight loss can improve AFib symptoms six-fold in patients who lost more than 10% of their body weight.

If you are having difficulty losing weight, consider working with a nutritionist or healthcare provider who can implement a personalized nutrition program to help you safely and effectively reach your goals.

Sleep apnea

There is a strong association between obstructive and central sleep apnea and Atrial Fibrillation. Sleep apnea can add an inordinate amount of stress on the body, including the cardiovascular system. A 2021 study found that people with sleep apnea are 2-4 times more likely to develop AFib. If you have sleep apnea talk to your provider about treatments to help you manage symptoms, which may include lifestyle changes, acupuncture, a customized mouthpiece, or CPAP machine. This is especially important if you have been diagnosed with AFib. This study also showed that patients who underwent ablation to improve AFib symptoms had greater success (i.e. less symptom recurrence) if their sleep apnea was previously treated.

Smoking

Much like alcohol, nicotine is a stimulant that can increase heart rate and blood pressure. A 2018 review of research found that cigarette smokers have a 32% increased risk of developing AFib compared to non-smokers, but that quitting can lower that risk. Studies that look at e-cigarettes are not as plentiful yet, but preliminary research confirms an association; this 2022 study found that e-cigarette aerosols can increase arrhythmia in mice. A long-standing smoking habit can be hard to break, but it’s never too late to quit and the benefits make it well worth the effort.

Bottom line

Your heart is too important to ignore. Living a long, active, and healthy life with AFib is possible with the risk-factor modifications mentioned above. If you feel overwhelmed by the changes you need to make, consider working with a healthcare professional who can help you set goals that are realistic and achievable; your heart will thank you.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

PRP or Prolotherapy for Knee Pain

Platelet Rich Plasma (PRP) and Prolotherapy – Non-surgical Treatments for Musculoskeletal Pain

If you have suffered from chronic joint pain or a sports injury to a ligament or tendon, PRP (Platelet Rich Plasma) and Prolotherapy, regenerative injection therapies that promote repair and self-healing naturally, may be a treatment option for you. There are different levels of joint dysfunction. There are also different levels of treatment. The right injection therapy can help you increase function, decrease pain and healing time, and get you back to living your best life faster. Injection therapies also help some people avoid orthopedic surgery! Regenerative injections can also be used to rejuvenate aging skin and regrow hair.

PRP – Platelet Rich Plasma

Platelet-rich plasma is an injection procedure that uses concentrates from your own blood, the platelet-rich portion of your plasma, to help your body heal and regenerate naturally. Platelets are very small cells in your blood that are involved in the clotting and healing process. When injected into the damaged area, PRP causes a mild inflammation that triggers a healing cascade. As the platelets organize in the treatment area, they release a number of enzymes to promote healing and tissue responses, including attracting stem cells and releasing growth factors to repair damaged tissue. As a result, new collagen and elastic fibers begin to develop. As the collagen matures, it begins to shrink, causing a tightening and strengthening of the tissue in the damaged area.

Prolotherapy

Prolotherapy is a safe and simple regenerative medicine injection treatment used to strengthen weak and damaged ligaments and tendons due to chronic injury or overuse. Many patients with stretched, torn, or injured ligament and joint attachments have difficulty returning to pre-injury level of functioning due to limited blood supply to these structures. Chronic anti-inflammatory/ NSAID use or overuse of steroid injections further impairs this process. Surgery can often produce scarring and a limited range of motion without addressing the root cause of dysfunction. The technique requires injection of Dextrose or Ascorbic Acid (Vitamin C), and methylcobalamin (Vitamin B12) precisely into the site of pain or injury, where the ligament or tendon attaches to the bone, joint capsule, trigger point, or inside joint.

Prolotherapy creates a mild, controlled inflammation that stimulates the body to lay down collagen with the formation of new tendon, ligament, and cartilage, resulting in a strengthening of the weakened structure. This injection process stimulates the body’s natural wound repair process. A typical treatment course is 3-6 series of injections, given every 3-4 weeks. Prolotherapy has been used for over 60 years with numerous case reports and an increasing number of controlled studies showing its effectiveness.

Physical Conditions that Can Benefit from Injection Therapies:

  • Knee Injuries
  • Shoulder Injuries
  • Rotator Cuff Tears
  • TMJ Dysfunction
  • Tennis Elbow / Golfer’s Elbow
  • Joint Instability
  • Lower Back Pain
  • Plantar Fasciitis
  • Osteoarthritis
  • Support for Hair Regrowth

The best way to find out if you are a good candidate for either PRP or prolotherapy is to receive a comprehensive evaluation to rule out other possible causes of your pain (through appropriate medical testing) and to provide you with an accurate diagnosis first before recommending the most effective treatment.

If you have any of the conditions mentioned above and are looking for a non-surgical treatment option to treat your condition, please give us a call today to schedule your appointment. 

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

References:

Bae G, Kim S, Lee S, Lee WY, Lim Y. Prolotherapy for the patients with chronic musculoskeletal pain: systematic review and meta-analysis . Anesth Pain Med (Seoul). 2021 Jan;16(1):81-95. doi: 10.17085/apm.20078. Epub 2020 Dec 16. PMID: 33348947; PMCID: PMC7861898.

Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. Int J Mol Sci. 2020 Oct 21;21(20):7794. doi: 10.3390/ijms21207794. PMID: 33096812; PMCID: PMC7589810.

Managing Fibromyalgia Pain with an Integrative Approach

Managing Fibromyalgia Pain

Characterized by widespread pain, fatigue, and cognitive difficulties, fibromyalgia (FM) is a complex disorder of the central nervous system (CNS). It affects the brain’s messaging system causing those who have it to experience heightened sensitivity to pain. A fibromyalgia flare-up can last for months at a time and cause debilitating physical and emotional distress. Symptoms can vary from person to person and often suggest other conditions, making it a very difficult diagnosis. Despite all that has been learned about fibromyalgia over the last two decades, people with FM can go years without a proper diagnosis.

Fibromyalgia is associated with many other conditions like Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis), sleep dysfunction, infections like Lyme disease or E-BV (Epstein-Barr Virus), digestive problems such as SIBO (Small Intestinal Bacterial Overgrowth), or Celiac Disease and other food allergies that can cause leaky gut. It can lead to autoimmune disorders like Hashimoto’s thyroiditis or autoimmune arthropathies. People suffering from FM may also exhibit reactions to environmental toxin exposure, like mold or heavy metals, which can be diagnosed through specialty labs looking at stool, urine, breath, and bloodwork.

A functional approach to treatment

Once you receive a fibromyalgia diagnosis, there are various treatment options and lifestyle habits to consider. As a functional medicine practitioner, my approach to treating fibromyalgia is multifaceted; I look at digestion and diet, sleep, hormone imbalances, injuries (psychological and physical), infections, environmental exposures, genetics, and more.

For example, I often find that fibromyalgia is related to a deficiency in delta-wave deep sleep; medications like Xywav, which promotes deep-wave sleep have been helpful in reducing chronic pain. If you don’t get enough deep delta wave sleep your body can’t recover, and chronic pain can be an issue. (We find that this is common in those with fibromyalgia.)

A common area of pain is the cervical spine. Treatments like physical therapy, acupuncture, or injection therapies like prolotherapy, perineural injection therapy (PIT), or PRP (platelet-rich plasma) therapy may be helpful. You may also consider having your jaw evaluated for TMJ by a dentist specializing in temporomandibular joint problems, which can often cause referred pain in the head, neck, and shoulders.

Another treatment to consider is Low-Dose Naltrexone (LDN). When chronic pain is a result of neuro-inflammation (brain inflammation), LDN can help by reducing the upregulation of the microglia that cause this inflammation.

If you have leaky gut from a food allergy, then inflammation of the intestinal tract leads to nutritional deficiencies and toxicity; I’ll want to look at dietary changes and supplementation. Supplements that may be helpful include D- ribose, fish oil, glutathione, and IV magnesium with B complex and Vitamin C (also known as Myers cocktail).

Because FM affects the CNS, it can influence your experience of pain and emotional sensations; therefore it’s very important to consider my patients’ emotional health which is often not addressed in chronic pain. There are many stress-reduction therapies that can be done from the comfort of your own home including yoga, mindfulness-based meditation, breathing exercises, and even a therapy called Emotional Freedom Technique which involves tapping acupressure points and utilizing positive affirmations. However, if you feel overwhelmed by symptoms, look for a psychotherapist who specializes in working with people with chronic pain. Dealing with chronic pain is emotionally exhausting; seeking help can be a vital lifeline for many.

As with other chronic illnesses, treating fibromyalgia is not a straightforward process; it requires a multifaceted treatment approach with close collaboration to help you recover or better manage your illness.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

Additional Resources:

Consumer Guide: 18 Things You Should Know Before Choosing a Doctor to Treat Your Fibromyalgia