How to use curiosity to break a habit?

Sail full of Zephyr
Awe of each swell
Destination wherever
Curiosity propel

While striving imprisons, curiosity sets me frees




why I share my perspectives as a physician....

Why I share my perspectives ...
while outwardly difficult to differentiate by another, I am aware of two reasons:

1.  Being a physician with opportunity to meet people in need reaching out to me; sharing my honest perspective is simply being.
2.  Being owner of the waxing and waning delusion that good deeds or anything for that matter will somehow make me complete; when in fact I was, am and will always be ok.
The vividness of each moment are obscured by thoughts of pride, shame, hope or fear; and brought to a brilliant focus by the power of each breath.

Global food supply: Do we have enough?

50 million square kilometers of farmed land globally.
500,000,000,000,000 square feet.
Let’s imagine each square ft only grows 1/4 lb of vegetables per square feet years. (Not too hard, I think even I can do it.)
That is 125,000,000,000,000 lb of vegetables per year.
Devide by say 10 billion global population (now at 7.7 B);

12500 lb of vegetable per person per year!

Yup we have enough food!!


Say all I have is my house lot.
Lets assume a person need 3lb of vegetables per day or ~1000lb per year.
My house lot is 6000 sq ft; let’s say after house and etc., 2000 sq ft (say 40x50 garden) left to grow.  So whether or not I can feed a family of 4 depends on if I can achieve a yield of 2lb per sq ft.  Still does not seem that much but never tried before.

My intentions for Christmas Eve Dinner tonight

I will drink 2 cups of water.
I will eat 5 oz of non-starchy vegetables before dinner.
I will listen with curiosity to each one’s perspectives as their own and refrain from commenting or offering solutions.
I will share my own authentic experience briefly and concisely only if I think it might be useful to others.
I will enjoy the vividness of each moment.

Could it be the flavinoids? Since I have been eating 5oz of vegetables three time a day; I have not caught a cold

Could it be the flavonoids?  Since I have been eating 5oz of vegetables three time a day; I have not caught a cold.
Vegetables contain more than 6000 flavonoids.  Scientists are discovering that many of these are essential for our health.  While scientist are working on isolating and figuring out the right dose of each of the thousands of these powerful nutrients and attempting to package them into some marketable miracle cures; I need an approach.  I am of the perspective that one sensible approach to living  is to eat a wide variety of vegetables in the amount of 5oz three times a day in accordance to World Health Organization’s recommendation that is accessible to most of our 7.7 Billion fellow global citizens.  I believe that these fundamental requisite for wellness is accessible to all who has air, water and sunshine that makes the vegetables grow.

Review article.
“Flavonoids, a group of natural substances with variable phenolic structures, are found in fruits, vegetables, grains, bark, roots, stems, flowers, tea and wine. These natural products are well known for their beneficial effects on health and efforts are being made to isolate the ingredients so called flavonoids. Flavonoids are now considered as an indispensable component in a variety of nutraceutical, pharmaceutical, medicinal and cosmetic applications. This is attributed to their anti-oxidative, anti-inflammatory, anti-mutagenic and anti-carcinogenic properties coupled with their capacity to modulate key cellular enzyme function. Research on flavonoids received an added impulse with the discovery of the low cardiovascular mortality rate and also prevention of CHD. Information on the working mechanisms of flavonoids is still not understood properly. However, it has widely been known for centuries that derivatives of plant origin possess a broad spectrum of biological activity. Current trends of research and development activities on flavonoids relate to isolation, identification, characterisation and functions of flavonoids and finally their applications on health benefits. Molecular docking and knowledge of bioinformatics are also being used to predict potential applications and manufacturing by industry. In the present review, attempts have been made to discuss the current trends of research and development on flavonoids, working mechanisms of flavonoids, flavonoid functions and applications, prediction of flavonoids as potential drugs in preventing chronic diseases and future research directions.”

Antibiotics is not enough! Cellulitis, gangarene in diabetes type 2

Antibiotics is not enough!!

Nature provides the non-discretionary “medication”:

1. Water 2 cups 4 x a day
2. Non-starchy vegetables 5 oz 3 x a day, before meals; NO substitutes, everyday including weekends and holidays


Addiction is an experience not a personality

Addiction is an experience.  It is the experience of habitually trying in vain to meet a need with substitutes; or grasping to meet an imagined need.  I think when I acknowledge such experiences I am more likely to gain the needed perspectives to see things as they truly are.

Today she came to my office not for herself but to help her sister who just had a newborn and needed to see me.  She told me she is now working as counselor for others who are experiencing problem with addictions.  She shared with me that she can now see how her personal experience with addiction resulted in her compassion for others.  She felt that her work to help others is not merely a job but more a way to be and a way of life.

I don’t think I have all the words to fully express such miracles which I have the privilege to witness and learn from as a family physician.  I do think of my work as not merely a job but a series opportunities to learn and authentically share perspectives with individuals in their moments of need and openness.

Why I love taking care of patients with mental health challenges

I enjoy looking after people with mental health conditions because in most cases what they need most are simply perspectives.  I watch in awe as they develop these wellness perspectives in groups I run and in their own time realize they are all OK!  I listen and gain perspective they share authentically and generously and become well.

Can Type 2 Diabetes decrease risk of cancer?

If Type 2 diabetes leads me to eat a more plant-based diet with 400 gram of non-starchy vegetableswhich not only puts diabetes into remission but also decrease my overall risks of cancer as a result; then it’s a great thing!!

Many discomfort and sufferings are kind warnings my body provides; if I do not turn away and respond by meeting my true needs, these warnings are good for me.

Why plant-based foods decrease risk of cancers.
http://www.aicr.org/reduce-your-cancer-risk/recommendations-for-cancer-prevention/

No More Diabetes Club - new members welcome

Remission of type 2 diabetes is a practical diet for primary care.

He jumped out of his chair and said “take my picture!”
My patient came in today to see me.  He asked me what his HbA1C from this week was.  I looked it up and told him it was 5.1;  I then remembered I had told him if he ate 400 grams of non-starchy vegetables per day there would be a good chance he’d get off his diabetic medications and put his diabetes into remission.  I told him we’d then take our selfie and post the picture in our NO More Diabetes Hall of Fame.

According to a study published in Lancet, “at 12 months, almost half of participants achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care”

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext





My son asked me ...

My son asked me how do I know I am OK?

This is my answer:

“Thanks for asking for my perspectives.  It is just one perspective.

At least for now, the way I understand it is that being OK is a given.  For example, if I get hit by a car and die in the next moment; this moment is the last moment for me.   So existence of the next moment for me is an assumption.   So in any given moment, I can only truly be as OK as I already am.  For example, If I get diagnosed with cancer, many things I considered to be terribly not OK will suddenly have less or no relevance.

While knowing I am OK can be an intellectuals exercise; feeling I am OK is more of a moment by moment experience.

So to know when I feel OK, I need to know when I don’t feel OK.
To not feel OK, simply try the following:

Hold my breath
Don’t drink water
Don’t eat the essential nutrients
Focus on pride or shame based on the past
Focus on hope or fear of future

In each case I will soon feel discomfort or suffering due to needs (real or imagined) unmet.

What I do next determine if I am OK or not OK.

I can get what I need and feel OK or get a substitute which leads to unhelpful behaviours; repeating these unhelpful behaviours can lead to addiction to the substitute.

I can let go of an imagined need and be OK or get a substitute which leads to unhelpful behaviours which can lead addiction to the substitute.  There are only substitutes for a imagined need.

I also know things are never quite what they seem to be;  what things seem to me is a conclusion based on my limited experience.  There are many more perspective only visible to me if I remain curious and open to others perspectives. Thanks for being open to mine.”

A prescription I wrote for myself

Only in 1999, OxyContin was marketed with slogan "The One to Start With and the One to Stay with".  This foreshadowed the unfortunate opioid crisis.


There are other powerful advertisement slogans carrying promises of relief from suffering.  Could some of these mindsets lead us to even greater crisis?


Substitutes for water

Coca Cola – Open happiness
Sprite – Obey your thirst
Coca Cola – It’s the real thing
Beer - Where there's life, there's Bud.
Champale Malt Liquor – Champale Makes You Feel Special, Every Day
Remy Martin - Become guest of honor
Red Bull – “It Gives You Wiiiings!”
Dr Pepper – “What’s the Worst That Could Happen?”

Substitute for nourishment

Wheaties – The Breakfast of champions
Frosted Flakes – They're G-r-r-r-r-eat!
McDonald’s – You Deserve a Break Today
Burger King – Have it your way
Kit Kat – “Have a Break, Have a Kit Kat”
Winston Cigarettes – Winston Tastes Good Like A Cigarette Should

Substitutes that extinguishes health warnings signs

Alka Seltzer – I can’t believe I ate the whole thing
Rolaids - How do you spell relief?
Pharmacy - A daily dose of happily better afters.
Pharmacy - Want drug, Meet us
OxyContin - The One to Start With and the One to Stay With

Substitutes that perpetuates the illusion of inadequacy.

L’Oreal – “Because You’re Worth It”
DeBeers – A diamond is forever
Lexus – The relentless pursuit of perfection
Alfa Romeo - Beauty is not enough Power for your control
Chrysler - Drive = Love
Disney Land – The happiest place on earth
Vacation - Happiness Is Just Around The Corner
Vacation - Another Day In Paradise
Approximately four in five Canadian adults have at least one modifiable risk factor for chronic diseases (self-reported tobacco smoking, physical inactivity, unhealthy eating and harmful use of alcohol)
(Health Canada)

“Mental health and physical health are fundamentally linked. People living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions. Conversely, people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population”.
(Canadian Mental Health Association)


It is my opinion that physicians have the opportunity to engage patients in their moments of pain and sufferings.  In my experience, during these moments, patients are more open to share their illness experience and receptive to my personal wellness perspectives.


  • Healthy behaviour can repair and prevent illness.
  • Healthy behaviour is no more discretionary than compliance with medications, brushing teeth every morning or getting routine oil changes for my car.
  • Role modelling of healthy behaviour is a personal, familial and social responsibility.
  • My needs for healthy behaviour are no different than my patients.
  • My conversation (about healthy behaviour) has the power to change culture (of wellness)


Whether I am in my office or in the emergency department, patient motivated by their sufferings, makes great efforts to present with honesty and a genuine willingness to accept a solution or new perspectives.  If indeed four in five Canadian adults have at least one modifiable risk factor for chronic disease, then I am of the new perspective that by spending time in self-management education and support as well as treating the presenting problem in each patient encounter,  I can potentially quadruple my impact on population health.
I also think by running Physician-led Patient Self-management Education and Support Groups for 15-20 patients at a time; I can further multiply my value by investing more "upstream" in our healthcare system.  


Rationale for Wellness Groups Model at Ajax Harwood Clinic

Weekly Physician-Led Groups creates an accessible and safe place for participants to experience the benefit of regular personal reflection and authentic sharing around two important evidence-based health promotions:
Eat Well Plate
A healthy diet includes at least 400 grams of vegetables and 2 servings of fruit per day, excluding potatoes, sweet potatoes, cassava and other starchy roots.   (WHO)

Mindfulness-based Wellness Program
We promote Mindfulness and Meditation as a part of Canada’s Mental-Health Strategy
I believe like myself other family physicians may be in a position to initiate an honest conversation rather than accepting the mindset - that all sufferings are to be avoided and that there are no options but to use substitute to meet my needs real or imagined.


At meetings and conferences for physicians, I share my new way of practicing medicine "stethoscope in one hand and a box of spinach in the other".  To me stethoscope represents technology and treatment; the box of spinach represents education and self-management. I also share the following invitation with all health care providers interested in experiencing "Physician-led Group Patient Self-management Education and Support".  I think this may be one effective way to share my perspective on this subject with others in a way that does not take me away from my practice workflow.




I think wellness is simple but not easy.  My moment to moment awareness is affected by exposure to the media.  I have written myself a prescription as a reminder and will share it with my patients.

Sciatica - Self-administer management that works for me

I discovered the following exercise that helps me manage my sciatica.  It is the only self-administered back decompression exercise that utilizes abdominal musculature to counter the compressive action of paraspinal muscles and gravity
1. Sit up, stand up or lay straight, shoulders back and down, take 3 stacked inspiration to ensure lung is in maximal inflation; diaphragm down and abdomen should protruded to allow more room for full inspiration.
   
2. While holding the breath in
   
3. compress abdominal muscles and feel the spinal decompression from internal pressure - a person with 40” waist line, at two PSI intra-abdominal pressure can generate 250lb of decompression force along the spine.  For 30” waist line, 140lb of decompression.
With practice, this decompression action can be used intermittently anytime, anywhere and during any activity.

Several patients managed to learn this technique from me and are able to stop all analgesics and alleviate leg-dominate pain on-demand.

In one 85 year old lady; she was able to stop all her analgesics and wheelchair dependency.

What is Personality disorder?

One patient told me he has an addictive personality.  Another told me she is borderline.  As a family physician, I find these labels of questionable value; as they do not help me understand the individual or help the individuals understand self.  I see individuals as being defined by a growing collection of perspectives.
I developed sciatica 2 years ago.  I have gained the perspective that the sciatica is a constant reminder for me to maintain a good posture, exercise and nutrition.  I watch my patients die.  I gained the perspective of impermanence of my life and preciousness of each moment.  With each perspective gained I change.  I am grateful for these perspectives and for those who shared them with me.

Heraclitus, a Greek philosopher born in 544 b.c. said, “No man ever steps in the same river twice, for it's not the same river and he's not the same man.”
So If I am unhappy with things as is; perhaps, I need to change things or I need a new perspective.

I run a weekly “Getting unstuck” group.  Participants are invited to share their personal and authentic perspectives with each other.  As a participant I leave each session transformed.

Denial, Acceptance, Anxiety and Perspectives

In denial I may react with recklessness; 
in acceptance I may respond with courage.
anxiety is my trail in between
the vistas offer me perspectives 
which make up the substance of who I am.

4 rule I live and die by

Last week, my patient with chronic illnesses with multitude of behaviour risk factors came to me in great distress. I listened to her at great length and this is how I engaged her.
I asked her if she would confirm my impression that she is in great distress and extremely unhappy with her lot in life.  She said yes.
I then asked her if her sufferings is sufficient for her to consider my perspective.
She said yes.
I then asked her if she would be willing to refrain from saying “I can’t” until she has given some consideration of the hardship of her present experience.  She also agreed.
I then shared the rules I live and die by with her.

1. Breath fully with chest out and abdominal muscles engaged.
2. Drink 2-4 liters of water per day.
3. Eat 400 grams of non-starchy vegetables per day.
4. Mindful of above 3 things being all I need and say yes with curiosity to the gift of each and every moment.

She agree to start coming to the “Getting Unstuck” group next week.

Circle - group norms for authentic communication

This are the groups norms that seems to work for our groups at Ajax Harwood Clinic


I shall only speak when holding the talking piece!

As a listener:
I shall respectfully listen to others perspectives as their own and not offer comment or solution unless explicitly asked.
I shall respect confidentiality of everyone.

As a speaker:
I shall respect everyone’s time by being concise and ensure what I share is relevant to everyone in the group.
I shall not make jokes about others or single other people out, even if I have good intentions.
I shall bring value to the group by only offering my personal and authentic perspectives and experiences and try to use the “I voice”
I shall try to contribute to the group by sharing my authentic experience even if it is only one word or one sentence, however, I know I do not have to share if I choose not to.  

Our conversation has the power to change culture.

Only in 1999, OxyContin was marketed with slogan "The One to Start With and the One to Stay With".  This foreshadowed the unfortunate opioid crisis.  I believe some other prevailing delusional mindsets may have also led to crisis.

I believe family physicians may be in a position to lead an honest conversation rather than accepting the prevailing mindset - that all sufferings are to be avoided.

Much of prevailing mindset is perpetuated by advertisement slogans that sells substitutes based on the promises of relieve from suffering.

Substitutes for water

Coca Cola – Open happiness
Sprite – Obey your thirst
Coca Cola – It’s the real thing
Beer - Where there's life, there's Bud.
Champale Malt Liquor – Champale Makes You Feel Special, Every Day
Remy Martin - Become guest of honor
Red Bull – “It Gives You Wiiiings!”
Dr Pepper – “What’s the Worst That Could Happen?”

Substitute for nourishment

Wheaties – The Breakfast of champions
Frosted Flakes – They're G-r-r-r-r-eat!
McDonald’s – You Deserve a Break Today
Burger King – Have it your way
Kit Kat – “Have a Break, Have a Kit Kat”
Winston Cigarettes – Winston Tastes Good Like A Cigarette Should

Substitutes that extinguishes health warnings signs

Alka Seltzer – I can’t believe I ate the whole thing
Rolaids - How do you spell relief?
Pharmacy - A daily dose of happily better afters.
Pharmacy - Want drug, Meet us
OxyContin - The One to Start With and the One to Stay With

Substitutes that perpetuates the illusion of inadequacy.

L’Oreal – “Because You’re Worth It”
DeBeers – A diamond is forever
Lexus – The relentless pursuit of perfection
Alfa Romeo - Beauty is not enough Power for your control
Chrysler - Drive = Love
Disney Land – The happiest place on earth
Vacation - Happiness Is Just Around The Corner
Vacation - Another Day In Paradise

I am of the opinion that by befriending my sufferings and pains, I can discover the message of wellness.  My behaviour can be informed by pain and sufferings.
It is my opinion that physicians have the opportunity to engage patients in their moments of pain and sufferings.  In my experience, during these moments, patients are more open to share their illness experience and receptive to other's wellness perspectives.

Clinical encounters with patients gives me the opportunity to share the following personal perspectives:
  1. Healthy behaviour can repair and prevent illness.
  2. Healthy behaviour is no more discretionary than compliance with medications, brushing teeth every morning or getting routine oil changes for my car.
  3. Role modelling of healthy behaviour is a personal, familial and social responsibility.
  4. My needs for healthy behaviour are no different than my patients.
  5. My conversation (about healthy behaviour) has the power to change culture (of wellness)



Hip fracture hurts!

According to Bones and Joints Canada, 30,000 Canadians fracture hip per year!  See link

In my experience many senior have dietary deficiency.

So I share the following information with my patients.

Based on study of 142,000 people over 60 years of age; those who eat 3-5 servings of vegetables and fruits are 39% less likely to break a hip compared to those who ate 1 servings or less.

According to research, dementia increase risk of hip fracture by 200%; according to a study, seniors who consume more than 1.2 servings of vegetables test 11 years younger on cognitive testing than those who eat no vegetables.



What’s the cause of bunions?

I think not all shoes forms were originally designed for comfort.  Many were designed for fashion and is the cause of most cases of bunions.  I think only wearing shoes with sufficient width can prevent bunions in most individuals.

Don’t miss that melanoma!


Melanoma are treatable but must be picked up early.
If you see any of the following features please don’t wait and ask your physician to check it.

1. Many shades of black
2. Blurry or irregular borders or margins
3. Irregular surface features (bumpy)
4. Growth in size
6. Just looks weird


What to do for wisdom tooth infection?



For wisdom tooth infection; if you have no fever and you can’t get to your doctor, you might try 8 oz of very warm salt water rinse hourly while awake.  1/2 tsp table salt to 8 oz water.   Avoid chewing on affected side.  After 24 hour, if no better, may  we’d to start antibiotics.

Pus is yellow under pressure and cause inflammation and pain; it’s trapped between gum and yet-fully-exposed tooth; warm salt water shrinks gum and facilitate drainage; mechanical irritation from brushing may cause more swelling and impedes drainage.  Water Pic can help irrigating the area and facilitate drainage.

It’s a matter of Life and Death

I ate some cheese cake last night.  If I have only read about others experiences about cheesecake, how can I know what it is like to eat cheesecake.  Each time I eat it would be a new experience; depending on how hungry, the type of cheesecake, who baked it, what occasion, etc.  Not having eaten cheesecake ever is also an experience.

So it is also in the case of life and death; being somewhat “healthy”, I think most of my perspective is on living and very little on dying.  Each day I live, I gain perspectives on life and little to no perspective on death.  I think it is so as I often find myself planning and fretting about a future which I know not would ever happen.  As a result of such preoccupation with the future, I am often asleep to my moment to moment experience.
I am grateful to be a physician; I know now that each time my patients comes to me for help and authentically share their sufferings; I am gifted with the opportunity to gain new perspectives on what it is like to lose bodily function or bits of life which I take for granted.  To receive this gift, all I need to be is curious, in the moment and compassionate.

Longjohns, common colds and arthritis

My father rarlely catches a cold.  He also has a habit of only drinking warm water.  I found out through the internet long ago that virus multiply fastest at around 32 degrees Celsius.  I also read recently that our immune system is less effective at temperature lower than 37 degrees Celsius. No matter what the reason, I am going to keep warm this winter and use my longjohns; as 1/3 of an adult body surface area is in the legs.
The other reason I use longjohns in the colder season is to prevent inflammation in my knees.  I think the immune system can be perturbed by infections and temperature fluctuations. I think that might be the reason for the experience of catching colds, body aches and arthritis flare ups that is more prevalent in cold and damp weather and climates.  I think the reason damp weather provoked arthritis flare up may be due to the fact that humid air is more conductive or provides less insulation against the cold ambient temperatures.

One other cold prevention strategy I suspect based on my experience is the sufficient consumption of vegetables.  In a large group of Sudanese children, researchers found that those with the highest intake of both green leafy vegetables and non-leafy vegetables had about 25-45% lower risk of experiencing diarrhea, cough with fever, or measles[3]. Results were adjusted for socioeconomic factors and overall nutritional status.


How to stop shin splints?

Shin splints describes a condition which sufferers complain of pain in the area that is the front aspect of the lower leg.  This area is also known as the peroneal region and consist of the peroneal muscles.  Shin splints pain in the peroneal muscle group.  It is caused by excess usage of the peroneal muscle group.  I ask my patients with shin splints to walk or run while being mindful to lift the knees higher when taking each step.  This allows the peroneal muscle to work little less and still allow the toe to clear the ground.  During recovery, avoid activity that strains the peroneal muscles or exercises that requires dorsiflexion of ankle.

Why I don’t sleep with pillows?

My wife and I gave up on using pillows for more than 10 years.  Pillows just made no more sense to me.  In my way of thinking, as we should frame a house as straight as possible, should not our spine be also as straigh as possible.  As a desk jockey, I already spend most of my waking hours with my neck in flexion; it makes no sense to use my pillow to keep my neck in flexion all night long.  I used to have chronic ( many years) neck pain until one day my hospital physiotherapist taught me to do a full cervical extension exercise.  That and abandoning pillow usage have proven to eliminate neck pain for me for many years so far.

How I manage my own sciatica with the only self-administered lumbar decompression exercise I know

I discovered the following exercise that helps me manage my sciatica.  It is the only self-administered back decompression exercise that utilizes abdominal musculature to counter the compressive action of paraspinal muscles and gravity
1. Sit up, stand up or lay straight, shoulders back and down, take 3 stacked inspiration to ensure lung is in maximal inflation; diaphragm down and abdomen should protruded to allow more room for full inspiration.
   
2. While holding the breath in
   
3. compress abdominal muscles and feel the spinal decompression from internal pressure - a person with 40” waist line, at two PSI intra-abdominal pressure can generate 250lb of decompression force along the spine.  For 30” waist line, 140lb of decompression.
With practice, this decompression action can be used intermittently anytime, anywhere and during any activity.

Healthier physician means healthier patients?

My Breakfat


“physician heal thyself”, someone once said!

I agree!  I found some evidence suggesting healthier physician means healthier patients.  So perhaps the stakeholders of our healthcare system would be interested in initiatives that drives physician wellness.  I am thinking a wellness session for physicians might take the form of an experiential learning session on running physician-led groups for self-management education and supports.  The participants will gain perspectives that also apply in personal ways and develop wellness together with patients. In my experience, every participants including myself takes away new perspectives necessary for wellness at every group encounter.

Here is a Canadian study suggesting healthier doctors result in healthier patients.

Orange peels: the future antidepressants?


One of my fond childhood memory was the smell of orange peel in the fire urn during cold winter evenings at my grandfather’s house.  I think it still triggers dopamine release for me.
Last week, I learned about an over the counter medication for venous diseases; it is diosmin, a phytonutrients, concentrated from orange peels.  I did some cursory search on the internet and found out that diosmin and other plant source flavonoids may also have potential use in managing diabetic retinopathy and mood disorders.

My thoughts are that we don’t all have enough time for the scientist to figure out which phytonutrients does what; perhaps all these findings are in support of the notion of:
Eat Well Plate
A healthy diet includes at least 400 grams of vegetables and 2 servings of fruit per day, excluding potatoes, sweet potatoes, cassava and other starchy roots.   (WHO Nutrition Fact Sheet).   

The following are more evidence supportive of more vegetables in our diet as a way to be happier.

Mental health and physical health are fundamentally linked. People living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions. Conversely, people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population. (CAMH, December, 2008)

SMILES’ was a 12-week, parallel-group, single blind, randomized controlled trial of an adjunctive dietary intervention in the treatment of moderate to severe depression.  ... MADRS score <10, was achieved for 32.3% (n = 10) and 8.0% (n = 2) of the intervention and control groups, respectively

What I did to recover from knee pain

I injured my left knee for the third time few years ago.  At the time I lacked a clear awareness or perspectives of why I exercise and over did it on a spin machine at the gym.

This was an useful experience, as I am now of the new perspective that what my body needs exercise to maintain good health.  This maintenance of good health does not require me to qualify for the Boston Marathon, become as flexible as the yoga teacher at the gym or being able to compete at a body building competition.  By the way, I do not claim to have made any effort in above endeavours, but from time to time, I find myself mindlessly behaving as if I am.  Alas! the injuries to my back, my knees and all the time in front of the mirror.

Anyways, back to my knee injury.

One of my teacher once taught me that the knee is intrinsically an unstable joint.  The shoulder, hip and elbow all have some sort of "ball and socket"; the knee is different in that it is a "ball on plateau".

Image result for knee joint line diagram

The stability of knee joint hence depends on the strength of quadriceps and hamstring.
The challenge is that during convalescence many leg exercises that might strength these muscle groups can also further damage injured ligaments and injured miniscus.  The exercise I used for my knee during recovery is the “horse stance”.  This is also know as an “Isometric” exercise where the joint structure is placed under stress without motion and less risk of further damage.




Plantar fasciitis or “heel spurs” or foot pain: Is orthotics or arch supports necessary?

Suffer plantar fasciitis or "heel spurs"? Perhaps expensive arch supports are not necessary.
As a family doc who used to suffer the above condition, I'd like to share my insight.

The pain from plantar fasciitis or "heel spur" is a myofascial pain that is felt anywhere along the arch of the foot from the heel forward.
It's related to fatigue and spasms of the small muscles in the arch of the foot.  ( this is why it often partially relieved after walking for a while)

To relax and stretch the muscles involved try this:

When walking, place more weight on the heels and lightly lift toes off the floor... Imagine gently touching the roof of the shoes with the top of toe nails.

Worked for me and few friends and many patients; I hope it works for others too.

Why I practice medicine with Stethoscope and box of spinach?

Whether I am in my office or in the emergency department, patient motivated by their sufferings, makes great efforts to present with honesty and a genuine willingness to accept a solution or new perspectives. If indeed four in five Canadian adults have at least one modifiable risk factor for chronic disease, then I am of the new perspective that by spending time in self-management education and support as well as treating the presenting problem in each patient encounter, I can potentially quadruple my impact on population health.

I think the use of Physician-led Group Patient Self-management Education and Support allows me to engage 15-40 patients at a time can further multiplied my value as a physician by investing more "upstream" in our health care system.

At meetings and conferences for physicians, I share my new way of practicing medicine "stethoscope in one hand and a box of spinach in the other".  To me stethoscope represents technology and treatment; the box of spinach represents education and self-management.  I also share the following invitation with all health care providers interested in experiencing "Physician-led Group Patient Self-management Education and Support". I think this is an effective way to share my perspective on this subject with others in a way that does not take me away form my practice workflow.


Wellness Groups at Ajax Harwood Clinic


Approximately four in five Canadian adults have at least one modifiable risk factor for chronic disease (self-reported tobacco smoking, physical inactivity, unhealthy eating and harmful use of alcohol)

(Health Canada)

“Mental health and physical health are fundamentally linked. People living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions. Conversely, people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population”.

(Canadian Mental Health Association)

Ajax Harwood Clinic is a case study in the CFPC-Published October 2018 “Best Advice Guide: Recovery-Oriented Mental Health and Addiction Care in the Patient’s Medical Home”, CFPC

We run weekly Physician-Led Groups to encourage personal reflection and authentic sharing around two important evidence-based health promotions:
  1. Eat Well Plate
    A healthy diet includes at least 400 grams of vegetables and 2 servings of fruit per day, excluding potatoes, sweet potatoes, cassava and other starchy roots.   (WHO)
  2. Mindfulness-based Wellness Program
    We promote Mindfulness and Meditation as a part of Canada’s Mental-Health Strategy


Please contact Ajax Harwood Clinic at 905-683-0690 or email ajaxharwoodclinic@gmail.com if you’d like to attend any of the groups for more information.

Weekly Wellness Classes at Ajax Harwood Clinic (except civic holidays)

  • Mindfulness Training Tuesdays and Thursdays 8:00AM - 9:00AM
  • Healthy Lifestyle - The Owner's manual for your body and mind: Tuesdays 10:00AM - 11:30PM
  • Stress? Learn to be the master the monkey mind: Tuesdays 1:00PM - 2:30PM
  • Feel stuck in life? Get unstuck with mindfulness: Tuesdays 3:00PM - 4:30PM
  • Get ready for a new year of school and work with our Summer Mood Camp! Tuesdays 5:45PM - 7:15PM
  • Walking-Talking Mindfulness Training at St. Andrew's Community Garden: Wednesdays 8:00AM - 8:45AM

Everyone is welcome and see you at the groups  😊!


Carlos Yu BMath, MD, CCFP(EM), FCFP  

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