Dear Wise Patient Community,
Russia’s entirely unfair and cruel invasion of Ukraine is happening so fast. We are awash in images of destruction and bloodshed. We watch people fighting for their towns and villages. We watch dead bodies and blown-out buildings. We watch people fleeing toward safety – hopefully – in neighboring countries. Will there be a Ukraine to return to? It is hard to watch. It is hard to not wish upon Russia a severe financial and social isolation that lasts long beyond their pummeling of Ukraine, to prevent their next pummeling of Elsewhere. Then we think how many civilians in Russia never asked for any of this, and are victims themselves of autocracy. How to help them? Cruel and unreasonable control over people, seemingly in the hands of a single ruler, is a terrible situation. No government is perfect, but may the world’s conscious countries and powerful businesses continue to pick a side and increase their measures to stop Putin and this sad invasion of Ukraine.
May I learn more about refugees. It took a Google search for me to appreciate there are more than 84 million refugees, asylum seekers or internally displaced people in the world (source: UNHCR). I know little about where they are, how they live, and what level of health problems they face. I know little about what I can do personally to help make a positive difference in their lives.
Happy Endemic:
On the covid front, at least, the group of people with no immunity to SARS-CoV-2 continues to shrink dramatically and hospitalizations continue to plummet, like this:
Source: UW Medicine
“Happy Endemic!” as a patient recently wrote to me. I’m sure most of you saw that Inslee will lift Washington’s mask mandate on March 12, though masks will still be required in healthcare settings. Nobody seems sure yet about when masks will become optional within our local school districts, even though the evidence that supports masks being optional in schools is the strongest of any age group. In the upcoming weeks, we expect to get lots of questions from our members, especially those who are immunocompromised or senior, about one-way masking in different circumstances. Recall that one-way masking means you can choose to wear a reliable mask that, alongside your vaccinations, is so protective against covid (and presumably most/all other respiratory viruses) that it doesn’t matter if others around you are unmasked. Additionally, as effective oral treatments for covid become more readily available, most notably, for now, Paxlovid, we will do our best to own the evidence that supports their approval, in order to most accurately advise you if you get infected, or re-infected, with SARS-CoV-2. We salute President Biden’s mention in his State of the Union speech of an initiative whereby people who test positive will be able to immediately receive antiviral medication from a pharmacy at no cost, presumably without needing a prescription from a doctor. As with some other common viral infections where antiviral medications are available (e.g., influenza, HSV outbreaks), earlier treatment is likely to be more effective.
Dr. Nazlee Navabi, in the house!
Yesterday was Nazlee’s first day boots-on-the-ground doctoring at Wise Patient. She wowed us all, again, with her knowledge and passion for the full spectrum of primary care medicine. For those of you newly under her care, know that she can’t wait to get to know you, and has already started that process by meeting several times with Naomi and beginning to review your charts.
Nazlee with her trusted platoon Health Coach for the week, Gina
Eating advice from Shelly Najjar:
Each time one of you who has met with Shelly Najjar of Confident Nutrition has voiced your gratitude for her ability to help you relate to food in more positive and nutritious ways, my ears perk up. I desire to reverse my own pandemic-blamed flare of stress eating. When I mentioned that to Shelly, though, I learned she is no fan of the psychology of moderation:
Why I Don’t Teach Moderation to My Nutrition Clients
By Shelly Najjar, MPH, RDN, CD of Confident Nutrition
People often ask me, “It’s about moderation, right?” Not really. Here’s why I don’t recommend moderation as a goal for my clients.
Too often, moderation as a goal will lead to a binge-restrict-binge-restrict cycle, because as a goal, it’s a restriction. (Don’t believe it? Consider this: do you try to moderate eating water, leafy green vegetables, or other healthy foods?)
Focusing on moderation doesn’t get us to our goals. But moderation as a natural byproduct or outcome of a different goal (like eating with alignment in your tongue, body, and brain) lets us find the true balance we’re looking for.
Moderation may not look like what you imagine. Many of my clients, at that point, are no longer thinking of moderation, but of enjoying their food. They no longer need to “moderate” because they’re relearning to trust their own bodies to tell them what, when, and how much to eat.
Here’s one practical way to experiment with this:
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Turn your focus to something else, like satisfaction.
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Ask: “What would satisfy me in this moment… and after I eat?” (it’s the second half that we often miss)
Want to learn more about this approach? Get Shelly’s free, weekly-ish email newsletter with practical tips (that don’t overwhelm!) on topics like gentle nutrition and self-care. She asks that we emphasize that she does not do intentional weight loss: “I’m a health at every size provider and focus on long-term modifiable risk factors, and weight is not one of them.”
May you find warmth and togetherness in the remainder of this Winter,
Sam