Rachels Blog

Cardiovascular Testing

Cardiovascular Testing


In the month of *hearts* I thought it would be smart to talk about keeping our hearts healthy!  I receive many inquiries about how best to “screen” for heart disease, or the risk factors for heart disease, and here are the items that I think are most important:


  • Check weight, height and body mass index (a ratio of the two), or even better: body composition (a simple 5 minute test using bioelectric impedance).
  • Check blood pressure.  It remains one of the most important risk factors for heart disease and if it’s high, be sure you check it at home at different times throughout the day to see what your average blood pressure is.
  • Check fasting glucose, hemoglobin A1C (long term measure of average glucose), or even better, fasting insulin to look for signs of pre-diabetes.
  • Check a detailed cholesterol panel, a VAP panel, that also screens for genetic markers for lipid risk and examines particle size to help determine risk.
  • Check an hsCRP (C-reactive protein) that measures inflammation, particularly as concerns the cardiovascular system.  This blood test is the MOST associated with risk of heart attack.
  • Check a homocysteine level.  An elevated homocysteine increases cardiac risk and reflects an issue with folic acid metabolism.


These are the basic tests that I consider in anyone that I want to help prevent heart disease.  In someone who already has risks for heart disease, we may also want to consider an EKG or an echocardiogram (an ultrasound of the heart that can look at heart size and function).  Even more sensitive is an EKG and echocardiogram performed during exercise (a stress ECHO).  I generally reserve that test for those that are undergoing a significant stress (for example, surgery) or those in whom I am concerned about imminent heart disease.  Another screening test that should be considered is a coronary calcium score—which is an x-ray that can calculate the amount of calcium deposited into the coronary (heart) vessels.  This reflects the degree of atherosclerosis, or hardening of the arteries, and can be a great motivator to behavioral change when elevated.


Keep in mind that getting more love in your life, reducing stress, exercising, stopping smoking and generally enjoying your life will all make your heart happy and less vulnerable to disease.


In this season, a big hug from my heart to yours and I hope we all take good care of our own hearts and the hearts of those we love.

Beating the Fall Viruses!

Beating the Fall Viruses!

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Welcome to the sunny, crisp days of fall in Santa Cruz County!  We love it and so do the viruses that wreak havoc on our respiratory system.  Fall encourages more indoor time and the return of the young to classrooms where viral colds, coughs and flu’s spread from hands and mouths and the air we breathe.  How can you bask in the season’s harvest and protect yourself from the season’s ills?  Here are some tips!


  • Boost your immune system—Most of us are aware that when we are “run down”, we get sick more easily.  The best immune booster is good, solid sleep, at least 7-9 hours nightly, depending on your needs.  Kids need more—9-11 hours.  Exercise also improves immune strength.  Gentle exercise, such as tai chi, qi gong and yoga, is particularly good for reducing the negative effects of stress on the immune system and is energizing for those who feel fatigued.  Eating well—lots of anti-oxidant rich dark fruits and veggies, beans and omega-3 rich nuts will nourish your bodies ability to fight disease.  Fall and winter provide us naturally with antioxidant and Vit. C rich fruits—apples, kiwis, pineapple guavas, and all citrus fruits.  And if you don’t eat well or simply want to optimize your health, a good multivitamin can help.  Research shows that the Chinese herb astragalus has immune powering properties and is safe and effective to take preventatively during the cold and flu season.  A little extra vitamin C (in citrus or taken as a supplement) can also help.  Traditional Chinese medicine and homeopathy can also assist in strengthening your immune system for the season.
  • Limit your exposure—Just like your mama said, wash your hands (and encourage your sick friends and children to do the same)!  Cough into your elbow, where the germs can stay, rather than into your hand where they can easily spread.
  • EXPOSED!—So now your adorable viral-laden niece or neighbor just sneezed in your face, or you simply feel that scratchy-throat, tickly nose, “I’m about to get sick” dread…What to do?  As a mother of pre-school aged toddler twins, I perfected my cold-avoidance strategies and here’s my secret formula:
    • As much sleep as you can get.
    • Avoid caffeine as much as possible (your body needs its strength for fighting illness, don’t push it further)
    • Only gentle exercise, meditation or stretching (ditto the above)
    • Vitamin C 1000 mg three times daily
    • If you (or your kissing partner) can take it, fresh garlic chopped and mixed in honey applied to the back of the throat every several hours throughout the first day or two of illness
    • A combo immune herb/supplement containing Echinacea, Astragulus, Andrographis, Vit. C, Zinc, Elderberry and garlic—my favorite is EHB by Integrative Therapeutics plus Elderberry lozenges or liquid (which taste great!).  Another good one is Wellness Formula by Source Naturals.
    • The Chinese herb Yin Ciao (three tabs three times daily)
    • And chicken soup (or the vegetarian equivalent) really does help clear mucous—not to mention help you feel loved, which is the only real benefit of being ill in the first place!


So enjoy the brilliance of Fall, stay strong in body and spirit, and keep those nasty viruses at bay!


Rachel Abrams

(please consult your physician regarding any interactions between medicines you are taking and the recommended herbs and supplements)



Anti-inflammatory Living

Anti-inflammatory Living


You probably don’t spend much time thinking about inflammation in your body, but inflammation is a buzz-word in the medical community these days is because it is such an important part of health and wellness. We generally think of inflammation as painful redness or swelling around injuries or joints, but the process of inflammation is used throughout the body to fight off harmful microorganisms. It is a vital process, but unfortunately, too much inflammation actually damages the body. Think of the good scientist, Dr. David Banner, when he transforms into the incredible Hulk, with collateral damage to buildings and healthy tissue everywhere. In high levels, inflammation is the root cause of many of the top killers today: heart disease, cancer, stroke, emphysema, asthma, diabetes, Alzheimer’s disease and inflammatory bowel disease. Inflammation is responsible for the pain of arthritis and other musculoskeletal injuries and is the active force behind diseases where the immune system attacks the body, such as rheumatoid arthritis, lupus or Hashimoto’s thyroid disease. Now, why is this? It seems our modern lifestyle, in addition to inflaming the populace (e.g. road rage, soccer fans gone awry), causes inflammation inside the body through what we eat, how we live and, yes, what we feel.

There are medications available to reduce pain and inflammation, and sometimes, they are just what the doctor ordered, for example, steroids for an acute asthma attack or non-steroidal anti-inflammatory drugs, NSAID’s (think ibuprofen or naprosyn), for an acute attack of gouty arthritis. However, oral steroids over the long term can be quite dangerous and even our over-the-counter ibuprofen or naprosyn, not to mention prescription Celebrex, taken regularly can cause kidney failure, ulcers, increase the likelihood of heart attack and in a recent study, actually prolong the amount of time it takes to recover from an injury. As a treating physician, I prescribe these medications, but, as with any medication, I like to use natural means of treatment first in order to minimize the amount of medication needed, if any. In the case of inflammation, from whatever cause, we have LOTS of options!

Many integrative physicians point out that the most powerful natural anti-inflammatory agent we have is—my favorite—SLEEP! That’s right, just by getting your Z’s you are reducing chronic pain, arthritis and cardiovascular risk. A new 5 year study found that middle-aged people who got just one more hour of sleep a night than their peers were one-third less likely to have increased calcium deposits in their arteries—the kind that lead to “hardening of the arteries” and more heart attacks, strokes, and Alzheimer’s disease. Sleep is vital to our health and happiness. If you are missing sleep in your life, look at my recent blog “Sleepless in Santa Cruz” for healthy tips on falling and staying asleep.

Just as important as the calming effects of sleep on your inflammatory and immune system, is the mood that you live within while awake. As one might suspect, if you are angry or aggressive in the outside world, your immune system becomes “inflamed” as well, getting ready to fight off an enemy or protect a potential injury. Any kind of relaxing, meditative activity can help, such as regular exercise (especially if it is enjoyable!), tai chi and qi gong (Chinese martial arts known to reduce blood pressure and decrease the pain of arthritis), yoga, prayer, or meditation.

Finally, and perhaps most importantly, everything you put into your mouth sends a chemical signal to your body and can influence the inflammatory process. Red meat, high fat dairy products, hydrogenated oils, and all deep fried foods increase inflammation in the body. So that burger, fries and milk shake are probably not the best choices if you suffer from any inflammatory conditions.

Foods high in anti-oxidants, which can be found in plenty at your farmer’s market, help decrease the inflammatory process of “oxidation” and protect your tissues. Look for yellow, orange and red vegetables, such as peppers, carrots and winter squash. Dark colored fruits, such as berries, and citrus fruits are also powerful anti-oxidants and are packed with many other vitamins as well. Dark leafy greens (spinach, romaine lettuce, chard and kale) are some of the most nutritious foods you can eat and are powerfully anti-inflammatory, as are onions and garlic, which are a wonderful accompaniment to your greens. People don’t realize that many common spices have powerful anti-inflammatory compounds as well, especially ginger, rosemary, turmeric (the dark yellow-orange Indian spice, also called curcumin), oregano, cayenne, clove, and nutmeg. To accompany your meal, both black and green teas have strong anti-oxidant action and there are numerous studies linking the consumption of green tea to protection from all cancers.

Most of you have probably heard of the health benefits of cold-water fish and fish oil. Research on fish oil began because the Inuit Eskimos, who eat large quantities of fish, have extremely low rates of heart disease and heart attacks. This is because fish is one of the richest sources of omega-3 fatty acids, which are some of the most potent and well-researched anti-inflammatory compounds available. Omega-3’s lower triglycerides; prevent and treat depression; decrease the pain of arthritis, menstrual cramping and other muscle aches; improve asthma, eczema and allergies; help menopausal symptoms and prevent heart attacks. The safest sources are good quality fish oils, wild Alaskan salmon, and smaller fish rich in oils such as sardines, herring or mackerel. Flax seed and flax seed oil are rich in omega-3’s as well, but must be kept cold or at room temperature to retain their healing properties. Grinding them and adding to smoothies or using flax oil 3:1 in salad dressing is a wonderful way to get your omega-3’s. Walnuts are also a rich source of omega 3’s, as are leafy green vegetables, making salad with summer veggies and fruits, walnuts, and a vinaigrette with olive and flax oils a delicious anti-inflammatory contribution to your summer table.

So sleep long and well, breathe deeply and then get out to your neighborhood farmer’s market so that you can prepare yourself an anti-inflammatory, life-giving feast! Eat well, live well and be well.



11 Tips for Optimal Health





11 Tips for Optimal Health

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1. Love. No, really. And not just on Valentine’s Day. The research shows that the health protective effects of regular affection, relationship, and community are more impressive than whether or not you smoke. So get your hugs on; it’s good for you. And if you don’t have someone to snuggle with, it turns out that affection with your pet helps, too. I love you Spot.


2. Move. Humans did not evolve to sit in armchairs. Our entire physiology has evolved around the vigorous physical work it has taken to survive for the last 10,000 years. So when we take “vigor-man or woman” and make them sit at a desk all day and come home and sit some more—they get slow, depressed, irritable and inflamed—on the inside. This stagnation creates the basis for heart disease, strokes, diabetes, depression and cancer. So move. In whatever way you enjoy. Walk. Skip. Dance. Make your body happy.


3. Sleep. Americans are more deprived of sleep than exercise—which is saying something! The average amount needed is 8 hours—with 50% of folks needing more than 8 hours. If you get less sleep than you need on a regular basis, you are more likely to be depressed, irritable, overweight (yes, less sleep causes weight gain) and have poor concentration and performance. And coffee does not help. Cut the caffeine and get your zzzz’s! You’ll feel better!


4. Enjoy. It makes a big difference to your physiology if you spend your time in anger, blame and resentment (more inflammatory reactions, high blood pressure, poorer immune response) or in gratitude, joy and play (calmer nervous system, balanced immune response, less risk of heart disease). Life is full of difficult situations, but the way that you approach those situations makes all the difference. And because we spend so many hours at work, do your best to choose work that you enjoy, most of the time. And don’t forget to play!


5. Eat food. If you can’t pronounce it, don’t eat it. If it doesn’t look like any recognizable fruit, vegetable, grain or meat, don’t eat it. If sugar is the first or second ingredient, don’t eat it. Try to stick to fruits, veggies, whole grains (skip the white stuff), plant proteins (beans, nuts and legumes) and some high quality (e.g. organic, no added hormones) animal proteins. Most of us know this. You might want to get some support in eating this way if it’s hard for you—it is well worth the investment as food really is medicine—all foods send chemical signals to your body that contribute to your health or your decline. And if you just can’t eat well, as least take a multivitamin and some essential fatty acids (fish or flax oil). It’s a good start.


6. Pray or Meditate. When life gets difficult, all you have are your inner resources (patience, love, trust, a sense of perspective, creative problem-solving) to get you through it intact. Taking some deep breaths, and even a small amount of time, to express gratitude, ask for help, find peace, and set your intention for your day, is invaluable in maintaining your equilibrium on the inside and the outside. Meditation or prayer significantly reduces all causes of cardiovascular disease, eases depression and anxiety and helps us stick to our good health decisions.


7. See your Doc once by 45. Even if you are healthy. Sometimes we have health risks we are unaware of. I’ve had tri-athletes with severely elevated cholesterol. It’s good to know these things early because there are many approaches we can use to enhance your vitality and life span.


8. Detoxify. We live in a world rife with chemicals that didn’t exist 50 years ago and we have no idea what the majority of those chemicals do to humans. But for good reason, many of us in the science world are concerned about emerging research showing the effects of toxins on brain function, cancer, fertility and obesity. Limit your risks by ditching that Teflon pan (ever wonder where that flaking Teflon goes when it disappears from the pan?), eating organic as much as possible (especially milk, meat and eggs), not heating food in plastic, finding non-toxic alternative for pesticides, and using green cleaning and home maintenance products. Exercise, sweating, drinking plenty of water and eating fiber are good ways to detoxify naturally.


9. Watch out for addiction. Okay, we’ve all got them. Coffee, cigarettes, marijuana, alcohol, chocolate, sugar, soda, T.V, Facebook, even exercise—you can treat just about any activity addictively. If you are using an activity to avoid experiencing how you actually feel, it’s an addictive use of that activity. Some addictions are more dangerous than others, but if we use our addiction to numb our negative emotions, we stop ourselves from taking action to change the way we feel (e.g. changing jobs or relationships, getting therapy, setting boundaries with others). We live in a very addictive society, where there is a pill for every ailment. Take an honest look at your life and give yourself the gift of change where it’s needed. It’s better than a double latte.


10. Limit screens. Oh, for goodness sake, didn’t we think that computers were better than television? Not. If you spend all of your time in front of a computer, television, or smart phone, what are you missing? Items one through four on this list. Human interaction (texts and e-mail are not the same thing), movement, sleep, good food—don’t get swallowed by your screens. Get outside, get some sunlight, hang with your friends, surf. Live inside your body (that’s the part of you attached to the hands on the keyboard or remote).


11. Don’t obsess. Change takes time. Be patient with yourself. And perfectionism, even with your health, is not good for you. Life is short. Don’t forget to dance and occasionally eat chocolate cake.