The end of a year can be a stressful time for many of us. We may have a different routine for school or work, not to mention the many opportunities to celebrate with family and friends and the increased expenses when buying gifts and food. The holiday season may also be the ultimate test of our trying-to-stay-healthy plans. An average American adult gains 1-2 pounds during each holiday season that are not reversed months later. How can we enjoy the holidays and stay on track with our wellness goals? Try the following ideas to have a healthy, jolly holiday season!
- Stay well-hydrated. Family gatherings and parties often have an endless selection of beverages. Drinks, whether with or without alcohol, can contribute many unnecessary calories if you consume unwisely. But making the most powerful beverage (WATER!) festive and fun does not have to take a lot of effort. Adding fresh cranberries and mint leaves to a pitcher of water with ice on top can turn plain water into a cheery, festive drink. Many fruit or vegetable-infused water recipes are available online without adding calories to what you drink. Other examples include rosemary and watermelon; orange, lemon, lime and grapefruit slices; blueberries and strawberries; fresh ginger slices and lemon. Use your creativity and have fun with WATER!
- Create an active family tradition. Meeting family and friends over a meal is often the heart of the holidays. For some families, the schedule is full of parties that range from school groups, work pot-lucks, friends’ gatherings and family dinners—so many that they wish they could be had at breakfast time. Consider having an alternate activity as a way to get-together: walking to a new park or on a new trail is a great way to meet with a few friends as you can catch-up with each other while you are being physically active. Other active ideas to add to the holiday tradition include trying a new activity or sport together; adding a walk before or after the family dinner; inviting the extended family to join in on a game of Twister or other active games; or getting some fast music going during a party to get everyone up and moving. Chores such as getting the house ready for visitors, cleaning the dishes by hand and raking leaves are also excellent ways to keep muscles strong.
- Be mindful about the portion size. The temptations of baked goods, chocolates, candies, etc. are everywhere this time of year. It is challenging for people who love sweets and are trying to lose weight by reducing their caloric intake. The products may be homemade with love by someone special, which makes it even more difficult to politely decline. It may be unrealistic to completely avoid sweets, but this may be a good time to practice controlling the portion size. Some like to set a goal for themselves to limit the amount of sweets per week, while others find that they will likely consume less if they hide them in harder to reach places. Many cookies and other baked goods freeze very well, so you may prefer to spread out the calories over the next 6 months by keeping them in the freezer instead.
Finally, enjoy plenty of delicious winter fruits and vegetables (kale, sweet potatoes, winter squashes, oranges, and beets for example) that provide important vitamins and minerals along with fiber to help you stay healthy.
Occasionally indulging in favorite foods is normal for anyone who is making changes to their lifestyle habits. Unless you have certain medical conditions, these occasional slip-ups will not hurt your health if you stay on track most of the time. Eating healthy, being physically active, and maintaining a healthy body weight year-round is the most effective method for preventing chronic illnesses like diabetes. If you would like more information about preventing or managing diabetes, visit our website tu.edu/mobec for the Mobile Diabetes Education Center’s schedule or call (707) 638-5970. Have a safe and healthy winter!
By Anne Lee, MEd, RD, CDE
Diabetes Program Manager at Touro University California
Physician Assistants (PAs) like myself are frequently question asked, “Are you the doctor?” After all, we’re wearing a white coat, carrying a stethoscope, and taking care of people. We are not doctors, but we are medical professionals who diagnose illness, develop and manage treatment plans, prescribe medications, and often serve as a patient’s principal healthcare provider. With thousands of hours of medical training, PAs are versatile and collaborative. PAs practice in every state and in every medical setting and specialty, improving healthcare access and quality. We always introduce ourselves as PAs, but when you’re at your medical appointment, you don’t always pay attention to the title of the person; you just know that they are going to take care of you.
You may have seen a PA in the past or a PA could currently serve as one of your providers. However, there are still not a lot of us. In 2017, there were about 123,000 PAs in the country according to the American Academy of PAs. There are more than twice that many nurses in the state of California alone.
Last year marked the 50th anniversary of the PA profession. The first PA program built itself from the fast-track training that medical doctors received during World War II. Historically, there have been two models to PA education. The Duke model is built on inpatient care, and the MEDEX model emphasizes service in community clinics. But as the profession has grown, these regional differences have diminished.
PAs are educated on a medical model and have the flexibility to provide many of the same services that doctors do, only with the support of a supervising physician. They also have the professional flexibility to shift between medical fields.
Perhaps the next time you ask, “Are you the doctor?”, you’ll hear, “No, I’m the PA and I am going to take care of you today.
For more information about the PA Profession: https://www.aapa.org/
Grace Landel, PA-C, MEd
Director of the Joint MSPAS/MPH Program at Touro University California
By Dr. Trina Mackie, Associate Professor of Public Health at Touro University California
With the California wildfire season already taking an early start, climatologists anticipate that this year’s fire season may be among the worst on record. While difficult to pin to any one event, climate change is likely playing a part in the overall number, size, and timing of the recent fires. As these events become a new normal for our area, it is important to know what we can do to protect our health when air quality suddenly declines.
In the event of a fire in your area, smoke and particulate matter can severely impact outdoor air quality. After making sure that you are in a safe location, the first step is to reduce the time that you spend outdoors. Any outdoor exercise that would raise your breathing rate should especially be avoided. The next step is to prevent the hazardous outdoor air from moving indoors. Make sure that windows and doors are well sealed. Newer homes with central air conditioning can be set to re-circulate indoor air, but rolled towels around door and window frames can also serve as an extra protective boundary. If your home is not air conditioned and temperatures are high, it might be most appropriate to shelter inside the air-conditioned home of a friend or family member. Consider organizing in advance with your neighborhood or community to identify suitable cleaner air shelters.
Unhealthy chemicals can also reach air indoors from many sources. When staying sheltered indoors, it is important to keep indoor air pollutants to a minimum. Because pollutants often stick and settle in dust, it is important to keep your home clean with wet mopping and dusting. However, vacuuming is discouraged when air quality is poor as it can re-suspend the dust and particles unless the vacuum has a high-efficiency particulate air (HEPA) filter. These guidelines are not only important when the air quality is unsafe, but they can also improve indoor air conditions year-round.
Further preparation can be done by purchasing a HEPA filter air cleaner, which may make sense, particularly for those who are the most sensitive to poor air quality conditions such as children, seniors, and individuals with cardiovascular disease or asthma. If you are an at-risk individual, consider setting up a “clean room” in your home. Choose an interior room with few windows and doors that you can easily keep clean and equip with a portable air filter.
In summary:
- Stay indoors
- Reduce activity
- Reduce other sources of indoor air pollution
- Use air conditioners and filters
- Use room air cleaners
- Create a clean room at home
All of these steps should be taken before considering a special type of mask called a NIOSH N95 or P100 Particulate Respirator. Although they can be purchased at most hardware stores, these respirators need to fit properly to the face to work best. These masks must have two straps that both go around the head with clearly labeled NIOSH certification. These respirators are different from surgical masks and other one-strap paper masks which do not protect the wearer from harmful particles in smoke.
Despite the challenges and upsetting tragedies that come with each wildfire, there is much we can do as individuals to be better prepared for unsafe air conditions. Our local governments are collectively working to do more in urban management and land planning that can reduce fire hazard and wildfire risk going forward.
By Nate Gartrell
In case the literal clouds of smoke that billowed up from San Francisco’s Hippy Hill last April 20th weren’t enough to tip you off, marijuana is now legal in California. And while some cities and counties have resisted the change, many others (especially around the Bay Area) are doing just the opposite, clearing the way for existing medical pot dispensaries to start selling to the recreational 21-and-up crowd.
Vallejo is certainly in the latter category; in February, the Vallejo City Council passed an ordinance that opened the city’s 11 dispensaries up to recreational sales. But if you thought that the emergence of recreational marijuana, however, was going to kill the black market, think again. Added taxes that came with the new legalization laws have led to grumblings among legal pot sellers about a decline in foot traffic since the New Year, and they think off-the-grid dealers are picking up that demand. Despite the challenges the industry faces, marijuana grow sites, dispensaries, and delivery services are popping up all over the state, and that shows no signs of stopping. At the same time, cannabis products that do not induce a “high,” like CBD oil, are gaining more acceptance among mainstream doctors and catching the eye of the country’s top medical researchers.
If there was anything surprising about California legalizing marijuana, it was that other states—Colorado, Washington, and Oregon—beat us to the punch. When voters turned down Prop. 19, the 2010 legal marijuana initiative, it ended a streak of California pioneering new liberal marijuana laws. In 1977, comedian Steve Martin joked to a crowd of San Franciscans that he wouldn’t want to be caught smoking marijuana out there, because “you might get a ticket for that.” Martin got laughs, but he wasn’t wrong; the year before, a state law came into effect that made possessing less than an ounce punishable by no more than a $100 fine. Twenty years later, California enacted the country’s first medical marijuana laws, which quickly became the butt of jokes around the nation and late night talk show hosts theorized what crazy medical maladies pot heads from the Golden State would concoct to get their weed cards. As it turned out, it didn’t take much; saying you suffer from chronic headaches sufficed just fine.
For a perspective from within the marijuana industry, we spoke with Maurice Solis, one of the operators of a Vallejo cannabis club called ReLeaf Alternative Healing, who told us that he entered the business with the same type of cynicism about the medical marijuana laws: that they were being abused by the overwhelming majority of “patients.” He reluctantly entered the cannabis industry after leaving a career he enjoyed, car sales, and he said at first his cynicism was confirmed right off the bat.
“The first dispensary I worked in was in San Jose in a part of town that was not good, not even a little bit,” Maurice recalls. “But as I started getting rare patients that did have a medical need, I would work with them and begin tracking their symptoms, figuring out what worked and what didn’t, and I started to get real joy out of that.”
As Maurice began to study up on medical cannabis, the dispensary began to change its product line, and his thinking began to transform as well. “As my business partner and I learned more about the medical benefits, different types of people started to see us and it totally changed our clientele,” Maurice said. “It made me a believer in the fact that cannabis can be a medicine and we wanted to expand on that.”
ReLeaf, Maurice and his co-founder, Ayn Nguyen, have the motto that “we wanted to be more medicinally-based and do as much research on it so we could help patients.” This includes partnering with neuroscientists for a research project through Stanford University, which has studied the benefits of dronabinol and other cannabis products to patients with epilepsy and autism.
“Our main focus is happiness,” Maurice said. “We are almost like the local corner store; we know our customers, we know our patients, we know when they’re going through tough times in their lives and when they’re going through great times. We’re very social and our main goal is to see them happy.”
With legalization of marijuana for adults 21 and up, the market for recreational cannabis has been something analogous to wine tasting. There is an endless amount of indica and sativa strains, each with different densities, textures, and smells. Search across the Bay Area’s numerous dispensaries, and you’ll also find a wide range of cannabis oils and waxes, vaporizing pens, THC-laced snacks and candies, pills, pre-rolled cigarettes, joints, and even palm tree leaf cigars, not to mention a hard-to-find, semi-legal, pre-rolled marijuana cigar line named after one of Vallejo’s most famous rappers. There are even marijuana syrups that one can pour into a soda, juice, or drink straight up.
Nowadays, since co-founding ReLeaf, Maurice gives public talks on his transition and the future of medical and recreational marijuana, and he’s gotten involved in the community in ways that would have seemed unthinkable in the “Reefer Madness” era. ReLeaf has joined up with the Vallejo Chamber of Commerce and participates in community events, also making a point of opening its walls for local artists to hang their work.
“I don’t blame people for having those stigmas associated with cannabis,” Maurice said. “I came into the industry with a bias; and I know if I came into it like that, then other people are going to also. My job is to shed a better light on it and be a better example.”
“One of the most common things I hear is that it’s going to attract teenagers to start using marijuana, but statistics show there is no correlation between legalization and teen use,” he continued.
Another of the biggest misconceptions Maurice has heard, he said, is that marijuana dispensary owners are “all millionaires.” However, he said that is far from the case. “I would probably be making more if I stayed in the car industry,” he said. “But I don’t get that type of joy from helping people; it’s not the same when you’re selling a car compared to when someone comes in really sick and in tears, and for the next months you see them when they are coming in happy and relatively free.”
The City of Vallejo was unquestionably resistant to medical marijuana a few years ago, but Maurice said that times have changed over at City Hall, and with the passing of several ordinances that paved the way for cultivation and distribution within city limits, that seems to hold true. Of course, on a national level, there are growing concerns throughout the “weed legal” states that the US Justice Department might begin to pursue criminal prosecutions against growers and dispensary owners. In the Bay Area, the top prosecutor in the federal district that oversees the East Bay and San Francisco resigned shortly after the DOJ announced it was expanding the breadth of marijuana cases it would pursue. In California’s eastern federal district, where Vallejo sits, the top US Attorney is McGregor Scott, who led the 2006 prosecution of two dispensary owners in the Modesto area who were granted clemency under President Barack Obama. And while Californians have a lackadaisical attitude about marijuana, the federal penalties remain stiff. “It’s always something that you have in the back of your mind,” Maurice said, but he thinks cities throughout California would “go to bat” for dispensaries, which bring in lots of tax revenue.
“There are tons of things you can do with the plant itself,” Maurice said, citing the litany of known uses for the hemp plant, which doesn’t yield usable amounts of THC. “This is why we feel that the federal government has a big fight on their hands if they push against it.”
While marijuana does bring in tax revenue, the New Year also brought new pot taxes, which has opened the door for the black market to undercut legal marijuana businesses. There is also a well-documented surplus of marijuana statewide; weed grows like, well, a weed, and the state is producing more marijuana than Californians can smoke. As a result, dispensaries are pickier about what marijuana products they buy from distributors, and illicit growers are more tempted to transport their product across state lines. “A lot of folks who weren’t able to get a state license, they were sitting on millions of dollars worth of inventory,” Maurice said. “They’re not just going to leave it on the shelf.”
ReLeaf is open from 9 a.m. to 8 p.m. daily. It is located at 1 Benicia Road in Vallejo, with plans to expand into Monterey and Dixon. For additional information and for the daily menu, visit weedmaps.com/dispensaries/releaf-alternative-healing or releafalternative.org. Reach them at (707) 980-7868 or email them at releaf4life@gmail.com.
Nate Gartrell grew up in Benicia, studied journalism in college, and has written for a handful of media outlets since age 15. He aspires to visit all 30 Major League Baseball stadiums and to hit the trifecta at the horse track.
By Richard Riemer, DO, Senior Associate Dean of the College of Osteopathic Medicine at Touro University California
You may think that the current epidemic of drug addiction in the United States is limited to adults. After all, whether it’s addiction to cigarettes, alcohol, gambling or drugs, cultural norms hold these to be the moral failings of our older population. But scientific research has confirmed that addiction is a brain disorder and that immature and developing brains are especially vulnerable to the unhealthy effects of these drugs. Complex interactions between the two “B’s”, your biology and biography, contribute to your personal risk of addiction, including your genetic makeup, where you were raised, exposure to physical or psychological trauma, even your family structure. Since our brains do not fully mature until age 25, it would make sense that a young person’s brain is most vulnerable to the ravages of these drugs.
Brain maturation does not occur to all parts of the brain at a uniform pace and at the same time. The last portion of the brain to mature is called the prefrontal cortex, located just behind your forehead, and it is a one of the key actors that plays a role in substance abuse and addiction. Science first dismissed the prefrontal cortex as silent or insignificant. But on September 13, 1848 at 4:30 pm in Cavendish, Vermont, a 25-year-old railroad foreman named Phineas Gage was severely injured in a construction site explosion which launched a 3.5-foot iron rod through his head. This tamping iron damaged his frontal lobes, and miraculously, Phineas still walked away from the work site. Soon after the accident he seemed completely healthy. But friends who knew him noticed a big change in his personality. While there were no overt signs of brain damage, friends who knew him best recognized a big change in his personality. No longer patient and agreeable, he was impulsive, moody, restless, obstinate and childish. He disregarded advice which conflicted with his own personal desires. In fact, Phineas manifested behaviors which we often observe in an addicted personality, such as the inability to make decisions in their best interest and carry through on plans, as well as the inability to control cravings.
Illicit drugs in vulnerable populations are the equivalent of a chemical tamponing rod. They cause brain destruction and rewiring of formerly healthy brain circuits. Just like Phineas, the addict has difficulty sustaining attention, concentrating, reasoning, and solving problems. He also loses the daily struggle to resist urges to pursue and use drugs despite knowing their unhealthy consequences.
Our observations prove the point that immature brains are at risk. Consider that substance use often starts during adolescents. Approximately 7.9% of adolescents or 2.0 million adolescents aged 12 to 17 in 2016 were current users of illicit drugs according to the National Survey on Drug Use and Health (2017). It would then make sense that strategies that foster brain health and healthy brain maturation will reduce risk for substance abuse and addictive disorders.
So how do we personally curb the stem of illicit drug use, particularly in our most vulnerable populations? Interventions introduced as early as the prenatal period and throughout the brain’s developmental years may prevent many of these risks according to the National Institute on Drug Abuse’s Principles of Substance Abuse Prevention in Early Childhood. Early intervention can increase protective factors and reduce risk, have positive long-term effects, increase physical health, and even reinforce positive behaviors in the social environments where children interact like home and school. Themes of healthy nutrition during infancy and toddlerhood, a nurturing parent, a supportive and sensitive home, school and community environments, school readiness, and maternal avoidance of smoking, excessive alcohol use, illicit drug-use and prescription drug abuse, all reduce the risk to our children. Mental illnesses that affect our youth such as anxiety disorders or impulse-control disorders also increase the risk for drug abuse. Deploying these strategies and practices in our homes, communities and schools will stem the tide on the opioid epidemic and in particular, reduce the risk to the most vulnerable in our society, our children.
Learn more by visiting www.drugabuse.gov.
