Are You Staying Healthy This Winter? (How are you getting your Vitamin D?)

 

Here we are, neck deep in another Alaskan winter. For some of us this is the best part of living in the state. From many, I hear grumbling about the cold, the dark, the aches, and the pains that come with winter. Those complaints, plus depression, are a real part of the season we experience. As our environment changes we become deconditioned, get dehydrated, and most Alaskans become deficient in Vitamin D.

Vitamin D deficiency is a common winter problem everywhere, but much more of a problem for us in the far north.  Symptoms can be aches, pains, fatigue, frequent infection, and depression. To combat this many local researchers and physicians recommend that all Alaskans take a supplement with 5X the recommended daily allowance. I thought that sounded extreme, until I started to research why.

Due to our latitude, we only get Ultraviolet B/UVB rays May through August. We cannot produce Vitamin D without UVB rays. That leaves us with eight months out of the year that we cannot create Vitamin D at all.

Most experts feel it’s almost impossible to get enough Vitamin D in food. No plants contain it, and few animal products do. We are fortunate because oily fish, like salmon, are one of the best sources. I like salmon, but don’t think I could eat it the 5-7 days per week it would take to get enough. That is why we have fortified foods, like milk, orange juice, and cereals. You would still need to eat 5-8 servings of the fortified foods to get your recommended daily allowance. So it is possible, but I am just taking the supplement; One tiny little capsule, with 5x the recommended daily allowance.

Our long cold winters lead to dehydration as well. Our cold outdoor air holds less moisture than warm air.  All the heating we do indoors dries the air out even more. Our sinuses and our skin are where we notice the most problems, but it affects all of the systems of the body, to include our immune system. So we are more prone to getting sick.

We need to get more fluid in our air and in our food. The tendency to make more soups, cocoa, and tea in the winter helps more than just warming us up. Using a humidifier or a pot of water on the fireplace helps reduce the dryness of the inside air. This will help manage bloody noses and allergy problems for many. Some more sensitive people need to resort to saline rinses for their sinuses. For the skin I recommend buying lotions that are low in water content. Coconut oil is an amazing natural product for healing, soothing, and protecting skin. It is expensive as a cooking product, but cheap compared to other skin products.

Please don’t let the news about the lack of UVB in the winter give you an excuse for not getting outside. We still get benefit from the sunlight. When it hits our eyes it stimulates the production of dopamine, our body’s natural “happy drug.” We need all the happiness we can get in the winter time.

Whether this is your first Alaskan winter or your 50^th, you will get through it better if you stay active, get your Vitamin D, and stay hydrated. This could be your best winter yet.

What’s your plan to stay healthy?

Reconsidering RICE for Injury Recovery

There is so much to do here in Alaska for those of us inspired to go outside and play. Many of us play too hard, too fast, and get ourselves injured. I always preach/advise to train in smaller versions of the play you plan on doing to prevent injuries. That’s a lot easier said than done when you have cabin fever. By the fall half of my family, and most of my friends, are nursing injuries of some sort.

For injuries that don’t land us in the ER, the gold standard for treatment for the last 30 years has been RICE: Rest, Ice, Compress, and Elevate. Today many professionals believe clinical evidence doesn’t support the practice. Even the researcher who originally championed the regimen, Gabe Mirkin, has come out to denounce his previous conclusions as flawed.  (Mirken, G. 1,2) I moved away from it a few years ago in my practice, and have had improved outcomes. It’s been nice to have strong science to back up my clinical observations. There are various new acronyms jockeying for favor, even one called MEAT, but none that are sticking like RICE did.

Not everything has changed. Compression and elevation are still good. Just keep the compression light, so you don’t compromise circulation. The biggest changes in advice involve Rest and Ice.

By Rest we mean; Stop doing what got you injured.  Many apply Rest by immobilizing or not using their extremity for days. This rest causes weakness and stiffness. In comparison studies, people who move recover sooner than people who rest. We recommend progressive movement, within any range of motion you have that doesn’t aggravate your pain.  People who can’t move actively, we’re moving passively. Movement, combined with elevation is excellent at improving circulation and reducing edema. It is what I do treat swelling in my post-operative patients. Move, then use, then strengthen; as sensibly and as soon as you can.

The most controversial recommendation is the advice to stop using Ice to treat inflammation. The argument is that we don’t want to treat the inflammation, because inflammation leads to healing. If we stop one “domino”, we stop the cascade. The clinical research seems definitive that healing is inhibited and slowed when ice is applied. Icing to get back into a game is not recommended either. It reduces, strength, speed, endurance, and balance; which increases injury risk. (4,5,6,7,8)

What ice is good at is numbing. So now we/you have to balance yourontrast baths (ice then heat) have not shown any efficacy either, other than as a convenient tool for torture. ith heat. ween.  desire for numbing your injury, and your goal of recovery. There are times that all of us will pick numb. An ice pack for 10 minutes on, 20 min off for the first few hours is optimal. Even contrast baths (ice then heat) have not shown any efficacy to reduce swelling or speed healing. (9,10) However, I find it a convenient tool for torture.

After 48 hours, I recommend heat for managing pain. Heat actually has a long history of use to speed healing and manage pain in scientific literature, and in traditional medicine. Adding heat does not trigger, or inhibit the complex cascade of inflammation. It does increase blood flow, which provides nutrients to assist with healing. Along with reducing pain, it increases range of motion and mobility. I see its benefits on a daily basis.

You should check in with a health care provider for an assessment if you aren’t getting better in a week or two, whether you are sticking with RICE, or living on the edge with me.  I am sorry to say, I don’t have an acronym that will help you remember the recommended changes, but I trust we will heal faster if we just “let it go.” (Some ice and movie reference intended.)

Authors note-( if you want to have some sort of disclaimer)  You will find a lot of information that contradicts the findings here. That information is based on text books that are decades old, and advice based on decades old theories that have been disproved in application. This advice here has been gleaned from the last 10 years of research in professional medical and sports journals. Persons who want to research the latest information further, can easily do so. 

References

1.       Mirkin G. Why Ice Delays Recovery. March 16, 2014. http://drmirkin.com/fitness/why-ice-delays-recovery.html. Accessed 7/26/2014  *

2.       Mirkin G, Marshall H. The Sports Medicine Book. Little Brown and Co. 1978 *

3.       British Journal of Sports Medicine. Cooling an acute muscle injury: can basic scientific theory translate into the clinical setting? Mar 2012, Vol. 46 Issue 4, p296 3p. *

4.       International Journal of Sports Medicine. July 2001: Vol. 22 Issue 5. p. 379-384 6p.

5.     Med Sci Sports Exerc. Microvascular perfusion and intramuscular temperature of the calf during cooling. May 2012 44(5) *

6.     American Journal of Athletic Training. What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults? 2012;47(4):435–443.*

7.     Journal of Strength and Conditioning Research. Topical cooling (icing) delays recovery from eccentric exercise-induced muscle damage. 2013 May;27(5):1354-61. *

8.     Athletic Training & Sports Health Care: The Journal for the Practicing Clinician Nov 2012, Vol. 4 Issue 6, p247 2p.

9.     Physical Therapy Journal. Comparison of Three Treatment Procedures for Minimizing Ankle Sprain Swelling.1988; 68:1072-1076.

10.  American Journal of Hand Therapy. A systematic review of the effectiveness of contrast baths.

2009 Jan-Mar;22(1):57-6

Sometimes it feels like spring time will never get here in Alaska. I am always thankful for when I see the rhubarb start to peek out from the frost. I know the bleeding hearts are not far behind. Soon I will be sporting dirt under my fingernails, and my annual war with chick weed and dandelions will be officially on.

This time of year I see a lot of injuries in the clinic, mostly “thrown out” backs, and muscle strains. People get out and start work in their gardens, or start playing their sport of choice. Even people who have been skiing or snowboarding regularly have a month or two of relative rest during break-up to get deconditioned. You can save yourself a trip to the doctor, and early season strains and sprains if you take some precautions.

Most of us do too much our first time out. The best advice is to ease yourself slowly back into the activity.  If you have an organized practice you are going to, try and get out a week, to 3 days before
the first practice, and do about half as much as you expect to do in your first practice. You will still be sore the next day, but much less likely to be injured at the first practice, and not as sore as you would have been without it.

Try not to let the soreness discourage you from going out and doing it again though. That soreness is part of the process of your muscles building themselves stronger. That increased strength will also help stabilize your joints and protect them through the season. Let your sore muscles rest for about 24 hours. Then stretch a lot the 2 days after you did the work, and get back on the proverbial horse to work out the stiffness within 36 to 48 hours.

Before you start your activity, be sure to warm up. Give yourself a good five minutes to get your heart rate up, and move slowly through the range of motion of the movements you expect to participate in. That is the best way to prevent injury.

Stretching can be important too, but stretching is not the secret to preventing injury that we were trained to believe it was back in the 70's and 80's. Stretching prior to work outs has been found to actually increase injuries.  Unfortunately many of us have been trained to stretch in the wrong way, at the wrong time, and to extremes.

If you want to stretch, it is best to stretch after you have exercised, when your muscles are warm and used to movement. Once you are warmed up, and active, your connective tissue is much happier in obliging in stretching. Really good research has shown that stretches done that are pain free, for prolonged periods of time, have the best results in increasing length of tissues. That would mean a minimum of 30 seconds, and to be honest, we have not yet found a maximum. Clinically we are stretching people who really need it, up to 20 minutes at a time.

Stretching in extreme ranges and with pain actually puts our muscles on guard. Our body reacts by engaging neural and mechanical feedback loops that fight back against the stretch. It is like arm wrestling with yourself; pushing and pulling at the same time.

Another mistake we make with stretching is bouncing. We saw Jane Fonda bending over and bouncing as her stretch. We thought this was the norm, and emulated it. Now, just the memory of that iconic bouncing makes me cringe. Rapid stretching can tear the muscles, which leads to inflammation and scar tissue deposition. This of course leads back to stiffness. Bouncing can also lead to injury of your nerves. Nerves do not stretch, and do not like tension, so be very wary of any tingling or sharp sensations when you stretch.

This spring, please don’t join the army of walking wounded. Start slow, and warm up. Maybe take a quick walk before you start gardening.  Stretch after you are warmed up; or even better, after your exercise. Our summers are too short to spend nursing injuries.

See you out there!

Chives and Plantain, Two plants that could be growing in your yard this spring.

Written 4/11/2013

I have recently been speaking to a client who is a naturopath, and he was telling me about some of the plants that are likely growing in my yard, that are traditional medicines. It turns out that some plants I thought were weeds, are plants that are not only edible, but have been used as medicines for centuries.

Within three feet of my house there are four plants that have bloomed every year since I moved into my Alaskan home. I am going to share two of them with you.

The first green to peek out of the ground in my garden is always chives. Scientific name; allium schoenoprasum. I am familiar with them, and am always glad to see that they have weathered another winter.

Chives are native here in Alaska, and are a miniature version of the green onions you buy in the grocery store. They grows in healthy tufts, with long spears that are tender and tasty. The flowers are beautiful lavender “pom-poms” of small trumpet shaped flowers. They have an amazing flavor, and one stalk can provide ample flowers to decorate your salad and give it incredible flavor.

Alutiic, Athabascan, and Inupiat cultures each had different names for chives, but used them similarly. Traditionally, the whole onion is eaten raw for treatment of colds, flu, and stomach upset.  Onion oil, or mash from the bulb, is used as a disinfectant. In my undergraduate studies, we tested its antiseptic qualities by swiping onion and garlic on “infected” petri dishes. Nothing would grow anywhere either was swiped, so I have no problems recommending it as a handy topical disinfectant.  

If you don’t have any in your garden and would like some, it transplants well. You can buy them at local greenhouses, or the seeds in local grocery stores.

Another traditional medicinal plant that grows in my garden is plantain, or plantago lanceolata.  It is a very hearty weed that I have failed to eradicate from my flower garden for years. It grows like a dandelion, in a tuft. Its leaves are broad, with ribs running parallel along the length. It doesn’t appear to have a flower, but a comely fruiting body, or seed head, which can run the length of the stalk.

Plantain is native to Europe, and has been used as a medicine and food for thousands of years. It has become ubiquitous in the Americas.  Native cultures have taken up its use, and have aptly coined it “white man’s foot print”. It is safe to eat in a salad, or steamed, but is bitter, so in modern times is not eaten much.

Externally its’ most frequent use seems to be as a topical salve.  Survivalists use it in the field for bites, rashes, burns and abrasions. They make what is called a ”spit poultice.” The person who needs it, puts it in their mouth, and chews up the leaf. The chewing and saliva break down the cell walls. Then the poultice is placed over the wound or rash to relieve pain and irritation.  

Naturopaths and ethno-botanists tend to harvest it to have on hand. One method of storage is to juice the leaves and roots in a blender, then mix the fluid half and half with honey. The salve is used to numb, reduce inflammation, and pull out toxins. I came across many stories about its use to treat snake bites. If I were in the woods, snake-bit, and saw some plantain handy; I would definitely make a spit poultice, and make my way as quickly as possible to a hospital.

Even the plantain seed husk is useful. It’s used to thicken soups and sauces, and used as a medicine. It is a cousin of the psyllium plant, whose seed husk is used commercially as the primary ingredient in Metamucil.  It is also believed to be effective at controlling cholesterol and is currently being researched to test that claim.

These two plants are just the tip of the iceberg when it comes to local plants that are traditional foods and medicine; it’s not even a fraction of them growing in my yard. Grab a field guide, and see what you find in your yard.

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Please educate yourself with pictures, diagrams, videos, and other resources available here for your continuing your exploration and understanding of Alaska’s Flora.

Traditional Flora of the Alaska Natives, by Ann Garibaldi, is a book that has been compiled as a complete reference source for traditional uses, but not for preparation. You can get it at the local library, or download and print it for free off the computer.  

UAA, Alaska Native Heritage Program   http://aknhp.uaa.alaska.edu/botany/medicinal-flora-of-the-alaska-natives/

Store outside your Door http://www.anthctoday.org/storeoutside/

This is both a Face Book page and a video series that can be found on you tube.

So Where Does the Time Go?

Where does the time go? It usually isn't cleaning the house.
Today we went out and did a little x/c skiing, which I interrupted with harvesting of poplar buds for making medicine.
We got back in time for a little 7 y/o meltdown. It was her first time skiing, and she was really overtired and frustrated. Probably thirsty too. Luckily for us she got busy with making tunnels and mountains in the snow outside for about an hour to let herself decompress.

Then it was off the church for separate child and parent meetings about the sex-ed class she is starting tomorrow after church. Luckily I had some smoked tuna in my bag, that I could feed her on the way there, to make up for the late lunch we were going to have.
While sitting in the class, and sharing how traumatized many of us were by our parents version of "sex-ed," I am trimming cottonwood tips to increase their surface area for when I get them into the slow cooker back at home.
On the way home we stopped at Costco to return an unwanted Christmas present, and picked up lunch on the go. I wanted to do a little shopping, but the crowds dissuaded me. I thought Sundays were bad.
Back at home I started doing a little work on my web-page for the clinic. I can't do that for long, because the kid needs some attention. So we do a little Tae Kwon Do practice with Sophia. I was 8 months pregnant with her when I got my purple belt, so I can coach her through a lot of things she is learning. She is really enjoying it so far.
Then I break to make a snack. Leftover salmon needs to get used, as well as some tomatoes. I mix them with cream cheese, and pickled devils club to make a dip. Then I check the wool boots I made for my husband. They are still drying from his last wet fitting.

Back to the web-page. It reminds me I have a few articles that I have written for a local magazine that I would like to publish on my web-page. The magazine does not have an online version though, so I can't link to the articles. So it is time to start a blog.
Then my husbands points out that I haven't cleaned up my mess from making the dip. Good point, I need to put some things away.
In the mean time, Sophia is going to spend the night at friends, so I am helping her pack up her overnight gear.
Back to the web page again for awhile, before company shoes up to whisk off the kid. We talk business for awhile, and do a little Hapkido show and tell for the parents (Husband and I take turns getting tossed on the floor). They think they will start Hapkido and Taekwondo as well.
Before they leave, I get back to processing the poplar buds. Trimming the terminal branches and buds and melting coconut oil into the slow cooker ( kept on simmer). I switch from my right hand to my left to reduce the inflammation I will get in my joints tonight.
Buds and melted coconut oil in the pot (I should have gotten more coconut oil at Costco today), and I add the sheers to the mess I have in the sink.
Yes I need a blog to share my articles. Maybe this will reduce the time I spend on Facebook.
Sunday is tomorrow. More felting, writing, web-page design, cooking, and wild crafting will be done. Maybe the cleaning fairy will come by this week to help out.