Weight Loss and Improvements in Mental Health

Weight Loss and Improvements in Mental Health

Weight Loss

People today are busy with work, kids, and the normal activities of daily living. Many people do not make time for physical activities, eat on the run, and find little time for themselves due to the demands of life.

America is a country with over 70 million people considered to be obese. This means that 39.6% of our population is at risk for many health issues due to being overweight. Weight loss ads are all over the television as well as on the internet and social media.

Keeping these statistics in mind, we need to realize the importance of weight loss and understand all the benefits that come with losing extra pounds. Weight loss provides many advantages. People who lose weight will typically see lower blood pressures, lower blood sugars, increased physical activity, and improvements in pain as well. People with chronic back and joint pain note that their pain levels improve due to less stress on their body from the loss of excess weight.

People see a big improvements in their mental health. Studies show that losing weight leads to higher self esteem levels, more positive body image and feelings of contentment. After losing even 5-10% of body weight people report less depression, improved relationships, longer sleep duration and lower anxiety levels. Overall, weight loss has shown that people have an improved perception in their quality of life and more self confidence.

The weight loss journey may be tough and hard but the benefits and rewards in a person’s overall health are worth the time and effort. Today there are apps like My Fitness Pal or Lose It to help with this effort to keep track of food intake and exercise. This will help keep people accountable as they make the scales drop.

Set a goal and make a change. Help yourself become a healthier version of you!

MILD Procedure for Major Pain

It is estimated that around 80% of Americans will experience back pain in their lives.  There are many different causes of back pain, many different associated symptoms, and just as many treatments available.  One of the more feared treatments have been back surgery, since, until recently, it is most of the time severely invasive, and comes with an extended recovery time.  However, for certain types of back pain, a newer, less invasive procedure has been developed, aptly named Minimally Invasive Lumbar Decompression, or MILD. If lumbar spinal stenosis, or LSS, is the culprit, then MILD may be the treatment.

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In order to understand what the MILD procedure it, it is important to know what LSS is.  Lumbar spinal stenosis means a narrowing or pinching (stenosis) around the lower (lumbar) part of the spinal cord.  The spinal cord rests in the spinal canal, which is a tunnel in back part of the vertebrae. This tunnel is comprised of vertebral bones stacked on top of each other, with a disc in between them, and ligaments that run up and down keeping these bone/disc stacks both sturdy and mobile.  Years of wear and tear on the back can cause the discs to bulge, the bony joints to swell, or the ligaments to enlarge. Normally, the spinal cord has plenty of room in its spinal canal home, but if any of those wear and tear side effects occur, this can bulge, swell, or enlarge into the canal, and cause compression of the spinal cord.  This compression is responsible for back pain, and pain, numbness, tingling sensations that go down the legs. The pain is typically worsened with standing or walking, and relieved with leaning forward or sitting.

If the cause of the spinal stenosis and the pain symptoms is enlarged ligaments, that’s where the MILD procedure can help. This procedure involves a special, spoon-like tool that scrapes off the extra ligament that is pushing on to the spinal cord, and suctioning it out.  The incision is about 5mm long, about the width of a baby aspirin, so no stitches or staples are required. The procedure is done with local anesthesia and IV sedation, not full anesthesia, which makes recovery time quicker. After the procedure, patients are able to walk out of the hospital, no bed-bound recovery.  Risks of the procedure include infection and increased bleeding, but the complication rate is very rare, and the procedure has been demonstrated to be as safe as epidural steroid injections.

There are many therapies for back pain that help relieve the symptoms, and improve functionality, but are not correcting the problem itself.  There are many surgeries to correct the problem, but they can involve high risk, and lengthy recovery times. The MILD procedure is a way to correct the issue causing the pain, without the difficulties associated with an invasive spinal surgery.  


Deer TR, Mekahil N, Lopez G, Amirdelfan Kasra. (2010), Minimally Invasive Lumbar Decompression for Spinal Stenosis. The Evolving Treatment of Pain, 1(S1): 29-32

Mekhail, Nagy, et al. (2012), Functional and Patient-Reported Outcomes in Symptomatic Lumbar Spinal Stenosis Following Percutaneous Decompression. Pain Practice, 12(6): 417–425. doi: 10.1111/j.1533-2500.2012.00565.x

Staats PS, Chafin TB, Golovac S, Kim CK, Li S, Richardson WB, Vallejo R, Wahezi SE, Washabaugh EP, Benyamin RM, MiDAS ENCORE Investigators. Long-term safety and efficacy of minimally invasive lumbar decompression procedure for the treatment of lumbar spinal stenosis with neurogenic claudication: 2-year results of MiDAS ENCORE. Reg Anesth Pain Med. 2018;43:789-794.

Superfood: Beet & Orange Salad with Grilled Trout + Walnuts


  • 12 oz. Boneless Skinless Trout
  • 10 oz. (about 2) Red Beets
  • 6 cups Arugula Lettuce Leaf
  • 2 oz. Goat Cheese
  • 8 Tbsp Walnut Halves & Pieces, Chopped
  • 1/2 cup Tarragon, Chopped
  • 2 ea Orange Segments
  • 1/2 cup Balsamic Vinaigrette


  1. Preheat a char-grill or grill pan. Spray with oil to help stop the trout from sticking. Grill the trout until the internal temperature reaches 145F degrees, about 2-3 minutes on each side. Set aside.
  2. Peel and section oranges and set aside. Roast or boil whole beets until cooked through and tender, about 45-60 minutes depending on size. Chill then peel skin and dice. Set aside. Toast walnuts until golden brown and fragrant. Set aside.
  3. For each salad: Toss together 1/2 cup orange sections, 1 1/2 cup lettuce, 1/2 oz. crumbled goat cheese, 1/2 oz. (2 Tbsp.) walnuts, 3 oz. cooked trout, 2 Tbsp tarragon and to Tbsp dressing. Plate the salad.
  4. In the empty bowl, add the beets and toss lightly with leftover dressing. Place beets on the salad last (this will prevent everything from turning red).

Nutrition Facts:

  • Calories: 420
  • Total Fat: 30g
  • Saturated Fat: 5g
  • Total Carb: 15g
  • Protein: 25g
  • Dietary Fiber: 4g
  • Sodium: 380mg

Superfood: Grilled Salmon with Orange Grapefruit Caprese


  • 4 ea Wild Salmon Filet, 4 oz.
  • 1/8 tsp Fine Ground Black Pepper
  • 1/8 tsp Kosher Salt
  • 1/3 Tbsp Canola Oil
  • 4 oz. Mini Mozzarella Balls
  • 4 oz. Orange Sections
  • 2 oz. Grapefruit Sections
  • 2 Tbsp Extra Virgin Olive Oil
  • 1/8 tsp Kosher Salt
  • 1/8 tsp Black Pepper
  • 4 leaves Fresh Basil, Torn


For the Salmon:

  1. Drizzle olive oil on the salmon and season with salt and pepper. Place salmon on a pre-heated grill and cook for approximately 3 to 4 minutes on each side. Place on a baking tray and place in the oven for 5 minutes until firm but not dried out. The internal temperature should be 145F. Remove from the oven and set aside.

For the Grapefruit Salad:

  1. Use mini mozzarella balls for this recipe and cut in half. Toss mozzarella cheese, orange and grapefruit segments together and mix with olive oil, salt, freshly ground black pepper and fresh torn basil leaves.
  2. Place the grapefruit salad over the salmon and serve.

Nutrition Facts:

  • Calories: 320
  • Total Fat: 18g
  • Saturated Fat: 6g
  • Total Carb: 4g
  • Protein: 34g
  • Dietary Fiber: <1g
  • Sodium: 390mg

Superfood: Quinoa Tabouleh


  • 1 cup Quinoa
  • 2 cups Water
  • 1 ea Small Tomatoes, Fresh, Diced 1/4″
  • 1/2 cup Peeled Cucumbers, Seeded and Diced
  • 1 cup Fresh Italian Parsley, Chopped
  • 2 Tbsp Fresh Mint Bunch, Chopped
  • 1 Tbsp, 1 1/2 tsp Lemon Juice, Fresh
  • 1/2 cup Green Onions, Thinly Sliced
  • 1/4 tsp Salt
  • 1/4 tsp Fine Ground Black Pepper
  • 1/4 cup Canola Oil


  1. Place quinoa in a pot with water and bring to a boil; lower heat to simmer and cook until tender and outer ring is visible, about 15 – 20 minutes. Drain and chill.
  2. Add the tomatoes, cucumber, parsley, mint, fresh lemon juice and scallions.
  3. Fold in the olive oil to separate the grains. Season with salt and pepper.

Nutrition Facts:

  • Calories: 260
  • Total Fat: 16g
  • Saturated Fat: 1.5g
  • Total Carb: 25g
  • Protein: 6g
  • Dietary Fiber: 4g
  • Sodium: 130mg

Got Pain? Why You Should Try Acupuncture

  • Knee Pain

For many of us, who suffer from injuries or pain, we eventually seek medical help.  According to recent surveys, 80% of Americans will suffer from some pain at some point.  Many of these folks, suffer from chronic pain- defined as pain that has persisted for more than 3 months. Current options to manage pain include a myriad of options from physical therapy, dry needling, anti inflammatory medicines and as a last resort opioids. Given the recent opioid crisis, there has been a substantial push to reconsider options to manage pain.

Acupuncture has been around for thousands of years, some research even theorizing as early as 3300 BCE.  It began in China, using finely sharpened tools, and has since developed into a widely used medical practice.  It’s effectiveness has been appreciated for millenia, however, we have only recently began to understand how it actually works. It is estimated that about 2 billion people a year will get acupuncture treatments annually and it is used for a myriad of different conditions.  There have been multiple research studies, using MRIs, blood tests, and other methods, which have shown some of the amazing results acupuncture can have on a multitude of ailments.

A few studies have had patients receive acupuncture therapy, while a brain MRI was performed.  This testing showed consistent activation of different parts of the brain, which control different functions in the body, including pain perception, and mood.  For instance, studies comparing acupuncture and simple touching of the same areas (tactile stimulation), while an MRI was observing brain function, have shown that the amygdala and the hippocampus are deactivated during acupuncture, but not nearly as much during the tactile stimulation.  These two areas of the brain are activated during stress, hunger, pain, and other negative emotions. De-activating these areas will decrease the body’s perception of these negative emotions, therefore helping to manage depression, over-eating, and chronic pain.

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Acupuncture can have chemical impacts as well.  These impacts are due to the effects on neurotransmitters and endorphins, which help with mood and pain.  Acupuncture has been shown to increase the levels neurotransmitters, such as dopamine and seratonin, while decreasing noradrenaline.  Dopamine and seratonin play major roles in feelings of well-being and happiness. Noradrenaline is released during periods of stress, so decreasing the release of this neurotransmitter, can decrease the perception of stress.  Additionally, acupuncture has been shown to increase endogenous opioid peptides, or endorphins, which are the body’s natural pain relievers. These studies answer some of the questions as to how acupuncture can help with depression, anxiety, and pain.  

The Eastern medicine theory on the way acupuncture works, is due to qi (pronounced “chee”), or the body’s energy.  Qi flows through certain pathways, called meridians, and when these meridians are disrupted, the body reacts with pain.  There are twelve different meridians,
each corresponding to a different body system. The acupuncturist would follow the meridian map, according to the patient’s medical concern, and place needles in specific areas along the targeted pathway.  Doing so restores the body’s qi, and helps it flow smoothly through the meridians.

Joanna Wroblewska, MD has a quite unique perspective to this.  She is board certified in anesthesiology and pain management. On a typical day, she will treat patients with headaches, migraines, neck pain, back pain and even musculoskeletal pains such as joint pains.  With over a decade of experience, she has developed an exceptional perspective on how pain affects patients, not just physically, but emotionally, psychologically and socially.

Joanna has studied acupuncture and she integrates components of acupuncture into her daily medical practice. She acknowledges that acupuncture is not for everything or everyone, but it has a role.  When performed well, it has lasting results and can certainly supplement current
westernized approaches. She integrates acupuncture with current western treatments to treat various conditions and her patients are benefiting from this approach.

Acupuncture has various mechanisms of how it works.  The most postulated theory is that it helps stimulate your body’s own neural and hormonal systems to help create a balance within your body’s environment. Acupuncture is no longer an exotic treatment, but rather a very well accepted form of medical treatment.

Speak with our providers- Margaret Truesdell- PA-C and Joanna Wroblewska, MD to understand how acupuncture can have a lasting impression to benefit your health.  We welcome you to experience this unique combination of western medicine and acupuncture!


Han, J S. “Acupuncture and Endorphins.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 6 May 2004, www.ncbi.nlm.nih.gov/pubmed/15135942.

Huang, Wenjin, et al. “Characterizing Acupuncture Stimuli Using Brain Imaging …” National Institute of Health, National Center for Biotechnology Information, 9 Apr. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3322129/.

Hui, Kathleen, et al. “Acupuncture, the Limbic System, and the Anticorrelated …” National Institute of Health, National Center for Biotechnology Information, 27 Aug. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3754836/.

Wen, Guoqiang, et al. “Effect of Acupuncture on Neurotransmitters/Modulators.” Journal of Trauma and Acute Care Surgery, Lippincott Williams and Wilkins, 5 Apr. 2016, uthealth.influuent.utsystem.edu/en/publications/effect-of-acupuncture-on-

Wen, Guoqiang, et al. “Effect of Acupuncture on Neurotransmitters/Modulators.” Journal of Trauma and Acute Care Surgery, Lippincott Williams and Wilkins, 5 Apr. 2016, uthealth.influuent.utsystem.edu/en/publications/effect-of-acupuncture-on-

Wen, Guoqiang, et al. “Effect of Acupuncture on Neurotransmitters/Modulators.” Journal of Trauma and Acute Care Surgery, Lippincott Williams and Wilkins, 5 Apr. 2016,

White, A. “A Brief History of Acupuncture.” Rheumatology, vol. 43, no. 5, 2004, pp. 662–663., doi.org/10.1093/rheumatology/keg005.

Superfood: Orange & Banana Oatmeal Parfait


  • 4 1/2 cups water
  • 1 1/2 cups quick oatmeal
  • 1/2 cup vanilla yogurt
  • 1 1/2 tablespoons honey
  • 1 ea medium banana, sliced
  • 2 ea orange sections
  • 1 tablespoon, 1 teaspoon grated orange peel


  1. In a medium sauce pan, bring water to rapid boil. Slowly pour oatmeal into boiling water, stirring constantly. Return to a boil. Reduce heat and simmer for 8 to 10 minutes, stirring occasionally. Remove from heat and let cool.
  2. Mix the oatmeal, yogurt and honey together. Chop the orange into small pieces. Divide the mixture into 4 bowls or jars. Top each parfait with 2-1/2 tablespoons each of banana and diced orange and 1 teaspoon orange zest. Serve cold.

Nutrition Facts:

  • Calories: 140
  • Total Fat: 2g
  • Saturated Fat: 0.5g
  • Total Carb: 29g
  • Protein: 5g
  • Dietary Fiber: 3g
  • Sodium: 35mg

Food for Thought…and Pain

  • Anti-Inflammatory Diet

Diet and exercise is well known to keep your heart healthy, but more and more research is showing that what you eat can directly impact your pain levels. The link between food and pain lies in systemic inflammation, and decreasing your inflammation can help to decrease your pain. By eating more foods with anti-inflammatory properties, and avoiding those that increase it, you can add another tool to your pain management belt.

First, what is systemic inflammation? Throughout the body, there are several inflammatory mediators, which are basically the body’s defensive line when injury or ailment occur. These defensemen can be everywhere…in the joints, in the back, in the gut. When inflammatory markers are activated, they stimulate the perception of pain, to tell you that something is wrong. Whenever and wherever there is pain, chances are, there is also inflammation.

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Next, how does food affect inflammation? Free radicals and foreign substances cause oxidative stress, which leads to the activation of the inflammatory mediators. Free radicals come from quick and sharp spikes in blood glucose and lipids (or sugars and fats), or processed foods which the body interprets as a foreign substance. The resulting oxidative stress caused by these foods is similar in process to rust on an old metal bicycle, so the body takes this as an injury that needs to be taken care of. The inflammatory markers are sent to take care of the oxidative stress caused by the free radicals, and systemic inflammation occurs.

What kinds of food increase and decrease inflammation? The culprits for increasing inflammation is processed foods, and added sugar. Fats are not so bad on their own, but when paired with sugar, the combination of the two is even more damaging. These are found in high sugar foods, white breads and pastas, soda, alcohol, and processed meats (hot dogs, bologna, etc.).

As far as foods that can help with inflammation and pain, the keyword here is “antioxidant.” These are found in vitamin and mineral-rich fruits and vegetables. The other trick is to avoid that sharp blood sugar and fat spike. Foods that shorten this spike are those that are high in fiber, like beans and whole grains, or good protein, such as chicken, fish and lean beef.

Overall, taking care of chronic pain requires a multi-faceted approach. Physical therapy, procedures, even surgery are all common tools to treat and manage chronic pain. However, there is one more tool to add to the belt, and that is a pain relieving diet.

Good luck and let’s hear back with how you are doing!

For more information, recipes, and meal planning tools, check out these resources!


Bonakdar, R., Cotter, N. and Rhodes, C. (2019). Nutrition, Inflammation, and Pain. The Pain Practitioner, (November/December 2017), pp.10-12.

Briggs, M., Givens, D., Schmitt, L. and Taylor, C. (2019). Relations of C-reactive protein and obesity to the prevalence and the odds of reporting low back pain.. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23187041 [Accessed 23 Jan. 2019].

Stone, A. and Broderick, J. (2019). Obesity and pain are associated in the United States.. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22262163 [Accessed 23 Jan. 2019].