Happy 2013! One thing I resolve for this year is to share more often what I feel is important for achieving optimal health in body mind and spirit. My musings of one year ago (yes, we got busy) still ring true as a call for self discipline and commitment, but right now I am really excited about a book published last year called “The Willpower Instinct”, more about that in next month’s post.

Meanwhile, to elaborate on my revised “My Body is My Home” page on my updated website, how diet and nutrition affect chronic pain continues to be a very hot media topic. Practical Pain Management and Pain Pathways journals have published articles on anti-inflammatory diet and diet for chronic pain repeatedly in the last year and a half, with a variety of health professionals’ opinions, and a several “anti-inflammatory diet” cookbooks are available as well.

Although each source has a slightly different take on the subject, the overwhelming consensus is that inflammation is at the root cause of not just all degenerative processes but pain in general- from arthritis, degenerated discs, tendonitis, R.S.I., you name it.
It all stems from our basic amazingly complex cellular metabolic processes, which either pump out pro- or anti-inflammatory mediators and chemical messengers, depending on many factors, mainly diet. For example, one of the key markers of inflammation is edema, and any swelling in the tissues compressing nerves will increase the pain of carpal tunnel syndrome, R.S.I., degenerated lumbar or cervical discs, and other neuro-orthopedic conditions.

#1 inflammatory dietary factor: high glycemic refined carbs and sugars, due to wide swings in blood sugar and increased insulin surges. Right up there: trans fats. Very significant: the imbalance of fatty acid intake in the modern diet- too much omega 6 (most polyunsaturated seed oils) and not enough omega 3 (flax/hemp/chia seeds, cold water fish, grass fed meats). Dairy or gluten – damned by many, but whether in moderation harmful to you can only be determined by elimination and then challenge.
Of course, negative nutrition- artificial sweeteners and fats- just plain toxic.

#1 anti-inflammatory remedy: a rainbow of fresh fruits and vegetables for potent antioxidants and phytonutrients, fiber, minerals like magnesium, potassisum, and bioavailable calcium. Emphasizing intake of omega 3 containing foods.
Spices like ginger and tumeric. Very important: Avoiding hypo/hyperglycemia from erratic eating schedule and intake of high glycemic carbs alone, by eating good quality protein and fiber with every meal, and favoring low glycemic carbs like sweet potatoes.

So who knew? Coffee and toast on the run, not much better than a typical fast food, trans fat- cholesterol laden breakfast bomb?

The year’s beginning is traditionally time to make and attempt to carry out “resolutions”- goals for some kind of positive change or accomplishment.

The ritual of taking stock and looking ahead is a good thing, but only the first step. The power to sustain change and ingrain a new habit (or resume one) comes from a deep desire and the discipline to carry on past the pitfalls and distractions of inertia, temptations of familiar temporary pleasures and comforts, and hidden self sabotage.

Let’s take the example of yoga. Why would you want to begin (or resume) a yoga class or home practice? Have you read or heard that yoga might help your physical pain, limitation, or condition; or reduce emotional/psychic stress? Or have you already had a positive experience with yoga- increased relaxation, well being, mobility, or vitality?

The more positive feedback one has with an activity, the more likely it is to be reinforced to become a habit. Still, commitment must be strong to sustain a habit through the treacherous shoals of our life’s passage- endless demands on our time from family, work or competing activities, or our natural sloth and inertia – much less effort to stay cozy in bed, or enjoy a leisurely morning coffee and the newspaper or a good book, and then the time is gone. It is essential to “keep your eyes on the prize”- your motivation, your “why”, and “just do it” so you can keep building those positive results and reinforcement, until your new habit is a part of your life you would not want to give up!

However, from that point on it is still not easy street. Guess what? After almost 30 years of essentially daily yoga practice (with 10 previous years of less commitment), I still sometimes have to steer myself to my yoga room in the morning, and resist the temptation to first sit down at the dining room table, or at the computer, or start fussing around outside in the garden. Why do I keep at it? Because if I don’t, in a day or few the physical and energetic consequences are obvious to me and everyone I come in contact with. And when I do honor my daily commitment, besides the obvious benefits to my body mind and spirit, there is that sense of mastery and satisfaction- that I have taken care of myself in the best possible way, so that I may be of maximum service to others.

Blessings for a healthy happy prosperous 2012!

Extricating ourselves from home and work, down to one of our favorite So Cal desert spots… Expansive and uplifting for heart and soul,
but there is a bit of a trade-off—the food! Specifically speaking, road food- away from our little No Cal bubble of local abundance of organic farm sourced fruits and vegetables, grassfed animals, free range chickens, wild salmon—is it really true that the vast majority of Americans want and eat, on a regular basis, fast food chain fare?! Sure, have healthy snacks for car food, but at some point one wants and needs a sit down dinner or breakfast.
But little victories come after prolonged searching, just at the edge of too tired and hungry—the little mom and pop pizza place in Bakersfield with a fairly decent salad bar, or the coffee shop in Apple Valley that offered grits and fresh sautéed potatoes as side dishes for the multivegie omelette.
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Still, thank God for Juice Plus! That nutritional gap it fills can get to be almost as big as those canyons in the desert mountains when we are down there. Thinking of all these people in our fast food nation- the task of helping them to embrace positive changes in diet and lifestyle can seem as vast as the open space of the high desert. But, the movement is growing, consciousness is being raised, and I am glad to be part of the process- to be of influence to those I can.

To learn more how influential our nutrition and lifestyle can be over our health and medical destiny, don’t miss guest presenter Paulette Suzanne discuss Epigenetics and how our DNA is not our destiny, Thursday Nov 17. See my Events and Gallery page for more information.

Gail Dubinsky M.D. specializes in orthopedic medicine, including osteopathic manual therapy, treatment of spinal, joint and soft tissue injuries, repetitive stress injuries, yoga instruction and therapy, and emphasizes nutrition and lifestyle changes for optimum health.

What do you get when you combine walking outdoors in nature, yoga, synchronized breath patterns, and meditative awareness?

Come join me and find out on my next Breathwalk, Saturday October 8, 9 – 10:15 A.M.
Breathwalk is a unique blend of breath patterns synchronized with walking and focused awareness, which can immediately influence and balance our mood and energy.

There are 16 different Breathwalk programs, each with a unique effect, created by a specific combination of the 5 steps: Awaken, Align, Vitalize, Balance, and Integrate. Depending on the need or situation, one can energize, relax, focus, motivate, connect, enhance intuition, and more!

We will meet at the Willowside School Parking lot, Hall Rd, just east of Willowside, in west Santa Rosa. After a brief orientation we will carpool the short not safe to walk distance to the Santa Rosa Creek as it crosses Willowside Rd. After a short standing yoga warm up series (not traditional asanas per se), we then will walk approximately 30-40 minutes on a flat gravel or dirt trail, returning for a brief cool down of balancing stretches and integrative “inner walk”.

Cost is $10. No need to RSVP, just show up! Dress in layers suitable for movement and appropriate shoes. If weather looks questionable, call my voice mail 829-7596 the morning of, and if I have not left a message canceling it, we’re on!

For more information, see http://www.kundaliniresearchinstitute.org/breathwalk/welcome.html

Solstice is behind us, but we are just beginning with the summer fun! Weather is finally good (meaning season appropriate warm!), garden is in, hard work is done, now watch it grow, keep the weeds and varmints at bay, starting to reap the rewards!

There is no better time to change your nutrition for the better, with the amazing variety of fresh fruits and vegetables available now, in a progressive succession of what comes in and goes out of season. Did you know the prime way to reduce the risk of heart disease, cancer, all degenerative conditions ( including arthritis and dementia) and increase your energy, vitality and well being all boils down to a simple action: Eat your fruits and veggies! And lots of them- going for a daily variety of colors for all the synergistic nutrients that cannot be gotten from any supplement or vitamin. Why
not? Come find out in the next nutrition and lifestyle presentation I will be hosting with Joanna Rebelgale in  Santa Rosa Monday July 25. For more info, email me at dubinsky@rxyoga.com

From the steady dormancy of winter, now we have the start/stop energy- want to get out gardening, but alternating rain, sun, cool, warm, windy or not… Patience and timing- applicable for life in general!  Meanwhile, try to curb your enthusiasm out there weeding- beware of those repetitive stress injuries!

Just off the phone with a future patient with an all too familiar story. Car accident, immediate back and neck pain. Ambulances descend- off to the Emergency Room for cursory evaluation, as they are  never happy to be bothered with soft tissue injuries, lumbar strain, cervical strain. No “treatment” other than a few prescriptions, maybe not even Xrays.

So what has been accomplished? Besides the further trauma and stress of being strapped down on an uncomfortable board and  waiting long hours for attention, you have probably used up most if not all of your Med Pay insurance, assuming you had it. (please see my site http://www.gaildubinskymd.com/med_pay.html  , or my most recent blog in January. )

My soap box message for this month is: Refuse the Ambulance! Do not allow yourself to be coerced into being transported to the Emergency Room unless you are bleeding profusely, can not move parts of your body,  truly suspect you have  broken bones, or are/were unconscious (not just the “blackout” from psychic shock).  In the absence of those circumstances, it is just a huge unnecessary and unproductive stress, trauma and expense.  Far more healing to go home, ice, take arnica or an anti-inflammatory, and rest. I don’t even recommend going to the E.R later or the next day, or even urgent care. Instead, within the next few days, seek treatment with a doctor such as myself, chiropractor or osteopath, either known to you or by referral from friends or family, experienced in dealing with motor vehicle accident cases, whiplash, back and neck injuries, using hands on rehabilitation– pain pills and muscle relaxants only help symptoms temporarily.

What supports our healing from any orthopedic injuries in general? Rest, sleep, modified physical activity and movement- staying mobile without overuse and strain, and, just as important but not always considered: good nutrition!                                  An anti-inflammatory diet of fresh whole foods, fruits and vegetables provides the anti-oxidants your body needs to heal and repair. Fast food, junk food, processed food full of sugar and bad fats are pro-inflammatory, which translates to more swelling and pain.

Lemons to lemonade- can a negative event be a catalyst to develop better health habits in the long run?

Almost a month into 2011.. I am really enjoying the spare beauty of bare trees, stripped of leaves, revealing the clean lines of their branches silhouetted against the pale sky- down to bare essence. We can enact this simplicity and paring down with a year end cleaning out of all the unnecessary paper and other clutter that fills our energetic and physical space..leaving you lighter, fresh and ready for the growing days and tasks that fill them.

Garden sap definitely starting to rise- breaking the 4-6 week habit of basically staying out of the yard during the coldest year end spells, venturing outside to plant a few bare root items here and there, move some dormant plants around to redesign the yard some, plan other projects, and of course, the call to weeding now, pruning shortly to come. Herein lurk the most insidious threats of repetitive stress injuries!! A good time to start, resume or continue your Yoga for Gardeners practice, and remember: it’s not just stretching, but attitudinal adjustment! And remember to keep those clippers and pruning tools sharp..

On a totally different note, I am still trying to get the word out as an orthopedic doctor who treats a lot of motor vehicle accidents… have you checked your auto insurance policy lately? With the unfortunately high numbers of uninsured, underinsured, inattentive, incapacitated under the influence, and/or just plain incompetent drivers out there, it is important to protect yourself with generous medical benefits
and protection against people who have no or inadequate insurance whom you may have the misfortune to come into vehicular contact with! A bit more money for insurance up front will provide you with treatment you need, proper compensation, and greatly reduced hassle and stress (that alone is priceless) just in case you were to be in an accident. See my web site under medical practice- med pay, and talk to your insurance agent-
make it a new year’s resolution with immediate follow through!

As Thanksgiving approaches, it seems common to focus on being grateful for all we have, that sometimes we take for granted. But we know that cultivating that attitude of gratitude anytime is guaranteed to elevate our spirit and grant us a clearer perspective in relationship to all that is around us. What is in the forefront of my consideration these days is Commitment and its companion Discipline.

It seems to me that so many people struggle to follow through with their best intentions— let’s take for example to attend a yoga class. When one decides to try something new to their daily or weekly routine, it requires creating a new habit, outside our comfort zone. Habits are established by repetitive action over and over, preferably at the same time of the day or week. One begins with the motivation– the desire to relieve low back pain or neck pain,  a repetitive strain injury, sciatica, tendonitis, etc., or just learn better breathing or how to relax. Then what is required is the discipline to follow through and show up, not letting any excuses prevent doing so.

There are so many reasons to fall off the path of commitment- being busy, family emergencies, being sick, being too tired, being in too much pain, and more. It takes looking  deep within and inquiring why there are so many and frequent obstacles to taking care of ourselves, and how we can manifest a clear path so we can move forward on our goal. Trusting and reaffirming the original intuitive choice to move forward toward better health, no matter what the vehicle (yoga, Tai Chi, exercising at the gym, eating better), is the first step. The second is to make a strong affirmation to yourself in whatever way is most effective (note on the mirror, saying it out loud every morning after rising, etc). The third is (and Nike does not own this!) to truly Just Do It, on a repetitive basis!

In my physical chemistry class way back in college, I learned about the “energy of activation”:  it takes a lot of energy and will power in the beginning, in other words an uphill battle. However, after persevering, one crests the peak and then it is downhill from there! So it is with committing to a healthy new habit, and practicing the discipline to maintain it. It will feel really great on so many levels to succeed.

From the summer that really wasn’t, with bipolar weather strongly in depressive mode (grey and cool) for months with one manic spike (106 degrees F?!), now we are in a beautiful Indian summer on the first official day of fall. I am now in somewhat of an identity crisis- a newly minted Level 1 Kundalini Yoga Teacher, but my professional reputation over the last 20 years is the orthopedic doctor who teaches therapeutic, largely Iyengar based, yoga for back pain, repetitive strain injury, etc. Can we integrate the two? Probably not, as Kundalini yoga is not to be blended, hybridized, or otherwise modified other than adapting certain asanas for physical limitations. As a tremendous tool for my personal transformation, it shall serve as making me a better physician and  yoga teacher, in whatever specialty or style I choose, as well as  better wife, friend, family member, and all around human being!

Autumn is always for me a time of new beginnings and “projects”; this year’s looks like it will be helping out in family matters, the aging parent thing. Just when I thought I was done with monthly flights  to Los Angeles, I guess we will be continuing in that vein! Ample opportunity to practice attitudinal reality adjustment: things are as stressful and difficult as we make them out to be in our thoughts and expectations. Repetitive stress of negativity can be overcome by substitution of a different choice: to assume everything will work out fine, smoothly, and without a hitch. And the amazing thing I am learning is: being more positive makes my life a lot easier!  If we are going to be creatures of habit, may as well make them more beneficial and pleasant ones….

This fall and winter are shaping up to be a bit more mellow than the first part of the year..No public appearances planned other than for the Rohnert Park Garden Club in late October.Otherwise,  I teach one more 6 week session of Yoga for Pain Management at the Center for Well Being staring October 19. See my website gaildubinskymd.com home page for more information.

Enjoy the progression of the season!

Another busy 4 months since my last post, during which I have been conducting active research on the matter of whether getting up at dawn, give or take an hour, to practice yoga and meditation can actually add hours to the day…. I had always thought of myself as a reasonably disciplined individual with a mostly daily yoga practice, but nothing like a mandate from the Kundalini Yoga teacher training I am immersed in to really practice, one to two hours a day, no matter what else is in my schedule that morning, to make my life a whole lot different, and definitely better! The sleep schedule required some adjustment, and the decades old pattern of late night work and activity is falling by the wayside, but there are now 2 hours  in the morning I was always longing for, plus a way better start to the day than fretting that I had not had enough time for a decent yoga practice…

Now I am feeling more inspired than ever to bring my yoga to my medical practice, and give yoga posture and breathing exercises taylored to the individual, to help with lumbar strains, spinal disc injuries, arthritis or whatever other orthopedic injuries are causing chronic pain and dysfunction. At the same time, I love being an orthopedic voice or reason for my patients in my private practice as a primary care or consulting doctor, still my “day job” for sure.

So after all the cold and rain, it is now full tilt gardening season, with all the risks of repetitive stress injuries, repetitive strain injuries (still no internal consensus what to call it!) orthopedic injuries, back strains, tendonitis, and general excess and overdo. Besides stretching and strengthening, don’t forget that yoga for gardeners also involves non-violence, particularly to oneself. For instance, I have finally absolutely refused from last week onward to use a certain wheelbarrow which, due to its heaviness and lack of balance, has always managed to make me sore or injure me in some way – No More!   So, take a moment to figure out how you can make your gardening more easy and safe, and eliminate what just doesn’t work for you-  redesign, delegate, or  drop it….

We are going corporate in June, down to Stanford Research Institute for presentations on both Yoga for Gardeners and R.S.I.? Rx:Yoga!  The ultimate message: Yoga is a lifestyle of sustainability – for body mind and spirit.