​Today I'm talking with Dr. Michelle Peris about my favorite topic- joint health! Please join us as we discuss lifestyle and dietary interventions that can help reverse arthritis, and dive in to my 7 step plan to reverse chronic joint pain.

First off, if you care about this topic, take 16 minutes and listen to this interview by Dr. Zwickey>>>
She's an immunologist and was my immunology teacher in medical school. This is an interview for the Natural Medicine Journal.

Here's the Facebook live I shot, sharing my experience and answering everyone's questions>>>
This was filmed the morning of Monday, Jan. 11th.

Here's the Moderna fact sheet I was given when I received my vaccine:

(and get on my list to get future updates here>>>)

first up, no I don't know when you can get a vaccine

 
My clinic doesn't know. No clinics know. Unfortunately, I don't recommend calling your doctor to ask right now. All medical centers are being inundated with calls about the vaccine. The distribution is just now starting to trickle out to us medical providers outside the hospital setting.

but I can share with you what the plan is


While I don't have the exact when, where, and how of vaccinating our community, I can share what the Oregon Health Authority has planned.

Here's the main information website>>>

The vaccines are becoming available according to Phases. Different people fall into different phases, based on their occupation and medical history.  We are currently in Phase 1A, which includes all of us who see patients in person.

You can read more the specific Phases this local newspaper article from Nov. 19th>>>

but how will I know when and where I can get it???


I get that there is a lot of high emotions around this right now. I get that many want a concrete plan, now! But like so much over this last almost-year, we're having to be flexible and go according to ever-changing time frames.

If you want email updates from the Oregon Health Authority, give them your email in the little pop up box on their website>>>

I will send out further emails when we have reached Phases that are more relevant to my community. I will be sending out as many updates as I think will be helpful. Even if they don't pertain to you, maybe they will be helpful to a friend, family member or coworker, so stay tuned for more details to come.


do I think you should get it? (and variations on this question)


A vaccine, like every other recommended medication, supplement, or any other treatment, should of course always be an individual and informed decision.

There will always be public health recommendations that some cannot or should not follow based on their unique medical history.

So while I won't make a blanket statement telling everyone what to do, I will talk about the joint decision making conversations I have with patients.

You need to weigh the risks and benefits of doing [the thing, whatever it is] with the risks and benefits of not doing the thing.
Add to this conversation your present health status, workplace exposures and potential for family exposure, and there is no one-size-fits-all answer.

With that being said, from a public health standpoint, I am supportive of community-wide vaccination of those for whom this is the right decision.

yeah, but are you getting it?


A lot of people want to know.
Am I getting it?

Yes, yes I am.

If I were a 100% telecommuting person, never seeing any patients in person, and 100% of my loved ones around me were in absolute perfect health, then I may feel like I have the luxury to delay being vaccinated.

But I am not in that position.

Because while of course I am taking care of myself and my immune system in many other ways, I see this as one additional way I can help prevent the spread through my community and through my household. I consider this particularly imperative for the good of my patients I see in person.

But again, this is an individualized decision. I'm just sharing it publicly.

If you have further questions, I encourage you to discuss them with your trusted healthcare provider and come to a decision that is right for you.

Lastly, while you are collecting relevant information and making decisions during this time for you and your family, I encourage you to do a "source audit" on your newsfeed.

Where does it come from?
Who is saying it?
Who else is saying this?
Who are those countering this argument?

There's a lot more I can say about analyzing logical fallacies, but we'll leave it here for now.

I can tell you, from years of reading and interpreting primary literature (published research articles) that if your only sources of information are social media and YouTube, you will be missing out on a lot.

So cast the net wide to make sure you are getting the full picture, not just what the algorithms want you to click on.

More to come later, but that's all for now,
Dr. Angela

What are your New Year's plans? 🥳
Mine involve guiding a small group through reversing chronic joint pain and degeneration.

That's all 😆

Starting Monday, I will be leading Foundations of Resilience.
We will be making big impacts & positive changes over just 4 weeks.

If your resolution is to have healthier joints, join us now.
Check it out,  full details and sign up here>>> 

We have space for a couple more, sign up before we're full.

I just had to write about food during the week of our national food gorging, aka Thanksgiving (for those of us in the States). And during the week of Thanksgiving, when we show gratitude and feast to our heart’s desire, this is also the worst time to talk about diets.
 
So I’m not going to do that.
I’m instead going to talk about the mindset behind why we change our diet, what is diet anyway, what are we looking for, and just how do we know it’s working anyway?
 
Let me share an excerpt from my book Younger Joints Today. It’s a book about reversing chronic joint pain, and has a ton of information on how nutrition affects joint health.
People use the word “diet” in many unhealthy ways. It often involves severe restriction, a sudden change in a desire to get healthy. Many times, there are unhealthy motives behind dieting and diets.
 
Instead of “diet” meaning “restriction,” I prefer these definitions instead: “habitual nourishment” and “regimen of intent.” How do you intend to nourish yourself every day?
 
So, diet can mean how you regularly nourish yourself. Or it can mean restriction, and deprivation.
Start out by asking yourself, ‘why am I dieting?’ Why are you changing how and what you eat? What are your reasons, and what are your goals?
I find this piece immensely important, and often overlooked.
Your intention and your reason set the stage for how successful you are in making changes.
 
If you are going on an extreme detox diet because you read about it in a book, or a blog, or because someone you know is also doing it, or because you feel guilty for over-indulging over the holidays…. Pump the breaks. Those are all external factors influencing your decision.
What they say you should do.
 
How about you? Don’t you have any say in the matter???
Instead, I would like to invite you to make dietary changes because you want to, because your curious, because you’d like to experience some novelty, fun, and learn a thing or two about what foods are right for you along the way.
 
All books, blogs, videos, and social media posts can do is provide information. Some of that is relevant, but it can’t all be relevant to everyone. Is a carnivore diet the key to everlasting health, or will a vegan diet save us all? Trying to lump us all into one, “this is best for everyone” diet just won’t work.
 
You would be smart to look for guidance through this process by a professional. Many types of professionals can assist, such as Naturopathic Doctors, functional medicine practitioners, nutritionists, and holistic health coaches.
 
The success of your dietary changes will depend on your goals that you established from the start. You did set goals, right? Otherwise, how can you tell if it’s working and worth doing?
A trial of a dietary elimination, for example dairy elimination to see if it is affecting digestive health, may last 3 to 6 weeks. A nutritional intervention to address autoimmune, neurologic, or rheumatic conditions may last much longer. The key is to have a plan, be well prepared, and know what your benchmarks for success are.
 
Whatever your plan, I suggest you take phrases such as “cheat day,” and “cheat meal” out of your vocabulary. It just plain sets up negative thought loops, reinforces shame, and is just overall creepy verbiage. What, are you monogamously married to this diet?
Instead, just acknowledge when you are following your dietary changes, and when you are choosing to not follow it. That’s all. A rational adult making a well thought-through decision.
Any diet, or diet-pusher who leans on “no cheating”-type anti-cheerleading (bullying, if I’m being honest) earns an instant “eww-factor” in my book.
 
By all means, make the dietary changes you wish, based on internal-derived interests and goals, with a specific expectation established. And if all of this seems a bit too much, get some assistance whenever you need to help you create your path forward.
 
Wishing you a holiday season full of gratitude for your meals and those you share your meals with,
Dr. Angela

Why do we do the things we do?
Why do we do things we don’t want to be doing, and why is it sometimes so hard to start doing things we want to be doing?
 
These questions and more led me to my side hobby of behavioral sciences.
I find it fascinating to learn all about the seemingly simple science of habits, that is actually anything but.
 
I write much more about this in my Step 4 of my book Younger Joints Today, a whole chapter in fact, talking about habits and lifestyle decisions as they impact our joint health.
 
If you, like me, geek out on this topic, a few of my favorite authors on the subject are Carol Dweck, Brene Brown, Charles Duhigg, James Clear, Brendon Burchard and anything that the brothers Heath (Chip and Dan) write.
 
So why am I choosing to talk about serious topics like addiction right now? Because I’ve seen the stats on increased alcohol and opioid abuse for my state since the pandemic began, and I imagine those stats are similar globally right now. The need for support around this topic is timely.
 
My aim here is to talk generally about habits, addictions, what we can all try on our own, and when to reach for help.
 
The American College of Lifestyle Medicine defines lifestyle medicine as, “the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease.”
 
This subject quickly transitions into the topic of habits, good and bad, as well as addictions.

I’ll start first with talking about addiction. I like the definition Dr. Nzinga Harrison has described on her In Recovery podcast (a great resource for those who are or who love someone in addiction recovery), which is that addiction is persistent behavior despite negative outcomes.
 
I like this because of its generality, it’s applicability to any type of addiction, and its absence of specifics on use. Becoming addicted to a substance or behavior can happen at various levels and frequency of use, depending on genetics, medical history, trauma history, social circumstances, and more.
 
I am not an addiction counselor, so for those needing intensive support, they may consider an in-patient treatment center or for local (Oregon-based) counseling, I often refer to Christy Hey or Molly Rodden at Well Life Medicine Center.
 
When to turn to a counselor? Well, like in so many other realms, think about turning to a professional when you feel you can’t go it alone any longer. You probably know what I mean. You can’t keep it all together, it feels like something’s got to give, and you just can’t see what the first step out of this is.
That’s what professional support is for.
 
Like counselors and treatment, choosing to participate in group meetings focused on addiction recovery is also an individualized approach. Most know about AA, with associated off-shoot branches such as NA (Narcotics Anonymous) and OA (Overeaters Anonymous). I do not believe there is a one-size-fits-all approach to addiction recovery. For those looking for a non-religious recovery organization, SMART Recovery is an option.
 
Ok, now addictions aside, what about those who are struggling with more of a, “I really know I should/shouldn’t be doing this,” but don’t put the behavior in the same category of seriousness as an addiction.
 
Well, I’ll continue talking about alcohol a little bit more, then we’ll move onto other topics.
Going sober for a month is no new fad. Many choose to do this January of each year. There’s also Sober October, and a number of diet plans and programs (such as Whole30) where 30 days of alcohol abstinence is a part.
 
For many, going 30 days cold turkey with no booze is daunting. If you’re looking to cut back, or do a temporary alcohol elimination, a few self-guided programs out there are the Alcohol Experiment by Annie Grace or Sober Sis by Jenn Kautch (the latter is geared towards women with a Christian/ spiritual affiliation).
 
Jumping off all this, my strongest recommendation is to get a coach to help you work through the patterns you’re wanting to change. Whether it’s reducing your alcohol, smoking, sugar, or increasing your sleep, exercise, or healthy eating, getting step-by-step accountability, tools, and support every step of the way is your ticket to success.
 
Your doctor or counselor may fill this role. Or perhaps your personal trainer or athletic coach. If you need a “lifestyle coach” there are many types of holistic health coaches, nutrition coaches, all sorts of people available (now at the click of a button) to help you succeed and make positive lifestyle choices stick.
 
It is also extremely valuable to have someone there on the not-so-good days. We all have ups, and downs, and the occasional bump in the road (or the road is entirely blocked). It can help to get some perspective, and comprise the toolbox of resources you need to cope and work through the rough spots.
 
Your toolbox for tough spots is highly individualized. When those cloudy days come, do you have a supportive person to talk to? Do you have activities, hobbies, and self-care ideas at your fingertips? Are you intentionally creating the environment around you to minimize triggers and maximize successful habit changes? A lot can to into your toolbox, and I suggest you have as many resources in it as possible.
 
Check out that chapter in my book I mentioned above if you want to read more about how I work through the process of positive lifestyle changes with my patients. It takes creativity, adaptability, and an individualized approach to match you up with who and what you need as you go through your journey.
 
I wish you the best on your path towards ever-improving health,
Dr. Angela

Hey, you: move your body.
Yes, you.
I’m speaking to all of you, of course.
 
I bring up physical activity to my patients with joint pain of course, but did you know it can also be beneficial for those with digestive concerns, anxiety, depression, and even hormonal imbalances?
If you’re looking for a “magic bullet” for health, regular physical activity is about as close we can get.
 
No matter who you are, and you have going on, move it, shake it, and don’t forget to have fun.
 
In this week’s topic, movement as medicine, I’m going to skip right over all the stats on why exercise is healthy for you.
Because, snooze.
And, I know from my years in practice that stats and data don’t change minds and hearts.
 
Even the word exercise is highly problematic.
It conjures up ideas of boring chores, counting repetitions, and forcing yourself to do something you don’t want to do.
 
So instead, let’s celebrate all the amazing things our bodies can do by moving them in ways we enjoy.
 
But where to start?
And although you probably know by now that my unofficial motto is, “just start somewhere,” let me share with you a few great folks. In the interest of geography and current guidelines, I share those I know personally who offer virtual classes and sessions:
 
Jill and Cara with PUSH Fitness – these two Salem-based personal trainers help women of all ages celebrate their fitness and strength, no matter where you’re starting from. Small group in-person and virtual class options.
 
Christal and gang with Fusion Fitness – evening classes including VXN dancing. Small group in-person and virtual class options.
Melissa with Optimal Living offers not only yoga classes (private and group) and nutrition counseling but is also my go-to mindfulness and meditation expert. Exclusively online.
 
Taylor Harris with Flow As You Are Yoga. A few of you out there will recognize her from my original Healthy at Home and Move With Us videos. Taylor merges mindfulness, mind-body awareness and yoga during her virtual sessions.
 
Dawn with Bit by Bit Bodyworks – who adepts combines mindful movement with body awareness in small group and private virtual sessions.
 
Gillian Byers – a body-positive personal trainer and Reembody Method Apprentice.
Rachel – a Seattle-based personal trainer, also a Reembody Method Apprentice.
 
Tami – my all-time personal favorite Zumba teacher. She is a great instructor who makes sure those of all levels are having fun and getting in a great workout. Weekly virtual and in-person outdoor classes (Portland).
The trainers at Training Day PDX, which was my original and most-love weight-lifting gym, offers online coaching.
 
Evolution Healthcare and Fitness – is a gym I have enjoyed weight lifting classes from, and currently teaches both in-person small groups and virtual classes.
 
Now more than ever we are connected across long distances. Your personal trainer could be a city, a state, or a time zone (or more) away. Your yoga teacher could be all the way across the globe, and that’s not really all that unusual nowadays.
 
But if you’re looking for “low-touch” i.e. DIY home movement options, here is a list of curated choices from yours truly as well as those shared with me by friend, family, and patients:
 
Yoga with Adriene

Miranda Esmonde-White has mobility and movement-based courses, videos, and books
 
The big caution with the DIY approach is to listen to your body, and honor what unique needs it has every day. Some days may desire high-impact energetic exercise. Other days may need restorative, gentle movement. Don’t force it, and stop to modify whenever you need.
 
So now I’ve given you a ton of places to start. I wanted to give you enough choices for all types of needs.
Where to start? Anywhere. Truly. Just pick one video, one coach, one exercise, and try it on for size.
You can’t go wrong if you just keep moving and have fun.

 
I am starting off this month-long series with Mental Health first. That was an intentional choice. I find it’s a  major positive (or negative) momentum for our health; when our mood is good, all the other little things we know we “should do” for our health and well-being seems so much easier to do, right?

And when our mental health is suffering, well….everything else seems to slide down to meet it.
 
As I shared in the videos and posts all this week (on Instagram and Facebook), Mental Health is a big topic. It covers everything from a psychological crisis to persistent lack of motivation.  You might recognize the latter as the existential ennui I’ve heard mentioned quite regularly recently.
 
First off, if you or someone you know is in a mental health crisis and is a potential danger to themselves or others, here are a few numbers to know:
National Alliance on Mental Illness Helpline: 800-950-NAMI (6264) or text “NAMI” to 741741
 
Now, let’s talk more about the more insidious types of mental health struggles that most of us face.
 
I want to start off with a little homework for you, if you’re willing.

Think of yourself as a bucket. Yep, you’re a bucket. The more full of live-giving energy-water you are, the better you feel, the better you can handle life’s stressors, and overall the better your well-being.
 
Now, dear bucket, things in life can add, subtract, or are neutral to your bucket’s contents.
People, environments, interactions, the entertainment you choose, your meals, the way you spend your time, everything is either a positive, negative, or neutral effect to your bucket’s fullness.
 
You know what adds to your bucket’s lifeforce. They make you feel good, feel whole, feel healthy.
You know what depletes your bucket’s contents. They make you feel anxious, on edge, irritated and wiped out.
 
Now, your homework is to intentionally think through all your interactions, all your actions of the day, and decide…. Are they filling you up or depleting you?
 
Next up, what to do about it?
I break this topic up into self-care at home, and professional support.
One is not better than the other, and your needs are not fixed. One day, week, month, year may require different amounts of each type. Honor that.
 
Professional support can come in many styles.
The first to come to mind may be a therapist, mental health counselor, or psychologist. One of my favorites in the Willamette Valley is Molly Rodden at Well Life Medicine Center.

Finding your professional guide is an individualized process, so talk with other providers you see to get a referral or perhaps try to match up your interests and needs in this giant mental health provider directory.
 
Self-care for mental health will look a little different for us all, though there are some general themes. Movement, nutrition and lifestyle play important roles in balanced mental health, and I will be discussing those in depth in the weeks to come.
 
A first step is to take a critical eye on your list of things that fill up vs. deplete your bucket and see where you can make improvements.
 
Bucket fillers go by many names, a few of which are self-care or stress-reduction tools.  Call them whatever you want, here’s a short list of ideas on ways to fill your bucket:

• Meditation
• Mindfulness-based stress reduction
• Journaling
• Daily rituals at the beginning or end of your day
• Keeping sleep and wake times fairly consistent (within an hour day-to-day)
• Getting sun exposure early in the day
• Gentle movement practices that focus on breathwork and feeling centered: yoga, Qi Gong, Tai Chi, Yoga Nidra

The average person will find some of these ideas interesting, and some repelling. That’s ok. We don’t all have to fill our buckets the same way. The important thing is that you are filling yours in a way that honors your needs.
 
And what to do when things just aren’t going your way?

We have control about many potential stressors in our life, but not all. Most of us will have the occasional not-great day.

This would be an excellent time to reach out to your professional support, and in addition, have your go-to mental health “toolbox” set up. This might include:

• Specific guided meditation apps/videos that you use when anxiety, depression or other concerns are their strongest.
• Drinking water. Have you drank any water today?
• Eating. Have you eaten? Eating a protein-rich or health fat-rich snack or meal can help stabilize blood sugar and is a better mood stabilizing choice than sugar and carbs.
• Stretching/movement. Move your body, tune into how and what your body is feeling. Yoga and Yoga Nidra can be good practices for this.

 
Find your “well of course I can do that.” This will be unique to us all, and changes day by day. Maybe one day it will be taking a brisk walk outside in the sun (even if it’s cold). Another day it may be showering and putting on clothes. Or cooking yourself a homemade meal.
Find and do your “well of course I can do that.”
 
I hope this week has given you a new perspective on how you think about mental health, as well as new tools and ideas for how you can best take care of yourself going forward.

Many of you will remember my video series Healthy at Home from a few months ago, where I interviewed experts on various health topics about how they help their patients and clients stay their healthiest while we're all at home more.

Well, I've been relatively quiet the last two months (for me anyway), taking care of my own health (details I'm sure will come up in future videos).
I am now bringing back the Healthy at Home idea, with a twist.

All through November, each week I will focus on a common health topic and address different factors my patients often face each day. I've realized that there are so many commonalities among challenges we all face at this time, and much of the education I provide to patients can also be shared with my community.

This is not the diagnosing, prescribing, recommending, etc. part of my visits of course, but I will be sharing a ton of education and resources (all the best I give to my patients)- so I hope you enjoy.

Here's the plan:
Week of 11/2: focus on mental health
Week of 11/9: focus on movement & exercise
Week of 11/16: focus on lifestyle medicine, habits & addictions
Week of 11/23: food of course!
Yes, even through the whole Thanksgiving week I'll be sharing the best I have to offer with you all.

So keep an eye out for posts, videos and blogs all month long- right here, and on Instagram and Facebook.
Starting next Monday!

Wishing you (and helping you achieve) a healthy holiday season, Dr. Angela