Stone Medical Blog

Welcome Dr. Powell! 

January 2017

Welcome Dr. Bill Powell D.O., Anne and their 3 children to the Stone Medical Family, January  2017!

Bill Powell will be starting in clinic full time starting January 2017 and will be in clinic 4 days a week.  He arrives from a thriving practice in Ellensburg Washington where he has been practicing family medicine and being an assistant professor in the medical school in Yakima.  He has added training and is an expert in manipulative medicine as well. He is excited to join us because of the expert functional medicine education and practice our clinic provides. As with all of our clinicians he soon will be certified in Functional Medicine.

Bill and Anne have three children.  Their son is currently living in Chile and their two girls will be in middle school and high school in Ashland.  Bill grew up in northern California, with his grandfather starting Powell fly fishing rods.  Bill became very familiar with the rivers around southern Oregon and northern California in his youth. He looks forward to rediscovering them.

He will be practicing full spectrum family practice.  Please welcome this great family to our “family” here in southern Oregon!

 

Managing Eczema with Dr. Leslie Stone

December 2016

From GrowBaby at www.growbabyhealth.com

Winter weather can often exacerbate eczema on sensitive skin. Dry and cold air can increase the dryness of skin, leading to the need to moisturize. The decision to moisturize is a good one, however, most lotions have acetyl alcohol in them. Alcohol is a drying ingredient and can create a vicious cycle once applied.

According to a 2016 scientific publication in the American College of Allergy, Asthma and Immunology (ACAAI), researchers looked to answer the questions regarding bathing frequency and eczema care.  The authors note, "daily bathing is fine, as long as it's followed by lots of moisturizer. In other words, soak and smear." However, what kind of moisturizer is best? And what else can you do to help manage itchy and dry skin?

 

Baby is crying in the rash

Dr. Leslie Stone gives us insight into how she helps parents manage eczema in their children, especially during the winter months:

"Eczema is the same color as skin or lighter. If it is not red, then the skin is often not infected and doesn't require a separate course of management. However, if it is red, that skin is no longer protected, at which point a topical antibiotic ointment is needed, such as bacitracin--usually best tolerated. Bacitracin is an easily found OTC ointment. For preventative measures, look first to management choices such as creams, coconut oil (pending no parent has a nut allergy or there is no suspected nut allergy in the child), and of course, essential fats. If you are breastfeeding, a daily dose of 3,000 mg of fish oil is my suggestion. And, if your child is not breastfeeding, then at least 120 mg of DHA supplementation is needed. Emily also suggests looking into the triggers of eczema, such as imbalanced (too much) intake of: gluten, dairy, soy, eggs, and corn."

Managing Eczema:

1) Skip the soap: Baths are a great way to decrease stress and relax for your child, but if they are prone to eczema, soap is really drying. Stick with warm water only and take baths as often as your child enjoys.

2) Choose creams that don't have alcohol as an ingredient: Aquafor or Cetaphil are great choices as well as Burt's Bees Baby ointment and Honest Company's organic healing balm. Coconut oil is the least processed and whole-food choice when it comes to choosing a moisturizer, pending your child is not sensitive or allergic to tree nuts.

3) Dehydration can also be a cause of dry skin: Winter time doesn't equate to great water intake because it's cold to drink. Think beyond water as a hydrating fluid. We love to include chamomile, mint, fennel, and even lavender tea as hydrating choices for your child. Bone broth is also a therapeutic, nutrient dense, and hydrating option.

4) Essential fats are co-factors for healthy skin: Daily fish oil intake, or at least 3-4 servings of cold water fish a week can lead to hydrated skin. Plant-based options such as walnuts, almonds, avocado, chia seeds, flaxseeds, and coconut are wonderful daily choices.

5) Rotating major food triggers can help resolve dry skin: We are all susceptible to over-consuming foods such as gluten, dairy, corn, and eggs as they are in so many of the foods we eat. But, we also cannot ignore the role that they play in atopic dermatitis such as eczema. Rotating these foods (skip daily intake, include every 5-7 days) to see if their is improvement in skin health is important. A complete elimination of the perpetrators may be necessary. Eliminate problem foods for at least 21 days before reintroducing.

 

October 2015

Check out this awesome article printed in the October Issue of Experience Life Magazine. Dr. Michael Stone is interviewed about how genetics can play a role in your health, and how nutrition and lifestyle choices can help you find your balance! You are not doomed by your genes!

Genetics might load the gun, but environment can pull the trigger,” says P. Michael Stone, MD, MS, IFMPC, a family physician in Ashland, Ore., and a faculty member at the Institute for Functional Medicine.

Focusing your eating to support your unique genetic makeup — and account for its potential weaknesses — can be one way to set the safety on that gun, he explains.

We know that, for virtually any condition, there can be improvement with nutritional intervention. And if we know more about a person’s SNPs, there is often a specific and detailed list of nutrients and foods that can markedly improve the trajectory to health.

Stone says patients often arrive at his clinic with the results from their nutrigenomic testing panels in hand, asking for help with what to do next.

To create effective action plans, we look not just at their genetics but also at their lifestyle, including nutrition, sleep, relaxation, and resilience,” he says. Stone has developed what he calls a therapeutic alliance with in-clinic nutritionists to help with diet change and education.

My job is the view from the stethoscope, and their job is the view from the fork; together we support the patient in his or her healthy nutrition and lifestyle changes.

October 2015: Experience Life, Making Sense of SNPs

https://experiencelife.com/article/making-sense-of-snps

March 24, 2015

"What Your Skin is Trying to Tell You"

Check out Dr. Michael Stone's recent interview in Experience Life Magazine! In this article, 4 functional medicine physicians explain how skin can sometimes be the proverbial canary in the coal mine. Often other imbalances in your body can manifest on your skin, and here they describe functional ways to address skin issues. In his section on Skin Tags, Dr. Stone describes what skin tags mean and what tests he orders to find out more about your health.

Skin Tags

Small, sac-like protrusions found on the neck or eyelids, under the breasts or armpits, or around the groin.

What might be causing them: Blood-sugar and hormonal problems.

There’s at least one good thing about skin tags, according to Michael Stone, MD, MS, a functional practitioner in Ashland, Ore.: “If you figure out the cause and respond appropriately, you might just prolong your life.”

Stone explains that skin tags can form when high blood-sugar levels drive an increase in our epidermal growth factor, which controls how fast certain areas, or what doctors call “islands,” of skin grow. They can be a sign of insulin resistance, a condition where cells don’t respond properly to the insulin that normally helps them absorb blood sugar.

Some experts estimate that up to 75 percent of the U.S. population has insulin resistance. And it’s connected to metabolic syndrome, a group of traits linked to obesity and diabetes.

When Stone evaluates skin tags, he looks far beyond the skin. He also considers the amount of fat a patient carries around the waist, since an apple-shaped silhouette indicates that the body is converting glucose into visceral fat instead of using it for necessary body functions. He tests for fasting blood sugar and fasting insulin, and administers a two-hour glucose-tolerance test. He discusses the patient’s history, finding out when the patient started noticing the skin tags and what life events were taking place at that time.

To check out the Full Article, click on the Link below!
https://experiencelife.com/…/what-your-skin-is-trying-to-t…/

 

February 10, 2015

Balancing Vaccinations

Michael Stone MD, MS, IFMCP, Family Physician, Father of 4, & Grandparent of 2

For all of us this is an important discussion. I have had a family member crippled with polio (now vaccine preventable) as an 11 year old. This family member was in a coma for a week, and rehab for a year in New Jersey. I had a cousin who died hours after the initial symptoms of hemophilis meningitis (now vaccine preventable) in Corvallis, Oregon. I have held babies while dying of diphtheria in Thailand where they hadn't had the diphtheria vaccine, and have watched young children in our under-vaccinated community become ventilator dependent with pertussis in North Idaho. On the other hand, I have also watched more than one child following an MMR vaccine at 18 months (Medford, Oregon) develop severe fever and tumble down the autism spectrum disorder abyss. It is exactly because I live with these two extremes that a balanced conversation about vaccines has to continue.

I am right smack dab in the middle of the opposing realities - to vaccinate or not vaccinate, and I do not feel is all or none. In our state (Oregon) it cannot easily or legally be none. If a child is under-vaccinated in our school district (for chickenpox) and there is an outbreak, the under-vaccinated are kept out of school for 21 days (Bobcat Growler Newsletter, January 26, 2015 Ashland, Oregon). In Los Angeles, some pediatricians are refusing to see patients or letting them go from their practice for refusing to vaccinate (AP Jan 30, 2015 Alicia Chang-Measles outbreak Doctors Respond- Some won't see patients with anti-vaccine views). A study from Belgium follows an outbreak from a Waldorf, under-immunized school. While reading through it, I began to connect the dots to the reaction of the the recent Disneyland measles outbreak. The Disneyland exposure has affected 14 states and over 95 people. In the Belgium article, 63 of the 65 measles contractors were not vaccinated.

Canada suggests <25 vaccinations, Mexico <30 vaccinations, and the US recommends 37 vaccinations before a child is 12 (WHO website). (Of the three North American continent countries, only Mexico adds vitamin A to their schedule to help with immunity development). Even though the US gives more vaccinations, our statistics for vaccinate-able infectious diseases do not always look better than the countries to the north or south.

Polio is nearly gone, small pox is nearly gone. Is it only because of vaccines? There is not an absolute yes or no answer. Do vaccines have nothing to do with it? Not an absolute yes or no answer. Where and when does the conversation take place that allows for the individual patient and their uniqueness? What are the risks or benefits of vaccinations for you, your child, or your grandchild? There is a lot of fear surrounding vaccinations, and is it one of our jobs to give perspective to patients and our community.

Let's bring this discussion forward. It is 18 million deaths from influenza that drive investigators to seek possible interventions and treatments. It is the sudden death of a child from a vaccinate-able illness, or the encephalopathy following a routine vaccination, that for me, is the tension of this conversation. These circumstances create a need. For the person on the other side of my stethoscope, the discussion of vaccination policy protocols can no longer be placed on hold. It is rampant infectious disease that causes all of us to seek efficacious interventions. It is under-immunization that prompted the CDC to come to our community in Ashland, Oregon, 3 years ago to seek answers from us, as physicians, community leaders, and parents. This gray hair is continually seeking markers that can be used to understand individual vaccine risk (snps, mitochondrial dysfunction issues).

The challenge for this discussion is the absolutes. "Vaccinations prevent and are low to no risk." "Vaccinations harmed 'my child, my grandchild, my friend's child'." "It does more harm than good." "The immune response isn't as good as with vaccines" (note the two attached papers: obstacles vs. waning maternal antibodies). The tension persists when the conversation shifts to adverse vaccine associated illness (Adverse Vaccine Diagnosis). We have all heard the sides of the arguments. So absolutes are difficult here.

The vaccination discussion is about balancing parental protection: fear of causing harm vs. fear of neglect, especially when the immunity in my family, my school or my community is low. It is about offering known functional medicine (naturopathic, nutritional, TCM) treatments to promote natural killer cells, defensins, and the like, that help promote and boost immunity.

So do we give vaccinations in our clinic? Yes we do. We approach it with the eye on the individual. We are very mindful of the levels of excipients in the vaccines (we give vaccines with the lowest levels of aluminum, and avoid thimerisol containing vaccinations). We alter recommendations for the newborn and for the pregnant mother.

We support immune response with nutrition, and place focus on sources of food that promote strong immunity. We look to probiotics from fermented foods; essential fatty acids and fat soluble vitamins (A, D, E, and K); B vitamins to increase mitochondrial function that are found in protein rich foods, and dark leafy greens; and include minerals like zinc, iron, selenium and magnesium that all help promote balance within our immune system. We know that higher simple sugar intake can imbalance our defenses. So, we look to a diet that includes colorful fruit and vegetables, lean protein, whole grains, nuts and seeds, and high quality fat. If a family member has lung disease, cancer, or are taking immune suppressing medications, then they have a greater risk of infection in the under-vaccinated community, and certainly benefit from nutritional intervention. If there is a history of neurological issues in a sibling or the family, we will do testing which checks to see how their mitochondria (powerhouses of their cells) are functioning. If they are sluggish, we will recheck to make sure they have increased their normal activity before we launch into the vaccination schedule (Kingsley, Haas).

All of these choices are made to improve the health of all membranes of cells, sinuses, lungs, intestines, and skin.

Platitudes on either side of this argument suggest surety - whether you are abjectly against or for vaccinations. Surety of the best option for you is what I seek when I'm looking across the stethescope during a local epidemic - and that's what you want, too. Sometimes surety is difficult. Therefore, we have to approach vaccinations thoughtfully and individually.

Stone Medical, PC with GrowBaby Health, www.ashlandmd.com

PDF Download: Waning of Maternal Antibodies Against Measles, Mumps, Rubella, and Varicella in Communities With Contrasting Vaccination Coverage

PDF Download: Measles, Mumps, and Rubella

PDF Download: Obstacles in measles elimination

PDF Download: Vaccine injury table

Braeye T, Sabbe M, Hutse V, Flipse W, Godderis L, Top G: Obstacles in measles elimination: an indepth description of a measles outbreak in Ghent, Belgium, spring 2011. Archives of Public Health 2013 71:17. doi:10.1186/0778-7367-71-17

Haas RH, Parikh S, Falk MJ, et al. Mitochondrial disease: a practical approach for primary care. Pediatrics 2007;20:1326–1333. [PubMed: 18055683]

Kingsley JD, Varman M, Chatterjee A, Kingsley RA, Roth KS. Immunizations for patients with metabolic disorders. Pediatrics 2006;118:E460–E470. [PubMed: 16816003]

Waaijenborg S, Hahné SJ, Mollema L, Smits GP, Berbers GA, van der Klis FR, de Melker HE, Wallinga J :Waning of maternal antibodies against measles, mumps, rubella, and varicella in communities with contrasting vaccination coverage. J Infect Dis. 2013 Jul;208(1):10-6. doi: 10.1093/infdis/jit143. Epub 2013 May 8.

Wood RA et al. An Algorithm for Treatment of Patients With Hypersensitivity Reactions After Vaccines. Pediatrics 2008;122(3):e771-7.

January 13, 2015

We want to thank Global Advances in Health and Medicine for their incredible work. We feel so fortunate to be given an opportunity to share the reason behind GrowBaby with a global platform. Thank you to Dr. Leslie and Dr. Michael Stone, Emily Rydbom, Elliot Stone, Lucas Stone, Lindsey Wilkens, and Kathryn Reynolds for working so tirelessly to make this a reality. Stone Medical, PC, and GrowBaby Health could not have done this without you!

ABSTRACT:

A retrospective chart review analyzed the effect of customized nutri- tion on the incidence of pregnancy-induced hypertension (PIH), gestational diabetes (GDM), and small-and large-for-gestational-age (SGA, LGA) neonates, examining consecutive deliveries between January 1, 2011, and December 31, 2012, at a low-risk community hospital. The population was divided into 3 groups: (1) study group (SG), (2) pri- vate practice (PP), and (3) community healthcare clinic (CHCC). All groups received standard perinatal management, but additionally the study group was analyzed for serum zinc, carnitine, total 25-hydroxy cholecalciferol (25 OH-D), methylene tetrahydrofolate reductase, and catechol-O-methyl transferase poly- morphisms in the first trimester prior to intervention, with subsequent second trimester and postpartum assessment of zinc, carnitine, and 25 OH-D after intervention. Intervention consisted of trimester-by-trimester nutrition and lifestyle ed

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