Fall 2019

Page 1


IN THIS ISSUE OCTOBER 2019 THERAPY 05

Prevention and Therapy

08

Prevention and PTSD – It’s Real, Just Ask A Vet Therapy

07 Know the Signs and Symptoms WELLNESS 10

Back to School

12

Wellness in the Workplace

13

Nutrition and Fitness

15

Financial Wellness

COACHING 17

Life’s Purpose - Step 1

18

Life’s Purpose - Step 2

19

Life’s Purpose - Step 3

MEDICINE 21

Post Trump

22

Chinese Medicine

RECIPES 25

Recipes Powered by Acute Care Triage, Inc. 27134-A Paseo Espada, Suite 324, San Juan Capistrano, CA 92675 www.acutecaretriage.com


Meet The Team

President & Founder

Director of Customer Care

CIO

EDITOR

Tracy Wood, CPC, ELI MP, HHA

Perla Galan

Zee Shah

Virginia Gannaway

Rev Brian Shaffer

Pren'tis Knight President, ZTEK Corporation

Dr. Stephanie B. Nielsen, PHARM.D., CCN

Sue Ayers, MS, LPC Dir. of Psychology services

Dr. Mary Jo Ruggieri, PH.D.

T.S. Wiley

Rosie Schulman, RN

Dr. Deborah Werenko

Dr. Boyce Berkel

Frank Magana

Jerry Dyer CEO Emeritus

Danish Designer

Chief Medical Officer

Director of Nursing

CONTRIBUTORS

American Journal of Integrative Medicine, Page 03


THERAPY

American Journal of Integrative Medicine, Page 04


PREVENTION AND THERAPY BY DR. RENNIE SCHOEPFLIN

Don’t we all prefer to remain well, rather than to have to get well? When flu season comes around and our coworkers begin to get short with us, sniffle, cough, and then call in sick, don’t we all hope and pray that we won’t get sick, too? Well, as the old saying goes, “An ounce of prevention is worth a pound of cure.” Therefore, we try to live healthfully: balanced meals, plenty of rest, regular exercise, stress management, the avoidance of risky behaviors, and exposure to germs. To become well educated about the rules of prevention and to follow them consistently turns out to be cheaper for both our health and for our pocketbooks. But then, when we do get the flu, the time for prevention has passed. We stay at home, rest, drink plenty of water, and maybe take something to reduce our fever. And those simple therapies more often than not, help to get us well and back to work. But if, after three days or so, our fever still hovers around 103, every muscle and joint in our body aches, our skin remains pasty and dry, and our throat is so sore that we can barely swallow—what then? “It’s time to get to the doctor.” But do you really feel strong enough to go? Do you want to infect the others in the waiting room? No, of course you don’t.

ern existence. Overtaken by the worries and difficulties of life, our bodies begin to break down, our personalities become distorted, and the worst in us comes to dominate our attitudes and behaviors. Just as with infectious diseases, certain lifetime habits will make us less susceptible to both the chronic and acute stages of mental and spiritual disease. It pays to become educated in true wellness. The importance of life-work balance, rest, stress reduction, proper financial management, child rearing techniques, and ways to work through relational difficulties will inevitably arise at both home and work. Many find not only solace but remedy as well in the maintenance of a living, active spiritual life. It may be only a lucky few who will never need therapy in their lifetime. But for all the rest of us, we will need both an ounce of prevention and therapeutic assistance to live healthy, balanced, and complete lives. If you find you could benefit from a interactive wellness program, log in today to acutecaretriage.com, or call 866-228-5111 and see what can fit into your life. Dr. Rennie Schoepflin

But of course, this doesn’t just apply to infectious diseases, sprained or broken ankles, or heart disease. We are not just bodies; we are also minds, spirits, and community members. So the same principles of prevention and therapy apply here as well. What do I mean? Stress and depression are epidemic in our world today. The result of home, workplace, personal, and global pressures, stress and depression have become almost an expected outcome of our modAmerican Journal of Integrative Medicine, Page 05


PTSD – IT’S REAL, JUST ASK A VET BY COL. SUSAN ROGERS, PH.D.

PTSD – It’s Real, Just Ask A Vet As we approach Veteran’s Day, our minds turn to the still escalating problem in the area of mental health in America. Our war Veteran’s struggle every day with both physical and mental disease and trauma. Vietnam gave us Agent Orange, and the subsequent physiological damage it delivered for generations. World War II gave us nuclear fallout in Japan. The Desert conflicts has dropped a spotlight on PTSD.

At Acutecaretriage.com, we can help you deal with these symptoms in a safe, secure environment using emails, texting, and Zoom. You can participate in private messaging with your clinician and learn how to deal with the problems you’re facing. We can also help you with your family members and the problems they may be dealing with. Our goal is to offer you a protected, trustworthy place to help you navigate the special issues you’re having as a result of serving in the military.

What is Post Traumatic Stress Disorder (PTSD)? It’s a disorder that can happen to any of us under the right circumstances. By definition, it is a reaction to being exposed to a traumatic event where a fear of death or harm is imminent. Usually, you have feelings of intense fear, helplessness, or horror. Just because you may have experienced a traumatic event does not mean you will develop PTSD. However, it’s important to look at some of the symptoms. The symptoms of PTSD can vary. Some of the symptoms include reliving the event in what some call a flashback, avoiding reminders of the event or place where it occurred, feeling “on guard” or unusually watchful, flashbacks of the event, nightmares, disturbing memories, trouble sleeping or concentrating, feeling numb or detached, angry outbursts, being easily startled, and feeling depressed or guilty. It’s important to note that you may have one or a few of those symptoms, and some may last a shorter time than others last or appear at different times. What’s important is whether the symptoms are affecting your daily functioning. This is an original work authored by Col. Susan Rogers, Ph.D.

American Journal of Integrative Medicine, Page 06


KNOW THE SIGNS AND SYMPTOMS BY TRACY WOOD, CPC

Knowing that someone you love and care about is addicted or has a substance abuse problem is a difficult and painful weight to carry.

• Difficulty cutting down or controlling the addictive behavior despite repeated attempts.

The word addiction is used throughout our vocabulary, most often as a label given to a person who is seen as not being able to live without a particular substance or behavior. In reality, addiction is a grim biological, psychological, and social condition that deeply affects the mind, body, and emotional wellbeing of the person. Although the drug of choice may be different, what is a constant for most people suffering in silence with addiction are the pain, isolation, anger, guilt, and shame underneath all addiction.

• Loss of enjoyment or success in occupation al, social, educational, or recreational activities once enjoyed; person becoming more focused on the substance or addictive behavior(s).

For most people struggling with an addiction some of the following symptoms are “red flags” that a loved one is in trouble. This person might not be reaching out for help yet, but if the following signs and symptoms are observed, they are in trouble. There are many addictions to both substances and behaviors; regardless of the drug of choice, the signs and symptoms are remarkably similar. Even if the following symptoms are not clearly present, someone can still be struggling with addiction. Common signs of addiction are: • Tolerance- the need to engage in the addic tive behavior in increasing amounts to get the desired effect. • Withdrawal- when the person does not take the substance of choice or engage in the addictive behavior, physical, emotional, and behavioral symptoms build. One must have first developed a physical or psychological dependence (often referred to as depen dency) in order to experience withdrawal. The proof of dependence is the experience of withdrawal.

• Withdrawal Symptoms: Dilated pupils, diarrhea, runny nose, excessive yawning, goose bumps, sweating, agitation, vomiting, leg pain, and shaking.

• Loved ones feel worry, guilt, anger, helplessness, and frustration with their loved one. • Drinking or using alone and secretively, trying to avoid getting caught or trying to avoid suspicion • Blackouts • Borrowing money • Feelings of remorse after using • Using drugs or behaviors to escape feelings or responsibilities • Suicidal thoughts • Using excuses to drink, “ I had a bad day”, I’m stressed at work”. • The need to have a steady supply of the substance or an ongoing ability to engage in addictive behavior • Changes in mood and behavior not accounted for by other explanations • Continuing to use, despite the negative consequences affecting relationships, occupation, health, and wellness • Expressing concern themselves for the behavior. If you are concerned about a loved or are here for yourself, please take a few minutes and ask yourself these questions: American Journal of Integrative Medicine, Page 07


KNOW THE SIGNS AND SYMPTOMS

(CONT.)

1. Do you have a “gut” feeling that something is wrong? 2. Are you or your loved one isolating? 3. Are there any physical changes in appearance, hygiene, weight gain or loss, appetite changes, unusual markings on body? 4. Are there noticeable changes in motivation related to job, education, self-care, or romantic or family relationships? Red flags will be present in all people dealing with an addiction, but these signs are sometimes hard to see. It depends on the severity of the addiction and the drug of choice. Things to watch for are extreme mood changes— happy, sad, excited, anxious, nervous, or irritated. Causes for concern include changes in appearance of this person without the care that you had previously seen. Other signs and symptoms associated with addiction are:

• Sleeping more or less than usual, or at different

times of day or night, outside of normal sleeping habits

• Changes in energy—unexpectedly and extremely tired or energized

• Weight loss or weight gain outside of normal experiences

• Unexpected and persistent cough, sniffling, yawning

• Secretiveness, lying, stealing, especially if the

person does not “need” to lie or can afford stolen object.

• Changes in socialization • Unexplained absences with poor explanations or no explanation at all

• Drug paraphernalia, such as pipes, papers, scales • Hiding pill bottles in car, children’s rooms, garage, and other places around home or office.

American Journal of Integrative Medicine, Page 08

The most important factor in finding out whether someone has an addiction or not is trust. Trust is earned, and trust is tested; try to be supportive and understanding even in the face of overwhelming proof or repeated suspicion. A confrontation with someone with an addiction is likely to lead to denial, re-direction, defensiveness, and blame.

Common Substance Addictions

• Alcohol • Nicotine • Marijuana • Food • Prescription Drugs • Amphetamine and methamphetamine • Benzodiazepines (Valium, Xanax, Klonopin) • Gambling • Cocaine • Hallucinogens (LSD, Ecstasy, MDMA, Psilocybin) • Inhalants • Sedatives, hypnotics (Ambien) Behavioral Addictions

• Internet • Self-injury • Eating • Exercise • Gambling • Gaming • Sex • Shopping • Work If you or someone you love needs help, contact us at www.acutecaretriage.com or call 866-228-5111. When you reach out, one of our qualified practitioners will reach right back! Be well. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition-Text Revision, (Washington DC, American Psychiatric Association. 1994).


WELLNESS

American Journal of Integrative Medicine, Page 09


BACK TO SCHOOL HOW DO KIDS FEEL THE FIRST DAY! BY SHIHAN DEANNA E. BIVINS Thinking back to when I started school years ago, I was always nervous on the first day of school. I would hide and run from my mom when she would ask me to get in the car. And just think, that was 47 years ago! Well, times have definitely changed for kids & teens who return to school each year and at a completely different level! One would think it would be exciting for a child or teenager going back to school. Why, you ask? Well, summer is over and they’re looking forward to seeing old friends and meeting new ones. At least that was the feeling back in the day. Unfortunately, times have changed drastically in the last fifteen years. Kids and teens are terrified more then ever to go back to school because of the fear of being bullied or nervous and scared of the uncertainty of school. Anxiety is at an all-time high for kids and teens around the country. Why is this you say? I would say that this is due to the random shootings in recent times in our country, along with all the incidents of bullying. Kids & teens are more than ever are in FEAR of returning to school. You know how it’s common for teachers to have their kids sit in alphabetical order in the classroom? Kids who have a last name that starts with a W, T, S or P sit in the back. And they know that if someone came in and started randomly shooting, they would be the first ones to get hit. What a sad thing for kids and teens to think about! It's important nowadays for parents to sit down and speak to their children and teenagers and teach them to be hyper-vigilant. A child or teen with hypervigilance will be continuously scanning the environment, searching for anything that could mean danger or pose a threat. They will be on high alert in order to protect themselves. This will give them much more power and build their confidence when they know their surroundings, they observe different areas of the classroom and know where to go to on the campus if the need ever arises! It also teach them self-awareness. The benefits of self-awareness include:

American Journal of Integrative Medicine, Page 10

- Better prepared and more proactive children and teens - Improved critical-thinking skills and decisionmaking abilities This is key if, and when, something should happen on the school grounds or in their personal life. They need to be able to go into action and think clearly! In addition, it will also help them in strengthening communications and relationships and enhancing their leadership capabilities! They should be able to step in if needed during a crisis and not wait to see if someone's going to figure out what to do. How to Get Your Teen Excited to Go Back to School: - As a family celebrate the end of summer - Talk about their anxiety or worries - Let them know to be excited for new friendships & adventures when starting at a new school Something else that is very important for parents to do is to encourage children to take self-defense or bullyproof classes. Workshops and programs that could teach them key value self-defense techniques and knowledge could save their lives!


BACK TO SCHOOL HOW DO KIDS FEEL THE FIRST DAY!

(CONT.)

There are also situation awareness classes where instructors talk with parents, children and teens about their environment and various situations. Topics could include having a ‘plan of action’ every time you go out or ‘what to do if ___’ situations. Did you know that there are bulletproof backpacks and hoodies for kids and teens? This is just another example of how the school environment has changed since we were students. It's important for parents to sit down and keep talking to their kids now more than ever! The most important thing is for a family and their kids to be proactive! Everything they learn and do can change in a blink of an eye. Parents should be monitoring how their kids are socializing on all social media platforms; Facebook, Instagram, Snapchat, WhatsApp, WeChat and many more! There's news feeds and information that kids and teens can see regarding any type of shooting, attack, etc... that can set them off and make them afraid to go anywhere, especially school. Parents should get together with their kids and know exactly what their kids and teens social media platforms are and set a time limit on how long they're on them. Having some kind of online structure and time limit will encourage their kids and teens to be involved in other activities such as sports, after school programs or clubs, reading, etc.. And lastly, everyone coming together and learning to eat healthier meals and live healthier lifestyles will also help tremendously. This has been proven to benefit how you feel emotionally, physically and mentally. Enjoy going back to school, be safe and have fun! Keep Kick n it up a Notch! Live lLife with Passion Shihan Deanna E. Bivins 7th Degree Black Belt Director of Martial Arts and Fitness American Journal of Integrative Medicine, Page 11


WELLNESS IN THE WORKPLACE EMPLOYMENT LAW BY KATHLEEN MORENO, ESQ “Employment law” refers to the legal rights and obligations between employers and employees. In the United States, the employment relationship is regulated at the federal, state, and local levels. These regulations are complex, overlapping, and constantly evolving. Most employment law issues fall into two broad categories: • civil rights (including laws against discrimination, harassment or retaliation based upon any protected characteristic) • wages and hours (including laws regarding minimum wage, overtime, breaks, and other conditions of employment) Employees may also have claims based on a contract or agreement with their employer. Employment lawyers can provide advice and training to an employer’s human resources staff regarding sensitive personnel issues. They can help with compliance and documentation issues. These include offer letters, employment agreements, handbooks, and policies. They will also work to resolve disputes between employers and employees. This can be accomplished through litigation or negotiation. Most employment lawyers will focus on representing either employees or employers. Labor Law The terms “labor law” and “employment law” are often used interchangeably. Nonetheless, socalled “traditional” labor law refers to the legal rights and obligations under the federal National Labor Relations Act (NLRA). The NLRA protects the right of employees to engage in group activity for the purpose of making demands regarding their conditions of employment. Such group activity is often, but not always, organized through a labor union. Traditional labor attorneys will advise on unionmanagement relations. These issues include collective bargaining, grievances, and labor demonstrations. Labor attorneys can also represent unions or employers in litigation before the National Labor Relations Board. This is the government entity charged with enforcing the NLRA. American Journal of Integrative Medicine, Page 12

Again, most traditional labor lawyers will focus on representing either unions or management. If you need some advice on labor law, or in another area of law, log into your mWell platform. Ask to be connected to a practitioner in your home state. Peace of mind doesn’t have to cost you a fortune. Be well. Kathleen Moreno, Esq.


NUTRITION AND FITNESS - WHAT YOU NEED TO KNOW TO CHANGE YOUR BODY'S FUTURE FOR LIFE! BY SHIHAN DEANNA E. BIVINS I know firsthand what it feels like to deal with weight issues, understanding about nutrition and staying fit. Getting proper health and fitness education on how to change your lifestyle is very important for all ages. Be aware that disease is on the rise in the US, and not just with adults, but now with kids and teens! Nutrition for Life:

and adults! Whole foods, plant-based nutrition - all these types of foods are out there. Aim for at least 50% of your plate to be fresh and living foods. Eat a banana instead a cookie. If you’re eating a hamburger, perhaps order it with spinach and tomatoes or a salad, instead of french fries. Your body will adapt to this. That's all it will know and soon you'll see and feel yourself having more energy and feeling healthier.

It’s your choice. What you feed your body now will either tax it or fuel it. Did you know that your gut is your second brain? If your gut doesn't feel good, then that affects your body and everything you do over time. The foods we ate 10-15 years ago had more nutritional value then the foods we are eating today! The majority of foods that we’re eating now are processed and once your food is cooked at 116 - 118 degrees, you’ve just killed all the nutrients out of it! Now as people are getting older, different ailments and health issues are on the rise! Arthritis, diabetes, high blood pressure, autism, inflammation, pain, high cholesterol etc.... If you have any of these health issues or concerns, or know people in your family that do, it's not too late to make changes! Plus it's important to fuel your body with the proper nutrients that it needs. In addition to this, most families nowadays are eating fast food, not fresh, raw or living food. They're constantly on the go, and so they grab whatever they can, wherever they can. My goal is to give you simple little tips when you’re on the go so that you can still eat healthy and fuel the body at the same time! Your goal would be to eat more fresh and living foods versus cooked and processed foods. Stop! Gradually reduce your intake from drinking carbonated and energy drinks and eating refined sugar, artificial foods and processed foods. Know that eating poorly will affect your health with your looks and aging process. Even as young kids

Fitness for Life: There are so many benefits with exercise that will help your mental health! Did you know that exercise can have a major effect and positive impact on depression and anxiety, in addition to helping prevent and improve a number of health challenges, including high blood pressure, diabetes and arthritis? The list goes on. In doing this, you'll release feel-good endorphins. That would be the happy drug! Research has shown and proven that exercise provides better sleep, improves memory, relieves stress and promotes an overall better mood. That plays a huge factor on your cardiovascular system. Your heart needs to be strong along with your muscles. American Journal of Integrative Medicine, Page 13


NUTRITION AND FITNESS - WHAT YOU NEED TO KNOW TO CHANGE YOUR BODY'S FUTURE FOR LIFE!

(CONT.) There are many types of fitness programs out there for you to pick and choose from for what would be best for you. Fitness should become a natural way of life, such as simple exercises. It doesn't have to be aggressive aerobics. Take a brisk walk for 5 to 10 minutes, do 2 sets of 10 jumping jacks and gradually work up to more! These little spurts of movement will help your body every day! Ever notice how your body feels when you’re under stress? Your muscles may be tense, especially in your face, neck, and shoulders, leaving you with back or neck pain or painful headaches. You may feel a tightness in your chest. You may also experience shortness of breath or have problems such as insomnia, heartburn, stomachaches or diarrhea. The worry and discomfort of all these physical symptoms can in turn lead to even more stress, creating a vicious cycle between your mind and body. Exercising is an effective way to break this cycle. Physical activity helps to relax the muscles and relieve tension in the body. Since the body and mind are so closely linked, when your body feels better, so too will your mind. Just know you have to unlearn what you've learned. You don't know what you don't know. Stay tuned for more nutrition and fitness tips! Live Life with Passion Shihan Deanna E. Bivins 7th Degree Black Belt Owner of Red Dragon Karate Academy

American Journal of Integrative Medicine, Page 14


FINANCIAL WELLNESS ESTATE PLANNING BY FRANK PISANO, CPA, J.D

Estate Planning should be considered by everyone regardless of his or her personal circumstances. Estate planning is developing a plan for the systematic distribution or passing of your assets on death. When a person does not properly plan, the odds are that the person does not have a will, trust, or any plan that takes effect upon death. When no will is in place at the death of the individual, the person’s assets pass by the laws of intestate succession. Intestate succession sets rules for the distribution of a person’s assets in these circumstances. No consideration is given to what the deceased would have intended had a will and trust been in place. The simplest of estate plans consists of a will and trust for distribution of the person’s assets. This usually includes a Power of Attorney for Asset Management and a Health Care Directive. These give instructions for managing your assets or your health care if you are unable to do so. You may be unable to make such decisions in your later years or if your health seriously deteriorates. It is recommended that individuals consult with their attorney to draft their wills and trusts in accordance with their desires. A trust can be extremely complicated or very simple. You as an individual decide how complex you want it to be. Every state has different rules. So, it is imperative that you meet with an attorney licensed in the state you presently live to write your wills and trusts and implement your estate plan. Your mWell program has access to a variety of estate planning professionals. Log in today and ask to speak with a planning specialist. We all know our lives and journey will end. Its better to plan for your family, than allow the state to do it for you. This is an original work authored by Frank Pisano, CPA, J.D. American Journal of Integrative Medicine, Page 15


COACHING

American Journal of Integrative Medicine, Page 16


LIFE’S PURPOSE - STEP 1: BY REV. BRIAN K. SHAFFER, GC-C, FT, LLPC, NCC Reconnect with Your Childhood Dreams As children, we are dreamers. We imagine that we are superheroes, flying through the air with our towel-capes and righting all the wrongs in the world. We pretend that we are princesses or knights, riding horses, fighting battles, and dancing in castles. We dream of what we will be when we grow up—imagining ourselves as dancers, businesspeople, firefighters, teachers, nurses, and much more.

While you are at it, allow yourself to close your eyes and reconnect with that childlike belief that anything is possible.U

While all of this may seem to be just child’s play, it is actually vital insight into your life purpose. As kids, we were not told that there are impossible dreams, or that we are intended to follow in our parents’ footsteps. We have never heard that there are limits to our lives. We don’t know that something can’t be done, and we aren’t afraid of failure. We haven’t taken on the limiting beliefs and fears of authority figures, parents, friends, and others. Think about it, we are born as a “10” in a world of tens. What do I mean by that? How many times have you seen a newborn baby and said to someone, “Oh my gosh, that is the ugliest kids I have even seen!” It just doesn’t happen! While maybe it should, we all see babies as whole, perfect, and complete. A 10 in the world of tens. This is important, because in our childlike imagining we believe in endless possibilities. Think about it, when you were asked what did you want for your Christmas, did you ponder it for days? Hell no you didn’t! You had a list a mile long. You knew that jolly old fat guy would deliver every last thing on that list. In that freedom to dream, as children, we connect with the true, unedited, unadulterated calling of our souls, and that is where our life purposes lie. Our goals as children often have, at their core, the truest expression of who we are and what makes us authentically happy. The first step to finding your life purpose needs to take you back to your childhood dreams. Take out a piece of paper or a journal and write “What I wanted to be when I grew up” at the top of the page. Then, think back to everything that you ever dreamed of becoming. Write it down. If you have a difficult time remembering your childhood, just focus on the different kinds of careers that c all t o you now, or for as far back as you can remember.

Questions for introspection: 1. How easy was it for you to remember your child hood dreams? How did it feel to re-imagine yourself in those careers? How is that different from how you normally feel on a day-to-day basis? 2. If you found it hard to connect with your childhood dreams, why do you think this was the case? see your APP, call the nurse hot line 866-228-5111, or log on to https://acutecaretriage.com

American Journal of Integrative Medicine, Page 17


LIFE’S PURPOSE - STEP 2: BY TRACY WOOD, CPC

Find Your Underlying Passion Grab your list of childhood dreams and read through them. Do they have anything in common with the different careers you imagined? It’s possible that you don’t see much in common at all, but take heart. There is a life purpose hidden within, whether or not it pops off the page at you. To find it, ask yourself, “Why did I want to be this?” Go through each career or dream and see what answer comes up for you. Keep drilling down until you come up with the underlying passion. To help drive this home for you, I’ll use myself as an example: As a young child, I wanted to be a police officer, a doctor, a lawyer, a writer, and a public speaker of sorts. While these professions may seem on the surface to be very different, the underlying reason why I wanted to do each of them is the same; I wanted to change the world in a meaningful way. If I asked myself why I wanted to change the world, I would say that I wanted to make a difference in people’s lives, to help people and to take away their pain. And that is my life purpose: “to help people and take away their pain.” So, what is the underlying reason that you wanted to be each of the professions on your list? If you

American Journal of Integrative Medicine, Page 18

are having a difficult time with that, try writing down everything that you love doing, or the moments that you have done something that you were very proud of. Why do you or did you love those experiences so much? What might be the underlying purpose? See if you cannot put this into a simple statement, such as “to provide solutions to others,” or “to teach others.” Read the statement aloud, starting with, “My life purpose is,” then add your statement. If this is your life purpose, you will feel it deep within you—and you may very well have a physical reaction to it. Embrace that. This can take some time; stick with it and keep writing down thoughts or “ah ha!” moments as they come to you. Questions for introspection: 1. How did it make you feel to come up with a simple purpose statement? Do you feel more empowered? Less stressed? More alive? 2. Once you identified it, did you have a sense that you always “knew” it? Where do you think that knowledge came from?


LIFE’S PURPOSE - STEP 3: BY TRACY WOOD, CPC

Begin Living that Life Purpose Now In our society, we tend to focus on what we do for a living, not why we are doing it. However, that is just the opposite of what you want to do if you intend to live your life in alignment with your true purpose. As you will soon find, that is one of the very best things about living your personal passion: no matter what you are doing throughout the day, you can focus on connecting to and living your life purpose, and that shifts your whole life to be more satisfying. For instance, when I identified my own life purpose— “to help others and heal their pain”—I found that I had not always been living this purpose. At the time, I was in real estate. I sold the American dream! I helped people solve the problems linked to home ownership and feeling successful within their own family. Now, that career changed radically in February of 2007. My eldest sister died of a drug overdose. I was lost! My family was lost. There was a huge void that was created in that moment. I realized while I made an obscene amount of money, it wasn’t making an impact. It didn’t really improve anyone’s quality of life. I realized I was empty. At that moment, I realized that when you are truly living your life in alignment with your higher calling, all work is life-purposeful work. My entire career shifted. More often than not, you may have found yourself very worried about choosing the “right job” or taking the “best opportunity,” but the truth is that when you understand your life purpose, you can live that calling in almost any profession, although the right one will fit you like a glove—it will just flow. In my case, the realization of my purpose set me on an interesting journey through the second half of my life. Building on this awareness, I allowed myself to be open to other ways of helping people. I designed the blueprint for what now is Acute Care Triage. I recognized that people in the world were in the same place as me. They were mentally drained, emotionally empty, and physically out of balance. Finally, I felt the inspiration to create my current mobile health and wellness model.

The idea here is to understand that it is not so important what you are doing; it is far more important why you are doing it. The job itself is literally irrelevant; when you have a clear idea of your higher calling, you can live that purpose in whatever employment you find yourself. Once you understand that the profession itself is not as important as your life purpose, you can easily understand that every moment that you create—in or out of “work”—should be dedicated to living this true passion. In this way, your work is your life; whatever you do, say, or create in any situation or interaction is on purpose for your highest calling, and therefore, is spiritual work. You then become a perfect expression of your soul every moment of every day, and there is nothing more beautiful or fulfilling than that. Questions for introspection: 1. Write down your life purpose statement. What jobs can you think of that might fulfill that purpose? Which of these seems like the best fit for you right now? 2. List some ways that you might be able to live your life purpose in your daily interac tions with others. Make sure that you include yourself on your list. How will you feel if you take these kinds of actions? Commit to do one or two of those things today.

You see, the deep calling to “help people and heal their pain” can be fulfilled by a host of choices and life paths, —none of them wrong—and the same will hold true for you. American Journal of Integrative Medicine, Page 19


MEDICINE

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POST TRUMP – AFFORDABLE CARE ACT BY TRACY WOOD, CPC

One of the biggest changes that the Trump administration brought to the Affordable Care Act was the impact on the health insurance penalty. This penalty changed each year and was part of the ACA law that most Americans likely found confusing. As rules around the ACA have continued to be challenged, many Americans are unsure of the status of the penalty for not having health insurance in 2019. In years past, a financial penalty was assessed for every month that Americans went without health insurance coverage. The amount of the penalty increased year-byyear. Some of these penalties, for instance, were assessed based upon your income. The more you earned, the more you owed. Seem fair? Yeah, lets get back to that question. The penalty was higher for leaving minor children uninsured than it was for adults. On December 22, 2017, President Trump signed the Tax Cuts and Jobs Act. It repeals in 2019 the Obamacare tax on Americans who don't have health insurance. Some suggest, it removed the incentive for healthy people to get insurance. The Congressional Budget Office, CBO estimated 13 million people would drop their coverage as a result. Industry insiders suggest health care costs will rise because there will be fewer healthy people paying premiums. Health insurance companies will be left with just the sicker people. What does the removal of the mandate really mean at the household level? In Theory, fewer people will get wellness/preventive care necessary for chronic condition management. That leads to the disparity from one family to the next. Emergency Rooms report more people without insurance using ER/UC facilities as a substitute for primary care. That increases costs up for everyone. One industry insider forecast that premiums will rise between 35 and 94 percent over three years. And what’s worse? Parts of the South and Midwest will bear the brunt of the price hikes. Mississippi, Louisi-

ana, Kentucky are some of the poorest states in the US. The average American consumer spends more than $10,000 a year on medical expenses. New study by academic researchers found 66.5% of all bankruptcies were directly linked to medical issues. The new administration’s efforts to dismantle the protections of the ACA since the day the powers shifted in Washington have been thwarted off by people on both sides of the isle. Most notably, the late Senator John Mc Cain. While the federal mandate has gone, state specific mandates have begun to go into effect. A trend of states instituting their own penalties assessed when its citizens do not have insurance have taken hold. Some places where a health insurance penalty is still assessed: • New Jersey. This state has a health insurance penalty that will go into effect in 2019. The health insurance penalty is based on New Jersey’s prices for bronze level health insurance policies. • Massachusetts has had a health insurance penalty since instituting a state health insur ance program in 2006. In the past, they did not assess a health insurance penalty if someone paid one at the federal level. How ever, with the elimination of the federal health insurance penalty, they will begin charging a state fee. • Vermont has instituted a health insurance penalty for uninsured individuals in that state. The health insurance penalty law goes into effect in 2020. • District of Columbia. This city has signed their own health insurance penalty into law. It goes into effect in 2019. • Arizona and California have legislation on the way.

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POST TRUMP – AFFORDABLE CARE ACT (CONT.) The law requires that employers with 50 or more full-time-equivalent employees provide health care coverage to their full-time employees or pay steep penalties. Full-time employees are those working on average 30 or more hours per week. Under the ACA, these employers are required to offer health insurance to their employees. This group insurance must be at a reasonable cost and offer minimum value. Employers who fail to meet this requirement must pay a tax penalty. This provision is often referred to as the “pay or play” mandate. Recently, the federal government announced that the “pay or play” mandate has been delayed until 2015 for employers with 50 or more full-time equivalent employees. The impact of changes in the law will continue to unfold over the next several years. We can certainly predict additional changes and delays in the implementation of healthcare reform. Much of the focus has been on the immediate future. However, it is important for employees and employers alike to be aware of some of the provisions that will affect them in 2018. This is particularly true for employers with 50 or more employees. Many of the mandated changes will be phased in over the next several years. But one provision will change significantly in 2018 for employersponsored coverage. A 40% excise tax on “high cost” employer sponsored health coverage is due to start. According to Price Waterhouse Cooper’s 2013 survey of 1,100 employers, nearly 30% ranked the excise tax as having a significant financial impact. Innovative strategies will become more popular to help reduce overall costs of employee healthcare coverage. These include an increased fo-

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cus on wellness programs, high deductible health plans, value-based benefits designs, and telemedicine, to name a few. acutecaretriage.com, Inc. has strategically positioned itself to address many of these challenges by its forward thinking approaches to healthcare delivery. We provide employers and individual consumers access to high quality, affordable, and innovative employee assistance, wellness programs, and telemedicine. This is accomplished through our state-of-the-art web-based technology platform. It is available from the comfort of the home or anywhere that is convenient for the consumer. More information can be viewed at the company website: www.acutecaretriage.com. References: Amy Bergner and John Stenson, “What employers should know about the Affordable Care Act: The future is now,” HR Innovation (PricewaterhouseCoopers LLP: Summer/Fall 2013) 4-11, http://www.pwc.com/en_US/us/hr-management/publications/assets/hr-innovationfall-2013.pdf Stephen Miller, “Health Care Law's Employer Mandate Delayed until January 2015,” SHRM Online, (Society for Human Resources Management: 12 July 2013), http://www.shrm.org/ hrdisciplines/benefits/articles/pages/mandate-delayed.aspx U.S. Department of Labor, “Application of Market Reform and other Provisions of the Affordable Care Act to HRAs, Health FSAs, and Certain other Employer Healthcare Arrangements,” Technical Release No. 2013-03 (U.S. Department of Labor: 13 September 2013), http:// www.dol.gov/ebsa/newsroom/tr13-03.html


CHINESE MEDICINE AND LIVING IN HARMONY WITH THE SEASONS BY KI ENNES M.AC., L.AC

Quiet, stillness, the conservation of one’s energy. These are the gifts of winter. According to the Five Element tradition, Metal nourishes Water. In autumn, the season of the Metal element, we focus on the lungs. Strong healthy lungs can make an easier transition to winter and the Water element. The kidneys, adrenals, and urinary bladder belong to the Water element. According to Chinese medicine, the kidneys are not just a pair of organs. Instead, they represent a much greater set of functions. They represent functions such as hormonal activity and fluid balance. After the rush, excitement, and stress of the holidays, our kidneys/adrenal glands have had quite a workout. We should take a tip from Mother Nature since Chinese medicine is based on nature. Winter is the time to conserve your resources. To strengthen and support your kidneys, follow these tips:

Follow these tips, and enjoy the winter season in good health. For more information, visit the Oriental Medicine section of www.acutecaretriage.com. References Liao, SJ, “The Origin of the Five Elements in the Traditional Theorem of Acupuncture: A Preliminary Brief Historic Enquiry,” Acupuncture and Electro-Therapeutics Research, 17(1992), 7-14, http://www.ncbi.nlm.nih.gov/ pubmed/1351340. “The Kidneys and How They Work,” US Department of Health and Human Services, (23 March 2012), http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/. This is an original work authored by Ki Ennes M.Ac., L.Ac. ,Director of Oriental Medicine

• Sleep more. The sun sets earlier and the night is longer. We should go to bed earlier and rise later. • Expend less energy. Believe it or not, one of the best ways to strengthen the kidneys is to rest. Lying down for a 20 minute nap is optimal. Be sure to turn off the TV or computer. • Recharge your “batteries” or energy reserves. Winter is a good time for inner work such as reading, spiritual study, meditation, Tai Qi, and Qi Gong. Focus on things that preserve and culti vate your inner strength. • Keep your lower back warm and supple. Don’t expose your back to the cold. Do gentle yoga stretches and avoid strain. • Eat foods that nourish the kidneys. These include most beans, especially black beans and kidney beans. Barley, walnuts, Miso soup, and seaweed, like the kind that surrounds sushi, are also kidney nourishing foods. • For those who feel cold easily, add dried ginger, cinnamon, black pepper, and cloves to your fa vorite recipes or beverages. • Take Chinese herbs for immune support. Visit our website if you have postnasal drip, dry cough, productive cough, stuffy nose, runny nose, or a sore throat. Chinese herbs can sup port your immune system and help keep you healthy, naturally.

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RECIPES

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RECIPES BY PERLA GALAN Sweet Potato Veggie Patties

Step 4 Stir in black-eyed peas, tahini, salt, and pepper. Form mixture into 4 patties and place them on the prepared baking sheet. Bake for 15 minutes, or until golden brown and crispy. Step 5 Serve patties with lettuce, tomato, onion, and mayonnaise-mustard mixture.

Salmon on a Bed of Watercress

Serves: 4 Ingredients 2 Tbsp. mayonnaise 1½ tsp. whole-grain mustard 1 medium sweet potato, peeled and diced 1 can (15 oz.) black-eyed peas 2 Tbsp. tahini ¼ tsp. salt ½ tsp. ground black pepper 4 large lettuce leaves 1 large tomato, sliced ¼ cup diced onion Directions Step 1 Combine mayonnaise and mustard in a small bowl. Set aside. Step 2 Preheat oven to 350°F. Line a baking sheet with parchment paper. Step 3 Place the sweet potato in a medium microwave-safe bowl. Cover loosely with plastic wrap and microwave on high for 5 minutes. Remove from microwave, uncover, and cool slightly. Mash with a fork until smooth.

Serves: 4 Ingredients 4 center-cut salmon fillets (8 oz.), skin on, 1" thick 5 Tbsp. extra-virgin olive oil, divided ½ tsp. kosher salt ¼ tsp. ground black pepper 1 Tbsp. fresh-squeezed lemon juice 2 cups fresh watercress leaves, stemmed (rinsed and patted dry with paper towels) Directions Step 1 Brush both sides of the salmon with 2 tablespoons oil and season with salt and pepper. Step 2

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RECIPES (CONT.)

Brush 2 tablespoons oil on a grill pan over medium-high heat. Add the salmon, skin-side up. Grill until golden brown on each side, about 5 minutes per side. Transfer the salmon to a plate and tent with foil to keep warm. Step 3 Combine the lemon juice and the remaining tablespoon oil in a medium nonreactive bowl and whisk to combine. Add the watercress leaves and lightly toss to coat evenly. To serve, use tongs to transfer equal portions of the watercress leaves to 4 serving plates. Top each with a salmon fillet and drizzle with any dressing left over in the bowl from the watercress. Serve hot. Serves: 2

Sugar-Free Cinnamon Chia Pudding

Zucchini Pasta with Veggie Meatballs

Serves: 4

Ingredients 4 large zucchini 1 Tbsp. grapeseed oil 3 cloves garlic, minced 1 tsp. salt ½ tsp. freshly ground black pepper 1 package (8.5 oz.) MorningStar Farms Veggie Meatballs, defrosted according to package directions 1 jar (24 oz.) marinara sauce 3 Tbsp. grated Parmesan cheese Directions Step 1 Cut the zucchini into thin, noodle-like strips using a spiralizer or mandoline.

Ingredients ½ cup chia seeds 1½ cups unsweetened almond milk ½ tsp. vanilla extract 8 drops liquid stevia 2 tsp. ground cinnamon Shop Ingredients Directions Step 1 Mix chia seeds, almond milk, vanilla, stevia, and cinnamon together in a lidded container and refrigerate overnight

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Step 2 Heat the oil in a large skillet over medium-high heat. Add zucchini and garlic; cook and stir until just tender, about 5 minutes. Season with salt and pepper. Step 3 In a large saucepan over medium heat, combine veggie meatballs and sauce. Cook, stirring occasionally, until heated through, about 10 minutes. Step 4 Top zucchini noodles with sauce and meatballs. Sprinkle with Parmesan cheese.


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