Be Well and Enjoy Your Holidays,
The Marino Center Staff

At the Marino Center we celebrate long life. But, we know it's not just about living longer, but rather - living WELL longer. With that in mind, we introduce THRIVE - our healthcare program - offered in both our Cambridge and Wellesley, MA centers designed for our patients on MEDICARE to address the unique needs of today's over 65ers. With respect for the body, mind and spirit, we believe that good health is a life-long process achieved through proper healthcare, healthy habits, a balanced diet, exercise, rewarding relationships and savoring life's joys. And, as we age, a commitment to this holistic approach is increasingly important.

If you're 65 or over yourself, or if you're a son or daughter looking for a responsive and integrative healthcare option for your parents as they age, we invite you to THRIVE:

• Your needs may be changing and we're here to listen - Through longer, more personalized visits, Marino Center healthcare providers take the time to listen to you, understand your needs and work together with you to get you - and keep you - well.
• You've got your life to live, so convenience is key - Our integrative healthcare model brings primary care and complementary services together under one roof - making the Marino Center a convenient, one-stop source for your health and wellness needs.
• You're still in the game, and our whole team is behind you - The Marino Center's team of compassionate, innovative practitioners has expertise in a wide array of specialties and works collaboratively to ensure that every aspect of your healthcare is explored.
• You're unique, and we see the overall picture - We concentrate on every aspect of your well-being - physical, emotional, spiritual and more. As you age, eating right, exercising, keeping your mind sharp, taking care of yourself and maintaining your sense of purpose and zest for life are all crucial elements of health and happiness.  
• You're busy, but we'll keep you on track - With today's busy lifestyles, it's easy to miss the latest health information, forget to schedule appointments and more. With appointment reminders, information on your Medicare-eligible visits, healthy aging tips, wellness programs and more, we keep you in the know while you're on the go.
   

Here's how THRIVE works:

• There are no membership fees or extra paperwork needed to take advantage of THRIVE. If you are enrolled in MEDICARE, this primary care program is for you.
• To join, simply call or email our THRIVE Coordinator, Ashley Harrington, at 781-235-5200, extension 6504 or aharrington@marinocenter.org.  Ashley will walk you through the program and schedule your initial visit.
• If you have turned 65 within the last year - as part of your Medicare benefits, you are entitled to a free one-time "Welcome to Medicare" Initial Preventative Physical Exam with your Primary Care Provider.  NOTE:  The visit must be made during your 65th year or this Medicare benefit is lost.  
• If you are 66 or older - as part of your Medicare benefits you are entitled to a yearly free "Wellness Evaluation" visit with one of our THRIVE Nurse Practitioners.  During this visit, the NP will review and talk to you about your medical history, review your risk factors and make a personalized prevention plan to keep you healthy.  NOTE:  This annual Medicare Wellness Evaluation is not the same as what many people often refer to as a physical exam.  It does not include a hands-on exam or the tests that your doctor may recommend, nor does it include treatment of any new medical problems.  For these services you would need to make an appointment with your PCP and regular Medicare fees would apply.  
• Based on your frirst THRIVE appointment, if risk-factors or health conditions are identified, you will be scheduled for a follow-up appointment with the appropriate Marino Center practitioner - for example a Physical Therapist and/or Nutritionist - for assessment and a treatment plan going forward.  
• As a THRIVER, throughout the year you will receive important benefit notifications, health tips for the over 65er, profiles of THRIVERS, and much more.
• And, now you're THRIVING!
   

Throughout the healthcare process, you are an active participant in determining your optimal healthcare plan; custom-tailored to your needs. Healthy aging involves continuing to reinvent yourself, finding new things to enjoy, learning to adapt to change, staying physically and socially active, and feeling connected to your community and loved ones. The Marino Center is here to assist you with all of these goals. With a healthy approach to life you are ready to THRIVE - no matter what your age.

Again, to become a THRIVER or for more information on THRIVE, please email or call Ashley Harrington at aharrington@marinocenter.org or 781-235-5200 extension 6504.

FLT is not just a weight loss program
Most programs are focused on weight while FLT is best used as a first line treatment for common, chronic health problems (e.g., high cholesterol, insulin resistance, unhealthy body composition).

The FLT eating plan is different
Most programs are focused on low fat diets while FLT emphasizes the importance of a low-glycemic eating plan that is consistent with current research.

FLT incorporates medical foods and nutritional supplements
The appropriate use of medical foods and supplements enhances program effectiveness and shortens the time it takes for you to achieve risk reduction goals.

FLT has been demonstrated to be effective in human clinical studies
Most programs lack clinical evidence of effectiveness.

Getting Started—A Matter of Fat
In order to measure your progress, you first need to know your current health status. A variety of health assessments may be performed, including a quick, non-invasive measurement of your body fat and lean muscle mass. Excess body fat can greatly increase your health risks. But a higher ratio of muscle increases your metabolism and is associated with a lower incidence of illness.  Improving your muscle-to-fat ratio is perhaps the most powerful tool in controlling the aging process and restoring vitality.

With a physician prescription, the program, or some of its component parts, may be reimbursable through your health insurance or Medical Savings Account/Flexible Spending Account. Patients report success in getting FLT covered by insurance, but be sure to call your insurance company for more information on what your plan will and will not cover. (***See more about insurance below.)

Your personal FirstLine Therapy program offers:

• Initial and follow-up testing
• Practitioner consultations
• Program guidebook
• Solutions for staying active
• Simple eating guidelines
• Progress tracking
• Lifestyle counseling
• Nutritional product recommendations

Reversing & delaying chronic illness can help you regain and maintain health.  And that’s what FirstLine Therapy is all about.

• Stress-related disorders
• Fatigue disorders
• Polycystic ovary syndrome
• Premenstrual syndrome
• Menopause
• Prostate problems
• Conditions related to overweight and obesity
• Heart disease
• High blood pressure
• Stroke
• Osteoarthritis
• Diabetes
• High cholesterol
• Metabolic syndrome
• Osteoporosis

Did you know:

• Chronic diseases account for 78% of annual healthcare costs.1
• Chronic diseases also account for one-third of the years of potential life lost before age 65.
• Most chronic diseases are caused by unhealthy lifestyle habits. For example, 91% of type 2 diabetes is caused by unhealthy habits and forms of behavior.
• Chronic, disabling conditions cause major limitations in activity for more than one of every 10 Americans.
• The prolonged course of illness and disability from chronic diseases results in extended pain and suffering and decreased quality of life.

FirstLine Therapy can help you regain and maintain your health.  For more information on FLT or to register for the program, please email aharrington@marinocenter.org and ask how you can start FirstLine Therapy today!

***FLT Insurance Coverage

Will the FLT Program be Covered or Reimbursed by my Insurance?

As with all of our health care services, this depends on the terms of your insurance policy.

For patients with a physician at the Marino Center:

• If you were referred to the program by a licensed provider (MD/DO or Nurse Practitioner) for a medical reason  (such as high cholesterol, pre-diabetes, high blood pressure), the office visits with our nutritionist and associated lab tests, and/or Med Gem resting metabolic rate measurement should be covered just like just like office visits for any other clinical problem.
• If you are doing the program just to lose weight, please call your insurance company to verify coverage. Some insurance companies cover visits to a registered dietitian for weight loss.
• If you’re doing the program because you just have a desire to feel great and take the best care of yourself, it may be more difficult to get reimbursed, although it is certainly worth submitting the bill to your insurer.  (We will not say you have a diagnosis you don’t have for the purposes of getting you reimbursed – that’s fraud).

For patients who do not have a physician at the Marino Center:

• Blue Cross and Harvard Pilgrim Insurance: Our nutritionists are providers for Blue Cross and Harvard Pilgrim, if you were referred to the program by a licensed provider (MD/DO or Nurse Practitioner) for a medical reason (such as high cholesterol, pre-diabetes, high blood pressure), the office visits with our nutritionist and associated lab tests, and/or Med Gem resting metabolic rate measurement should be covered just like just like office visits for any other clinical problem. If you are doing the program just to lose weight, please call your insurance to verify coverage.
• If you have insurance other than Blue Cross or Harvard Pilgrim and were referred to the program for a medical reason and have out of network nutrition benefits, you are likely to get reimbursed, although we will ask you to pay for the program.  You will receive an itemized bill showing what you paid as well as the diagnosis and procedure codes your insurance company requires in order to evaluate your claim.
• If you are doing the program just to lose weight, please call your insurance company to verify coverage. Testing for resting metabolic rate (which is optional) may not be covered.
• If you have insurance other than Blue Cross or Harvard Pilgrim and you are doing the program because you just have a desire to feel great and take the best care of yourself, it may be more difficult to get reimbursed, although it is certainly worth submitting the bill to your insurer (We will not say you have a diagnosis you don’t have for the purposes of getting you reimbursed – that’s fraud.)

Flexible Spending Accounts:
Flexible Spending Accounts and Medical Savings Accounts are likely to cover the cost of the program including supplements, though every plan is different. Again, call them and ask. It is unlikely that your insurer will cover the cost of any recommended supplements.

If you have additional questions regarding insurance, please contact, Ashley Harrington, First Line Therapy program coordinator at aharrington@marinocenter.org.

Reiki is a hands-on Spiritual/Energy Healing practice originally taught in Japan in the 1920's by Mikao Usui, and transmitted and developed further in the U.S .in the 1930s.  It is now practiced all over the world as a simple yet profound hands-on healing method.  Reiki promotes and supports all healing processes, and also provides relaxation, stress reduction, and a feeling of well-being.  Reiki is useful for self-treatment as well as treating others.

Reiki is easy to learn, and the ability to practice it is developed through a combination of instruction and attunement practices. Instruction will be given at the Marino Center by Usui Reiki Master Dr. Robert Weissberg.  Dr. Weissberg has practiced Reiki since 1999, and has been a Teaching Master since 2004. He is also a primary care physician here at the Marino Center, Cambridge and offers Reiki treatments there.

The class occupies a full day, from 8:30 AM to 6:30PM, with breaks for lunch, snacks, tea, etc. Students should bring their own lunch, or plan to eat at one of the local establishments.  A manual and supplemental materials will be provided and students will receive four traditional attunements, which pass on the ability to practice Reiki.  At the end of the class, students will be fully qualified to treat themselves and others with Reiki, and they will receive certificates a few weeks after the class.

The tuition is $150, with a $50 deposit required in advance, the balance payable on or before the day of the class.

”Live in the sunshine, swim the sea, drink the wild air.” by Ralph Waldo Emerson

Light is the basic component from which all life originates and is energized.  We have managed to disconnect ourselves from sources of natural light with our fluorescent lights, indoor lifestyles, glasses, contact lenses, sunglasses, processed foods and overcooked foods.  Sunlight is an important biological nutrient. The sun can re-charge our emotional and mental batteries, and decrease depression.   However, overexposure is dangerous - as it can lead to skin cancer, cataracts, premature aging, wrinkles and painful sunburns.  The sun doesn’t discriminate.  

Natural sunlight on the skin (with no sunscreen) promotes the synthesis of Vitamin D, an essential vitamin needed by the human body.  Vitamin D is essential for healthy bones, a strong immune system and protection from certain cancers. NOTE:  Skin that has been repeatedly treated with sunscreen solutions apparently produces a lower quantity of Vitamin D.  Your Vitamin D level can be checked in a routine lab test.  It is generally safe to take 1000-2000 IUs of Vitamin D per day as a supplement.

How many minutes in the sun (with no sunscreen) is safe?  This topic is very controversial.  The American Medical Association recommends that everyone get 10-15 minutes of direct sun (with no sunscreen) several times per week to promote natural Vitamin D production.   The American Academy of Dermatology, however, states:  “there is no scientifically validated threshold level of ultra-violet (radiation) exposure from the sun that allows for maximal Vitamin D synthiesis without increased skin cancer risk”.  The Academy recommends getting Vitamin D that occurs naturally in foods, foods fortified with Vitamin D, and from Vitamin D supplements. 

How can we enjoy the sun, yet protect ourselves and those we care about?  First  of all, get some background on what all the abbreviations mean!   The sun emits several types of rays or ultraviolet radiation.  The main ones are UVA (ultraviolet A) and UVB (ultraviolet B) and UVC (ultraviolet C). UVC rays are mostly absorbed by the Earth’s ozone layer and do not effect the skin.

UVA rays stay constant all year round and are the main type used in tanning beds. UVA rays penetrate deep into the skin and are a major source of wrinkles and skin damage.  They are considered the most damaging (compared to UVBs), partly because we don’t feel a “sunburn” happening with UVAs.  Some studies indicate that UVAs can also pass through glass: e.g. when you are driving along in your car.   (UVBs do not pass through glass).  UVA rays also can pass through CLOUDS.  (So, a cloudy day does NOT mean a day for skipping sunscreen.)

UVB rays are ultraviolet rays that are strongest in summer months when the Earth is closer to the sun.  This is “the sunburn ray” or “tanning ray”–which is responsible for most of the tanning changes in lighter skin tones.  UVBs affect the outer skin layer or epidermis.  UVB rays can start effecting certain skin types in 60 seconds. Both UVA and UVB rays can be very damaging to the skin.  Excess sun exposure can promote collagen breakdown (collagen makes  skin look more youthful), create damaging free radicals in the body, interfere with DNA repair, and decrease optimum functioning of the immune system.  Both UVA and UVB rays can cause skin cancer.

What is SPF?  SPF = Sun Protection Factor.  The SPF number tells you how long you can stay in the sun without burning from UVB rays.   (The SPF number does not address other kinds of skin damage from UVA rays).  What do the numbers mean?  EXAMPLE:   SPF 15.  If you normally start to burn at 15 minutes, SPF 15 lets you stay in the sun ~15x longer (3.5 hours) without burning.  SPF sun screen numbers indicate sun screen protection from UVB rays only. .  However, broad spectrum ingredients are incorporated into some products to offer protection against both UVB and UVA rays.

How do you choose healthy sunscreen products?  All products are not equal in quality and safety.   Some ingredients can actually enhance skin damage and some contain toxic products that are absorbed into the body.   Some products like sunblocks will deflect UV rays, whereas sunscreen uses chemicals to absorb UV rays.  Both help to reduce UV exposure but neither eliminate exposure completely. 

Expiration Dates:  Products are generally designed to be safe and effective up to 3 years. (check expiration dates.)  However, many experts recommend buying new products each year.

TIPS for CHOOSING SUNSCREEN PRODUCTS:

“When you see the weather report and it says ‘partly cloudy’ and then the next day it says  ‘partly sunny’—what’s the difference?”       ---author unknown—

• SPF levels:  FDA recommends SPF of 15-50, depending on skin type.  A 50+ SPF may protect against UVB rays that cause sunburn, but still leave the skin at risk for UVA damage.  Another danger of high SPF is that many users consider 1 application per day enough, when they really should be applying sunscreen more frequently.
• Frequency of use.  Sunscreen should be re-applied every 1.5 - 2 hours or immediately after swimming or after perspiring heavily.  
• NOTE:  The American Academy of Dermatology recommends that you use a sunblock every day all year round.  Clouds, glass windows, and surfaces such as sand, pavement, sidewalks, water, snow and ice will also reflect UV radiation.  (i.e., these types of surfaces DO NOT BLOCK UV radiation.)
• American Cancer Society Recommendation:  SLIP, SLOP, SLAP, WRAP.  Slip on a shirt; Slop on sunscreen (every 2 hours), Slap on a hat, Wrap your eyes in protection.   NOTE: always apply your sun screen with clean hands.
• Avoid products laced with Vitamin A (or retinyl palmitate), as they may accelerate the growth of skin tumors and lesions.
• Protect your lips with lip balm.  (See http://www.ewg.org  Search:  “How Does Your Sunscreen Work?” and “Skin Deep”.   Check out best lip balms.)
• Type of Products:  It is better to use creams vs sprays or powders. (better coverage and probably safer).
• Choose BROAD SPECTRUM products which offer protection against both UVA and UVB rays.  Make sure your sunscreen contains at least one of these ingredients: Zinc, Titanium dioxide, Avobenzene,  or Mexoryl SX.   Another benefit of these products is that they break down more readily in Nature, which is better for marine life.
• AVOID ingredients such as Oxybenzene (a synthetic estrogen), Vitamin  A (retinyl palmitate) and combination insect spray/sunscreens.   FDA guidelines REQUIRE labels to provide information on broad spectrum protection.  Claims for ‘broad spectum protection” are  allowed if a product passes specific FDA tests for blocking UVA rays and have an SPF of at least 15.  Products with lesser protection must carry a warning that they don’t protect against skin cancer.   Terms such as sunblock, sweatproof, or waterproof are NOT allowed.
• If you want bug spray protection as well, buy a specific, separate product for that and apply BEFORE you put on sunscreen.
• Do look for WATER RESISTANT products for pool, beach and exercise (sweat). However, be mindful that sunscreens can lose their effectiveness after 40 minutes in the water. “Sunscreens rub off as well as wash off, so if you’ve towel dried, reapply sunscreen for continued protection.”  (American Academy of Dermatology,  http://www.aad.org)  FDA guidelines require labels to state whether products are water-resistant for either 40 or 80 minutes.
• BE PREVENTIVE:  Don’t get burned!  Wear cover-up clothes: a shirt, hat, shorts.  Find some shade.  Wear sunglasses which offer protection  from UV radiation, a cause of cataracts.  (Remember: slip, slop, slap, wrap!)
• Avoid 10 AM-3 PM sun exposure times.
• NOTE:  Those with Rosacea should avoid sun exposure during peak hours.  When in the sun, going unprotected is not an option.  Avoid chemical sunscreen, say NO to fragrance and consider a sunscreen with a tint that helps hide redness.
• SPECIAL RECOMMENDATIONS for INFANTS and CHILDREN:  Keep infants less than 6 months old out of direct sun. Cover them up, make shade–if you can’t find natural shade.   Avoid mid-day sun.   Avoid using sunscreen products on infants–the chemicals can be toxic.  (use only a small amount of product, only as a last resort.)
• NOTE:  AVOID the use of SPRAY-ON SUN PROTECTION PRODUCTS—as well as POWDERS on INFANTS and YOUNG CHILDREN.  Although these products may contain protection from sunburn—they may also be damaging for infants and young children to breathe in these chemicals.  (maybe also for adults!!!)
• TODDLERS and CHILDREN:  Choose 30-50 SPF.  Test a small amount of product inside the wrist to make sure there is no rash or allergic reaction.  Apply often. Check with children’s schools to make sure they  can use sunscreen if frequently out in playgrounds, or doing outdoor sports training.
NOTE:  One bad sunburn in early childhood can increase your risk of skin cancer.
• TEENS:  Limit the use of tanning parlors—which expose the skin to as much as 15x the UV radiation of the sun.  This may contribute to increased rate of melanoma skin cancer, as well as general skin damage.  (Both UVA rays and UVB rays are used in tanning salons; but UVA rays are the main type used).  Many chemicals are also used in tanning parlors and are not FDA approved.
• Natural tanning creams:  Check with your dermatolgoist for the best, safest products.  OR check out products at http://www.ewg.org  (Search article: ‘SKIN DEEP’)
• Can foods help protect you from skin cancer?   Certain foods that are high in phytochemicals may help repair cells after sun damage .
• These foods include: prunes, raisins, red grapes, blueberries, raspberries, strawberries, plums, cherries, kiwi fruit, citrus fruits, red and orange peppers, tomatoes, kale, spinach, brussel sprouts, alfalfa sprouts, broccoli florets, onions, eggplant,  avocados, carrots,  pumpkin seeds.   “It’s possible eating a rainbow could delay sunburn, but that doesn’t mean a salad is equal to sunscreen.”  (Prevention  Magazine,  April 2012)

Enjoy the Natural Sunlight, and Protect your Skin!
 

REFERENCES: 
Book:  52 Small Changes by Brett Blumenthal
Berkeley Newsletter:   “SunScreen Safety” by Lynn Marie Bower.  (from the Healthy House Institute)  http://www.healthyhouseinstitute.com/a_1087-Sunscreen_Safety
http://www.ewg.org   Search article: “Does Your Sunscreen Work?” and “Skin Deep”.
http://mayoclinic.com/health/sunlesstanning/SN00037     At bottom of Mayo Clinic article, check out other skin care articles, e.g., “Best Sunscreen: Understand Sunscreen”;  “Sunscreen Options,”  “Does Sunscreen Expire?”   “Skin Care: 5 Tips for Healthy Skin.”
http://www.fda.gov/forconsumers/consumerupdates/ucm258416.htm “FDA Sheds Light on Sunscreens (2012)

Originally Posted on June 7, 2011 by wellnessshifterladies

"There may be much that Western medicine can learn about infertility from the Eastern healing traditions," says the Marino Center Wellesley's Yan Jennifer Cao, Licensed Acupuncturist and Herbalist, trained in Traditional Chinese Medicine (TCM).

From a historical perspective, much of Chinese medical practice and theory developed around the needs of the royal families. The key to succession was the birth of heirs, so the fertility of the royal families was a major concern for ancient Chinese physicians. As a result, much of Chinese medicine is centered on women's health issues including fertility, menstruation and menopause.

In China, the use of acupuncture and TCM for the treatment of infertility has a history dating back thousands of years and is very well accepted today. The Chinese healing tradition is more focused on the whole person, the environment that they live in, their social relationships, diet, etc. By helping the patient to achieve an appropriate state of balance, they can work towards improving the patient's health, and in this case, their fertility. 

TCM is a holistic medical system consisting of acupuncture, herbal medicine, meditation and diet. In the holistic philosophy of TCM, all parts of our bodies are seen as interconnected. Energy and signal transactions (Qi flow) are carried through pathways called meridians, which are distributed on the surface of the body. It is believed that blockages of the Qi flow through meridians cause imbalances which, in turn, result in illness. Acupuncture attempts to heal by restoring the flow of Qi through the meridians--allowing the body to heal itself.

In the United States, the use of acupuncture and TCM for fertility issues continues to rise. "Many clinical reports and my own clinical experiences have demonstrated that the integration of acupuncture may bring increased opportunities for successful results to women with infertility issues who have had no response from conventional methods such as medicine and IVF," reports Ping Yao, Licensed Acupuncturist at the Marino Center Cambridge.

"Having a baby seems like it should be such a natural thing," adds Cao. "But to someone who has been trying for months or even years, it can become an all encompassing issue - filled with emotions and anxiety. Integrating acupuncture and TCM can to bring that individual into balance and prepare them for what lies ahead."

To schedule an acupuncture appointment at the Marino Center, please call 617-661-6225 for Cambridge, or 781-235-5200 for Wellesley. 

Frozen Grapes from The Joslin Diabetes Quick and Easy Cookbook
Frozen grapes are a particularly welcome dessert. They can also make a superb ending to a spicy meal.

DIRECTIONS:
Pick the seedless grapes off the stem and place them on a rimmed baking sheet lined with paper towels. Freeze until hard - about an hour. Once frozen, transfer the grapes to a self-sealing plastic freezer bag.

When ready to serve, pile the frozen grapes in pretty dessert goblets or dishes. Mix the colors-red, green, purple and black. Just remember

Nutrition Information:
Fifteen grapes are about 60 calories and 15 grams of carbohydate = to: 1 carbohydrate (1 fruit) exchange.  NOTE: Imported grapes are high in pesticides. Buy only organic imported grapes or avoid imported grapes altogther, It is generally SAFE to eat domestic conventional grapes as they test low in pesticides.

Natural Gingerale from "The Thrive Diet" by Brendan Brazier

This is a simple, healthful drink that is especially refreshing on a hot day.  The ginger froths up to give it an effervescent quality. Use sparkling mineral water in place of regular water if you want even more fizz. Because of the combination of raw lemon and ginger, this drink with help raise the body's pH and reduce inflammation.

INGREDIENTS:
1 fresh lemon
2 cups water (plain water or sparkling mineral water)
1 Tablespoon agave nectar
½ Tablespoon grated fresh ginger
Sea Salt to taste

DIRECTIONS:
Squeeze the juice of the lemon in a blender. Add water, agave nectar, ginger and sea salt; blend.  Makes about 2 cups.  Keep refrigerated up to 2 weeks.

Nutrition information:
Makes 2 servings of 1 cup per serving. 1 cup = 40 calories, 10 grams carbohydrates, -0- protein, -0- fat. (80 calories for 2 cups)
 

It’s that time of year when warmer weather calls us to get out of the house or office….for some fresh air!

Fresh air is very important to our health and well being, as it supplies oxygen to the brain and to every cell of the body.

Highly oxygenated air also contains more negatively charged particles called ions (vs. the positively charged ions associated with high carbon dioxide concentrations).   Adequate oxygen, together with negative ions, gives us a “lift.” 

If you work in a windowless office environment, you breathe in the same air over and over again (less oxygen, more carbon dioxide, and more positive ions).  Poor air quality can lead to symptoms such as:  dizziness, nausea, headaches, fatigue, exhaustion, irritability, depression, and increased susceptibility to infection.  http://www.natural-health-restored.com/fresh-air.html   If you experience symptoms, drink extra water and use a saline nasal mist spray periodically throughout the day.

There’s no substitute for REAL fresh air.

Benefits of Being Outside:

• Reconnection with Mother Earth
• Natural Stress Reduction
• Improved mood and lifted spirits, reduced depression
• Increased brain level of serotonin---which helps to improve mood and promote a sense of happiness and well being.
• Improved quality of sleep
• FREE Exercise in many forms: walking, hiking, water sports, gardening and yard work
• Access to local produce!!!!  If you like to grow vegetables, herbs and fruits….they may be right there in your own back yard!

Clean, fresh air (oxygen --plus negative ions) is more available around plants, trees, and other vegetation; near moving water, lakes, rivers, waterfalls, the ocean, at beaches and in sunlight. (Negative ions are more highly concentrated in sunlight).  Negative ions help us release toxins if we’ve been ill, thus improving the immune system.  They soothe the nerves and increase healthy cellular metabolism. 

NOTE:  Interaction with Nature and fresh air may even increase life expectancy:  “upping survival odds by about 15% over 5 years in one Japanese study.”   http://www.prevention.com/print/25848

For those who like to get their hands in the dirt—-there are many steps along the way to a great garden/lawn: from preparing the soil–raking, weeding, rototilling, spading, fertilizing, lifting bags of soil–to planting….and continued weeding all Summer!   Yardwork also involves removing fallen branches and brush, mowing the lawn—all good exercise--requiring the utilization of many muscle groups.

While doing yardwork, it is wise to keep several points in mind:

• Remember to stay well-hydrated.  Sip water regularly.
• Don’t do gardening/yardwork on an empty stomach.  Give yourself a combination healthy carbohydrate/protein mini-meal before beginning your work: e.g. a 1/2 turkey or peanut butter sandwich OR a fruit and handful of nuts OR a small protein shake (made of protein powder or yogurt and fruits like berries).  You may also need similar nourishment following an intense time of yardwork/gardening.
• Remember to BREATHE!  Take deep breaths and oxygenate your cells with fresh air.
• SUN and Vitamin D:  Enjoy the sun but also practice protection from overexposure to ultraviolet rays. 
• Rules of thumb for Sun Exposure:     —Spend 10-15 minutes in non-peak sun hours, using no sun screen.  Peak sun hours are 10 AM-4  PM.  During that time, apply a sunscreen of at least 30SPF with UVB/UVA protection.
• Pay attention to your body and muscles while you are working. These tips can help, e.g:  —Avoid extending your neck or staying on your knees for extended periods of time (20-30 minutes).—Use a small stool and knee pads to minimize back strain and support knees. —Pull your shoulder blades together, to avoid rounding of the back.  And —Use long handled and telescoping tools to reach instead of bending forward, which strains the hips and lower back.

Gardening and yardwork aren't your thing?   Not in the realm of possibilities for you?!  It is not for everyone.  However, you should make the most of other opportunities to be outdoors this time of year: like taking a 30 minute daily walk.

You may also want to to include other moderate level physical activities to fully enjoy this time of year. In the following chart*, notice how many calories can be burned by doing just 10 minutes of physical activity!!!:

Calories Burned in 10 Minutes of Physical Activity*

Too busy with young children at home to do any of the above activities?  No problem!   Pushing a baby stroller for 30 minutes burns 75 calories for a 125 lbs woman, 85 calories for a 150 lbs woman, and 105 calories for a 175 lbs woman.**

You can also go to the website: www.fitday.com to enter your personal information, get some tips on ways to burn calories for you.

Whether you are a gardener or not, enjoy all that Mother Nature has to offer!!

• *K. Brownell, weight loss management book:   The LEARN Program for Weight Control.
• ** website: www.caloriecount.about.com

• Age-and gender-appropriate history
• A comprehensive physical examination
• Counseling, anticipatory guidance (“what to expect”) or interventions to reduce health risks

During a preventative visit, you and your practitioner may want to address an acute medical issue (for example a cough or injury) or address a substantial change in a chronic health condition. If the time and resources we devote to these issues are significant, we will bill your insurance company for these services (as has been our practice all along). In this case, a co-payment will be required and will be billed to you after the visit.

Other services such as labs that are not considered part of the preventative exam visit may also generate additional costs in the form of a deductible and/or co-insurance. You should check with your health plan if you have questions regarding your benefits.

If you have any questions about a billing statement you receive from the Marino Center, please contact our Billing Department at 617-661-0333

Thank you.
Marino Center for Integrative Medicine
Practitioners and Staff

“Know then, whatever cheerful and serene supports the mind…..supports the body, too.”  John Armstrong

In the most recent Annual Report to the Nation on the Status of Cancer, (compiled by leading cancer organizations, updated 3/28/12), findings indicate: overall new diagnoses for cancer—for both men and women-- have decreased an average of less than 1% per year from 1998-2006.   Rates of death for men, women and children have continued to slowly decline (2004-2008 studies). 

Although these statistics are headed in the right direction, there is a need for much better numbers!  

A diagnosis of cancer can trigger a strong reaction of fear, anxiety and worry in the individual affected---as well as within family members and friends.   What is important to know is:  there are proactive steps a person can take towards his/her own health and healing, as well as steps one can take in being a strong support person for someone with the diagnosis.

Many cancers can be caught early or managed well —utilizing the variety of early detection, diagnostic and treatment methodologies available.  When you combine these conventional approaches with complementary therapies such as acupuncture, massage and stress reduction in an integrative approach, you can become empowered to manage your disease.   

What are the best Treatment Methods? 
There are many types and levels of cancers.  Each person has his or her own unique health blueprint and complexity of factors to consider.  And so, there is “no one-treatment-fits-all” answer to this question.   Treatment programs need to be individualized.

Traditional state-of-the-art cancer treatment centers, like Dana Farber, Mayo Clinic, and Sloan Kettering, offer excellent diagnostic and treatment options as well as emotional, mental and spiritual support. (see Society for Integrative Oncology Practices under REFERENCES). Major mainstream treatment centers, including those associated with well-known teaching hospitals, offer a wide variety of integrative services.  In Boston, The Leonard P. Zakim Center for Integrated Therapies is part of the internationally known Dana Farber Cancer Institute, associated with the Brigham and Women’s Hospital and Harvard Medical School.

At the Marino Center, we support an integrative approach to the treatment of cancer. Conventional medical and surgical treatment options—together with complementary modalities—can enhance and speed up the healing process.

Some examples of complementary care treatments include: nutrition; relaxation, mindfulness and meditation practices; visualization; spiritual and religious practices; exercise; music therapy; laughter and humor; body work therapies such as:  physical therapy, acupuncture, chiropractic, massage, and lymphatic drainage--to name a few; energy healing such as Reiki;  yoga and Tai Chi;  and emotional support therapies. For this article we will focus on: nutrition therapy, mindfulness, chiropractic, manual lymphatic drainage. acupuncture, massage, exercise and physical activity, Reiki (energy healing); emotional support; and laughter/humor and creativity.

Nutrition Therapy  
It is important to eat a wide variety of healthy, whole foods on a daily basis.  A good, “clean diet” can nourish and rebuild cells, enhance the immune system and the healing process, and provide more overall energy.  The typical American diet--containing a high percentage of acid-forming foods--- operates against healing.  High acid-forming foods include:  sugar/syrups, refined grains, chemicals and preservatives in foods, and an excess of acid-producing items like coffee and alcohol.

It is important to eat more alkaline-forming foods such as a diet rich in green vegetables. Also include: some fruits, healthy fats from nuts, seeds, avocado, olive oil; high fiber beans and legumes, and high omega-3 fatty acid fish such as wild salmon.  Grains should be whole grains (high in fiber), not refined.  Vegetables and fruits offer a variety of vitamins and healthy phytochemicals, as well as fiber. Animal proteins should be steroid-free.  It is advised that-- if buying beef—buy grass fed.  For eggs, buy those from free-range chickens, raised in healthful conditions. Home cooked foods can be more appealing, as well as more healthful: for example: soups, stews and home-made shakes.  (See Cookbooks under REFERENCES).

Adequate fluid is important for overall workings in the body and to “flush” the system from toxic breakdown products.  Gastro-intestinal health is a key ingredient for good nutrition and healing.   A healthy gut will ensure more optimum absorption of key nutrients and increased release of toxic waste materials.   Probiotics can be helpful for intestinal balance.   Digestive enzymes and healing shakes may be helpful for others.  If there are food intolerances, allergies, or sensitivities—these should be addressed.

Supplements
There is controversy regarding the proper amounts and types of nutrient supplements during cancer treatments.  The best advice comes from experts in this field including your oncologist and nutritionist with a specialty in cancer treatments.
Detox programs/Cleanses:  There are a number of positive testimonies regarding natural healing -- through detoxification programs and cleanses.   One should not attempt such programs alone; and it is advised that such programs be discussed with your integrative health care provider.

MIindfullness Practice
Mindfulness, and other meditative practices, can be of great support during cancer treatment/recovery----and in one’s life in general.  According to Jon Kabat-Zinn, meditation/stress reduction guru, mindfulness can be defined as  “Awareness, cultivated by paying attention in a sustained way, on purpose, in the present moment, and non-judgmentally.”  Kabat-Zinn teaches that practice in mindfulness can bring ‘profound healing and transformation into one’s life’.  Susan Bauer-Wu, PhD, RN states that mindfulness meditation practices “have been shown to positively affect the quality of life and biological outcomes in many populations including cancer patients and in healthcare professionals”.  http://www.cancernetwork.com/nurses/content/article/10165/1698208  “Mindfulness Meditation”, S.Bauer-Wu, Integrative Oncology 10-19-2010

Being in treatment for cancer can be an emotional, high anxiety, high stress time.  A practice of mindfulness  and present moment living can ease stress and result in decreased levels of the stress hormone cortisol---thus strengthening one’s immune system, and enhancing the healing process. Practicing mindfulness can also result in a greater level of expanded awareness, thus adding more meaning and hope in one’s life.  NOTE: The positive aspects of mindfulness practice are true for care providers and support people-- as well as for patients.

Suggestions for Staying Mindful

•Pay attention to your breathing, in and out
•Let thoughts just pass through the mind---without judging or grabbing onto them
•BE PRESENT in each moment: whether sitting, standing, walking, eating, or taking a shower
•Let each unfolding moment be OK (even if not your favorite moment).
•Be KIND to yourself.  Be SOFT with yourself

Chiropractic
Chiropractic treatment can relieve pain and stiffness in your bones, muscles, joints, tendons, and ligaments caused or intensified by surgery, chemotherapy, or radiation therapy.  Chiropractic treatment can help alleviate a variety of symptoms including: back pain, neck pain, headaches, sciatic nerve pain, painful walking, postural changes, and nausea. Chiropractic care in collaboration with conventional cancer care can reduce stress, increase mobility, flexibility, strength, and function, as well as help promote quality of life and overall well-being.  While Chiropractic can be beneficial to patients undergoing treatment, there are some precautions necessary to ensure safe delivery of care.  A chiropractor should review recent x-rays, bone and CAT scans to ensure there is no metastasis, or cord compression.  Also, platelet counts need to be monitored.  Some cancer treatments can lower your platelet count which puts you at higher risk for bleeding.

Manual Lymphatic Drainage (used to treat Lymphedema)
Lymphedema is an accumulation of lymphatic fluids that produce abnormal swelling in the body.  This condition can appear in some people who are undergoing, or have been through, cancer treatment.  When lymphatic drainage is blocked, protein-rich fluids gradually build up and stagnate in the soft tissues where bacterial growth can develop, possibly leading to infection.  To help prevent or control lymphedema, carefully observe changes in your body, learn how to plan in personal hygiene, and develop an exercise program. Lymphedema can occur as late as 15 years after surgery. Manual lymphatic drainage can also help. In addition, ask your clinician, if the at-home pump would be beneficial to you. For further information contact: National Lymphedema network @ 800-541-3259 or go to http://lymphnet.org or Information services of the National Cancer Institute:  800-4-CANCER Y-ME hotline: 800-221-2141, or go to www.y-me.org.

Acupuncture
Acupuncture is very effective for managing pain related to surgery, tumors, chemotherapy, radiation and inflammation. Cancer can be a very painful disease, and the treatments can sometimes cause pain, inflammation, and swelling. Other symptoms may include constipation, nausea, difficult urinating and respiratory depression.  Acupuncture can help with symptom reduction. Many cancers and cancer treatments cause a suppression of the bone marrow, the source of blood cells that are the army for the immune system.  Acupuncture increases blood cell production and enhances Natural killer Cells and Lymphocytes--which leads to increased immune response and decreased risk of infection. By managing the side effects of surgery, chemotherapy, radiation, reducing pain and inflammation, improving sleep, supporting normal digestive function and minimizing stress—the quality of life of cancer patients is improved with acupuncture treatments.  Eugene Mak, MD a board certified oncologist states that acupuncture “can also add to the patients’ sense of well being and decrease the malaise associated with any chronic disease, especially cancer…and imparts a sense of well being and accelerates patients’ recovery.”

Massage Therapy
Massage therapy is a touch therapy where techniques such as kneading, rubbing, stroking, and tapping are performed on the soft tissues of the body. Controlled research has shown that massage in cancer patients reduces anxiety, eases pain, helps control nausea, helps decrease medical costs of managing nausea and vomiting, improves sleep, and eases fatigue.  Massage is contraindicated with burns, open wounds, fever, and cancer that has spread to the bone or spine.  Massage is not only recommended for cancer patients, but also for their loved ones and caretakers.

Reiki
Reiki uses specific techniques to balance the natural life force energy in the body. It reduces stress to increase relaxation and avoid energy depletion. Reiki has been proven to raise the comfort and well-being of patients, post-chemotherapy treatments.  It is a method of healing developed in Japan in 1922.  Through this technique, practitioners channel healing energy through their hands.  It is not a religious practice.  One of the best Reiki options is to find a practitioner or training that teaches you how to do this on yourself or a loved one.  Reiki or any other healing energy modality should always be used in collaboration with conventional treatments.

Exercise
According to the National Comprehensive Cancer Network, one of the recommended nonpharmacological approaches to cancer-related fatigue and muscle weakness is increased physical activity.  There have been several random controlled trials on the topic. Overall, a combination of stretching, resistance, circuit weight training for all major muscles of upper and lower extremities,  aerobics and walking have aided cancer patients with fatigue, aerobic capacity, muscle strength, anxiety, depression, self-esteem, and quality of life.  Cancer and cancer treatment can be exhausting, and it doesn’t go away with sleep.  To begin your exercise regimen, see a physical therapist, personal trainer in a reputable fitness center, or check with your cancer treatment center for exercise groups or trials that you may attend. If none of these work for you, commit yourself to walk as often as possible.  (Reference: Cancer Epidemiol Biomarkers Prev 2007 16 (12) December 2007)

Emotional Support 
Emotional support is an important aspect of healing.  Emotional support comes in many forms, starting with trusted family and friends.  Although friends and family may offer the closest support, it is also important to seek additional sources----as primary support people also need time to restore their energies.  Options include: individual psychotherapy, a personal spiritual guide, coaching, and various support groups. There are numerous blogs to read, Chat Rooms to join, and online communities such as What Next, Circle of Sharing and Cancer Survivors Network.  Books and inspirational tapes can also offer great emotional support.  

Causes and fund-raising events can be inspirational: e.g. being involved in (or supportive of) a 5 mile run to raise money for breast cancer research. Many programs are offered at the cancer treatment centers themselves (for example, The Leonard P. Zakim Center for Integrated Therapies at Dana Farber) or for example: through cancer support groups and stress reduction programs at UMASS Memorial Medical Center in Worcester (cancer support:  http://www.umassmemorial.org/our-care/cancer-center-of-excellence/cancer-support-groups/cancer-support-groups;  stress reduction at the UMASS Medical Stress Reduction Program:  http://www.umassmed.edu/cfm/stress/index.aspx.  For more information re:  What Next, Circle of Sharing, Cancer Survivors Network and other Support groups and Services in your area, go to: http://www.cancer.org/Treatment/SupportProgramsServices/index

Laughter/Humor and Creativity  
Laughter and humor are an important part of coping and healing.  An American Cancer Society article states that humor therapy offers five main benefits: 1. Relief from Tension and Stress (release of “feel good hormones”), 2.  An aerobic and internal work-out, 3. Stimulation to the immune system, 4.Expansion of one’s perspective—resulting in increased coping skills and 5. EMPOWERMENT and enhanced quality of life.   http://www.joyfulaging.com/HumorTherapy.htm   
One can boost “feel good hormones” by watching favorite funny movies or TV comedy reruns, or by hanging out with funny, uplifting friends.   Also, check out writers and speakers like Loretta LaRoche who have made a career out of humor therapy!  See her website at: http://www.LorettaLaRoche.com   for books, DVDs, CDs.  NOTE: find humor and laughter in everyday events, even amidst the serious moments—whenever possible.   

Creativity 
It can be soothing and healing to engage one’s creative side with activities such as music or art, creative writing, or in the design of a special garden.  When we use ‘the right side of the brain’—we take our thoughts away from the usual “mind and worry tapes."  We can become lost (in a good way) in musical notes, the poetry of words, colors of paintings, or in the scents of nature.  Each person has a creative side---which offers many healing aspects in the journey to health and well-being.  Find the activities that call to you.  For Art Healing ideas, go to: http://www.curetoday.com   (SEARCH:  ART HEALING)

Choose those complementary modalities that call to YOU!    The following support therapies are available at the Marino Center:   Nutrition, Chiropractic, Physical Therapy, Massage, Lymphatic Drainage, Acupuncture, and Reiki energy healing (in Cambridge only).  

“What we do for ourselves dies with us.  What we do for others and the world remains, and is immortal.”     -by Albert Pine-

REFERENCES
BOOKS

• Anti-Cancer:  A New Way of Life by David Servan-Schrieber, MD, PhD
• Crazy Sexy Cancer Survivor:  More Rebellion and Fire for Your Healing Journey by Kris Carr
• Crazy Sexy Diet:  Eat Your Veggies, Ignite Your Spark and Live Your Life Like You Mean It by Kris Carr
• Eating Well, Staying Well: During and After Cancer (American Cancer Society book)
• Foods that Fight Cancer by R. Beliveau, PhD and D. Gingras, PhD
• Fresh Choices:  More Than 100 Easy Recipes for Pure Foods Choices When You Can’t Buy 100% Organic by D. Joachim and R. Davis
• Full Catastrophe Living: Using the Wisdom of your Body to Face Stress, Pain and Illness a classic by Jon Kabat-Zinn.  (also by Kabat-Zinn: his NEW Book:   Mindfulness for Beginners: Reclaiming the Present Moment in Your Life and his other classic:  Wherever You Go, There You Are.
• Happy Talk: Fun Ways to Talk to Yourself (133 pp) by Loretta Laroche
• Healing Gourmet.  Eat to Fight Cancer by S. Liu, MD; K.McManus, RD, and J Carlino, CEC
• Integrative Nutrition Therapies for Cancer by N.B. Kumar, PhD, RD
• Mindfulness-Based Cancer Recovery by Linda Carlson
• Mindful Eating by Jan Bays, MD
• Nourishing Wisdom: A Mind-Body Approach to Nutrition and Well Being by Marc David. (inspirational)
• One Bite at a Time: Nourishing Recipes for Cancer Survivors and Their Friends by Rebecca Katz
• SuperFOODs Rx:  Foods That will Change Your Life by S. Pratt, MD
• The Anti-Cancer Cookbook by Julia Greer
• The Cancer Fighting Kitchen by Rebecca Kitchen (5 Star Amazon rating!)

WEBSITES 

• http://stress.about.com/od/tensiontamers/a/mindfulness.htm  (Article:  “Mindfulness: The Health and Stress Relief Benefits” by Elizabeth Scott, MS, updated 1/29/11)
• http://www.cancerbuddiesnetwork.org/?gclid-CLO-26b7w68CFcjb4Aodmn74ZA   (Cancer Buddies Network)
• http://www.cancersupportcommunity.org/MainMenu/Cancer-Support/Online-Support-Groups.html   Cancer Support Community telephone helpline:  888-793-9355
• http://www.cdc.gov/cancer/dcpc/research/articles/arn_7508.htm
• http://www.dana-farber.org/Adult-Care/Treatment-and-Support/Patient-and-Family-Support/Zakim-Center-for-Integrative-Therapies.aspx  (The Leonard P. Zakim Center for Integrative Therapies @Dana Farber Cancer Institute)
• http://www.fruitsandveggiesmorematters.org
• http://www.healingthroughcreativity.org/index.php (Survivor art events)
• www.aicr.org  (American Institute for Cancer Research)
• www.cancer.org  (American Cancer Society)
• www.cspinet.org  (Center for Science in the Public Interest; See Nutrition Action HealthLetter).
• www.crazysexycancer.com
• www.dana-farber.org
• www.dana-farber.org/Nutrition
• www.happiness.co.uk/   (website for The Happiness Project and the book and CD:  Shift Happens:  How to Live an Inspired Life by Robert Holden, PhD.
• www.integrativeonc.org   (Society for Integrative Oncology:  a multi-disciplinary organization of professionals dedicated to advancing evidence-based, comprehensive, integrative healthcare to improve the lives of people affected by cancer.  Go to:  CLINICAL CORNER for listings of respected integrative oncology practices (including Mayo Clinic, Sloan Kettering, and The Leonard P. Zakim Center at Dana Farber in Boston)
• www.lorettalaroche.com  (website for Loretta LaRoche, including listed books, DVDs, news columns, presentations)